Health Education Teaching Ideas: Secondary

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AUTHOR Loyal Richard, Ed.; Hensley, Loren B., Jr., Ed. TITLE Health Education Teaching Ideas: Secondary. Revised Edition. INSTITUTION American Alliance for Health, Physical Education, Recreation and Dance. Reston, VA. Association for the Advancement of Health Education. REPORT NO ISBN-0-88314-529-4 PUB DATE 92 NOTE 304p. AVAILABLE FROMAmerican Alliance for Health, Physical Education, Recreation and Dance. 1900 Association Drive, Reston, VA 22091. PUB TYPE Collected Works - General (020) -- Guides - Classroom Use - Teaching Guides (For Teacher) (052)

EDRS PRICE MF01 Plus Postage. PC Not Available from EDRS. DESCRIPTORS *Class Activities; Curriculum Enrichment; *EducClional Games; *Health Education; Lesson Plans; Secondary Education; Substance Abuse; Teaching Guides; *Teaching Methods

ABSTRACT Part I of this teaching guide contains teaching strategies which originally appeared in the "Journal of Health nucation" (JHE) and were included in the first edition of this guide, published in 1983. Part II includes teaching strategies published in JHE since 1983. The guide is designed to be a reference for those seeking workable ideas in teaching and delivering health education programs to junior and senior high school students. However, the material can be adapted for middle school through college level. Within each part, articles focus on two major areas: process and content. Examples of process-focused articles are: "Health Games"; "Health Science Fairs"; "The Writing Process in Health Class"; "Teaching about Authoring Systems: Instructional Design Tools for Health Education"; and "Using College Students as Senior Peer Teachers in Youth-to-Youth Health Education." EXamples of content-focuzed articles are: "Once upon a Synapse: A Drag Education Simulation in Three Acts"; "Teaching Abstinence to Today's Teens"; "Te ching the Four Cs of First Aid"; "Student-to-Student Teaching abaAt Tobacco Smoking"; and "Coping with Violence." (IAB)

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In N TA t, INCLUDING 69 NEW TEACHING IDEAS

U S DEPARTMENT OF EDUCATION "PERMISSION TO REPROCUCE THIS ONIce of Educational Research and Improvement MATERIAL IN MICROFICHE ONLY EDUCATIONAL RESOURCES INFORMATION HAS BEEN GRANTa) BY CENTER (ERIC) C Tnia document nos been reproduced as CI\ retelved from the person or organization tr\ originating It C MinOr changes have been mad. to improve reproduchon Quality 4114PeRp BEST COPY MAILZLE k Points of view or OPoll0+4 $11110 in INS dOCu TO THE EDUCATIO RESOURCES merit do not necessarily represent official OERI position or policy INFORMATION CENTER (ERIC1." Purposes of the American Alliance for Health, Physical Education, Recreation and Dance

The American Alliance is an educational organization, structured for the purposes of supporting, encouraging, and providing assistance to member groups and their personnel throughout the nation as they seek to initiate, develop, and conduct programs in health, leisure, and movement-related activities for the enrichment of human life.

Alliance objectives include:

1. Professional growth and development--to support, encourage, and provide guidance in the developmen and conduct of programs in health, leisure, and movement-related activities which are based on the needs, interests, and inherent capacities of the individual in today's society.

2. Communication--to facilitate public and professional understanding and appreciation of the importance and value of health, leisure, and movement-related activities as they contribute toward human we'll-being.

3. Research--to encourage and facilitate research which will enrich the depth and scope of health, leisure, and movement-related activities; and to disseminate the findings ..o the profession and other interested and concerned publics.

4. Standards and guidelines--to further the continuous development and evaluation of standards within the profession for personnel and programs in health, leisure, and movement-related activities.

5. Public affairs--to coordinate and administer a planned program of professional, public, and governmental relations that will improve education in areas of health. leisure, and movement-related activities.

6. To conduct such other acti vities as shall be approved by the Board of Governors and the Alliance Assembly provided that the Allianre shall not engage in any activity which would be inconsistent with the status of an educational and charitable organization as defined in Section 501(c)(3) of the Internal Revenue Code of 1954 or any successor provision thereto, and none of the said purposes shall at any time be deemed or construed to be purposes other than the public benefit purposes and objectives consistent with such educational and charitable status. Bylaws, Article 111 Health Education Teaching Ideas: SECONDARY Revised Edition

Part I, Richard Loya, Editor

Part II, Lorer B. Bens ley, Jr., Editor

Sponsored by the Association for the Advancement of Health Education

an association of the

Ameri :an Alliance for Health, F hysical Education, Recreation and Dance

ISBN 0-88314-529-4 CON3 'NTS PART I

Foreword to Part I, Kathleen Middleton Focus on Process

1 Stress on Reading, Elaine Ha ls 1 2 Affective Evaluation Techniques in School Health Education, Mary S. Sutherland 2 3 Five Cures for Dull Health Curriculums, Loren B. Bens ley, Jr. 5 4 Vary Your Teaching Methods, Glen G. Gilbert 7 5 Films for Effective Affective Teaching, James R. Mullen 9 6 Effective Teaching: Variety in the Classroom, Mary Sutherland and William Hemmer 10 7 Health Science Fairs, Henry A. Lasch 14 8 The Open ContractA Program of Individualized Study, B.E. Pruitt 16 9 The Many Faces of Role Playing, Lynn Teper-Singer 18 10 Extra Credit--Make It Meaningful, George F. Carter 20 11 Promoting Fxperiential Learning, Michael Hamrick and Carolyn Stone 21 12 The Hospital as Motivatoi for Health Learning, Saul Ross 25 13 Field Trips, James H. Price 27 14 Health Games 28 iris) Health Games, Simulations, and Activities, David E. Corbin and David A. Sleet 29 16 Learning Games 31 17 Horse Racing in the Classroom, Phillip Hossler 33 18 Fantasy Games, Ratph Bates 34 19 Choices, Lynn Teper-Singer 35 20 Constructing an Educational Game, Sally L. Easierbrook 36 21 Health 4 Fun: A Game of Knowledge, Raymond Nakamura 37 22 School Health Bee, Bernard S. Krasnoui 38 23 Not Merely Nostalgia, Ralph Edwardf, 39 24 Health in Concert, Clay Williams and Judy Scheer 40 25 Tuning in to Health Education, Warren L. Mc Nab 41 26 Ideas for Successful Health Teaching, Loren B. Bens ley, Jr. 42 27 The Student Interview Technique, Marc E. Meyer 44 28 Positive Peer Influence: School-Based Prevention, Aida K. Davis, Joan M. Weener, and Robert E. Shute 45 29 Ernie, Lillian D. Fesperman 49 Focus on Content

