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International audience; Objective: To analyse teachers’ health views in order to obtain general trends in factors influencing health and health education and to fit them into the negative–positive model of health proposed by Downie and collaborators.Method: This large international study involved 15 countries from Western and Eastern Europe, North and Sub-Saharan Africa, the Middle East and South America, with high socioeconomic and cultural diversity. The questionnaire constructed and validated by the European FP6 project BIOHEAD-CITIZEN was applied in each country to a balanced sample of pre-service teachers (Pre) and in-service teachers (In) of primary schools (P) and secondary schools, teaching biology (B) or national language (L).Results: Women, older persons, those having longer higher university education, primary school teachers (compared to secondary teachers) and language teachers (compared to biology teachers) have a more positive view of health. The major difference was found between countries, rather than religion, where five groups emerged from cluster analysis.Conclusion: The study does not lead to a comprehensive view of factors influencing teachers’ perceptions of health but results showed that there is a variety of variables associated with health and health education views. These findings can contribute to facilitate developing appropriate specific health education teachers’ training courses.

This paper presents the results of a questionnaire applied to 6001 teachers in 15 countries involved in the European project «Biohead citizen». The results show that teacher’s representations about health education and sex education vary from country tocountry but they also vary according to religious beliefs and the level of beleiving. Some conceptions work as obstacles to changes. From the results, the issues related to teaching practices and their training in health and sex education emerge., Cette contribution permet de présenter les principaux résultats d’une recherche conduite par questionnnaires dans le cadre du projet européen « Biohead citizen ». La recherche a été réalisée dans 15 pays auprès de 6001 enseignants, sur les représentations de l’éducation à la santé et à la sexualité. Les résultats montrent que les représentations des enseignants varient selon les niveaux de formations et les statuts, mais aussi selon les conceptions individuelles, les religions et les niveaux de croyance. Certaines conceptions apparaissent comme des obstacles au développement de l’éducation à la santé et à la sexualité. Les analyses permettent de souligner l’importance des formations et le travail à réaliser sur les pratiques enseignantes.

Cet article présente les résultats une partie de l’analyse de 6001 questionnaires recueillis auprès d’enseignants et futurs enseignants de 15 pays (Europe, Afrique et Moyen-Orient) dans le cadre du projet Biohead-Citizen. Il s’agit d’identifier les différences de conceptions des enseignants sur l’éducation à la santé et à la sexualité et de mettre en exergue les facteurs les influençant. Nous avons procédé par analyses en composantes principales et analyses discriminantes qui montrent l’importance des formations et des statuts (niveau de formation, niveau d’enseignement, discipline et statut) et l’incidence des représentations sociales et des conceptions individuelles (pays, religion, niveau de croyance) qui conduisent à des positions parfois très opposées sur l’enseignement et les contenus de l’éducation à la santé et à la sexualité, sur l’égalité des sexes, sur les droits des personnes et sur la prévention. Certaines conceptions apparaissent comme des obstacles. Se posent alors les questions des pratiques d’enseignement et de la formation des enseignants., This paper presents the results of a questionnaire applied to 6001 in-service and pre-service teachers from 15 countries (Europe, Africa and Middle-East) involved in the European project “Biohead Citizen”. The aim is to identify teachers’ conceptions about health and sex education and to show the relevant factors influencing them. We carried out principal component analysis (PCA) and discriminant analysis which highlighted the importance of training level and teaching group as well as the impact of social representations and individual conceptions (country, religion, faith level) that showed positions, often contrasting, about health and sex education, about sex equity, about human’s rights and about prevention. Some conceptions work as obstacles to changes. Teachers’ conceptions vary from country to country but they also vary according to religious beliefs and the level of believing. From the results, the issues related to teaching practices and their training in health and sex education emerge., Centro de Investigação em Estudos da Criança (CIEC) (UI 317)

