Self-Esteem and Health Instruction: Challenges for Curriculum Development

By Hayes, David M.; Fors, Stuart W. | Journal of School Health, May 1990 | Go to article overview
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Self-Esteem and Health Instruction: Challenges for Curriculum Development


Hayes, David M., Fors, Stuart W., Journal of School Health


To what extent can school health education curricula influence student self-esteem? Health education, as other school curricula, includes self-esteem enhancement as part of its educational outcome. This paper examines the role of school health education in enhancing self-esteem through direct and indirect instruction.

Self-esteem as a concept is difficult to define. Theorists suggest the definition depends on how self-esteem is conceptualized, such as: What constitutes the qualities of positive self-esteem? Related terms include self-love, self-confidence, self-acceptance (or rejection), self-satisfaction, self-evaluation, self-appraisal, self-worth, sense of adequacy, personal efficacy, sense of competence, self-ideal, congruence, ego, or ego strength. (1) However, self-esteem is the most common term given to self-evaluative behavior, attitudes, beliefs, or perceptions. (2)

The self-evaluation process may have motivational consequences with behavioral manifestations, such as how a person reacts to stressors. This definition centers on a more enduring estimate of general self-esteem rather than on more specific and transitory changes in self-evaluation, since self-esteem changes can be momentary and situational. For this paper, the definition of self-esteem as an estimate of general self-worth will be used.

SELF-ESTEEM IN HEALTH EDUCATION

Self-Esteem and Schoolchildren

Self-esteem is learned and relatively unstable in young children, and may be enhanced through positive educational experiences. However, rapid changes cannot be expected. Self-esteem is believed to be a stable quality in adolescents and adults. (3) Educators generally agree that higher levels of self-esteem are expected outcomes or by-products of a successful educational experience. Gurney (3) feels that childrens' self-esteem can be enhanced by teachers' encouragement of self-rewarding behavior by their students. With increasing self-esteem comes improvement in academic performance which, in turn, enhances self-esteem. Further, above-average levels of self-esteem are associated positively with better adjustment, more independence, less defensive and deviant behavior, and greater social effectiveness and acceptance of others. (3)

Self-Esteem as a Predisposing Factor

According to Bandura (4) and Rotter, (5) susceptibility to social influences appears to be mediated in individuals with low self-esteem, low self-confidence, low autonomy, and an external locus of control. Lower self-esteem could be an antecedent to unwise health behavior decisions. For example, adolescents with low self-esteem have a greater tendency to engage in premarital sexual relationships and are more likely to be responsible for teen pregnancies. As self-esteem decreases, sexual attitudes and behavior become more permissive. (6)

Self-esteem as a component of drug use has been researched by Botvin, (7) and has been linked to the problem behavior theory. (8) Other studies have shown that self-concept and self-esteem are linked to drug use. (9,10) However, Botvin and Wills (11) caution drawing conclusions about the extent of the impact of self-esteem and other variables on drug use. Indirect assessment of these variables limits drawing specific conclusions. Further, Hawkins, Lishner, and Catalano (12) report inconsistent findings regarding self-esteem as an explanatory variable for drug use.

Self-efficacy and locus of control also are potential predisposing factors for health behavior related to self-esteem. Self-efficacy has been used to describe an attitudinal component of global self-esteem. Self-efficacy involves the personal expectation that one can perform a specific behavior. (13) Self-efficacy focuses on performance rather than self-worth, but may have implications for health-related behavior manifested through higher of lower self esteem. This relationship, however, has yet to be explained adequately.

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