The Centers for Disease Control and Prevention (CDC) identified 6 behavioral categories most responsible for the major causes of morbidity and mortality: (1) behaviors that lead to intentional and unintentional injuries; (2) tobacco use; (3) alcohol and other drug use; (4) sexual behaviors leading to sexually transmitted diseases, human immunodeficiency virus infection, and unintended pregnancy; (5) poor nutrition; and (6) lack of physical activity. (1) Comprehensive school health education programs should provide students with the knowledge and skills to prevent these health risk behaviors. (1) CDC and its partners devised 4 strategies to help schools reduce these risks: (2)
1. Monitor critical health risks among students and monitor school polices and programs to reduce those risks.
2. Synthesize and apply research to identify, and to provide information about, effective school polices and programs.
3. Enable state, large city, and national education and health agencies to jointly help local schools implement effective polices and programs.
4. Evaluate implemented policies and programs to iteratively assess and improve their effectiveness.
The Office of Student Services and Health Promotion, West Virginia Department of Education (WVDE), in collaboration with the West Virginia University Prevention Research Center and local school health educators, is contributing to the implementation of these strategies through various assessment activities, including the Youth Risk Behavior Survey and statewide assessments of school-based tobacco control policies (3) and school-based opportunities for physical activity. (4) This paper describes the methodology and findings of a statewide school health education assessment initiative and how the findings are being used to design professional development training for school health educators in West Virginia schools.
WVDE HEAP Team
The WVDE has a long history of recognizing the role of teachers as important stakeholders in school health, and the active involvement of local teachers was deemed essential to this process. In 1996, the World Health Organization's Expert Committee on Comprehensive School Health Education and Promotion recognized the significance of involving teachers in the assessment of school health programs. (5) Accordingly, a team of West Virginia school health educators was convened to plan this assessment. Health Education Assessment Project (HEAP) team members were selected from a list of health education specialists nominated by their county school superintendents. Three health educators from each school level (elementary, middle, and high school) were selected from the list of nominations.
One of the team's first tasks was to select the grades in which to conduct the assessment. The team decided to conduct the assessment in sixth, eighth, and high school health education classes because health education is required as a separate subject in grades 6 through 8 and high school (1 unit). Health education is required at the elementary level in West Virginia but not as a separate subject. The HEAP team determined that testing in health education classes was their best opportunity to test a large number of students.
West Virginia HEAP Assessment Instrument
A second and equally important task for the team was to design the assessment instrument using items developed and validated by the State Collaborative on Assessment and Student Standards, Health Education Assessment Project (SCASS-HEAP). The WVDE has been participating in SCASS-HEAP since 1993. (6) The mission of SCASS-HEAP is to develop effective health education assessment resources through a collaborative process and to increase members' capacity to align curriculum, instruction, and assessment to improve student health literacy through improved instruction. SCASS-HEAP developed an assessment framework …