Health education in schools has been implemented through a diversity of strategies, depending on the concept of health and of health education. Classically, health education has provided mainly factual knowledge about diseases and their prevention, assuming the person as being healthy if the body components are working properly. In contrast to this biomedical (B-M) view of health, the biopsychosocial model (BPS-M) embraces a holistic view of health. This work intends to analyse and compare teachers’ conceptions about health and health education from 15 countries. These countries differ in their geographical distribution and their historical, political and socio-cultural development: 3 in North Europe (Finland, Estonia, Hungary), 5 in South Europe (Portugal, France, Italy, Romania, Cyprus), 3 in North Africa (Morocco, Algeria, Tunisia), 2 in Sub-Saharan Africa (Senegal, Burkina Faso), 1 one in the Middle East (Lebanon) and 1 in South America (Brazil). In each country the BIOHEAD-CITIZEN questionnaire (Munoz et al. 2009) was applied to six subsamples: in-service and pre-service teachers of primary and of secondary schools in biology and national language. The overall sample included 6001 respondents. Multivariate analyses were performed. Results showed differences among countries. Tunisian teachers are those closest to the B-M view of health whereas Finish teachers are the most BPS-M. Logistic regressions showed preferential association of classes within groups (countries, religion, teaching groups and levels of education) to either B-M or BPS-M view of health. These results may help explain differences in school health education found among countries and within countries., European project FP6 “Biohead-Citizen” CIT2-CT-2004-506015, Fundação para a Ciência e a Tecnologia (FCT) - CIFPEC - unidade de investigação 644

School plays an important role in health education and health promotion, and it has been recognised that teachers’ conceptions play a crucial role for the effective implementation of school health education. With the European FP6 Biohead-Citizen project on “Biology Health and Environmental education for better citizenship” we analyse the potential differences between several countries by associating teachers’ and future teachers’ conceptions to controlled parameters, such as social context, religion, gender. A questionnaire was constructed during the first year of the project, and following a pilot test, the final questionnaire was applied to 6379 teachers and future teachers. We then used statistical multivariate methods, as they are well suited to investigate complex data featuring the conceptions of many individuals, according to many topics. We show that a prominent source of variation in teachers’ conceptions is related to countries, and further suggest that there are differences in two kinds of conceptions: a) individual health responsibilities and abilities; b) social policies. In contrast, religion, academic level or training had no impact in teachers’ conceptions of health education. Another important feature is the gap between what teachers and future teachers say about their own health and what they say it should be taught in school., European project FP6 “Biohead-Citizen” CIT2-CT-2004-506015, Fundação para a Ciência e a Tecnologia (FCT), CIFPEC - unidade de investigação 644

Le Réseau des IUFM pour la formation en éducation à la santé et prévention des conduites addictives a pour objectif de développer des actions pertinentes dans le domaine de l'éducation à la santé. Il s'agit de valoriser le travail déjà réalisé, de soutenir le développement de formations initiales et continues et de contribuer à une meilleure articulation des actions en milieu scolaire avec les partenaires institutionnels. Son 2ème colloque national, qui s'est tenu à Paris les 19 et 20 mars 2008, avait pour thème les enjeux et dispositifs de l'éducation à la santé à l'école. Les actes de ce colloque illustrent, en une trentaine d'interventions, la diversité et la richesse des pratiques et des recherches dans ce domaine. Une première série d'interventions souligne l'importance de mettre en place, à l'école, des dispositifs et des projets qui visent à développer les compétences psychosociales. Les communications suivantes inscrivent l'éducation à la santé dans un nouveau champ qui a progressivement fait irruption dans le monde scolaire et qui dépasse les disciplines scolaires : " les éducations à... ". Une troisième série de contributions interroge les représentations et l'identité professionnelle des enseignants et acteurs de l'éducation à la santé, éducation qui pose la question de " l'enseignement " des compétences. Enfin, les textes de la dernière partie présentent les pratiques collaboratives et partenariales développées dans le champ de l'éducation à la santé en milieu scolaire.