Addictive Behaviors

30 Empathizing with Addicts, Peter Finn 53 31 How Much Can I Drink? H. Richard Travis 55 32 Senator Hogwash, Michael Young 58 33 Student-to-Student Teaching About Tobacco Smoking,Lorraine J. Henke 57 34 The Smoking Game, Ian Newman 59 35 Making Tobacco Education Relevant to the School-AgeChild, John R. Seffrin 63 36 4\ Humanistic-Individualized Approach toDrug Education, Jerry L. G-eene and Phillip G. Huntsinger 68 37 Drug Use Situations, Bruce A. Uhrich 69 38 Chemically Dependent--But Only for One Week,Kathleen Fischer 70 39 Learning by Teaching, Elaine Ha Is 72

Aging

40 Aging: A Need for Sensitivity.. Kenneth A. Briggs 73 41 Picnic in the Park: Humanizing an Aging Unit in a PersonalHealth Class. Michael J. Gaeta 75

Consumer Health

42 Health Anagrams, Kathleen M. Siegwarth 78 43 Consumer Wellness, One School's Approach, Jon W. Hisgen 79 44 A Healthy Consumer Health Class, Tom McFarlandand Ann Rudrauff 81 45 The Teenage Consumer, Lee Ann Larson 82 46 Crisis Hot Line Experience, Aloysius J. Jangl 84 47 Health Help Phone Numbers, Richard C. Hohn 86 48 Students Can Have a Say, Joan L. Bergy and Barney Hantunen 87 Death ane hung

49 A Unit for Independent Study in Death Education,Joan D. McMahon 89 50 Put a Little Life in Your Death, Charles R. O'Brien 94 51 Death Education: An Integral Part of SchoolHealth Education, Darrel Lang 95 52 A Teaching Strategy on I ragedy, Connie JoDobbelaere 97

Environmental Health

53 Health or Hazard? A Post-China SyndromeGame, Moon S. Chen, Jr. 99 54 Nuclear Power Debate, Bruce G. Morton 100

7 55 Health and Safety Education from the Trash Can, J. Clay Williams and Judith K. Scheer 101 56 Ecology Games, Ronald W. Hyatt 103 57 Guidelines for a Recycling Project, George H. Brooks 105

Family Life

58 Easy Ways of Getting into Trouble When Teaching Sex Education, Glen G. Gilbert 107 59 Three Teaching Strategies, Florence J. Snarski and Cecilia A. Lynch 109 60 The Implementation of Contraceptive Education, Warren L. McNab 111 61 Pregnancy--A Gaming Technique, Edward T. Turner 112 62 Contraception-Abortion Lifeline, Glenn E. Richardson 114 63 Teaching Students About Their Future Role as Parents, Jan Young 115 64 Ask the Students Themselves, A. Gordon Bennett 117 65 Test Tube Considerations, Deborah A. Dunn 118 66 Selected Impacts of Contraception on Man and/or Society, Patrick Kidd Tow 119

Mental Health

70 On the Level, Gus T. Dalis 126 71 Perceptions of Me, Jerrold S. Greenberg 129 72 Enhancing Positive Self-Concept Through Creativity in the Classroom, Barbara Beier 131 73 Ideas from a Class in Interpersonal Relations, Caroll Kaiser 132 74 Role Playing as a Tool in Mental Health Education, Lynn Teper 134 75 The Mirror Game, Rosa Sullivan 136 76 How to Cope with Stress in the Classroom, Charles C. Davis 137 77 Coping with Violence, Elaine Hals 139 78 Personality Spokes, Rosa Sullivan 140 79 About Yourself, Ruth C. Engs 141 80 A Lesson on Stress, Janet H. Shirreffs 142 81 Mental Health Auctioning Strategy, Patrick Kidd Tow 144 82 People Labeling Strategy, Patrick K. Tow and Hal Wingard 145

Nutrition

83 Creative Food Labels: Consumer Health Education, Moon S. Chen, Jr. 146 84 Sensible Dieting, Marilyn Mudgett and Dorothy Culjat 147

pi PART II

Foreword to Part II, Loren B. Bens ley 150 Focus on Process

85 The Writing Process in Health Class, Vicki Steinberg and Teresa M. Fry 153 86 Logo-Mania: Creative Health Art, Frank Calsbeek 155 87 Overcoming Xenophobia: Learning To Accept Differences, Judith A. Baker 157 88 Factors Important in Teaching Controversial Issues, Ansa Ojanlavnn 159 89 Teaching Ai)out Authoring Systems: Instructional Design Tools for Health Education, Paul D. Sarvela and Marilyn J. Karaffa 161 90 Tic-Tac-Toe, Mary Lawler 163 91 Picture Charades: A Health Teaching Device, Richard T. Mackey 165 92 Drawing Interpretations of Health, Vicki L. Cleaver 166 93 Ur .ng Team Games to Teach Health, Mark A. Croson and Rose Ann Benson 167 94 The Concept of Health and Techniques of Conceptual Analysis, Joseph E. Balog 169 95 The Town Council Meeting: Decision Making Through a Large Group Role Play, James D. Brown 172 96 The Health Reporter Pool, David Wiley 173 97 Health Education Supermarket, Mary S. Sutherland 174 98 Health Education to the Third Power (Cubed?), Susan Cross Lipnickey 175 99 Junior High School Students as Facilitators of Elementary School Health Education Carnivals, David K. Hosick and Parris R. Watts 177 100Thinking and Writing: A Strategy for Teaching Positive Health Decision Making, Paul Villas 180 101 Personal Health Via Community Health, Linda Olasov 181 102Using College Students as Senior Peer Teachers in Youth-to-Youth Health Education, Anthony G. Adcock 183 103Judgments Required from the Residency Coordinator, William N. Washington 185 104 A Community Resource Class Assignment, Ansa Ojanlatva 188 105Evaluating Health News, Michele J. Hawkins 190 106The Classics of Epidemiology: A Critical Thinking Approach, Wesley E. Hawkins 192 107Discipline: A Parenting Dilemma, Patrick K. Tow and Warren L. Mc Nab 194 108Counterbalancing Parental Concerns in Health Education, Lorraine G. Davis and Shirley Holder Hazlett 197 109Incorporating Health Education Competencies into a Content Course: The Disease Guidebook Project, Joanna Hayden 199 110Politics and Health, Randall R. Cottrell 201 Focus on Content

Addiction

111 Inoculating Students Against Using Smokeless Tobacco, Melody Powers Noland and Richard S. Riggs 205 112The 12 Puffs of Christmas, Warren Mc Nab 208 113Drive-A-Teen--A Program to Prevent Drinking & Driving, Susan Willey Spa lt209 114Analyzing Cigarette Smoke, David M. White and Linda H. Rudisill 211 115Promoting a Natural High, Catherine J. Paskert 213 116Alcoholics Anonymous: The Utilization of Social Experience in the Classroom, Robert G Yasko 215 117"Can a Bike Run on Beer," Melvin H. Ezell, Jr. 217 118Once Upon a Synapse: A Drug Education Simulation in Three Acts, William M. London 219 119Investigating the Social Aspects of Alcohol Use, Tom V. Savage 222 1.7.(:; Drug Use, Misuse and Abuse as Presented in Movies, Kerry J. Redican, Barbara L. Redican, and Charles R. Baffi 224 121 Learning About Alcohol Drinking Attitudes and Motivations by Examining the Vocabulary of Drunkenness, William M. London 226

