HealthSmart is an evidence-informed, K–12 health education program that focuses on the CDC’s six areas of risk for young people and is aligned with the National Health Education Standards and the CDC's Health Education Curriculum Analysis Tool (HECAT). At middle and high school, the program offers two units on sexual health: one focuses on sexual abstinence as a way to protect sexual health and avoid unplanned pregnancy, HIV and other STI; and the other encourages abstinence but also addresses safer sex practices for reducing the risk of HIV, other STI and unintended pregnancy through the use of condoms and other forms of contraception.
Abstinence, Puberty & Personal Health
HIV, STI & Pregnancy Prevention
Abstinence, Personal & Sexual Health
HIV, STI & Pregnancy Prevention
|16 lessons||14 Lessons||16 lessons||15 lessons|
|Age Group||Ages 12–14||Ages 12–14||Ages 14–18||Ages 14–18|
The HealthSmart sexual health units at middle and high school are intended to achieve the Healthy Behaviors Outcomes for Sexual Health outlined in the CDC's HECAT.
Each grade span offers two sexual health units, one that covers personal and reproductive health and focuses on concepts and skills that support students in using abstinence to protect their sexual health and avoid unplanned pregnancy, HIV and other STIs, and another that provides instruction about sexual responsibility, HIV, other STIs, testing and the use of condoms and other forms of contraception.
The ultimate goal of the HealthSmart program is to promote the healthy growth and development of youth and give them the knowledge and skills to make healthy choices and establish life-long healthy behaviors.
HealthSmart is grounded in sound educational and behavioral theory. It focuses on the primary areas of risk for children and adolescents identified and monitored by the Centers for Disease Control and Prevention (CDC). HealthSmart meets the National Health Education Standards, and reflects the characteristics of effective health education curricula defined by the CDC. It also incorporates key knowledge and skill expectations detailed in the CDC's Health Education Curriculum Analysis Tool (HECAT) for each grade level.
Lessons are designed to be easy to use, with clear, concise teaching steps focused on the essential concepts and skills that will enable students to develop, practice and support specific healthy behaviors. Activities are developmentally appropriate, challenge students in a variety of ways, and accommodate a range of learning styles.
In addition to the units that address sexual health, the HealthSmart program also offers units on Emotional & Mental Health; Tobacco, Alcohol & Other Drug Prevention; Nutrition & Physical Activity; and Violence & Injury Prevention. Lessons from these other content areas may also be relevant to the prevention of sexual risk behaviors, in particular, those that address knowledge and skills around decision making, healthy relationships, avoiding substance use and preventing dating violence.
The program is available in both print and digital editions. More information about the complete program can be found on ETR’s HealthSmart website.
HealthSmart is a sequential, school-based K–12 health education program. At the secondary school levels, the program is modular, with content units specifically focused on sexual health available for both middle school and high school students. It is designed to accommodate a wide range of learning styles and to appeal to students from diverse backgrounds.
Susan K. Telljohann, HSD, CHES, is Professor Emerita of Health Education at The University of Toledo. Her experience in health education spans over 35 years, including health instruction from the junior high to the university level. She has conducted research and published over 60 articles on health education in professional journals. Dr. Telljohann was one of the lead authors of the Center for Disease Control and Prevention’s original and revised Health Education Curriculum Analysis Tool (HECAT). She served as the President of the American School Health Association from 2000–2001, on the Board of Directors of the American Association of Health Education and the National Health Education Standards Revision Committee. She is the recipient of several awards, including the Howe Award from the American School Health Association and the Scholar Award from the American Association for Health Education.
William “Bill” M. Kane, PhD, CHES, served as Executive Director of both the American College of Preventive Medicine and the Association for the Advancement of Health Education. He was a Professor of Health Education at the University of New Mexico, and taught at several other colleges and universities over the course of his career. He served as Director of School Health Programs at ETR Associates, and also served on the boards of several nonprofit organizations devoted to public health and health education. Dr. Kane received many honors, and wrote or coauthored over 50 books and curricula focused on health. He remains a consummate model for those who work in health education of how to do this work with passion.
Hilda Quiroz Graham is an educator, international trainer, writer and keynote speaker. She has taught health classes and served as a mentor teacher and leader at both the middle and high school levels. She is the author of books, articles, curricula and training designs addressing K–12 safety, college and university safety, diversity/cultural fluency, school bullying, and health education. Her work serves public schools, community organizations, and law enforcement agencies. Hilda is the former Program Developer for the National School Safety Center. She continues to serve the Center as an associate trainer, and expert voice for national media addressing the topics of school safety, law enforcement/education partnerships, and school bullying.
Susan Giarratano Russell, EdD, MSPH, CHES, has more than 35 years of experience in education, health education and health promotion. For 20 of those years, Susan served as a Professor of Health Science in the undergraduate and graduate programs, and as coordinator of the teacher preparation program in health education for two California State Universities. She went on to consult for the Centers for Disease Control and Prevention’s (CDC) Division of Adolescent and School Health, where she developed curriculum-related tools for use in schools and community-based programs on nutrition, healthy eating and food safety, physical activity, asthma, tobacco use prevention, school connectedness and parenting. She was also a lead author on the recent revision of the CDC’s HECAT. She continues to serve as an expert reviewer, consultant and evaluator in health and education
HealthSmart is used in many different schools and districts nationwide. For example, it has been approved as the comprehensive Health Education program for New York City.
At middle school, lessons are 45–60 minutes long. High school lessons range from 45–75 minutes long.
Lessons can be taught once to several times a week.
