Test Design and 
Test Framework

Field 211: Health Education

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The test design below describes general test information. The framework that follows is a detailed outline that explains the knowledge and skills that this test measures.

Test Design

Format	Computer-based test (CBT)
Number of Questions	100 multiple-choice questions
Time*	3 hours, 15 minutes
Passing Score	240

*Does not include 15-minute CBT tutorial

Test Framework

Subarea 1—Health Promotion and Risk Reduction

Objective 0001—Understand theories, principles, models, and processes of health promotion, disease prevention, and health education.

For example:

• Describe major theories and models of health behavior, health education, and learning (e.g., health belief theory; Whole School, Whole Community, Whole Child—WSCC model) and their influences on health promotion, risk reduction, and individual and community health.
• Demonstrate knowledge of major elements, principles, and processes of health promotion and disease prevention (e.g., functional health knowledge, health-related skills, wellness behaviors, health beliefs, group norms).
• Analyze physical, cognitive, social, emotional, and environmental health issues in relation to the youth risk behaviors defined by the Centers for Disease Control and Prevention (CDC).
• Apply knowledge of how to locate, analyze, and summarize social, cultural, environmental, behavioral, and other health-related data to identify, prioritize, and communicate health promotion and health education subjects.
• Analyze the need for and role of health promotion, disease prevention, and health education in society (e.g., reducing health-care costs, improving quality of life).
• Analyze the effects of social, cultural, and economic factors on the health of individuals, families, and communities, and how social and cultural forces influence public perception of health promotion and education.
• Apply knowledge of primary, secondary, and tertiary disease prevention concepts and practices.
• Identify predisposing, reinforcing, protective, and risk factors that influence behaviors and attitudes.
• Describe how public health policies function to prevent or contribute to illness and disease and impact public health and well-being.
• Utilize health promotion and health education practices that are consistent with health behavior and learning theories and models (e.g., theory of planned behavior, health belief model, social cognitive theory).

Objective 0002—Understand prevention, types, causes, effects, diagnosis, and treatment of infectious, noninfectious, and chronic diseases.

For example:

• Demonstrate knowledge of types, causes, modes of transmission, and signs and symptoms of infectious diseases.
• Demonstrate knowledge of types, causes, signs and symptoms, and characteristics of noninfectious and chronic diseases (e.g., cardiovascular disease, cancer, diabetes, arthritis).
• Analyze the role of environmental, demographic, socioeconomic, cultural, and behavioral factors in increasing or decreasing susceptibility to illness and disease.
• Distinguish between controllable and noncontrollable factors (e.g., diet, heredity, pollution) that influence development of diseases.
• Analyze behaviors, choices, and conditions that contribute to or help prevent disease (e.g., related to hygiene, stress management, lifestyle, and nutrition).
• Demonstrate knowledge of routine health-screening approaches for a variety of diseases and the importance of regular checkups and selfexaminations.
• Apply knowledge of principles, strategies, and behaviors for preventing, managing, and treating illness and disease.

Objective 0003—Understand the health consequences of alcohol, tobacco, and other drug use and strategies for reducing risks related to alcohol, tobacco, and other drug use.

For example:

• Analyze social, mental, physical, emotional, and environmental health issues as they apply to alcohol, tobacco, and other drug use.
• Distinguish among drug use, misuse, and abuse.
• Summarize classifications of drugs (e.g., stimulants, depressants, narcotics, hallucinogens) and their short- and long-term effects on health status and the functioning of body systems.
• Identify ways in which internal factors (e.g., depression, self-esteem, personal values) and external factors (e.g., media, family, peers) influence decisions related to alcohol, tobacco, and other drug use.
• Apply knowledge of skill-based, student-centered teaching and learning strategies (i.e., as illustrated within the National Health Education Standards) designed to prevent alcohol, tobacco, and other drug use.
• Demonstrate knowledge of how risky behaviors involving alcohol, tobacco, and other drugs increase the likelihood of engaging in other unhealthy behaviors.
• Analyze the health risks of alcohol, tobacco, and other drug use and the direct and indirect costs of such use to individuals, families, and society.

Objective 0004—Understand principles and strategies for promoting and maintaining mental and emotional health, including managing stress.

For example:

• Identify characteristics of positive mental and emotional health.
• Identify factors, conditions, and behaviors that influence mental and emotional well-being.
• Identify sources and signs of mental and emotional health disorders (e.g., mood, impulse, personality).
• Summarize short- and long-term effects of stress and mental and emotional health disorders.
• Demonstrate knowledge of strategies and resources for coping with mental and emotional health disorders.