Aging

122Helping College Students Understand the Older Adult, Margaret J. Pope 228 123As Old as Trees, Glenn E. Richardson and Susan Bicknell 229

Chronic Diseases

124Digging for Healthy Hearts: A Simulated Archaeological Dig for the Prevention of Cardiovascular Disease; Wesley E. Hawkins 230 125Cancer: A Mini-Documentary, Stephen C. Corey 233

Consumer Health

126Consumer Health: Medical Quackery, Carolyn E. Cooper 235

Enviromnental Health

127Environmental Health Simulations: Island City and Production, Glenn E. Richardson, Alan Burns, and Janet Falcone 237

Family Life Education

128Reducing Anxiety About Teaching a Human Sexuality Program, Louise Row ling 239

1 0 129Are You Ready for Prime Time Birth Control? Pamela Wild and Linda Berne 240 130"Hey! How Did That Baby Live in That Test Tube?" David A. Birch 242 131 Actions Teach Better Than Words: Teen Life Theater and Role Play in Sex Education, Peggy Brick 243 132Abortion Attitude Scale, Linda A. Sloan 247 133Marriage Yesterday and Today, Margaret J. Pope 249 134Teaching Abstinence to Today's Teens, Dee Gibbs Smalley 250 135Group Discussion on Contraceptive Issues, Barbara A. Rienzo 252 136Developing and Rejuvenating Relationships, Jane W. Lammers 254 137Courtesies and Rights Within Relationships, Bethann Cinelli and Robert Nye 256

First Aid and Safety

138 CPR Drilling Revisited, Mark J. Kittleson 258 139The Improvised ManikinHomemade CPR Equipment, Mardie E. Burckes 260 140Teaching the Four Cs of First Aid, Mark J. Kittleson 264 141 Mock Disaster: An Effective Lesson in Preparation for the Real Thing, Gary M. English and Cathie G. Stivers 263 142The Importance of Child Safety Seat Education, Karen D. Li ller 266

HIV-AIDS

143AIDS "To Tell the Truth" Gaming Activity, Jon W. Hisgen 268 144AIDS/HIV Teaching Ideas, Barbara Beier, J. Leslie Oganowski, Richard A. Detert, and Kenneth Becker 271

Mental and Emotional Health

145Stress Manifestations Among Adolescents, Charles Regin 274 146An Introductory Activity for Adolescent Communication and Intimacy, G. Greg Wojtowicz 276 147Show and Tell: Developing an Appreciation of Diversity, Kathryn Rolland 279 148Teaching Self-Awareness Through Idiosyncrasies, Patrick K. Tow, Beverly Johnson, and Patricia N. Smith 280

Nutrition

149Can You Name These Foods? Eileen L. Daniel 282 150"Digesting" Health Information, Richard A. Crosby 283 151 Nutrition Is the Name of the Game, Paula R. Zaccone 284

Personal Health

152Sun Smart: A Peer-Led Lesson on the Effects of Tanning and Sunning on the Skin, Mary Elesha-Adams and David M. White 288 153 A Quick and Easy Check for Foot Problems, Dianne Boswell O'Brien 290 PART I Foreword

Where is health taught at the secondary level? In the elementary school it is usually taught by the elementary teacher along with twenty or so other subjects. In the junior and senior high schools it can be found in many places: health classes; science classes; family living classes; social science classes; home economics classes; and drivers' education classes. In the school district where I taught, it was found in one high school in a class entitled "State Requirements." This unique class included all the "loose end" topics that were required by the State of California to be covered before high school graduation. Wherever health is taught in the schools, the ultimate success with students is not determined by the title of the class or placement within the curriculum. It is largely dependent upon the quality of the teaching. Health can be the most exciting, interesting, and meaningful class in the high school curriculum. Dedicated, energetic, caring teachers do make a difference. Teented teachers can motivate and positively affect the lives of the most gifted students as well as the ones with special problems. This book, Health Education Teaching Ideas: Secondary, is for those teachers. It includes innovative teaching strategies that are practical and appropriate in the secondary classroom. The original articles appeared in the "Teaching Ideas" column of Health Education and were compiled by a high school health teacher. This book should be a useful and exciting addition to the library of any instructor responsible for health education at the junior and senior high school levels.

Kathleen Middleton, Director School Health Programs National Ce-ter for Health Education id Contributing Editor to "Teaching Ideas" column of Health Education FocusonProcess

1 4 1 TEACHNG IDEAS

1. Help stude, to explore new and You find that you have venereal Stress on Reading controversial health issues by having diseaseyour boy or girl friend may them read and evaluate current news- have it, too-- what do you do? Do the terminally ill have the right to paper and magazine articles on various know they are dying? ELAINE HALS is a teacherofhealth edu- subjectslaetrile, cloning, test tube You know something that could get cation at South Shore High School, Brook- babies, food additives, new drugs, dis- your best friend in trouble. You feel what lyn, New York 11236. ease cures. this person did was wrong. You are 2. Have students keep a written log going to be questioned about the situa- (to be checked by the teacher periodi- tion. What will you do? In the last few years large cities cally) of feelings about the class, their .'Jse pamphlets and current publi- throughout the United States havedaily decisions, new material learned, cations instead of, or in addition to, text begun to put pressure on school dis-or anything the teacher feels is relevant books. tricts to stress the "three R's" moreto the class and the students. 8. Divide class into groups. Have reading, more math, and more writing. 3. Have students keep their own vo- each group research and investigate dif- In New York City, where I teach, all ofcabulary list of new words learned in ferent aspects of a subject and teach the the principals have been instructed toclass or from text, pamphlets or other class. increase the number of periods perreading sources. 9. Creative projects that combine week devoted to reading and other ba- 4. Have students write letters re- reading and writing with other disci- sics in the elementary schools. The high questing information, pamphlets, in- plines such as art, photography, music. schools have been instructed that all terviews. 10. Have class construct interviews or subject areas give reading and written 5. Offer reading lists of novels, maga- surveys, then have students survey or homework several times weekly, andzines, etc. for outside projects or just interview selected individuals and that course curriculum should stress the additional information. evaluate results. basics. Employers have also been 6. Give students controversial prob- Cognitive and affective can be made pressuring the schools to improve thelems for homework and have them to work well together. We do not have reading ability of their graduates. Thewrite answers that can later be dis- to forsake our humanistic, affective ap- push is now on to raise the basic skills cussed in class and even made into role proach to health education in order to level of today's youth. playing situations. help our students read and write better. How does this push for basics affect Instead of changing the educational Your parents catch you and your us as health educators? Do we regress to friends smoking grass in your room, goals we have for our students, we predominantly cognitive teaching? Do what would you do? should just add one morea better we return to stressing facts, and only You are caught cheating on an exam knowledge of the basics and how they those things that can be read, written, and the teacher wants to see your par- can help our students live better, and tested? Ab.:nit tc.n years ago health ents healthier lives. educators began to realize the importance of humanistic values and behavior modification that could be accomplished in health teaching. Our field has seen positive changes, and we have shifted our emphasis into the affective domain. Health education has truly become learning for livingexamination of values, decision making, and behavioral alternatives. If we help young people become better, healthier, and more aware, but do not help them to read better, are we in line with the educational goals of the country? Should we be? The pendulum has swung back to pre-1960s education. Should we as health educators re-evaluate our goals, and fall in line with other subject areas? Reading and writing are important; I do not mean to demean their significance. Yuuns people entering the job market must have basic skills in order to survive. Because both affective and cognitive education are valuable, I feel that we as health educators must combine them in wir teaching. Following you will find a few suggestions.

