SECTION 115.38. Health I (One-Half Credit), Adopted 2020

(a) General requirements. Students shall be awarded one-half credit for successful completion of this course. This course is recommended for students in Grades 9-12.

(b) Introduction.

(1) The goal of health education is to provide instruction that allows youth to develop and sustain health-promoting behaviors throughout their lives. The understanding and application of these standards will allow students the ability to gather, interpret, and understand health information; achieve health literacy; and adapt to the ever-evolving science of health. The health education knowledge and skills should be presented to students in a positive manner to support the development of a healthy self-concept and responsible decision making. The standards will help students reinforce, foster, and apply positive character traits.

(2) There are essential skills that repeat throughout six strands and embody the interconnection of health literacy. These skills include decision making, problem solving, goal setting, maintaining healthy relationships with self and others, seeking help and support, and recognizing various influences on health such as social, environmental, media, and genetic. These skills, developed early on and reinforced throughout a student's education, will foster mastery of health concepts. Health class educators are encouraged to partner with school counselors where available to schedule time for them to deliver classroom guidance lessons to help teach these essential competencies. In addition, areas in the standards related to abuse, neglect, violence, loss, grief, trauma, and suicide may directly affect some students in the classroom. Should the educator recognize signs of discomfort with instruction in these areas, students should be referred to the appropriate resource, identified ahead of such instruction, for additional help and support.

(3) Students will gain an understanding of health information and skills through six strands: physical health and hygiene; mental health and wellness; healthy eating and physical activity; injury and violence prevention and safety; alcohol, tobacco, and other drugs; and reproductive and sexual health.

(A) Physical health and hygiene education helps to prepare students for improved lifelong health outcomes. Learning about body systems lays the foundation for personal health and hygiene. Health literacy and preventative behaviors empowers students to make informed choices to support self, family, and community.

(B) The mental health and wellness strand recognizes that the knowledge and skills necessary to manage emotions, reactions, and relationships are essential to reaching one's full potential. Students gain knowledge about social and emotional health, including developing a healthy self-concept, understanding risk and protective factors, and identifying and managing mental health and wellness concerns. In the early grades, students develop fluency around emotions and self-regulation and understand the relationship between feelings, thoughts, and behavior. In subsequent grades, students learn and practice appropriate ways to solve interpersonal conflicts, work to develop a positive self-image, and develop healthy self-management skills.

(C) The healthy eating and physical activity strand addresses the importance of nutrition and physical activity to support a healthy lifestyle. Students apply critical-thinking and decision-making skills to make positive health choices. Students learn about essential nutrients, food groups, portion control, government nutritional recommendations, and the health benefits of being physically active. Students evaluate the connection between physical activity and nutrition and the prevention of chronic diseases.

(D) By focusing on injury and violence prevention and safety, the standards promote student well-being and awareness of dangerous situations. Supporting student well-being and providing instruction in digital citizenship, bullying prevention, first aid, and identification of safe and unsafe situations creates empowered and educated students who are able to make decisions that keep themselves and others safe. Beginning in Kindergarten and continuing through high school, students gain knowledge and skills to support safety and wellness at school, at home, online, and in the community.

(E) The standards under the alcohol, tobacco, and other drugs strand focus on a number of protective factors that develop empowered students who are able to make better-informed decisions, including understanding the impact of substance use on physical, mental, and social health. Through this strand, students learn key concepts about alcohol, tobacco, and other drugs, including the use, misuse, and physiological effects; short- and long-term impacts on health; treatment; risk and protective factors; and prevention. These concepts introduce healthy alternatives and ways for students to ask for and seek out help from parents and other trusted adults.

(F) In the reproductive and sexual health strand, students identify the characteristics of healthy and unhealthy relationships and learn to use communication and refusal skills to set personal boundaries and develop strategies for responding to sexual harassment and abuse. Students describe the changes associated with adolescent development and explain the process of fertilization, fetal development, and the importance of prenatal care. Students also learn that sexual abstinence until marriage is the only 100% effective means of avoiding unplanned pregnancies and sexually transmitted diseases/sexually transmitted infections (STDs/STIs) as well as the legal, financial, and social issues associated with sexual health and reproduction.

(4) An integral part of health education involves educators being aware of state laws relevant to human sexuality instruction. These laws include affirming:

(A) a local school district's control over the provision of human sexuality instruction to ensure that local community values are reflected in that instruction (Texas Education Code (TEC), §28.004(e)-(h));

(B) the right of a parent or legal guardian to be informed of the provision of human sexuality instruction to their child and review the content of that instruction (TEC, §28.004(i)-(j));

(C) the right of a parent or legal guardian to remove their child from any portion of human sexuality instruction without penalty to the child (TEC, §28.004(i));

(D) the centrality of abstinence education in any human sexuality curriculum (TEC, §28.004(e)); and

(E) the right of a parent or legal guardian to be informed of and consent to an abortion performed on their pregnant child (with judicially authorized or medical emergency exceptions) (Texas Family Code, Chapter 33).