Objective 0005—Understand interpersonal and family relationships, social support systems, and how to foster positive interpersonal communication to promote family and social health.

For example:

• Apply knowledge of interpersonal communication skills that enhance students' ability to communicate clearly and effectively about healthrelated needs and concerns.
• Identify effective verbal and nonverbal communication skills that promote healthy interpersonal and social relationships.
• Evaluate the effects of positive communication (e.g., I messages, active listening, assertive response) and negative communication on interpersonal, social, and family relationships.
• Recognize diverse structures of families, characteristics of healthy family relationships, and strategies for fostering positive communication and healthy relationships in families.
• Determine the characteristics and benefits of family and social support systems, strategies and skills for developing and maintaining friendships, and the importance of healthy, caring relationships for supporting individual well-being.
• Analyze positive and negative effects of group membership (e.g., necessity to conform to group norms, increased security, enhanced selfimage) and of not belonging to a group (e.g., alienation, individualism, nonconformity).
• Demonstrate knowledge of types, causes, and effects of peer pressure and ways in which assertiveness, negotiation, refusal, and other communication skills can be used to respond to peer pressure.
• Apply knowledge of how to design instructional strategies that enhance students' communication skills and ability to respond effectively to peer pressure.

Objective 0006—Understand principles of bullying prevention, conflict resolution, and violence prevention; and strategies for reducing health risks related to bullying, conflict, and violence.

For example:

• Analyze the types, sources, causes, and effects of bullying, conflict, and violence (e.g., intolerant attitudes, socioeconomic and cultural factors, social media, societal beliefs).
• Apply principles and procedures for avoiding risky situations and protecting oneself against violence and danger at home, at school, and in the community.
• Demonstrate knowledge of how to use self-management strategies (e.g., managing anger, identifying nonviolent strategies, using negotiation skills) to avoid and prevent conflicts.
• Apply steps, techniques, processes, and methods used in conflict management and resolution (e.g., role-playing, peer mediation).
• Recognize effective approaches, responses, strategies, policies, and resources for addressing bullying, including intimidation, exclusion, and aggression (e.g., social and emotional learning, using refusal skills, asking for assistance, reporting digital aggression).
• Apply knowledge of how to promote students' understanding of principles, policies, and techniques for resisting, avoiding, and protecting themselves against sexual harassment and assault (e.g., Erin's Law).
• Apply knowledge of how to design instructional strategies that enhance students' bullying prevention and conflict management and resolution skills.

 

Subarea 2—Physical Health

Objective 0007—Understand human body systems and physical, cognitive, social, emotional, and environmental health factors that affect health, growth, and human development.

For example:

• Demonstrate knowledge of the structures and functions of major body systems as they pertain to health, growth, and human development.
• Demonstrate knowledge of stages and characteristics of physical, social, emotional, and cognitive development and growth during childhood, adolescence, and young adulthood.
• Analyze ways in which physical, social, emotional, and cognitive processes, characteristics, and factors influence health during various developmental stages.
• Apply knowledge of ways in which various lifestyle behaviors and environmental factors (e.g., hygiene, exercise, sleep, nutrition, drug use, stressful living conditions) affect body systems and human growth and development.

 

Objective 0008—Understand nutritional principles and the role of nutrition in promoting and maintaining health.

For example:

• Recognize sources and functions of the essential nutrients (e.g., protein, vitamins, minerals).
• Apply principles of dietary guidelines in planning and making food choices (e.g., reducing intake of saturated fat and empty calories, identifying lowcost sources of nutrients).
• Analyze social, psychological, cultural, familial, and other factors that affect dietary habits and nutritional status (e.g., budget limitations, marketing strategies, media messages, nutrient needs, food allergies, food deserts).
• Demonstrate knowledge of the relationship between nutrition, health, and physical health status (e.g., deficiency diseases, weight management, positive body image).
• Interpret food labels and evaluate marketing descriptions and claims about food (e.g., low sodium, all natural, low fat, organic).

Objective 0009—Understand the role of health-related physical fitness in promoting and maintaining health.

For example:

• Identify types and characteristics of health-related physical fitness (e.g., strength, endurance, flexibility).
• Recognize the health benefits of maintaining a physically active lifestyle, including resources and activities necessary for lifelong participation in physical activity.
• Identify strategies for assessing individual fitness levels in order to achieve and maintain a desired level of physical fitness.
• Demonstrate knowledge of the short- and long-term effects of exercise on the body systems.
• Apply knowledge of safe procedures for physical activity.