Health education in elementary school results in classroom productions that can be written or not, which say a lot about the true teaching practices of the teachers. This research work aims at looking more closely at the correlation existing between what the teachers say and obvious traces that can be found in the classrooms (professional and children writings, posters, etc.). Collecting the different traces of health education activities (writings or devices) allows to draw a typology which leads to an analysis of the practices the traces come from and takes into account the problematic of health at school. The idea is in fact to highlight the strong points and the obstacles in the development of HE projects in class. The results show that teachers' practices in health education can be approached using diverse productions existing in the classrooms. What is significant in classroom practices is in correlation with the teachers' representations and traces of it can be found in the classrooms. The Analysis of common professional writings - like projects, teachers' plan books, lesson plans, document folders, etc. - compared with the initial intention claimed by the teachers, allows to validate the assumption that the gap recorded says a lot about educational device interactions, didactical approaches, types of supervision developed, obstacles and difficulties encountered when health education activities are put into practice in the classroom. The analysis underlines an important heterogeneity in teaching practices in terms of both the content of what is taught and the educational and didactical approaches. It also shows how difficult it is to define 'health education' as educational object. Health education is split into two goals: teaching knowledge and changing behaviours on one side and bringing scientific facts from a hygienist and behaviourist perspective on the other. It seems necessary to help and support the teachers in their dynamic to "promote health" at school.", L'éducation à la santé en école primaire se traduit, dans la classe, par des productions écrites ou non, révélatrices des pratiques réelles des maîtres. La recherche vise à examiner la corrélation existant entre les déclarations des maîtres et la présence de traces manifestes (écrits professionnels et d'élèves, affichages, etc.) dans la classe. Le récolement des différentes traces d'ES (écrits et dispositifs) permet d'en dresser une typologie conduisant à l'analyse des pratiques les ayant générés, à la mise en évidence du curriculum réel et à la mesure de l'impact sur la prise en charge des problématiques de santé au sein de l'école. Il s'agit de mettre en relief les points d'appuis et les obstacles à la mise en place de projets d'ES dans la classe. Les résultats montrent que l'on peut approcher les pratiques des enseignants en éducation à la santé à partir des productions diverses présentes en classe. Ce qui est significatif dans la pratique de la classe est en corrélation avec les représentations des maîtres et se retrouve sous forme de traces au sein de la classe. Les analyses des écrits professionnels usuels : projets, cahier journal, préparations, dossiers documentaires... et des productions des élèves : cahiers, réalisations diverses... confrontées à l'intention initialement déclarée par les enseignants permettent de valider l'hypothèse selon laquelle l'écart constaté est révélateur de l'interaction des dispositifs pédagogiques, de l'approche didactique, de la tutelle développée, des obstacles et des difficultés de mise en œuvre de l'ES au sein de la classe. L'analyse souligne une hétérogénéité importante des pratiques tant sur le plan des contenus enseignés que des approches pédagogiques et didactiques et une difficulté à définir l'" éducation à la santé " comme objet d'enseignement. L'éducation à la santé oscille entre deux pôles : d'un côté le développement des savoir-faire et des savoir être, et de l'autre l'apport de contenus scientifiques dans une perspective hygiéniste comportementaliste. Il apparaît nécessaire d'accompagner les maîtres dans leur dynamique de " promotion de la santé " à l'école.