(5) Educators also should be aware of and abide by the statutory prohibition on taxpayer resource transactions between state governmental entities, including public schools, and abortion providers or an affiliate of an abortion provider (Texas Government Code, Chapter 2272).

(6) Statements containing the word "including" reference content that must be mastered, while those containing the phrase "such as" are intended as possible illustrative examples.

(7) Students should first seek guidance in the area of health from a parent or legal guardian.

(c) Knowledge and skills.

(1) Physical health and hygiene--personal health and hygiene. The student understands health literacy, preventative health behaviors, and how to access and evaluate health care information to make informed decisions. The student is expected to:

(A) analyze health information based on health-related standards;

(B) develop and analyze strategies to prevent communicable and non-communicable diseases; and

(C) discuss the importance of early detection and warning signs that prompt individuals of all ages to seek health care.

(2) Mental health and wellness--social and emotional health. The student identifies and applies strategies to develop socio-emotional health, self-regulation, and healthy relationships. The student is expected to:

(A) discuss and demonstrate perspective-taking and ways to show respect for others' feelings and express empathy toward others; and

(B) analyze forms of communication such as passive, aggressive, or assertive and their impact on conflict resolution.

(3) Mental health and wellness--developing a healthy self-concept. The student develops the capacity for self-assessment and evaluation, goal setting, and decision making in order to develop a healthy self-concept. The student is expected to explain and demonstrate decision-making skills based on health information.

(4) Mental health and wellness--risk and protective factors. The student recognizes the influence of various factors influencing mental health and wellness. The student is expected to

analyze how adverse childhood experiences such as abuse, neglect, and trauma can influence brain development and how to recognize, process, and overcome negative events for overall mental health and wellness.

(5) Mental health and wellness--identifying and managing mental health and wellness concerns. The student develops and uses appropriate skills to identify and manage conditions related to mental health and wellness. The student is expected to:

(A) discuss the suicide risk and suicide protective factors identified by the Centers for Disease Control and Prevention (CDC) and the importance of telling a parent or another trusted adult if one observes the warning signs in self or others; and

(B) discuss how the use of suicide prevention resources such as the National Suicide Prevention Hotline reduces the likelihood of suicide.

(6) Healthy eating and physical activity--food and beverage daily recommendations. The student analyzes and applies healthy eating strategies for enhancing and maintaining personal health throughout the lifespan. The student is expected to:

(A) evaluate food labels and menus to determine the nutritional content and value of foods and make healthy decisions about daily caloric intake;

(B) compare and contrast the impact of healthy and unhealthy dietary practices; and

(C) describe how a personal dietary plan affects overall health and how a plan might differ over the lifespan.

(7) Healthy eating and physical activity--physical activity. The student identifies, analyzes, and applies strategies for enhancing and maintaining optimal personal physical fitness throughout the lifespan. The student is expected to:

(A) analyze the relationships between nutrition, physical activity, and quality of life as they relate to mental, physical, and social health benefits; and

(B) analyze the relationships between body composition, diet, and physical activity, including how to balance caloric intake and physical activity.

(8) Healthy eating and physical activity--risk and protective factors. The student analyzes and applies risk and protective factors related to healthy eating and physical activity. The student is expected to:

(A) evaluate the nutritional differences between preparing and serving fresh or minimally processed food versus serving commercially prepared or highly processed foods; and

(B) evaluate the connection between physical activity and dietary choices as they relate to the prevention of chronic conditions.

(9) Injury and violence prevention and safety--safety skills and unintentional injury. The student identifies and demonstrates safety and first aid knowledge to prevent and treat injuries. The student is expected to demonstrate basic first-aid procedures, including how to perform cardiopulmonary resuscitation (CPR) and choking rescue and how to use an automated external defibrillator (AED).

(10) Injury and violence prevention and safety--healthy home, school, and community climate. The student understands that individual actions and awareness can impact safety, community, and environment. The student is expected to:

(A) formulate strategies for avoiding violence, gangs, weapons, and human trafficking; and

(B) assess the dynamics of gang behaviors.

(11) Injury and violence prevention and safety--digital citizenship and media. The student understands how to be a safe and responsible citizen in digital and online environments. The student is expected to:

(A) develop strategies to resist inappropriate digital and online communication such as social media posts, sending and receiving photos, sexting, and pornography; and

(B) identify appropriate responses to situations in which digital and online safety are at risk, including identity protection and recognition of predators.

(12) Injury and violence prevention and safety--interpersonal violence. The student understands the impact of interpersonal violence and the importance of seeking guidance and help to maintain personal safety. The student is expected to:

(A) research and analyze how exposure to family violence can influence cyclical behavioral patterns;

(B) create a personal action plan, including identifying areas of support, for use when encountering bullying, cyberbullying, or harassment; and

(C) describe the ramifications of bullying behavior.

(13) Alcohol, tobacco, and other drugs--use, misuse, and physiological effects. The student understands the difference between use and misuse of different substances and how the use and misuse of substances impacts health. The student is expected to:

(A) examine examples of drug labels to determine the drug category and intended use;

(B) identify and describe the importance of the safe storage and proper disposal of prescription and over-the-counter drugs; and

(C) develop strategies for preventing the misuse of prescription and over-the-counter drugs, including recognizing the negative effects of combining drugs.

