Articles

Health Instruction Responsibilities for Elementary Classroom Teachers in Pennsylvania Sheila Patterson, Bethann Cinelli, Gopal Sankaran, Rebecca Brey, Robert N y e

on1 pre he 11s i ve school health education has rece i ved C significant visibility through numerous national, state, and local initiatives. Hcwlt/i\ Pcoplr 2000. ' a nationwide commitment to health promotion and disease prevention. includes specific objectives which fall within the f r a n c - work of K - I3 comprehensive school health educat ion. Objcctivt: 8.4 underscores the importance of comprehen- sive school health education:

Incrcasc to at least 7 5 8 the proportion of the nation's schools that provide planned and sequential kinder- garten through twelfth grade quality school health education.' Similarly. thc national education goals. Gotrls 2000,'

rcflccts a national initiative to improve the qual i ty o f education for all students. Comprehensive school health education also has become a focal point of major research studies and documents . O n e such example, Code Blue; Uriitiri,y ,+)r Hrril t l i irr Yorrth.- recognized the dangerous trend in adolescent health and specifically recornmended a "new" kind 01. health education that provides honest, rele- vant information. and teaches skills and strategies to enable students to make wise decisions.

Lavin ct al' conducted an analysis o f 1 5 health and education studies and reports conducted between 1989- 1991. She identified five common themes: education and health arc interrelated, the biggest threats to health are " s o c i a I in o r h id i ties ," ;I m o re c om prc he n s i ve i n t e g rate d approach i s need. health promotion and education efforts should he centered in and around schools. and prevention efforts arc cost effective.' Likewise. the American Cancer Society proposed a collaborative plan to institutionalize comprehensivc school health education for all school-aged childrcri niitionwide."

While ;I need for K - 12 comprehensive school health

education h a s be e n c I e a r I y c s t a b I i s h c d , va r i o u s fac t o r s greatly influence delivery and effectiveness of' comprehen- sive school health education. Lavin' identified six critical factors which inf luence comprehens ive school heal th education. One of these factors - professional preparation and practice - continues t o present a significant challenge t o the implementation and effectiveness of comprehensive school health education. Lack of teacher preparation in health education has heen identified as one significant barrier t o effective implementation of school health educa- tion. particularly at the elementary Icvel.'

All teachers with responsibility for health instruction should receive adequate professional preparation i n the development . implcmentation. and evaluat ion o f K - 12 comprehensive school health education. Allensworth" noted that teacher preparation represents a critical factor for implementing health education programs that result in behavior change. Lach of teacher preparation in health education. however. remains a problem for health and physical educators as well as elementary teachers.

Although professional preparation represents an impor- tant factor for health education effectiveness at all levels, i t is perhaps most critical at the elementary ( K - 6 ) level. Typically. at the K-6 level, the elementary educator is the primary health educator. I t often is the elementary educn- tors' responsibility to deliver health instruction and assess students' health knowledge. attitudes. and skills. Therefore. i t is imperative that elementary educators receive formal coursework in comprehensive school health education as a part of their preservice education or through staff develop- ment experiences. Seffrin'" recommended a strategy to close the gap between the state-of-the-art and state-of-thc- practice in health education that involves appropriate Icarn- ing experiences for elementary teachers during their preser- vice professional preparation. induction process and/or through inservice education.

Unfortunately. preparation of elementary educators in health education often i s limited. inadequate. o r ahsent from their preservice experiences and often not a part of

Journal of School Health January 1996, Vol. 66, No. 1 13

staff development program Since elementary educators must teach a range of subject matter. health education often is neglected. Scliool Hcwlth i r i Ainc,ricd' indicates 26 states ( 5 1 % ) required elementary teachers to have coursework i n health education to qualify for elementary certification. Of these 26 states. nine required courses in methods and mate- rials. nine required personal health and ;I methods and mater ia ls course. seven required personal health. five required health o r physical education, and five listed other requirements. Although states' requirements for certifica- tion appear t o address health education. little o r no informa- tion exis ts descr ibing the nature of these courses . the competencies addressed. and the expertise o r qualifications o f the instructor."

