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A complementary ecological model of the coordinated school health program (CSHP) reflecting 20 years of evolved changes is proposed. Ecology refers to the complex interrelationship among intrapersonal factors, interpersonal processes and primary groups, institutional factors, community factors, and public policy. Public health and child development theories that incorporate the influence of personal and social environments on health behavior, along with models that incorporate the influence of ecology, were consulted. Concepts from several models were combined with the eight components of CSHP to formulate an ecological model involving six program and services components in an inner circle surrounded by four concentric rings representing the healthy school environment, essential structures of CSHP, local school district governance, and family and community involvement. This complementary ecological model is intended to serve as an additional conceptual approach to CSHP practice, evaluation, and research, and should prove especially useful to practitioners and researchers who already have a fundamental understanding of CSHP.

Background: This study evaluated the extent to which school districts in Massachusetts adopted HIV education policies consistent with state education agency recommendations, and whether adoption of state-recommended policy language was associated with other core components of school-based HIV prevention programs such as staff development, curriculum, and implementation characteristics., Methods: A census of health coordinators (n = 251) and high school HIV teachers (n = 174) in randomly selected schools in Massachusetts were surveyed. Chi-squares and analysis of variance (ANOVAs) were used to analyze data., Results: Most districts' policies fully incorporated state-recommended language for training HIV teachers (62%), providing HIV education within comprehensive sexuality education (62%), and providing skills-based instruction (57%). Districts adopting state-recommended policies were significantly more likely to have trained more HIV teachers (82% vs. 59% of teachers trained; P < 0.001), provided HIV education to a greater percentage of students (90% vs. 50% of students educated; P < 0.001), and adopted research-based curricula (44% vs. 27%; P < 0.01). High school teachers who received training and those using research-based curricula covered more HIV prevention topics and used more skills-based instructional methods than those who did not receive training or did not use research-based curricula (P < 0.01)., Conclusions: Results suggest that strong, state-level HIV prevention education policy recommendations can help shape local school health policy and, when adopted locally, can positively influence the reach and quality of HIV education.

This paper presents results from a process evaluation conducted by the New Jersey Department of Education (NJDOE). Representative samples of middle and high school superintendents, principals, lead health teachers, and HIV teachers provided information assessing whether local district policy content was consistent with the state's policy code, the dynamics of local policy development, and school district staff perceptions and practices regarding HIV education policies. NJDOE also was interested in determining: if inservice training was accessible to teachers assigned to provide HIV education; the scope and impact of HIV inservice programs; and the training needs of staff assigned to teach the HIV curriculum. Finally, NJDOE was interested in determining: local curricula scope, sequence, and approach; the extent to which local curricula were skills-based; and local expectations for instructional outcomes. As a result of the evaluation, program staff identified areas needing remediation and planned for program improvement in new areas.

Several documents have been published offering guidelines for implementing AIDS education. These documents generally cite the need for AIDS education, and identify issues and concerns inherent in planning AIDS education. Though such guidelines are beneficial in establishing the legitimate need for AIDS education, the information provided does not address the pragmatic issues involved in planning and implementing AIDS education at the local level. This article recommends approaches for addressing five pragmatic issues at the local level: formalizing an AIDS education policy, addressing concerns about morality, placement of AIDS instruction within comprehensive health education, formulation of a curriculum development model, and relating to the local news media.

This article describes the present status of health instruction--one of the original three components of the school health program--and suggests ways to improve its effectiveness as one of the eight components of a comprehensive school health promotion program. The article also demonstrates the complexity of the theory base, content, methodology, and outcome expectations of health instruction; a complexity that demands the subject be taught by teachers who are thoroughly prepared and committed to teaching health.

Colleges are beginning to use the Role Delineation Project Curriculum Framework for curricular reform at the graduate and undergraduate levels. This paper describes the efforts of three universities to revise their curricula based on the Framework. At Towson State University, it is being used with other national and state standards to assess health educators. At the University of Alabama at Birmingham, it provided the structure by which the faculty determined the competence of exiting health majors. At the University of Georgia, it was used in strategic planning and graduate education restructuring. The Framework, while lacking material in certain professional development areas, provides the structure for departments to begin the process of health education curricula reform.