Leigh Szucs (00:00): Welcome
to our video titled CDCs health education curriculum analysis
tool HECAT sexual health module updates.
In 2021, CDC released an updated version of the HECAT
to help translate research into practice and support schools
in delivering quality health, and sexual health education.
Today, we're excited to provide an overview
of key updates for sexual health.
My name is Leigh Szucs and I am a health scientist
in CDCs division of adolescent
and school health also known as DASH.
In this role, I work primarily on DASH's health
and sexual health education portfolio, supporting research
and programmatic activities with school districts and schools
across the United States.
In today's presentation, we will begin by exploring data
about adolescent sexual behaviors and experiences
and talk about practices and strategies for schools
to address sexual health, including STI, HIV,
and unintended pregnancy prevention.
Specifically, we will talk about recent updates to CDCs HECAT
and do a deep dive into the chapter six sexual
health module.
Leigh Szucs (01:04): Recent updates include new
and revised examples of student level knowledge
and skill expectations important
for universal primary prevention schools.
The last section of this video will include several tools
and resources to help schools working
to address sexual health, including STI HIV
and unintended pregnancy prevention.
Let's begin by looking at CDC youth risk behavior survey data.
In 2019 CDCs nationwide youth risk behavior survey,
or YRBS was administered to high school students
across the United States, measuring several items related
to sexual health, including questions about sexual activity,
number of sexual partners, and use of condoms
and effective hormonal birth control.
Overall fewer students engaged in sexual behaviors
that increase their risks for HIV, STIs,
and unintended pregnancy from 2009 to 2019.
However, these trends data highlights some behaviors
that need improvements.
Over the last 10 years fewer high school students engaged
in sexual activity.
Students in all racial and ethnic groups were less likely
to have had four or more sexual partners between 2009 and 2019.
Leigh Szucs (02:17): The percentage of black, white,
and Hispanic students who had ever had sex
or were sexually active, decreased from 2009 to 2019.
Notably fewer sexually active high school students used
condoms between this time period
and fewer students got tested for HIV in 2019.
About 54% of sexually active high school students had used a
condom the last time they had sexual intercourse.
As you can see more male students used a condom
at last intercourse than female students and more white students
and Hispanic students used a condom
at last sex than black students.
About 9% of sexually active high school students used dual
methods of protection the last time they had sex.
Dual methods of prevention include using both a condom
and effective hormonal birth control defined
as birth control pills, an I U D or implant, a shot, a patch
or a birth control ring.
Leigh Szucs (03:18): More white students use dual methods
of prevention than black students or Hispanic students
and the percentage
of all students using the recommended dual method
to prevent against both STIs and HIV
and unintended pregnancy was low.
Lastly, about 9% of high school students had been tested
for sexually transmitted diseases during the past year.
As you can see more female students have been tested
for STDs during the past year than male students
and more black students have been tested
than compared with white students.
The tested for sexually transmitted diseases,
variable was only added to the national YRBS in 2019,
and thus trends are not currently available.
Collectively fewer students engaged in sexual behaviors
that increase their risks for STI HIV and unintended pregnancy
between 2009 and 2019.
However, this data highlights important areas for improvement
and present opportunities
for school-based education and prevention.
Given the prevalence of such behaviors and experiences,
public health and education professionals have
to identify opportunities to effectively reach students
and increase their knowledge, skills, services,
and support to enhance their sexual health.
Leigh Szucs (04:25): Luckily, schools are uniquely positioned
to improve the health outcomes for adolescents,
including addressing STIs, HIV, and unintended pregnancy.
Many factors contribute to the sexual health of young people
as the data just discussed and research shows
that well designed
and implemented sexual health education can provide youth
with the knowledge and skills they need
to protect their health, reduce sexual risks,
and become successful learners.
In helping promote sexual health,
schools are uniquely positioned to build staff capacity,
specifically core knowledge and skills
for delivering sexual health education,
teach functional health information and skills
that address STI HIV and unintended pregnancy, and offer
or link students to sexual and reproductive health services.
Schools that provide quality health education are using a
formal structured combination of planned learning experiences
that provide opportunities for youth to acquire the knowledge
and skills needed to make health enhancing decisions,
achieve health literacy, adopt healthy behaviors,
and promote the health of self and others.
Leigh Szucs (05:32): Curriculum is the primary organizing
framework for delivering such quality health information
and skills through schools.
So what exactly is a health education curriculum?
According to CDC,
health education curriculum includes five core elements.
One, they include a set of intended learning outcomes
or objectives that directly relate to student's acquisition
of health, knowledge, attitudes, and skills.