(14) Alcohol, tobacco, and other drugs--short- and long-term impacts. The student identifies and analyzes the short- and long-term impacts of the use and misuse of alcohol; tobacco; drugs, including prescription drugs; and other substances. The student is expected to describe the interrelatedness of alcohol and other drugs to health problems.

(15) Alcohol, tobacco, and other drugs--treatment. The student recognizes and understands the options for treatment and how to seek help related to the use and misuse of alcohol; tobacco; drugs, including prescription drugs; and other substances. The student is expected to:

(A) investigate and identify treatment options for substance abuse and addiction and misuse, including prescription drugs; and

(B) explain how to report suspected abuse of drugs to a parent, school administrator, teacher, or another trusted adult.

(16) Alcohol, tobacco, and other drugs--risk and protective factors. The student understands how various factors can influence decisions regarding substance use and the resources available for help. The student is expected to:

(A) compare and contrast physical and social influences on alcohol, tobacco, and other drug use behaviors;

(B) design materials for health advocacy such as promoting a substance-free life; and

(C) discuss ways to participate in school-related efforts to address health-risk behaviors.

(17) Alcohol, tobacco, and other drugs--prevention. The student analyzes information and applies critical-thinking skills to avoid substance use and misuse and recognizes the benefits of delayed use. The student is expected to:

(A) analyze the relationship between the use of refusal skills and the avoidance of alcohol, tobacco, and other drugs; and

(B) analyze the role that alcohol and other drugs play in unsafe situations, including sexual abuse and assault.

(18) Reproductive and sexual health--healthy relationships. The student understands the characteristics of healthy romantic relationships. The student is expected to:

(A) analyze how friendships provide a foundation for healthy dating/romantic relationships;

(B) identify character traits that promote healthy dating/romantic relationships and marriage; and

(C) describe how a healthy marriage can provide a supportive environment for the nurturing and development of children.

(19) Reproductive and sexual health--personal safety, limits, and boundaries. The student understands how to set and respect personal boundaries to reduce the risk of sexual harassment, sexual abuse, and sexual assault. The student is expected to:

(A) describe the characteristics of sex trafficking such as grooming, controlling behavior, exploitation, force, fraud, coercion, and violence;

(B) analyze the characteristics of harmful relationships that can lead to dating violence;

(C) analyze healthy strategies for preventing physical, sexual, and emotional abuse;

(D) analyze how a healthy sense of self and making and respecting decisions about safe boundaries and limits promote healthy dating/romantic relationships;

(E) explain and demonstrate how refusal strategies can be used to say "no" assertively to unhealthy behaviors in dating/romantic relationships;

(F) examine factors, including alcohol and other substances, that increase sexual risk and that affect setting, perceiving, respecting, and making decisions about boundaries;

(G) examine and discuss influences and pressures to become sexually active and why it is wrong to violate another person's boundaries and manipulate or threaten someone into sexual activity; and

(H) explain the importance of reporting to a parent or another trusted adult sexual harassment, sexual abuse, sexual assault, and dating violence involving self or others.

(20) Reproductive and sexual health--anatomy, puberty, reproduction, and pregnancy. The student analyzes adolescent development, the process of fertilization, and healthy fetal development. The student is expected to

analyze the importance of telling a parent or another trusted adult, obtaining early pregnancy testing, and seeking prenatal care if signs of pregnancy occur.

(21) Reproductive and sexual health--sexual risk. The student understands that there are risks associated with sexual activity and that abstinence from sexual activity is the only 100% effective method to avoid risks. The student is expected to:

(A) research and analyze the educational, financial, and social impacts of pregnancy on teen parents, the child, families, and society, including considering the effects on one's personal life goals;

(B) describe various modes of transmission of STDs/STIs;

(C) investigate and summarize the statistics on the prevalence of STDs/STIs among teens by referencing county, state, and/or federal data sources;

(D) describe signs and symptoms of STDs/STIs, including human papillomavirus (HPV), human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS), chlamydia, syphilis, gonorrhea, herpes, and trichomoniasis, and identify that not all STDs/STIs show symptoms;

(E) analyze the importance of STD/STI screening, testing, and early treatment for sexually active people, including during yearly physicals or if there is a concern;

(F) analyze emotional risks that can be associated with sexual activity for unmarried persons of school age, including stress, anxiety, and depression;

(G) analyze the importance and benefits of abstinence from sexual activity as it relates to emotional health and the prevention of pregnancy and STDs/STIs;

(H) identify support from parents and other trusted adults and create strategies, including building peer support, to be abstinent or for return to abstinence if sexually active;

(I) analyze the effectiveness and the risks and failure rates (human-use reality rates) of barrier protection and other contraceptive methods, including how they work to reduce the risk of STDs/STIs and pregnancy; and

(J) explain the legal responsibilities related to teen pregnancy, including child support and acknowledgement of paternity.

Source Note: The provisions of this §115.38 adopted to be effective August 1, 2022, 46 TexReg 2756