1 5 1 2 TEACHING IDEAS

Thurston Attitude Scales Affective Evaluation This is an equal-appearing-interval procedure that represents variovs strength of feelings toward a given statement, objective, or situation. Each stAtement Techniques hi w9ighted by judges to reflect degrees of feelings. The design of the instrument, in School Health order to construct a valid and reliable scale, can be a time consuming process. Directions:X = Disagree L = Agree Education Using these symbols on the exercise below, please indicate how you personally stand on the issues listed.

1 (1.5) Drug abusers are only hurting themselves.

2(2.0) A poor self concept may lead to drug abuse. 3. (2.5) Inability to make decisions based on the consequences of the Mary S. Sutherland is associate professor in the Department of Human Studies at Florida desired behavior may lead to drug abuse. State University, Tallahassee, Florida 32306. Likert Scale One of the most widely used techniques is the Likert Scale. Statements are constructed with responses on a five point continuum of strongly agree, agree, undecided, disagree, and strongly disagree. The testee selects the answer that Affective measures of evaluation at- best describes his/her reaction to the situation. tempt to indicate how a person feels about an idea or subject. KrothwohP in Directions: Please circle your response to the following statements. Strongly agree designing the affective taxonomy pro- = SA; Agree = A; Undecided = U; Disagree = D; Strongly disagree = SD. posed various degrees of internalization of values, ranging through awareness, 1. People abuse drugs when they possess a poor self concept. willingness to receive, controlled atten- SA A U D SD tion, acquiescence in responding, will- 2. Excessive peer pressure may cause a person to abuse drugs. ingness to respond, satisfaction in re- SA A U D SD sponse, acceptance of value, preference 3. Some drugs may serve a useful purpose. for a value, commitment, conceptualiza- SA A U D SD tion of a value, preference for a value system, a generalized set, and finally Sort characterization of a particular value. The continuum of affective responses is Individuals are given sets of cards containing statenwnts, traits, or pictures. further divided into five main categories They are then requested to sort these into piles according to their relative applica- of internalization: receiving, respond- bility, i.e. most like me to least like me. An example in a health course would be to ing, valuing, organization, and charac- distribute pictures of teenagers participating in various activities, and then to have terization. the students indicate which are most anyast applicable. The quote, "You are a product of every moment you have lived until today," will in part determine responses to any Forced Choice affective questions asked of individuals. Individuals are encouraged to select one of several given responses as an Considering the varied backgrounds and expression of their attitudessimilar to the interview technique described below, experiences within any school popula- except that individuals are not asked specific questions. tion, effective measurement and evaluation in the affective domain can be dif- Directions: Please indicate if you would choose the first option presented in the ficult. Many individuals unfamiliar with question, or the second. the affective domain or attitudinal mea- 2 Statements surement, have opined that the schools are teaching specific teacher held values, 1.I would rather be alone or with my friends. instead of the valuing process. These in- ^ 2.I prefer to work individually or within small groups. dividuals should be introduced to the 3.I would rather go to a movie or take a drive in the country. above information as well as to the decision-making process, such as that popularized by Simon and used by many Interview health educators in the classroom. Numerous methodologies have been The interview is a face-to-face encounter, in which the interviewer asks the proposed for the measurement of at- testee specific questions. Little deviation from the questionnaire is allowed, except to clarify ambiguous answers. titudes, some valid and reliable, others not. A sample listing follows of possible 1. Should drug abusers be encouraged to seek treatment or not to seek treatment? affective measurement techniques and 2. Should drug abusers be encouraged to improve their self concepts, or maintain appropriate examples of their applica- their present self concepts? tion in health education. The techniques 3. Should drug abusers improve decision-making processes, or continue pres- are presented in no particular order. ent decision-making practices?

2 1 6 Rating Scales Additional techniques to be utilized Rating scales are similar to tne Likert Scale, except that instead of using a include check lists and ranking sheets, standard set of options, specific adjective/verb describers are utilized: classroom teacher observations, anecdotal records (summaries of attitudes/ D:rections: Circle your response about drug abuses on the continuum behavior by the school staff), time sampling (what happened when), socio- DRUG ABUSERS Possess no Possess a Possess a grams, social distance scales, guess-who self concept. poor self good self questionnaires, and autobiographical concept. concept. sketches. DRUG ABUSERS Find it very Find it Find it easy In contrasting and comparing the var- difficult to difficult to to communicate. ious methods utilized for attitude as- communicate. communicate. sessment, it is most necessary to estab- DRUG ABUSERS Find it very Find it Find it easy lish a set and a setting for instrument difficult to difficult to to make a utilization. Each of the abovementioned make a make a decision. instruments can serve a valid and reli- decision. decision. able purpose if applied correctly in the Rating scales can be developed with three to seven responses, using describers or situation for which it was designed. single adjectives. The final form should depend on the particular purpose for the Affective measurement and evalua- utilization of the instrument. tion techniques could be used for health instruction in many ways. Semantic Differential 1.To determine student behavioral information to assist in the removal of barriers to In this instrument concepts are measured in terms of evaluation (good-bad), the efficientleffective functioning of the class- potency (weak-strong), and activity (fast-slow). The respondent checks his re- room educational process.Specifically with sponse on the scale; the evaluation process assists in distinguishing differences the so-called behavioral problem stu- between concepts and individual responses. dent, cumulative records are useful to Directions: Place an X or. the scale to indicate your feelings about each statement reinforce comments from anecdotal rec- below. ords and previous teacher time sample ABUSING DRUGS IS: studies. A sociogram exercise conducted Good Bad within the class determines the problem Foo:;sh Wise student's social status within his peer Beneficial Harmful group; but more importantly, teachers and administrators should observe student attitude and behaviors for true indi- DRUGS CAN BE: cators of causes of specific problems. In Good Bad addition, a clue to behavioral problems is Foolish Wise gained from a problem checklist and the Beneficial Harmful professional psychological technique of a Q Sort described above. However, in Open-ended Questions the final analysis, the teacher must usually sit down with the problem student The open-ended question calls for the respondent to answer by writing state- and communicate directly. The proper ments which reflect an attitude, belief, activity or value. It can assist in measuring leading questions should serve to flush attitude structure and socialization. out information related to the true causes 1. Drug abusers should be encouraged to of the problemis it lack of interest and motivation, poor self-concept, poor 2. Drug abuse is communication skills, uncomfortable environment or what? The causes of 3. A positive self concept is poor behavior can trually be determined by using one or a combination of affec- Projected Techniques tive techniques. An appropriate plan of action should be developed by the stu- Projected techniques are designed to reveal information about a person's dent, to change his behavior to a more deeper levels of feelings, and his reactions to a phenomenon via pictures. Gener- acceptable level for the classroom. ally given are the beginning, middle, and ending of a situation related to the 2.Health Instruction. Many of these pictures, from which the testee must be able to write a complete story. attitudinal devices find their best use in the area of classroom instruction. A Projected Behavior Thurstone attitude scale takes considerable time to develop and field-test, but Students are placed in a hypothetical situation arid are requested to determine indicates most clearly differing degrees how they would behave under those circumstances. of feelings toward a topic or statement. If Bob and Dan are friends of long standing. Bob tries to interest Dan in smoking a thehealth educator has timeto joint. Dan should: computer-score results, the Likert scales a. Smoke the joint. c. Take the joint and later throw it away. are most useful to compare differences in b. Refuse to take the joint. ci. Take the joint and later smoke it in private. attitudes. A modified version of the

