(These tips are based on the Lessons Learned from field experience and research.)
Where should skills-based health education be delivered?
Almost anywhere! Schools are an obvious setting because they can reach so many young people, but skills can be taught through non-formal school programs, community based organization programs, street programs, naturally occurring groups and clubs.
Who should implement skills-based health education?
Almost anybody, with good training and support, can implement a program. Teachers have obvious potential and the opportunity to get to know young people over time, but others, such as peer educators, religious leaders, community agency workers or NGO (non-government organization) workers can also contribute to skills-based health education.
What content should be covered in a skills-based health education program?
Skills-based health education for HIV/AIDS prevention should include a balance of knowledge, attitudes and skills related to the key individual, social and environmental factors that help to prevent HIV/AIDS. The content needs to be appropriate to the age or life stage of the intended participants, and should take into account the local conditions and what is truly relevant in the local environment and among those involved in the program - participants, teachers, families, and broader communities. This site offers some examples of teaching and learning materials that you may find useful, but, keep in mind that the program content should always be influenced by local needs and conditions.
The World Health Organization has produced a school health information series (external link) that outline skills-based approaches to a wide variety of health issues, including healthy nutrition, tobacco use prevention, violence prevention, reducing helminth infections, and preventing HIV/AIDS/STDs and related discrimination.
When should skills-based health education begin?
The short answer is "as early as possible."
The longer answer is:
SBHE programs can begin in the early grades of school and continue throughout schooling, but the content and methods used must be appropriate to the age and experience of the students. SBHE programs should focus on issues that are relevant to students and should be sequenced to progress from simple to more complex concepts over time. The curriculum should provide activities that build and reinforce the previous activities, and then extend into new areas. Those involved in designing and delivering programs are often concerned about sensitive issues like drug use or sexual risk taking behaviour: the key to addressing these issues is the appropriateness and relevance of both content and teaching and learning methods. There is no evidence that addressing these issues in an appropriate way increases risk taking behaviour - rather, the evidence shows improvements in behaviours associated with sexual risks, alcohol, tobacco, and other drug use, bullying and violence.
The sequencing and progression of the curriculum, sometimes called a spiral effect, should be guided by at least three major considerations:
What methods should be used?
Interactive and participatory teaching and learning methods should be central to effective skills-based health education programs. Such methods can have an impact on reducing risks and promoting behaviour that will lead to healthy development. Participatory methods allow participants (including the facilitator) opportunities to listen to, and learn from, each other, and can apeal to different learning styles. They include self directed and experiential learning (learning by doing). Here are a few examples:
"Critically, the values and norms expressed in these programs were tailored to the age and experience of the target population. As an example, ‘Postponing Sexual Involvement' was developed for middle school youths and focused upon delaying intercourse; given that the majority of middle school youths in the targeted areas had not yet initiated intercourse, the message was appropriate for most students. The Schinke-Blythe-Gilchrest curriculum and ‘Reducing the Risk', on the other hand, were designed for high school students and explicitly emphasized that students should avoid unprotected intercourse, either by not having sex or by using contraception if they did have sex. Finally, ‘AIDS Prevention for Adolescents in School' targeted higher risk youths, many of whom were already sexually active, and emphasized the importance of using condoms and avoiding high-risk situations.
The importance of promoting values and norms that are age- and experience-appropriate is demonstrated by the fact that ‘Postponing Sexual Involvement', which emphasized delay in initiating intercourse, did not reduce the frequency of intercourse nor increase the use of contraceptives among those students who had already had sex. Thus, it was an ineffective curriculum for sexually experienced youths. Similarly, ‘AIDS Prevention for Adolescents in School', which emphasized condom use, did not affect abstinence. Thus, it was less effective for sexually inexperienced youths. In other words, the norms emphasized in the curriculum needed to match the experience of the students".
From Doug Kirby. http://hivinsite.ucsf.edu/InSite?page=Prevention (external link)
Also see - Kirby D, 1999. Looking for Reasons Why: The Antecedents of Adolescent Sexual Risk-Taking, Pregnancy, and Childbearing. ETR Associates.
External links open in a new window and take you to a non-UNICEF web site.