Include in health and safety curricula functional knowledge that is critical to the topic, is scientifically accurate, and is associated with the acquisition of related skills.

One characteristic of health and safety curricula that generates positive behavior change is that "functional knowledge" (i.e., basic facts students need to make behaviorally relevant decisions) is taught. Determining functional knowledge in each selected content area (versus whatever interests the teacher or curious students or appears on a test) allows the most effective use of available instructional time. Even though knowledge is necessary, it is not sufficient for changing or maintaining healthy and safe behaviors. Other characteristics of effective curricula are skills development and social influences (Guidelines 2-07, 2-08).

In many situations, functional knowledge crosses a number of content areas. For example, teaching about the relationship between drug use and sexual activity uses instructional content from substance abuse prevention, human growth, development and sexuality, disease prevention, and emotional/mental health. Education related to providing first aid and cardiopulmonary resuscitation (CPR) draws from content areas of community safety and personal health. Sports nutrition programs that teach the effects of using performance-enhancing or weight-controlling pharmacologic and nutritional supplements draw from content areas such as substance abuse and information related to nutrition, hydration, physical activity, disease prevention, and mental health. A focus on tobacco use draws from content areas of consumer and environmental health, physical activity, oral health, addiction, personal appearance, development of heart and lung disease, and development of a variety of cancers.

Examples of content areas and of functional knowledge associated with the content areas are:

• Tobacco, alcohol, and other drug use prevention: Long-term and short-term negative physiologic and social consequences of use, and social influences on use.
• Growth, development, sexuality, and family life: Bio-psychosocial sexual development (e.g., reproductive cycle); abstinence as the only 100 percent effective way to avoid unwanted pregnancy, human immunodeficiency virus (HIV), and other sexually transmitted diseases; contraception; and parenting.
• Personal and oral health: Hand washing, proper tooth brushing, flossing and diet.
• Injury prevention and safety: Recognizing emergencies; rendering first aid such as cardiopulmonary resuscitation and other emergency lifesaving skills; proper use of protective gear (e.g., seat belts, helmets, wrist pads, guards for mouth and face); smoke and carbon monoxide alarms; rules for motor vehicle, pedestrian, and cycle safety; safe storage, handling, and avoidance of weapons; work-related safety principles (e.g., agriculture, food services); using proper lifting technique by teaching about the handling of heavy backpacks.
• Violence prevention: Healthy relationships, conflict resolution, empathy, impulse control, expressions and control of anger.
• Nutrition and physical activity: Healthful food choices, recommended serving sizes, exercise.

Centers for Disease Control and Prevention. Guidelines for school health programs to promote lifelong healthy eating. MMWR Morb Mortal Wkly Rep. 1996;45(RR-9):1-41.

Centers for Disease Control and Prevention. Guidelines for Effective School Health Education to Prevent the Spread of AIDS. MMWR 1988; 37(S-2): 1-14.

Centers for Disease Control and Prevention. Guidelines for school and community programs to promote lifelong physical activity among young people. MMWR Recomm Rep. 1997;46(RR-6):1-36.

Centers for Disease Control and Prevention. Guidelines for school health programs to prevent tobacco use and addiction. MMWR Recomm Rep. 1994;43(No. RR-2):1-18.

Centers for Disease Control and Prevention. School health guidelines to prevent unintentional injuries and violence. MMWR Recomm Rep. 2001;50(RR-22):1-73.

Children's Safety Network. Protecting Working Teens: A Public Health Resource Guide. Newton, MA: Children's Safety Network; 1995.

Cortese P, Middleton K (Eds). The Comprehensive School Health Challenge: Promoting Health Through Education (Volume One). Santa Cruz, CA: ETR Associates; 1994.

Kirby D, Short L, Collins J, et al. School-based programs to reduce sexual risk behaviors: a review of effectiveness. Public Health Rep. 1994;109:339-360.

Massachusetts Department of Public Health. Teens at Work: Injury Surveillance and Intervention Project, Occupational Health Surveillance Program; 2000. Available at: http://www.state.ma.us/dph/bhsre/ohsp/ohsp.htm.

National Children's Center for Rural and Agricultural Health and Safety. Creating Safe Play Areas on Farms. Marshfield WI: Marshfield Clinic 2003. Available at: http://research.marshfieldclinic.org/children/safeplay.pdf.

National Research Council and Institute of Medicine, Committee on the Health and Safety Implications of Child Labor. Protecting Youth at Work: Health, Safety, and Development of Working Children and Adolescents in the United States. Washington, DC: National Academy Press; 1998.

Neutens JJ, Drolet JC, DaShaw M, Jubb W (eds). Sexuality Education Within Comprehensive School Health Education (2nd edition). Kent, OH: American School Health Association; 2003.

Posner M. Preventing School Injuries: A Comprehensive Guide for School Administrators, Teachers, and Staff. New Brunswick, NJ: Rutgers University Press; 2000.