3 1 7 14

Likert suits small group discussion ac- measure changing attitudes, both short A. Today I learned tivities, as do rating scales, ranking term and long term. Instruments most Today I relearned scales, checklists, open-ended sen- helpful in measuring attitudes include B. tences, projected behavior techniques Thurstone scales, Likert scales, rating C.Today, I wish and closed sentences directed towards scales, behavioral projected techniques, In this manner the health educator gains specific behavioral objectives. Activities and behavioral pre ctices checklists. insight into the student's evaluation of should be deliberately processed, so that Great attention should be paid to fakabil- what is going on in the classroom. principles of communication, self- ity, wmantics, and criterion inadequacy. concept and decision-making may be Is the student merely feeding to the In the final analysis, the setting as re- applied to specific health content areas. teacher what the teacher wants to hear? lated to health education should deter- The abovementioned techniques are Do the terms of questions and state- mine the type of instrument used to ob- marvelous ways in which the class and ments mean the same thing to the tester tain the most valid and reli:ble informa- teacher can get to know and appreciate and the testee? Does the test really mea- tion possible for the most efficient/ each other, as well as marvelous step- sure what it is supposed to? effective use of time and money for all ping stones to effectiveteaching/ concerned parties and purposes. learning. In summary, an affective tech- 4. Evaluation of Classroom Learn- nique can be a learning activity, a way of ing. Attitudinal devices such as open- reinforcing and applying specific content ended sentences serve to indicate both covered, and lastly, can be one of many teacher effectiveness or learning effec- 1. Stanley and K. Hopkins. Educational and tiveness. Specific open-ended questions psychological measurement and evaluation. En- techniques to evaluate an effective glewood Cliffs, New Jersey, 1977, 229. health education program. might include: 3. Attitude Measurement. The methods and techniques described above

