The original and revised National Health Education Standards (NHES) and performance indicators provide the foundation for curriculum, instruction and assessment in health education. The article clarifies the revised NHES and performance indicators for classroom teachers, health education teachers, curriculum directors, state department of education health educators working on the development of state-level standards, and health education teacher education faculty working in institutions of higher education. This articulation of the standards and the performance indicators will facilitate their appropriate utilization in planning, implementing and evaluating health education curriculum, instruction and assessment for students in grades pre-kindergarten through 12 as well as professional preparation and development experiences for pre-service and in-service classroom and health education teachers. Therefore, a deeper understanding of the revised NHES and the performance indicators is important for classroom teachers, health education teachers, curriculum directors and other local school personnel as well as individuals working in institutions of higher education and state education and health agencies. This article provides an overview of the NHES, an in-depth description and clarification of the NHES and the sub-concepts and sub-skills embedded in the performance indicators, and strategies for integrating the NHES and performance indicators with health education curricula, instruction and assessment.
The National Health Education Standards (NHES) and performance indicators (1,2) provide the foundation for curriculum, instruction and assessment in health education. In 1995, the Joint Committee on National Health Education Standards released National Health Education Standards: Achieving Health Literacy. (1) In 2007, the revised standards and performance indicators, National Health Education Standards: Achieving Excellence (2) were released. Many state and local education agencies have developed standards and/or curriculum frameworks based on, or aligned with, the original or revised NHES. (1,2) Researchers re porting the results of the 2006 School Health Policies and Programs Study (3) note that most states (72.2%) and many districts (66.0%) required or encouraged districts or schools to follow standards or guidelines for health education based on the NHES. Additionally, researchers reporting 2006 School Health Profiles (4) state that many secondary schools (24.7% to 76.9% across states; median = 44.1%) and cities (0.0% to 63.7% across states; median = 33.3%) require teachers to use the NHES within required health education courses.
Despite widespread adoption or adaptation of the health education standards and involvement by local and state education agencies in activities related to the original and revised NHES, (1,2) there is a limited amount of information about the standards in the literature of education, public health and health education. (2-12) In an article written for the education community, Kolbe (5) made reference to the health education standards in his discussion of the role of coordinated school health programs in education reform. The emphasis of the original health education standards on health literacy was noted in the Institute of Medicine Report Health Literacy: A Prescription to End Confusion. (6) Peterson and associates (7) also highlighted the emphasis on health literacy in the original standards and argued for the need to promote health literacy in teacher preparation programs. Broadbear and Keyser (8) suggested that the emphasis of the original NHES and performance indicators on critical thinking was evidence supporting the need for health education teachers to develop students' critical thinking skills, whereas, Tappe and Galer-Unti (9) drew upon the original standards to identify strategies for developing advocacy skills in students. …