This paper presents the results of a questionnaire about teachers' and pre-teachers' representations coming from 17 countries (Europe, Africa, Middle-East) include in the European FP6 Biohead-Citizen research project which aims to understand how health and sex education can contribute to improving citizenship. School Sex Education is nowadays an important public health issue as it concerns not only youth AIDS prevention (and other sexually transmitted infections) and adolescent pregnancy prevention but also interpersonal relationships and psychosocial issues. Therefore school appears the best place to improve sex education and contributes to promote better citizenship. Questionnaire analyses the social representations and practices of teachers in several countries, focusing on their differences and associating them to controlled parameters (e.g. social context, religion, gender). In this communication we analyze data concerning teachers' and future teachers' conceptions on the topic of sex education derived from a questionnaire that was constructed and tested during the first year of the project. The questionnaire was completed by 5189 teachers and future teachers. We used statistical multivariate analyses, a method that has become standard for investigating complex data derived from many individuals that needs to be analyzed according to many variables (here we have used the responses to the questions as variables). The results show that the factors that correlate most closely with the teachers' and future teachers' conceptions are religion, the level of belief in God and the level of religious practices. It was also found that the level of teaching (primary versus secondary school) is also correlated with different conceptions on sex education. Detailed results will be presented and discussed., Cette communication présente les résultats de questionnaires recueillis auprès d'enseignants et futurs enseignants de 17 pays (Europe, Afrique et moyen-orient) dans le cadre du projet Biohead Citizen. Il s'agit d'identifier les différences de conception des enseignants sur l'éducation à la sexualité et de mettre en exergue les facteurs les influençant. L'éducation à la sexualité fait partie des missions confiées aux institutions scolaires. Elle concerne non seulement la santé publique à travers la prévention des infections sexuellement transmissibles, la prévention des grossesses précoces mais également la question de l'égalité de genre, des violences sexuelles, des rapports interpersonnels, du développement psychoaffectif et a des implications sociales conséquentes. L'école apparaît comme le lieu privilégié d'accès aux informations et aux connaissances scientifiques qui permettent de connaître et de comprendre les différentes dimensions de la sexualité. L'éducation à la sexualité vise aussi à susciter la réflexion des élèves et à les aider à développer des attitudes de responsabilité individuelle, familiale et sociale en partant de leurs conceptions et de leurs connaissances. Elle s'inscrit dans la construction du sujet, de l'élève et du citoyen et contribue à favoriser une meilleure citoyenneté. Le questionnaire a été renseigné par 5189 enseignants et futurs enseignants. Nous avons procédé par analyses en composantes principales qui ont montré l'importance des variables personnelles (genre, niveau de formation, niveau d'enseignement, discipline et statut) et l'incidence des variables sociales (pays, religion, niveau de croyance et de pratique religieuse) qui conduisent à des postions parfois très opposées sur l'enseignement et les contenus de l'éducation à la sexualité, sur l'égalité des sexes, sur les droits des personnes et sur la prévention. Certaines conceptions apparaissent comme des obstacles importants à la mise en place d'éducation à la sexualité et à la promotion de la santé. Les conceptions diffèrent significativement d'un pays à un autre mais également en fonction des convictions religieuses et du niveau de croyance des enseignants. Se pose alors la question des pratiques d'enseignement et de la formation des enseignants que nous discuterons.

One of the major objectives of the European FP6 BIOHEAD-CITIZEN project on “Biology Health and Environmental education for better citizenship” (STREP, CIT2-CT2004-506015, Carvalho et al. 2004) is to analyse the potential differences between countries by associating teachers’ and future teachers’ conceptions to controlled parameters, such as level of training, religion, political view and the broad socio-cultural context. A questionnaire was constructed with the participation of all Biohead-Citizen project research teams. The original English version was translated into each national language and after validation of the translation it was pre-tested before implementation in each country. A total of 6379 teachers and future teachers responded to the questionnaire. They were from 16 countries (of the 19 composing the Biohead-Citizen consortium) from Europe (West to East: Portugal, France, Italy, Malta, Germany, Poland, Hungary, Romania, Lithuania, Estonia, Finland, Cyprus), from Africa (West to East: Senegal, Morocco, Tunisia) and from the Middle East (Lebanon). Statistical multivariate methods to investigate complex data featuring the conceptions of many individuals were used. Results showed that the countries, rather than religion, have great effect on teachers and future teachers’ views conceptions on biomedical model or the health promotion approach. Furthermore primary school teachers (P), both in-service (InP) and pre-service (PreP), are more associated to the health promotion view than all the secondary school teachers: in-service Biology (InB), in-service Language (inL), pre-service Language (PreL) and pre-service Biology (PreB) teachers. Pre-teachers consider that health education should be taught at school, not only by the families, and that teachers should be obliged to teach even if they do not feel confident in doing it whereas teachers with teaching experience are more defensive in this respect, assuming exactly the opposite. In addition, the co-inertia analysis allows highlighting the correlations between differences in health education conceptions and the differences on political views., European Project FP6 “Biohead-Citizen” CIT2-CT-2004-506015, Fundação para a Ciência e a Tecnologia (FCT) - LIBEC/CIFPEC - unidade de investigação 16/644