Objective 0010—Understand sexual and reproductive health as well as concepts and principles for protecting sexual and reproductive health.

For example:

• Recognize the intellectual, social, emotional, and physiological changes that accompany the transition from childhood to adolescence.
• Demonstrate knowledge of human sexual development and human reproduction (e.g., conception, gestation, birth).
• Apply knowledge of responsibilities associated with dating and characteristics of healthy and unhealthy dating relationships.
• Demonstrate knowledge of factors that influence sexuality, gender, and gender identity.
• Analyze factors that influence decisions about sexual behavior (e.g., media messages, cultural norms, pressure), and strategies for making responsible decisions about sexual behavior.
• Apply strategies for distinguishing between reliable information and misinformation about human sexuality and sexual decision making.
• Recognize how to promote students' avoidance of sexual health risks, including counteracting pressure to be sexually active (e.g., setting limits, avoiding unsupervised gatherings where alcohol is present, using resistance and refusal skills).
• Demonstrate knowledge of the prevalence, types, characteristics, modes of transmission, and treatment of sexually transmitted infections (STIs).
• Recognize ways in which HIV is transmitted, effects of HIV on the immune system, current treatments for HIV, and differences between HIV and AIDS.
• Apply medically accurate and evidence-based strategies, methods, and resources for preventing and reducing the risk of STI and HIV infection and pregnancy.

Objective 0011—Understand principles, methods, and techniques for enhancing safety, preventing unintentional injuries, and providing care in medical emergency situations.

For example:

• Recognize safe and unsafe conditions that contribute to unintentional injury in the home, school, and community, as well as strategies for promoting safe environments and safe behaviors.
• Apply knowledge of principles, rules, and precautions related to traffic and pedestrian safety, fire prevention, poison prevention, water safety, and safety during recreation and play.
• Analyze behaviors and perceptions that contribute to unintentional injuries (e.g., alcohol use, fatigue, poor judgment), and strategies for reducing and preventing risk-taking behaviors.
• Recognize proper equipment for increasing safety and preventing injuries in various situations (e.g., life jackets, child car seats, bicycle helmets).
• Recognize procedures for responding to life-threatening respiratory and cardiac emergencies (e.g., CPR, clearing an airway obstruction, AED, Lauren's Law).
• Apply knowledge of basic first aid and emergency care procedures (e.g., first aid for shock, bleeding, burns, poisoning, and broken bones).
• Identify sources of help and procedures for obtaining assistance in an emergency or crisis.
• Recognize procedures to prepare for incidents caused by natural or manmade disasters (e.g., tornado, fire, lockdown).

 

Subarea 3—Health Literacy Skills

Objective 0012—Understand how to use risk-assessment, goal-setting, decision-making, and problem-solving skills to enhance personal, family, and community health.

For example:

• Identify characteristics, purposes, and functions of health riskassessment, goal-setting, decision-making, and problem-solving models and processes.
• Demonstrate knowledge of the relationship between risk factors and personal health, as well as methods and criteria for evaluating lifestyle behaviors and health risks.
• Demonstrate knowledge of strategies for increasing personal health literacy and reducing personal health risks.
• Apply knowledge of strategies, skills, and steps for developing realistic, measurable personal health goals and for maintaining and monitoring progress toward these goals.
• Apply knowledge of strategies for making, implementing, and evaluating health-related decisions to reduce risks and promote health.
• Analyze influences on health behaviors and use strategies to promote responsible decision making about personal, family, and community health.
• Apply knowledge of how to develop students' ability to consider shortand long-term consequences of lifestyle and health choices, goals, and decisions.
• Apply knowledge of how to promote students' use of critical-thinking and problem-solving skills to evaluate health-related issues, problems, and situations.
• Apply knowledge of how to design instructional strategies that enhance students' risk-assessment, goal-setting, decision-making, problemsolving, and critical-thinking skills.

Objective 0013—Understand the influence of social norms, family, culture, media, and technology on health, and strategies and skills for resisting unhealthy influences.