Two, curriculum have a planned progression
of developmentally appropriate lessons and learning experiences
that lead to achieving healthy behaviors or objectives.
There's continuity between lessons or learning experiences
that clearly reinforce the adoption and maintenance
of health enhancing behaviors.
Curricula, content, and materials correspond
with a sequence of learning events and help the teacher
and students meet learning objectives.
And lastly, health education curricula include assessment
strategies to determine
if students have achieved the desired learning.
In order to strengthen school health
and sexual health education CDC created the health education
curriculum analysis tool.
Leigh Szucs (06:39): As I said, HECAT,
is CDCs primary evidence informed tool
for advancing health education through schools.
The HECAT contains process guidance, appraisal tools,
and resources for carrying out a clear, complete,
and consistent examination of commercially packaged
or locally developed health education curricula.
Analysis results can help school and community leaders select
or develop appropriate
and effective health education curricula, revise,
and improve locally developed materials,
strengthen the delivery of health
and sexual health education, and improve educator's ability
to support healthy behaviors and outcomes among youth.
The HECAT aligns with the national health education
standards and CDCs characteristics
of effective health education curriculum.
HECAT was designed for use by several groups, including state,
local, territorial, or tribal health
and education agency staff, curriculum committees, teams,
or educators at schools and school districts,
youth serving community organizations, institutions
of higher education and other pre-service teacher training
programs and commercial curriculum developers.
As was mentioned in the beginning,
CDC recently updated the contents of HECAT based
on emerging research in adolescent and school health,
as well as practices from the field.
Leigh Szucs (08:01): As part
of that key update HECAT is now offered in two formats.
As you can see here, users can access the tool via the PDF
manual on CDCs healthy youth webpage
or through the interactive online application called
HECAT online.
Together these multiple user formats help
to improve the accessibility and reach of the HECAT.
Where we will spend the majority of our time today is talking
about HECAT's chapter six.
Chapter six includes 10 modules
to address single topic curricula
or comprehensive health curricula.
Each module contains a description
of the health topic includes the healthy behavior outcomes
relevant for that curriculum in the specified topic area.
All modules use the national health education standards,
core concept standard one as the framework for analysis.
This framework helps determine the extent
to which the curriculum is likely to enable students
to master the essential knowledge and skills
that promote healthy behavior outcomes.
Because school curriculum must meet local community needs
and often align with state
or local curriculum requirements HECAT users are encouraged
to review the full list of HBOS knowledge
and skill expectations,
and other HECAT information before completing any analysis.
Leigh Szucs (09:09): HECAT users can add, delete, or revise items
to meet school youth and community needs.
Now we will dive into the sexual health module highlighting new
and revised student level knowledge
and skill expectations.
As part of the recent update, let's begin by talking
about the healthy behavior outcomes or as I said, HBOs.
A pre-K through grade 12,
sexual health curriculum should enable students
to achieve 10 healthy behavior outcomes.
As you can see these range from establishing
and maintaining healthy relationships
to using appropriate sexual and reproductive health services.
During updates two new HBOs were added to this module.
HBO number one, recognized developmental changes
experienced by self and others during childhood and adolescent
and HBO four, give and receive consent in all situations.
Before we talk more
about specific knowledge expectation updates,
I want to take a moment
to connect the healthy behavior outcomes
and how HECAT uses knowledge and skill expectations
to help schools analyze, select,
and create sexual health education curricula.
When using HECAT to analyze curricula, the first step is
to identify the desired HBO, as you can see, they're in orange.
So in this example, let's say
that the sexual health education curricula is designed
for middle school students grade six through eight and one
of the desired outcomes is for students to give
and receive consent in all situations.
Leigh Szucs (10:55): So what information might be important
for students to have in reaching that goal?
The HECAT identifies what knowledge expectations shown
in green are aligned to help students achieve
that behavioral outcome.
Knowledge expectations, such as defining consent
and its importance for decisions about sexual behaviors,
as well as describing how consent cannot be fully present
when there is an imbalance
of power may lead students toward the desired health
behavior outcome.
Every knowledge expectation found in HECAT is aligned
or mapped with the healthy behavior outcome of interest.
As you can see there in yellow HECAT users may also be
interested in what skills are important for students
as they build knowledge in order
to reach the desired health behavior outcome.
In the blue boxes, you can see skill expectation,
examples that include examining how social expectations
influence healthy and unhealthy sexual relationships, practices,
and behaviors, as well as how
to demonstrate effective negotiation skills to avoid
or reduce sexual risk behaviors, a skill related
to interpersonal communication.