Classically, health education has provided mainly factual knowledge about diseases and their prevention. This educational approach is within the so called Biomedical Model (BM). It is based on pathologic (Pa), curative (Cu) and preventive (Pr) conceptions of health. In contrast, the Health Promotion (HP) approach of health education intends to improve health by promoting healthy habits (He) and by developing empowerment (Ep) for a healthy decision-making with regard to environmental (Ev) challenges. The aim of the present study focused on a comparison of the emphasis on either model (BM or HP) as it is presented by textbooks from 16 countries. Each country team analysed the textbooks that are more frequently used at each educational level. Text and image analysis identified that some countries, such as France and Italy, as more associated with the Biomedical Model, whereas Germany, Mozambique and Finland were more linked to the Health Promotion approach. Data organised for four pupils’ age groups (6-9, 10-12, 13-15, 16-18 years old) showed that text and images of the same textbooks gave similar results in terms of following either the BM or HP model, and showed different indicators of consistency (Pa, Cu, Pr for BM; and He, Ep, Ev for HP). Furthermore, although the analyses might be, to a certain extent, subjective (depending on the researcher), it was shown to be very reliable, since all countries, whose textbooks were analysed for the 4 age groups or only the 3 age groups, showed a similar tendency of evolving from a HP (early ages) to a BM approach (elder ages). The interesting finding that the younger pupils’ textbooks were more associated with the Health Promotion pole, whereas the older pupils’ textbooks were consistent with the Biomedical Model pole seems to be a matter of further and deep investigation., LIBEC/CIFPEC - unidade de investigação 16/644 da FCT, European project FP6 Biohead-Citizen CIT2-CT-2004-506015, Projecto da FCT “Análise de manuais escolares” (PTDC/CED/65224/2006)

School is an important setting for health education and health promotion, and it has been recognised that teachers’ conceptions play a crucial role for the effective implementation of school health education. With the European FP6 Biohead-Citizen project on “Biology Health and Environmental education for better citizenship” we analysed the potential differences between several countries by associating teachers’ and future teachers’ conceptions to controlled parameters, such as level of training, religion, political view. A questionnaire was constructed during the first year of the project, and following a pilot test, the final questionnaire was applied to 6379 teachers and future teachers. We then used well-suited statistical multivariate methods to investigate complex data featuring the conceptions of many individuals, according to many topics. We show that a prominent source of variation in teachers’ conceptions is related to countries, and further suggest that there are differences in two kinds of conceptions: a) individual health responsibilities and abilities; b) social policies. Religion, academic level or training had also an impact in teachers’ conceptions of health education. Another important feature is the gap between what teachers and future teachers say about their own health and what they say it should be taught in school. Results are then discussed., LIBEC/CIFPEC - unidade de investigação 16/644 da FCT., European project FP6 Biohead-Citizen CIT2-CT-2004-506015.

International audience

International audience

Classically, Health Education has been based in the Biomedical Model (BM) of Health, where the pathologic, Curative and Preventive conceptions are its main pillars. The more recent approach of Health Promotion (HP) looks for identification of Healthy habits, develop empowerment for healthy decision-making towards environmental challenges. The aim of the present study was to compare the emphases on either model (BM or HP) given by textbooks on the topic of Health Education of 14 countries. Results showed that the countries with higher percentage of BM approach were France (99.2%), Malta (98.5%) and Italy (91.0%) whereas the countries showing more tendency for the HP approach were Germany (64.6%), Morocco (51.0%) and Finland (50.1%)., European project FP6 Biohead-Citizen CIT2-CT-2004-506015., Fundação para a Ciência e a Tecnologia (FCT) - LIBEC/CIFPEC - unidade de investigação (16/644).