The I9Y I Pennsylvania School Health Education Study" found that of 2.066 elementary educators participating in a statewide survey. 83% had six or less credit hours in health education. Further. most (53% ) had not attended a health education inservice program within the past two years. Consequent 1 y , I a c k of profession a I prep a r a t i o n affects implementation of education curriculum:' Wiley" reported that of 286 teachers participating in a survey of elementary teacher training. perceptions and practices in health educa- tion. 40% indicated they never had taken a formal health educa t ion course a n d 3 3 . 4 % only had comple ted o n e course. Also. only 31% of teachers fclt their respective undergraduate teacher preparation programs adequately prepared them to teach health education."

As Varnes ' " contends. limited preparation in health education places elenientary educators at a distinct disad- vantage since health education content. methodology. and assessment strategies vary i n comparison t o other academic d i sc i p I in e s . In addition to ed uc at i ona I institutions , other concerned parties are revisiting the need lor improved health education at the elementary grades. For example. the A m e r i c a n C a n c e r S o c i e t y ' s na t iona l ac t ion p lan f o r c om pre h e n s i v e sc h oo I he a It h education de sc r i be s o bj ec - tives and stmtegies related to professional preparation. One o f the strategies advocates upgrading higher education preservicc for prekindergarten-grade I2 professional prepa- ration in health education."

One noted effort to address the issues o f professional preparation for elementary educators involved identifica- tion o f health instruction responsibilities for elementary ( K - 6 ) classroom teachers. In 1990, the Association for the Advancement o f Heal th Educat ion and the Amer ican

Figure 1 Heatth Instruction Responsibilities

for Elementary (K-6) Classroom Teachers

Responsibility I Communicating the concepts and purposes of health educalion

Responsiblity II Assessing the health instruction needs and interests of elementary students

Responsibility 111

Responsibility N

Responsibility V

Planning elementary school health instruction

Implementing elementary school health instruction

Evaluating the effectiveness of elementary school health instruction

School Health Association formed a joint committee to address professional preparation for elementary teachers. The committee modeled the instructional responsibilities and competencies after A Frtiiric1wwr.k f i ) r thci De\~c~Iopriicvit of' C o r ~ i ~ ~ r t c ~ r i c ~ ~ - R c i . ~ c ~ c l Ciirriculii ,for Eiitr? L ~ ~ ~ ~ t ~ l Heriltli Etliiccitors.'- The committee advocated five areas o f instruc- tional responsibility and 3 1 competencies t o be addressed in at least one three-credit semester preservice course in personal health. Further. such a course would include back- ground infomiation needcd to model health behavior and teach the 10 commonly accepted content areas of compre- hensive school health education. Figure I denotes the five major areas o f instructional responsibility for elementary (K-6) classroom teachers.

SURVEY BACKGROUND Purpose

Health i ns t ruc t i on re s po ns i hi 1 i t ie s and com pe te nc ies delineate guidelines for use by teacher preparation faculty t o d e ve 1 o p a p p ropr i a t e course w o r k in c o ni pre h e n s i v e school health educat ion for e lementary educators ." A review of professional literature found scant attention to the K -6 instruct ional re spon s i b i 1 i t i es for hea I t h instruction. Further, no published data were located determining the extent to which these responsibilities and competencies are used and deemed important for e lementary educators , Therefore. this survey determined usage and perceived importance of the K-6 health instruction responsibilities and competencies by elementary teachers responsible for teaching health education.

Instrumentation A survey instrument was developed comprised of 52

items. The survey and cover letter was reviewed by a panel of four experts lor content validity and clarity of wording and instructions. The survey then was piloted with seven elementary educators from a comparable school district. Bascd on pilot study results. one item was deleted. two items were revised. and the format was modified. Pilot participants unanimously suggested the item asking if e l e m e n t a r y e d u c a t o r s were a w a r e o f t h e K - 6 Heal th Instruction Responsibilities and competencies be deleted. They believed inclusion of this itern would result in a social desirability bias. The modification in format focused o n Area of Responsibility I - Cor?ii?iiiii;c,~itiii~~ rhr c o r i c q > t . s tirid piitposr.s oflieulrli c d i i c u t i o i i , After review and discus- sion of the 10 competencies listed in this section, pilot participants believed these competencies were addressed primarily at the district level as opposed to the responsibil- ity of an individual teacher. The practicing elementary educator on the panel also concurred. Therefore. the survey was modified by the replacement of the question "Do xou use ... " to "Doe.s your t1istric.t ... " for these 10 competencies. Cronbach's alpha internal reliability consistency estimate was .93 for the final 52-item instrument.