4 TEACHING IDEAS

Five Cures for Dull Health Curriculums

LOREN B. BENSLEY, IR., !S professor of riculum and acreative and com- the 3M Company. The curriculum health education, Central Michigan mitted health educator. When these is so sophisticated and so compli- University, Mt. Pleasant, Michigan two components are plugged into cated that 90% of our classroom 48858. each other, there will be generated teachersin Michigan are discour- electricity, excitement, enthusiasm, aged from using it. It cannot be said philoso- and vibrations in the student to turn that it isn't a good piece of work; it Thehealtheducation learning. Only phies, concepts, and attitudes of the him on tohealth isin fact a product of excellence. past are present in many of today's when the curriculum and the teach- Unfortunately, it's not realistic. This curriculums and are breeding irrele- er are united will there be an illu- author questions how realistic the rnination of the student. One with- vant,dull, meaningless, distasteful K-12concept iswithouttrained resultintotal classes in health education. out the other will health educators or health coordi- We are in a time of educational darkness.Unfortunately, much of nators. Wouldn'titbe betterin revolutions. Students are question- our school health education has not health education toisolatethree ing our systems, curriculums, teach- had the proper electrical engineer- grade levels where health could be ing to illuminate proper health atti- erqualifications,andpedagogy. emphasized? Isuggest that possibly They find themselves trapped in an tudes and behaviors of our students. health education be taught in the educational system intent on turn- Health education may not be as fourth, seventh, and eleventh grades. ing them into mechanical robots; bleak as the author has xesented it. I selected these grade levels be- irrelevant curriculums combined Recent years have brought new in- cause these are the ages where we with poor teachers are forced on sights and encouragement to cur- can help our students develop de- them. Fortunately, educational sys- riculum development in health edu- sirable health behaviors. The nine- tems are trying to change, but much cation. Approximately ten years ago year-old has a keen interest inhis of the change is no more than ar we had a national school health ed- body as well as in health in general. attempt to refine the existing ma- ucation study. From this was devised He shows excitement inlearning chinery, making it ever more effi- a sophisticated curriculum based on about the function of his total be- dent in pursuit of obsolete goals. the conceptual approach. About ing.Theseventh-grader,onthe Alvin Toff ler,inhis book Future four years ago, the state of Connec- other hand, is at the critical age in Shock, suggests that "instead of as- ticut did a comprehensive study on developing positivehealth behav- suming that every subjecttaught the health needs and interests of iors. At age 12 he is confronted with todayistaught for a reason iwel schoolchildren.Their document decisions about whether or not he should begin from the reverse prem- titled "Teach Us What We Want To should smoke or experiment with ise: nothing should be included in Know" is extremely valuable in the alcohol or drugs. At this age sec- a required curriculum unless it can hands of the health educator. Most ondary sex characteristics develop, be strongly justified in terms of the of us are familiar with the efforts of which create a variety of physical future.Ifthis means scrapping a New York State in designing a cur- and mental problems. The eleventh- substantial part of the formal cur- riculurafortheirpublicschools. grade student has reached the age riculum, so be it." Theirmostrecentadventurein of sophistication and needs informa- Today millions of students are forced computerized individualized in- tion that will guide his behavior as through health classes and exposed to structioniscertainly encouraging. an adult. He is now a health con- meaningless experiences which will in The State of Michigan is presently sumer and soon will be faced with noway result in favorable health behav- developing a curriculum K through health insurance decisions as well ior. 14 inhealth education. From the as a multitude of other alternatives. What evidence do we have to show most recent drug abuse crisis have We must alsorealize that within the public that we are accomplishing resulted ;ome excellent curriculums three years at least half of the girls our objectives? Will a student be a in this specific subject matter. will be married. healthier citizen because of a course in health education? Health in Three Grades Only New Names Can Be Magic Itis time that we in health edu- These new efforts are encourag- In a typical health course in the cation produce results, not a collec- ing; however, the relevance of some public schools, units have suchti- tionof meaningless philosophical of the products that have been pre- tles as Mental Health, First Aid, Sex statements and purposes. In order pared are questionable. Take, for Education, Alcohol, Tobacco, Drugs to produce results two components example, the school health educa- andNarcotics,etc.Thetitlesof must be integrated: a relevant cur- tion study curriculum produced by these units themselves are enough 5 to turn the students off to health. proach, a variety of micro-courses ucator, could be extremely relevant We were plagued for years with the would be offered in the curriculum. and educational for the student. An- term"hygiene"untilthe1920s, Students could meet the one-semes- other good idea would be to in- when Sally Lucas Jean came up with ter requirement by selecting any clude a course on ecology, or maybe the term "health education," indi- three6-weekmicro-coursesany a reading class in health education. catingthechange fromhygiene time between their freshman and In addition, I would like to suggest teaching to behavior modification. I senior years. This approach is based thatanadvancedcourse atthe think the time has arrived when we, on the beliefthat we inhealth junior or senior level be offered to as health educators, can be more education cannot accomplish all of students on an elective basis to ex- creative and original in making the the objectives for our courses in the plore in depth a variety of health- appearance of our curriculum excit- limited time allotted to us. What we relatedtopics. This could be of- ing to the learner. Just a change in end up with is100%cognitive fered during the summer when the titles of the units may turn a stu- learning, with no success in the af- instructor could take the class on dent on to health learning rather fective domain or action domain.I weekend camping trips and in an than turn him off from what he agree with Toff ler when he states outdoor situation informally intro- would anticipate as a dreadful ex- that "children should be permitted duce and discuss ideas pertinent to perience.For instance, instead of far greater choice than at present the health of both themselves and calling a unit First Aid, why not title lin selecting their curriculum]; they codety. it Emergency Medical Care? Sex Ed- should be encouraged totastea ucation could be called Human Sex- wide ariety of short-term courses."' Let Students Do the Teaching uality. A discussion of alcohol, to- Such everiences should be based Students can teach a health edu- bacco, and drugs could be titled on ivesent as well as future needs. cation course. Students learnin a Mood Modifiers, or a mental health Certain courses based totally on varietyofwaysfrom teachers, unit Psychic Ecology. The title of a behavioral change can be offered from materials, from experiences, unitshould arousethestudent's in school curriculums. I can con- and from other students. Much of curiosity and create interest. A cre- ceiveofshort-termcourseson what a student learns comes from ative and dynamic curriculum be- weight control, smoking, abuse, or gins with exciting topics. his peer group; some of the most physicalfitness,andactionpro- meaningful learningisfromper- Are there other topics not in- grams pertaining to ecology. Some sonal experience.Itis unfortunate cluded in the traditional health cur- ofthese experiences,ifusedas that many curriculums do not offer riculumwhich could makethe micro-courses, could be offered in opportunitiesforthesetypesof course more relevant and prepare the evening when students could learning experiences.Ina course students to face future experiences take them with their parents. I can centered around students teaching thatwillaffect foresee their mental and parent-child courses in students, the teacher could identify physical well-being? Could we in- weight control, nutrition, or physi- five or six students who have lead- troduce aunit,forinstance, on cal fitness. It seems that there would death education and suicide preven- he a wealth of potential in this type ership abilities and work with them tion? Why not include a unit on of cw riculum offering. individually to lead small groups of psychic phenomena, or one called their peers. This gives students re- Health in the Year 2000? Get Involved in the Community sponsibilityandpersonalizesthe instruction. This approach could be Another suggestion is for a prac- especially useful in large classes. Try Micro-Courses ticumcourseinwhichstudents On the other hand, the present would beactively engagedin a There are a number of opportuni- curriculum, based on a unit con- community project pertaining fo the ties for creativity in health educa- cept, may not be the proper way to improvement of the health of their tion curriculum design. The ideas teach health. A school using this community. Students should also be presentedinthisarticlearein- concept may require a one-unit giventhe opportunity toreceive tended to stimulate some thinking health education course fo; gradua- health education credit by working on the part ,of the reader. We have tion. In such a school, ninth-grade in a local hospital as a candy striper, only scratched the surface in look- students might attend health educa- working with patients as a volunteer ing for innovations in health education classes five days a week for one ina medical care facility, helping tion curriculum development. semester. I would like to propose a with cancer crusades,etc.These AlvinToffler.Future Shock. New student-centered rather than a learning experiences under the su- York: Bantam Books, 1970. p. 409. teacher-centered approach to cur- pervision of qualified people, co- Ibid., p. 412. riculum offerings. Under thisap- ordinated by the school health ed-

20 6 4 TEACHING IDEAS

Vary Your Teaching This chart was developed by me for use with pre-service and in-service teachers. Each method is rated as to the Methods likelihood of that particular method accomplishing various types of objectives. The ratings listed in three columns to GLEN G. GILBERT is an assistant profes- the right of the method are: "Mr mean- sor of health education, P.O. Box 751, Port- ing most frequently; "0" meaning occa- land State University, Portland, Oregon sionally; or if blank, it is highly unlik* 97207. that it would be used in such a manner. Objectives written in the cognitive Teachers of health education consis- domain generally require recall of in- tently ask two basic questions about the formation (e.g., the student will be able desirability of using innovative teaching to list the seven danger signs of cancer). methods. These questions have been Affective. objectives generally require an raised during numerous inservice work- analysis of feelings or perhaps result in shops over the last few years: (1) why an attitude modification (e.g., the stu- should we provide a variety of teaching dent will indicate her willingness to as- methods? and (2) how can we provide sume her part of the responsibility for such a variety of teaching methods? The early detection ot cancer by reporting answers to both questions are extremely any unusual findings to her doctor im- important and any competent health mediately without waiting for regular educator should be able to answer both checkups or pain). Psychomotor objec- questions. tives require action (not just writing and An answer to the first question can be thinking) during the activity or result in proposed after referring to what the ex- the student carrying out a physical ac- perts in the field have to say about the tion (e.g., the student will be able to need for variety in teaching methods. demonstrate on Resusci-Anne correct These authorities draw conclusions mouth-to-mouth resuscitation). Addi- based on research and personal experi- 3. The performance of students is one tional information on objectives is read- ence. They agree that providing a vari- reflection of teaching performance. If ily available in any of the methods ety of teaching methods is important if students are not performing well then books listed in the bibliography. we are to enhance the learning setting much of the responsibility must be as- It is suggested that the reader or stu- and to overcome any stigma attached to sumed by the teacher involved. Cer- dent keep clearly in mind the objectives health education as the result of histori- tainly it is a joint responsibility (student to be achieved by a class or course, then cal sins committed during the presenta- and teacher), but a large part of it must review the list, checking those methods tion of health education information. In lie with the nature of the instruction. which might achieve stated objectives. addition, the following are important Utilizing appropriate methods is likely Faowing such an appraisal, consider reasons for providing a variety of teach- to increase student performance. how each checked method might be im- ing methods. plemented and then make a decision 4. You can make anything worth learn- based on feasibility and likelihood of 1. An interesting methodology pre- ing interesting. If the material you are successful accomplishment of objec- vents many discipline problems. Stu- presenting is truly worth learning then tives. Following these guidelines should dents who are interested in what they you should be able to develop a strategy discourage selection based only on ease are doing are much less likely to act in- whereby the worth becomes evident to of use and will encourage innovation. appropriately in the classroom. This your students. Teachers must be willing Using this system an appropriate holds true for adult students as well as to face the fact that they may be present- technique should be located if the mate- younger students. ing irrelevant information. If you can't rial being covered is useful and impor- readily demonstrate that the informa- tant. The reader may notice an over- 2.It is a teacher's responsibility to pro- tion you are presenting is relevant, you abundance of available cognitive teach- vide an educational environment. This had better take another look at that in- ing methods. It generally requires more means teachers must do whatever is formation and perhaps update or elimi- preparation and thought on the part of necessary and within their capabilities nate it. the teacher in order to utilize techniques to motivate students to favorably alter How do we provide a variety of rele- which influence attitudes and stimulate health behavior; experience indicates vant teaching methods? Numerous texts action. that itis not an easy task.If teachers have been written on the subject in This article has presented a rationale must stand on their heads to reach the health education, as well as in other for emp'oying a variety of teaching students, then they should do it. Cer- fields. One technique found very help- methods and has presented a list of tainly we cannot reach every student, fulis to determine objectives to be methods to achieve that end. If readers but we can reach many. We cannot all achieved, then review the following are unfamiliar with any of the teach- be showmen or great orators, but we chart of strategies and make a decision ing methods, they may wish to review should do all we can to favorably alter as to which might best facilitate the some of the sources in the bibliography health behavior. achievement of stated objectives. and/or correspond with the author.