Each print edition HealthSmart Sexual Health Unit set at middle and high school includes the Teacher’s Guide that contains the easy-to teach lessons, with clear objectives, teaching steps and assessment; a classroom set of 30 Student Workbooks that include all student reading and activity sheets; and additional teacher resources such as keys and masters, PowerPoint slides, Student Journal pages, scoring rubrics and a health terms glossary in digital format.
The digital edition of the program provides online versions of all unit lessons; a student license that allows for PDF download and/or printing of all student activity sheets from the required student workbook for 30 students; and digital access to teacher keys and masters, PowerPoint slides, Student Journal pages, scoring rubrics and the health terms glossary.
Student workbooks are required for every student. Additional classroom workbook sets of 5 and 30 are available.
HealthSmart teachers also have access to the HealthSmart Teacher Support Website that features a wealth of free digital resources, including a Lesson Planning Tool that allows educators to quickly customize a lesson plan based on content, skills and the time available to teach health.
This curriculum can be used by either classroom teachers or community-based health educators. Individuals implementing HealthSmartshould be knowledgeable about the content, be comfortable discussing the material and answering sensitive questions about sexual risk taking, have experience using interactive teaching strategies such as roleplaying, and have good rapport with youth. Ideally, all educators implementing the program should be trained on its contents and teaching strategies.
It is essential to inform parents and guardians regarding the nature and scheduling of this or any sexual health education program. Prior to implementation of the curriculum, families should receive written notice describing the goals of the HealthSmart Sexual Health unit and the nature of the content to be covered. Parents also should be given an opportunity to view the curriculum and related materials if they wish. The vast majority of parents want their children to receive appropriate instruction and be given the information and skills they need to protect their sexual health, but parents/guardians also must be allowed the chance to opt out or exclude their children from participating in the program, if they wish.
HealthSmart is grounded in sound educational and behavioral theory. The Theory of Planned Behavior provides the framework for lessons and activities. Concepts from Social Learning Theory are strategically woven throughout the program. The Transtheoretical or Stages of Change Model serves as the foundation for activities designed to support student change of unhealthy behaviors. Activities are designed to appeal to students’ multiple intelligences, utilize brain-based learning methodologies, and promote a constructivist approach to learning.
Theoretical principles woven throughout the lessons and activities increase the likelihood that students will value and practice the healthy actions that prevent excessive morbidity and premature mortality. With the HealthSmart program, teachers utilize educational and health behavior theory to:
In addition, HealthSmart was developed to meet the 15 Characteristics of Effective Health Education Curricula as identified by the CDC Division of Adolescent and School Health. More information about these characteristics can be found below.
Logic models for the HealthSmart Sexual Health units can be found at the links below:
HealthSmart meets the 15 characteristics of effective health education programs defined by the CDC in the following ways:
For over 30 years, ETR has been building the capacity of community-based organizations, schools, school districts, and state, county and local agencies in all 50 states and 7 U.S. territories to implement and replicate evidenced-based programs (EBPs) to prevent teen pregnancy, STD/STI and HIV. Our nationally recognized training and research teams work in partnership with clients to customize training and technical assistance (TA) to address the needs of their agencies and funding requirements.
Professional development on lesson implementation maximizes effectiveness of the HealthSmart curriculum. ETR provides a 2-day training with a 1-day follow-up booster session—the ideal model for educators who are or will be teaching HealthSmart.
ETR provides a research-based approach to our professional learning processes. This includes the provision of pre-work (in order to prime the participants so they have the background and content information needed to fully engage in skill-building) in-person skill-building, and follow-up implementation support.
The first day of training focuses on understanding and applying the characteristics in lessons and assessments.
Participants review the characteristics and the research-based process for teaching critical health skills (e.g. goal setting, decision-making, communication, etc.). The major components of the HealthSmart curriculum also are introduced.
The second day of training focuses on how to effectively use the HealthSmart curriculum. Participants identify the Characteristics of Effective Health Education Curricula within a set of HealthSmart lessons. Then, working in small groups, they take part in practice teaching sessions for specific lessons (based on input from their site) and provide feedback to each other from the learners’ perspective. Participants also receive a reflection journal that will allow them to reflect on how each lesson is received by students and to document concerns and successes for each lesson.
The 1-day follow-up booster session is designed to strengthen and support implementation. Educators have an opportunity to share their successes and challenges regarding the specific lessons they’ve taught. They review how each lesson was received by students, discuss questions and challenges, and identify strategies to overcome any problems or concerns.
To request a HealthSmart training, please complete the Training & TA Request Form >>
ETR provides in-person and web- or phone-based TA before, during and/or after program implementation. TA is tailored to the needs of the site and is designed to support quality assurance, trouble-shoot adaptation issues, and boost implementation.
To support a holistic approach to teen pregnancy and HIV prevention programs, ETR offers a number of additional training and technical assistance opportunities, including content-specific workshops, skill-based trainings, organizational development consultation and much more. To learn more about these opportunities, visit our Training & TA pages >>
Adaptation suppport materials, training and/or TA are available to assist educators in meeting the needs of individual communities by implementing EBPs effectively and consistently with core components. All adaptation support is based on ETR's groundbreaking, widely disseminated adaptation guidelines and kits for effective adaptations.
ETR also provides evaluation support for EBP implementation. ETR uses well-established tools for measuring fidelity and outcomes. ETR's evaluation support blends participatory approaches with cutting-edge evaluation science. Services address process and outcome evaluation and include assistance with evaluation planning, instrument design and development, implementation fidelity, data management and analysis, performance measurement, continuous quality improvement (CQI) protocols, and effective tools and strategies for reporting results.
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