Of 52 items. 1Y pertained to demographic and profes- sional preparation information. 3 I assessed respondents' usage a n d perce ived impor tance of t h e Instruct ional Responsibilities and Competencies ( n = 3 I ) for elementary classroom teachers. and two items asked respondents to identify other instructional responsibilities which were not previously identified. Respondents assessed the usage and

14 Journal of School Health January 1996, Vol. 66, No. 1

perceived importance of all 3 1 instructional competencies by answering a two-part question. First, subjects responded (by circling yes or no) to the question. “In your position as an elementary educator, do you ... (one of the 3 1 competen- cies lisled).” Second, respondents indicated the ”degree of importance (high, average, or slight) you place on those same Competencies for cill elementary classroom teachers.”

Participants Elementary teachers ( n = 148) from a suburban school

district in southeastern Pennsylvania served as the popula- tion. Respondents constituted a sample of convenience. Consequently, representativeness of the sample is unknown and results may not be generalized to other school districts and other elementary educators. After receiving approval from the superintendent, building principals were contacted by telephone and a letter was sent to confirm their coopera- tion. Building principals distributed a letter to the elemen- tary teachers endorsing the project and encouraging teacher participation. Survey packets were delivered to teachers in April 1994 and collected two weeks later. Of 148 teachers receiving a survey, 91 (61%) were returned. Twelve surveys were incomplete and could not be used, producing 79 usable surveys for an usable response rate of 53.4%.

Most respondents ( n = 79) were female (9l%), listed the master’s! degree (62%) as their highest academic degree earned, and almost two-thirds (60.8%) had earned their elementary education degree prior to 1980. Additionally, 69.6% of respondents held a Pennsylvania Instructional Certificate which denotes 24 credits beyond baccalaureate degree and a minimum of three years teaching experience. A small percentage (7.6%) held a supervisory or specialist certificate, and one respondent possessed the Certified Health Education Specialist (CHES) credential. Two respondents were members of the American School Health Associatiion and no respondents reported membership in the Association for the Advancement of Health Education. Most respondents (50.6%) had worked as an elementary educator for more than 10 years, and 53.2% taught grades K-3. Among the respondents, 64.6% had completed one to five heali h/health education courses during their undergrad- uate and/or post-baccalaureate experiences. Nearly half (46.8%) indicated they were “somewhat prepared’ in teach- ing health education topics. Detailed responses to demo- graphic questions can be found in Table I .

S U R V E Y RESULTS Responses were tabulated and analyzed using the statis-

tical software package Number Crunching Statistical Systems (NCSS) for desktop computers. Frequency distrib- utions were determined and chi-square tests of significance were determined for the usage of instructional competen- cies and the total number of years worked as an elementary educator. Level of significance was set u priori at .0S. Frequency of instructional competency ranged from a low of 35.5% (“Does your district summarize the kinds of support needed by the K-6 teacher from administrators and others to ismplement an elementary school health education program”! to a high of 98.6% (“Do you incorporate appro- priate resources and materials.”) The most and least frequently used competencies can be found in Table 2. Of 31 competencies listed, 12 (38.7%) were rated as being

used by more than 80% of respondents. Table 3 provides summary inforniation on instructional areas of responsibil- ity, range of usage, as well as mean, high, and low usage.