21 7 Summary of teaching methods and strategies according to likelihood of meeting objectives in cognitive, affective and psychomotor domains

Cogmtwe Affective Psychomotor Knowledge Attitude Action

1. Musk ME 0 0 2. Cartoons MF ME 3. Brainstorming & buzz sessions MF 0 0 4. Stories with fill-in-the blanks ME 0 5. Interviews MF 0 6. l'antomimes ME 0 ME 7. Self-appraisal 0 ME 0 8. Panel discussions ME 0 9. Visits to agencies 0 0 10. Field trips 0 0 11. Bulletin boards, displays, flannel boards ME 0 12. Transparencies ME 0 13. Review bees MF 14. Value clarification 0 MF 0 15. Mystery puzzles ME 16. Word-o-games ME 17. Anagrams ME 18. Crossword puzzles ME 19. Games ME 0 0 20. Simulated situations or critical incidents ME ME ME 21. Problem solutions (a specific technique) ME 22. Mock radio and T.V. ME ME 0 23. Personal health improvement projects 0 MF ME 24. Student produced movies, slides, or videotapes ME 0 0 25. Debates ME 0 0 26. Skits ME 0 27. Plays MF 0 28. Role playing 0 Mr 29. Self-tests ME 30. Surveys 0 ME 31. Oral reports (individual or group) ME 0 0 32. Guest speakers ME MF 33. Computer assisted instruction ME 34. Programmed learning ME 35. Experiments ME 0 ME 36. Demonstrations MF 0 MF 37. Mobiles ME 38. Charts, transparencies or graphs ME 39. Models ME 40. Slides ME ME 0 41. Videotapes ME 0 0 42. Auditory tapes or records ME 0 0 43. Films and film strips ME 0 0 ME= Most frequently 0 z Occasionally If blank, it is rarely or never used in this way.

8 22 5 TEACHING IDEAS

Films for Effective Affective Teaching

MMES R. MULLEN is a teacher of One illustrationof how useful ing film a more directly involving Englishatthe Lower Cape May materials on affective education can medium. The "film modules,"as County Regional High School, Cape be when they are available is a pro- he calls his films, are structured to May, New jersey 08204. gram developed by a small firm of demand specific kinds of feedback psychologists and filmmake7:,in and interaction. The result is a re- New York City. The company, Film markably efficient, yet gentle gener- One of the most significant edu- Modules Inc.,is being funded by ator of mature behavior. cational trends of the last decade is theNationalInstituteof Mental The heart of each program isa the movement toward what is gen- Health, the New York State Depart- series of film modules that focus on erally known asaffectiveor hu- ment of Education, and the New situations of tremendou:, emotional intensity and which suddenly and manistic education. With rootsin the humanistic psychology of Abra- unexpectedly stop, leaving the view- ham Maslow and human-potential er so emotionally keyed up that growth centers like the Esalen Insti- he or she islikely to have an almost physical need for a discussion tute, humanistic and affective edu- or a general exelange of feelings cation (the terms are virtually inter- and reactions v ith others. As any changeable) deals with the growth teacher who has ever tried to ex- of the whole personthe develop- perimentwith group dynamics ment of sensory awareness, inter- knows, simply saying to students, personalrelations, and,perhaps "Well, what do you feeltell us most important, self-awareness and about your feelings"islikelyto self-knowledge. Every board of edu- elicit dead silence more than any cation in every city and town in the other response. The iilm modules, countly has some general statement on the other hand, make a verbal of goals for the development of the response a kind of necessary relief. whole person (usually couched in terms of encouraging "good citi- One indication of the success of zenship" and "sound mind"). But York State Narcotic Addiction Con- this concept inforcing a genuine inmost schools,these goalsare trolCommission under the um- and often profound emotional feed- empty pieties.Oftenthebest a brella title "Drug Abuse Self-Aware- back from students was the response teacher can do is to try to bring stu- ness." Four separate programs for to one of the drug abuse self-aware- dents up to grade, to advance stu- school-related use have been made nessfilmsforhighschoolstu- dents in basic skills, and maintain available. dents. A 17-minute module entitled a semblance of order. Issues such Each program inthe self-aware- "Fear" was tested with a group of as drug abuse, lack of interest, dis- ness series is based on a concept of high school teenagers selectedat ruptive behavior, and poor retention film usage which was developed by random in a rural school. The stu- are increasing. producer-therapistRobert Rubin. dents were so eager to talk about The time has come, more and The concept's first application was their own experiences of fear in a more educational reformers believe, a stress training program for police variety of situations that the discus- for affective education to assume its officers.It hasbeeninterposed sion became a kind of confessional. rightfulplace alongside the more withinthetrainingprogramsof "I felt like I was experiencing it my- traditional curriculum. One of the more than 150 police departments self," said one boy referring to the mainobstaclestothiskindof throughout the country since its re- module. "My heart was beating change, howeve.,is a dearthof lease in 1970. harder and Ididn't know what to good, proven materials. Teachers in ThebasicpremiseofRubin's do. And Iwas breal:ing out ina search of a geography book to use work is that in most cases films do sweat right whileAds watching it. intheir classes can choose from not elicit genuine involvement and I had this feeling that everyone was hundreds, and huge filmcatalogs feedback, but rather make of the tryingtoescape and I wasleft are readily available. But if a teach- viewer a passive observer who ex- there by myself." "But," added an- er triesto find atext or film on periencesthefilmvicariously,at other, "if you show your fearall affective education, he'd better have best. Starting several years ago, Ru- the time as you feelitinside of some inside information. bin began to explore ways of mak- you, then you're usually going to