For example:

• Analyze how attitudes, perceptions, and behaviors are influenced by social norms and how accurate social norms and statistics promote positive health behaviors.
• Demonstrate knowledge of the evolving nature of family roles and responsibilities and ways in which families influence health behaviors.
• Demonstrate knowledge of sociocultural and economic factors that affect the health of individuals, families, communities, and societies (e.g., population density, poverty, cultural beliefs about health).
• Recognize the influences of scientific, engineering, and technological developments on personal, family, and community health (e.g., disease prevention, food production).
• Summarize the value of diversity for society and apply strategies for promoting respect and acceptance.
• Recognize how various types of media influence health-related beliefs, perceptions, attitudes, and behaviors (e.g., in relation to body image, violence, sexual behavior, and alcohol and other drug use).
• Demonstrate knowledge of ways in which advertisers and producers of media attempt to influence children and adolescents in relation to products, services, and consumer behavior.
• Recognize strategies and skills for resisting negative media messages related to health.
• Apply knowledge of how to design instructional strategies that enable students to evaluate the impact of social norms, family, culture, media, and technology on health.

Objective 0014—Understand the role of the health education teacher as a resource person and methods for obtaining, analyzing, and disseminating health-related information.

For example:

• Apply knowledge for researching, locating, accessing, and selecting health-related information, products, and services.
• Analyze the validity, reliability, credibility, and usefulness of health-related resources and information.
• Apply criteria and procedures for evaluating and selecting health-related products, services, providers, and technology.
• Recognize valid sources of health information available for faculty, staff, students, families, and community members and strategies for providing appropriate health resources to address a variety of issues (e.g., in relation to language and technology barriers).
• Apply knowledge of health-related agencies, programs, and technology tools and networks at the local, state, and national levels.
• Evaluate and select techniques for the dissemination of valid health information and services to a variety of audiences within the school community.
• Apply knowledge of how to design instructional strategies that enhance students' ability to locate, analyze, and select valid and reliable sources of health information and services.

Objective 0015—Understand health-related initiatives, agencies, issues, and trends and how to advocate effectively for personal, family, community, and environmental health.

For example:

• Demonstrate knowledge of the roles of local, state, and federal agencies in addressing health concerns and needs (e.g., public health regulations, immunization programs, crisis counseling, inspection and licensing regulations).
• Analyze the effects of policies and laws on the health of individuals, families, and communities (e.g., restrictions on tobacco use, workplace safety requirements, initiatives for drunk driving, Healthy People initiative).
• Demonstrate knowledge of individual rights and responsibilities related to health care, including methods for creating and maintaining an active partnership with health-care providers.
• Recognize the influence of environmental factors (e.g., hazardous wastes, air pollution, water pollution) on personal, family, and community health.
• Analyze strategies for reducing or coping with health risks due to environmental factors (e.g., radon testing, asbestos and lead paint testing and removal).
• Demonstrate knowledge of how individual and community actions and policies affect the health and well-being of communities and environments.
• Apply knowledge of strategies for developing students' ability to enlist and support peers, families, and the school community in making positive health choices.
• Apply strategies for using media to promote and advocate for personal, family, and community health.
• Apply knowledge of how to design instructional strategies that develop students' ability to advocate for personal, family, and community health.

 

Subarea 4—Health Education

Objective 0016—Understand principles and procedures for planning, implementing, and evaluating a school health education program.

For example:

• Demonstrate knowledge of historical foundations, philosophies, models, goals, and best practices associated with comprehensive school health education programs.
• Recognize the structure, components, and benefits of an effective school health program that is based on the Centers for Disease Control and Prevention's (CDC's) expanded coordinated school approach and ASCD's Whole School, Whole Community, Whole Child (WSCC) model and whole child framework.
• Demonstrate knowledge of principles and procedures for conducting a needs assessment to plan an effective health education program.
• Apply knowledge of how to locate, gather, and use data related to district, state, or national level morbidity, mortality, and behavioral risk factors to determine health education program goals and priorities.
• Analyze and interpret needs assessment and other health-related data to determine priority areas for health education.
• Recognize factors that affect the health education curriculum (e.g., legislation, local community standards and needs, culturally diverse health practices).
• Demonstrate knowledge of the efficacy of various curricular models pertaining to key content health education areas and risk factors identified by the Centers for Disease Control and Prevention (CDC).
• Identify how to design a logical scope and sequence for a meaningful and comprehensive health education program.
• Recognize basic financial and budgeting issues related to implementing a comprehensive school health education program.
• Apply knowledge of strategies and methods for evaluating the overall health education program and for measuring effectiveness of health education instruction.
• Apply knowledge of how to design and select appropriate program evaluation assessments, including valid and reliable tests, survey instruments, and evaluation methods.
• Interpret results of a health education program evaluation.
• Describe how to use program evaluation results to determine and suggest improvements for the health education program.