When asked to rate (high, average, or slight) the impor- tance of each competency, only two competencies were judged as “highly important” by 80% or more respondents. The competency “Select realistic goals and objectives,” was deemed highly important by 87.8% of respondents and 8 1.3% of respondents believed the competency “Utilize information about needs and interests of students” was highly important. The competency that received the least rating of high importance was “Describe effective ways to

Table 1 Selected Demographics Characteristics of Elementary School Teachers (n = 791

Highest academic degtw earned to date: Bachelor’s Master‘s Doctorate Other

Year ebmentay education degree earned: 1990 to present 1980-1 989 prior to 1980 NA

31.6% 62.0% 1.3% 5.1%

8.4% 25 3% 60 8% 5.1%

Number d healthhealth education courses cornpleted during colkga experience - both undegiaduate and post-baccalaureate:

None 7.6% 1-5 64.6% 6-10 1 2 .7% 1 1 and more 5.1% Unsure 10.1%

Best description of your pntparation level (college) in teaching health education topics:

Not prepared at all 13 9% Somewhat prepared 46.8%

22 0% Prepared and current 16 5% Prepared but not up to date

~~ ~ ~~~~~~

Table 2 Most Frequently and Least Used

of 31 Instructional Competencies as Reported by Elementary School Teachers (n = 79)

Conpotency % Respondents

Repofling Use

Incorporate appropriate resources and materials Select realistic program goals and objechs Select valid and reliable sources of information

List behaviors and how they promote and compromise health Use affective skill-building techniques to help students

apply health knowledge in their daily lives Identify available quality continuing education programs in health

education for elementary teachers Describe effective ways to promote cooperation with and feedback

from administrators, parents, and other interested persons Summarize t h kinds of support needed by the K-6 teacher

from administrators and others to implement an elementary school health education program

about health appropriate for K-6

98.6% 94.6%

94.6% 93.5%

93.5%

52.0%

44.7%

33.5%

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promote cooperation with and feedback from administra- tors. parents, and other interested citi7ens." This compe- tency wis perceived to he highly important by o n l y 38.8% 01. respondents.

Chi-square t e s t s o f significance were calculated for competency usage and total number of years experience ;IS

an elementary educator. I t was hypothesi/ed that those elementary educators with more years o f experience would use the competencies inore often as they become more faniiliar with clemenlary teaching and the health interests 01' elementary students. The chi-square will determine i f ' statihtically signit'icant differences exist hut i t t1ocJ.s r i o t indi- cate specifically where those differences exist, This statistic does n o t detect whether statistical significance was related t o more o r less years of elementary teaching experience. Chi-square statistics were calculated f o r usage o f each competency and the variable "total number of years experi- ence as a n elementary educator." Relevunt to competency usage and total number o f years experiencc ;is a n elemen- tary educator. resul ts found ;I statistically significant rela- tionship for three competencies: I ) Involve parents in teaching and learning experiences. 3 ) Plan elementary school health education. and 3 Incorporate appropriate resources and materials.

S U RVEY I M P 1 I CAT I0 N S Survey results indicated all o f the K - 6 health instruc-

t iona l responsibi l i t ies and c o m p e t e n c i e s a re used by elementary cducators although usage varied. While the

Table 3 Summary Information for Area of Instructional Responsibility

and Competency Usage as Reported by Elementary School Teachers (n 701

Am of Mean usage per Instructional Number of competency per area ruponribility compotenclw of instructional

ruponsibilky Hgh Low Range

Communicating the concepts and putposes of heahh education 10 67.0% 883% 35.5% 528

Assessing the health instruction needs and interests of elementary studems 2 92 8%

Planning elementary school health instruction 5 74.0%

Implementing elementary school heahh instruction 12

Evaluating the effectiveness of elementary school heahh instrution 2

935% 920% 1 5

94746 447% 500

74 6% 986% 61 5% 37 1

63.9% 645% 632% 1 3

For Area of Respomrbdiry /, respondems assessed corrpefency usage based on rhe school dismds use (in @ace o/ rhe teacher's use) o/ rhese cornperencres

survey did n o t provide an indication a s to the extent of Liwareness among elementary teachers of these instructional responsibilities and competencies. iiwareness is a precursor to usage. Health educators need t o promote greater aware- ness. explanation. a i d discussion o f the K - 6 health instruc- tional responsibi l i t ies and competenc ies a m o n g those i n v o l ved. T h e se I nd i v idual s i tic I udc h i g her educat io t i

facul ty respons ib le for the prcaervice prepara t ion o f clcrnentary educators. teacher certification officers within s t at e depart men t 5 o f edit ca t i o t i . and ad ni in i s t ra tors and curriculum specialists working at the local/district levels. Once individuiils ;ire aware of these instructional responsi- bilities and conipetencies. ;I greater emphasis is needed for the irttc,qrcitiori and tipp/iuitiott of K - 6 instructional respon- sibilities and competencies in to the professionul preparation courses for preservice teachers in elementary and health education.