Leigh Szucs (11:52): Both may be critical
as students develop mastery of information
in that green column, leading them toward increased likelihood
of the health behavior outcome of interest,
giving and receiving consent.
This process of identifying the HBO,
selecting relevant knowledge
and skill expectations will be driven
by local priorities and needs.
However, HECAT users can use this tool and this process
to systematically inform their decisions
about sexual health education curricula
across all grade levels.
In HECATs recent update in the fall of 2021,
a number of new revisions were made to the sexual health module
and I'd like to draw your attention to six key updates,
including improvements in inclusive anatomy
and puberty language,
interpersonal relationship dynamics and personal safety,
STI HIV and pregnancy prevention
and treatment strengthening concepts related to sexual
and gender identity development and new
and updated knowledge expectations
across all grade spans pre-K through 2, 3 - 5, 6 -
8 and grades nine through 12, as well as additional specificity
to the skill expectations across all grade groups.
Leigh Szucs (13:09): Let's talk about each
of these key update areas.
So related to inclusive anatomy and puberty language,
new items across all grade spans included knowledge expectations,
such as using medically accurate terms
for body parts including genitals for older students,
new knowledge expectations, such as explaining how puberty
and development can vary greatly and be normal,
as well as describe the human sexual response cycle,
including the role of hormones and pleasure are now included.
Related to interpersonal relationships and safety,
several new items were included across multiple grade levels.
As you can see, for example in grades three pre-K to 2, 3 to 5,
6 to 8, and 9 to 12 new knowledge expectations
such as recognize the range of different family
and peer relationships, as well as identify characteristics
of healthy relationships can be found in this module.
Related to STI and HIV and pregnancy prevention
and treatment, several new items were updated
across secondary grades.
For example, new items such as describe the importance
of using a condom for STI HIV prevention at the same time
as using a more effective contraceptive method
for pregnancy prevention and explain what to expect
from youth friendly sexual health services
and providers can now be found.
Related to the strengthen strengthening concepts
around identity development several new items were updated.
Leigh Szucs (14:50): Beginning in grades three through five,
for example, knowledge expectations,
including describe personal characteristics related
to sexual identity, orientation,
and gender that make people different from one another,
as well as defining sexual orientation, including a sense
of identity attraction
and related behaviors can be found in this module.
Lastly, important updates
to the sexual health module include a strengthening
on the role of technology and impacts
on sexual health and relationships.
For example, in grades nine through 12, in new knowledge,
expectations states explain how viewing sexually explicit
pictures, messages or media can influence perceptions of
and expectations for relationships is now included.
Also in this module, new consent based language is included
that draws attention to the content and skills for giving
and receiving consent while also maintaining developmentally
appropriate content across grade spans.
Notably within HECAT's mental and emotional health
and violence prevention modules,
users can find complimentary knowledge expectations
for promoting sexual health.
Leigh Szucs (16:03): HECAT users should consult these additional
modules when developing, revising,
or analyzing sexual health curricula
where relevant knowledge expectations might be found.
That concludes the deep dive
into the knowledge expectations found
in HECAT's sexual health module.
We encourage users to review the module
in full before any systematic analysis of new
or locally developed sexual health education curricula.
In the final section of this video,
we will highlight key resources and tools
to help schools promote sexual health and address STI HIV
and unintended pregnancy prevention.
To accompany the HECAT,
CDC created a frequently asked questions page that talks all
about HECAT's features, forms, updated content,
and how to use HECAT online.
There's also a new HECAT fact sheets series that again,
details HECAT's core features for intended audiences
and provides in depth guidance on how to use HECAT online.
Other resources that might be helpful to schools
that are promoting or working
in sexual health education include CDCs characteristics
of effective health education.
This resource highlights the 15 characteristics
of effective health education curricula based
on a growing body of research and evaluation,
developing a scope, and sequence for health education.
This resource provides a step by step process for creating
or revising a scope and sequence for sexual health education
and the health education pacing guide and unit planner.
This tool provides templates and considerations for schools
and classroom teachers who are creating pacing guides
and unit plans in sexual health education.
Leigh Szucs (17:49): Lastly, everything presented
in this video can be found on CDCs healthy use webpage.
Additionally, CDCs tools
for healthy schools offers an e-learning training series
about HECAT that overviews key features of the tool
and how it can be used.
Both webpages and training series offer more detailed
information than what we covered today.
Check them out.
This concludes our overview
of CDCs HECAT sexual health module updates.
If you have questions or need additional assistance,
please reach out to CDC.
Thank you for spending time with us today.