Objective 0017—Understand instructional and assessment strategies that adhere to best practices as well as state, national, and professional standards, and that facilitate student skill development and application of functional health knowledge.

For example:

• Apply knowledge of how to plan and design instruction that facilitates skill development and application of accurate health-related knowledge.
• Apply knowledge of how to construct, select, and align appropriate and measurable cognitive, affective, behavioral, and performance-based objectives for health education instruction.
• Recognize approaches and strategies for incorporating technology, media, and other resources into health education instruction to engage and motivate students.
• Demonstrate knowledge of developmentally appropriate and supportive instructional strategies for addressing the assets, needs, concerns, and interests of all students as well as how to implement these strategies effectively.
• Describe a wide range of teaching and classroom management strategies that help promote positive personal and social behaviors within a safe, productive, and inclusive learning environment.
• Apply knowledge of how to analyze learning outcomes, assessment evidence, and learning activities to modify instruction and assessment to enhance student learning.
• Demonstrate knowledge of a variety of valid, reliable, formative, summative, and authentic assessment tools and techniques for measuring students' functional health knowledge and essential healthrelated skills and for providing feedback to students and families.
• Analyze health education assessment strategies and tools to determine their appropriateness for measuring students' performance and achievement and enhancing student learning.

Objective 0018—Understand the process of reading, and apply knowledge of strategies for promoting students' literacy development in the health education classroom.

For example:

• Demonstrate knowledge of the reading process (e.g., the construction of meaning through interactions between a reader's prior knowledge, information in the text, and the purpose of the reading situation), and apply knowledge of strategies for integrating literacy skills into health education instruction (e.g., providing purposeful opportunities for students to read, write about, and discuss health-related content to improve understanding).
• Apply knowledge of strategies that promote reading in the health education classroom (e.g., assembling a classroom resource library; encouraging students' independent reading, research, and inquiry related to health).
• Demonstrate knowledge of the role of vocabulary knowledge in supporting students' reading comprehension and concept development, and apply knowledge of strategies for promoting students' disciplinespecific vocabulary development (e.g., academic language).
• Apply knowledge of strategies for preparing students to read text effectively and for teaching and modeling the use of comprehension strategies before, during, and after reading, including strategies that promote close reading (e.g., breaking down complex sentences, monitoring for comprehension to correct confusions and misunderstandings that arise during reading).
• Apply knowledge of strategies for developing students' ability to comprehend and critically analyze discipline-specific texts, including recognizing organizational patterns unique to informational texts; using graphic organizers as an aid for analyzing and recalling information from texts; analyzing and summarizing an author's argument, claims, evidence, and point of view; evaluating the credibility of sources; and synthesizing multiple sources of information presented in different media or formats.
• Apply knowledge of strategies for evaluating, selecting, modifying, and designing reading materials appropriate to the health education activity and students' reading abilities (e.g., analyzing instructional materials in terms of readability, content, length, format, and images).
• Apply knowledge of strategies for providing continuous monitoring of students' reading progress through observations, work samples, and various informal assessments and for differentiating health education instruction to address all students' assessed reading needs.

Objective 0019—Understand professional and ethical issues in health education, including processes and skills for communicating and collaborating effectively within the school community.

For example:

• Identify the importance of adhering to school policies and professional standards when working with students, staff, administration, faculty, and community members.
• Apply knowledge of principles and processes for communicating effectively with diverse audiences about health and health education needs, concerns, standards, goals, services, and resources.
• Apply knowledge of principles and processes for collaborating effectively with students, families, faculty, administrators, community members, and stakeholders to support students and enhance school health programs.
• Demonstrate knowledge of the parameters of effective consultative relationships with educational, community, and outside agency personnel.
• Recognize the importance of district, state, and national health education guidelines and standards.
• Apply knowledge of ethical behavior and teaching practice as defined by the Health Education Code of Ethics.
• Recognize the importance of reflecting on the multiple roles of a health education teacher and engaging in ongoing, meaningful professional development and learning opportunities in the field.
• Identify career paths and opportunities in health promotion and education-related fields, and how to promote students' knowledge of prerequisites, skills, and resources for career development.
• Apply knowledge and skills for professionally advocating for health education as a critical component of the school community that supports the needs of students and contributes to a school's mission.

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