Pro fes s i o n a I p re pa rat i o n ;it t he p re se rv i c e and s t a I f de\elopnient l e v e l s has been recogni /ed a s ;I cr i t ical precursor for implementation o f school health education. Elementary education also can be strengthened by provid- ing inservice and continuing education courses f o r practic- ing elementary teachers which provide learning opportun- t ies a n d r e s o u r c e m a t e r i a l s f o r a p p r o p r i a t e use o f responsibilities and competencies. A \econd emphasis lo r staf f development \hould include a discussion of why each instructional responsibility and cornpetcncy is important h- effective elementary health education.

Information from the s u r w y al\o confirmed ;I need lo r continuous staf f development. For example. 97% of teach- ers reported the incorporation of appropriate resources and materials into the health curriculum. However. 3SV o f the teacher\ perceived appropriatc resource\ and materials to be o f slight or neutral importnncc to the health curriculuni. Further, 9 3 4 reported using erfectivc skill-building tech- n iques t o he lp s tudents apply hea l th knowledge . yet approxirnately 39% perceived this factor to be o f neutral o r slight importance i n teaching health educat ion. I n the preparation o f health education lessons. 005f o f teachers reported development of lessons which reflect the needs. interests. developmental levels. and cultural backgrounds o f their students. YCI. some 77% o f ti'achers perceived the importance level o l ' th i s responsibility ;is neutral or slight.

Elementary teachers usually d o no1 possess in-depth knowledge of health education content areas and concepts. Similarly. health educators often arc not cogni/ant o f the daily activities and expectations o f elementary educators. To broaden support and understanding for the importance o f delivering quality elementary he:ilth instruction. health educalors should continue to communicate and network with pro fe s s i o n a I a \ soc i at i o t i s o f e I e nic n ta r y ed ti cators . While a number o f members o f t h e American School Health Association and Association for the Advancement of Health Education are elementary educators. a need still exists to go beyond the parameters o f the discipline. Health educator\ need to explore niember\hips. read journals. and at tend m e e t i n g \ 01' the Nat iona l A \ s o c i a t i o n f o r the Education of' Young Children. Nxtional Association of S ti pe rv i s i on a n d C 11 r r i c u 1 ti i n Dc \,e 1 o p me n t . N ;i t i o ti ;i I A s s oc i a t i o n o f E I e i n e n t ary S c h oo I P r i n c i p a 1 s . Nation ;I 1 Association o f School Administrators, National Association 01 ' S t a t e B o a r d s o f E d u c a t i o n . N a t i o n a l E d u c a t i o n A \sot i at i on. a n d s i ni i I ar org a t i i /;it i on \ .

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CONCLUSION H i \ tor i c ;I I I y . health educa tors advoca te that health

education must he planned and sequential. and start at the preschool Ie\.cl and continue throughout the K - 12 school experience. Health educators recognize that those behaviors that inf l i ience hea l th s t a t u s hegin in c h i l d h o o d . a r e prevventi~hlc. and are amcnablc to change through compre- hensive school health education. Although these survey findings may n o t represent all elementary educators. they provide an initial justification lor continued preparation in health education for elementary educators and further atten- tion t o the K - 6 heal th instruct ion responsibi l i t ies for elementary educators. Further \tudies should explore the appropriate use of the K-6 instructional responsibilities and c om pe t ve nc i e s by e I e me n t ary e duc a tors. S i m i I a r studies s h o u l d he c o n d u c t e d with representa t ive s a m p l e s t o improve the generalizability to a greater range of elemen- tary educators.

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