03 9 get caught. As you go along and Rubin sees hisfilms as merely you learn to deal with your fear, one component in atotai educa- in Schenectady said during a discus- then it prepares you better for the tional program, and there are ex- sion of "Fear," "it prepares you bet- next time. But if you let your fear tensive teacher guides, intended to ter for the next time." run rampant, you go insane." A be used in a package of twelve les- The films also open the way for video tape was made of this dis- sons but adaptable to a number of some benefits not mentioned in the cussion and it was obvious from a differentformats. The supportive specificlessonplans. When one single viewing that the discussion written materials which guide the teacher in a high school on Long included not only the recognition leader in the use of the films are so Island used the films, the most strik- that the fei.r existed, but the more explicit that a teacher (or peer leading result he noted was that for the mature awareness that fear need not er) who has never had any experi- first time the students who favored be a mastering emotion, that being ence with group dynamics or affec- drugs and those who opposed them "intouch"withone'semotions tivecurriculum can follow them weretalkingtoeachother and helps one to deal in a more realistic easily. In line with the more proc- communicating. "Before, no matter and aduh way than if one were less ess-oriented goals of affective edu- what I did, they didn't want to com- aware. cation (as contrasted with the prod- municate witheachother,"the As the title of the series implies, uct-orientedgoalsoftraditional teacher said. "Many of the drug drug abuseisone target of the education), the introduction to the userssaidthey needed drugsto films.Itis only an indirect target, teacher's guide states: "The main communicate, but it emerged dur- however. Although each of the film task for the leader. . . when using ing the discussionthat they were modules inthis series deals with the film modules is to unlearn,or communicatingeffectivelyinthe teenagers using drugsinapeer- at least temporarily suspend, what discussion without drugs. That really groupsituation,the emphasis is you know about teaching. There is surprised them." more on the common emotions and no knowledgewhichyou can As for other specific results, the experiences of adolescent growth teach in this program." The instruc- teacher couldn't be sure"It's still than on the usual sermonizing lec- tions proceed with such suggestions in their minds," he commented ture so typical of drug prevention sev- as (inconnectionwith"Fear") eral weeks after showing the films. programs everywhere. If you really "Ask for volunteers to share per- "I don't expect itto provoke per- know who you are,the program sonal stories with the others about manent change, but they keep says, if you're in touch with your- re- when they were 'connedinto do- ferring to the films inall kinds of self and behaving in a mature and ing something they were afraid to contexts. It seems to have definitely sensible way, drugs won't trouble do and did it anyway." Or (in con- planted seeds. I've used you. It's only when your head gets a great deal nection with "Humiliation and An- of audiovisual material, and thisis messed up (as happens at times to ger") "Keep the discussion on tar- by far the most effective." theteenagersinthefilms)that get: 'How would it feel if you were drugs might cause you trouble. The "We spent a lot of time talking turned in?"Did anything like that about feelings and emotions," com- real key to the drug problem, in ever happen to you?'." The teach- short,is not lecturing and punish- mented another teacher who has er's guide includes a series of stu- also used the films. "For alarge ment, but human self-understand- dent work sheets which help stu- ing and self-concept. number of them it really hit home. dents apply what they learn about Lots of kids get completely turned themselves to reallife behavior. off whenadultsstartdiscussing A great deal of the success of Although the film modules are drugsfor thelastfourorfive Rubin'.film modules and the sup- definitely not product-oriented, years that's all they've heard. There portive material must be credited to they do have specific educational was none of that when we used the his talents as a filmmaker. The films objectives. The teacher's guide ex- film modules; they could identify have aquality of such complete plicitly states, for example, that itis with the kids completely." honesty and spontaneity thatit's desirable to establish that "mature Anotherunexpectedbenefit difficult to believe they were made behavior involves making aclear emerged in a mainly black and from written scripts and performed distinction between afeeling and Puerto Rican school district in New by teenage actorsin New Jersey an action." The guide also stresses York City, There are few minority- and Long Islandthat they aren't the importance of peer-group pres- group teenagers in the filmsthey real-life documentaries. The scripts sure in shaping discussions to ex- were intended mainly for a middle- and dialogue are basedon hun- amine feelings objectively and the class suburban audience, and the dredsofhoursoftapedgroup necessity of creating an open, hon- leader of thisparticular inner-city probes withteachers and young est, and relaxed classroom atmos- drug program reports that students people, often the same kids who phere (with helpful suggestions on who had seen the films in her dis- later performed inthe films.Itis how todothis).Invariousex- trict were delighted to observe that easy, therefore, for most teenagers perimental sessions with the films, for a change the poor and the mi- in settings varying from urban to students quickly realized many of norities are not depicted as being semi-rural to identify strongly with these objectives by themselves. "As closely associated with "the drug the experiences and feelings pre- you go along and learn to deal with problem." Seeing drug abuse notas sented. your fear," one boy in a high school a racialissue helped to calm the 10 24 defensiveness and hostility dis- The film modules programs offer education and to encourage are- played toward most drug programs. only a brief immersion in intensive laxed classroom atmosphere. In addition to the high school se- techniques fordevelopingself- Whatever their emotional benefit, ries, the company has also produced awareness, and their positive effects, the programs are proving to be use- a series on drug abuse self-aware- ifleftunsupported, willdissipate ful to a growing number of teach- ness for teachers, another program with time. A learning system has ers. As one teacher put it, "They for parents, and asingle filmfor been devised as a follow-up, called served as a perfect trigger for dis- students in elementary school that "role modules." Here the students cussion;theyhelped tocreate clears up many common misconcep- reenact(usingroleplaying tech- a nonthreatening environmentin tions and unreal fears. niques) the situations presented in which thekidsfeltfreetotalk Affective Teaching the role modules. The goal is two- about things that they were really fold,firsttoreinforce the emo- concernedabout."Rubin'sfilm Many educators quite legitimately tionalawarenessestheyhadat- modules offer a workable alterna- questiontheroleofschoolsin tained earlier from the films, and tive to Clifton Fadiman's illustrated psychologicaleducation.Affective second, to present the many options lectures of Dickens. As any teacher gains are difficult, if not impossible, availablefor mature behaviorin who has watched his or her classes tomeasure.Therefore,aresuch real life. driftoffina cloud of boredom materials safe when used by the One could argue that the teacher knows too well,it'sthe kind of average teacher? "Maybe affective who would readily agree to use the alternative the schools desperately education isn't much different from film modules is probably someone need. a bull sessionand shouldn't already inclinedto favor affective school be more than bull sessions?"

2 5 11 6 TEACHING IDEAS 411.'

3. Demonstrate the steps in logical 1. Aroue students' interests and at- Effective Teaching: order. tention before starting. 4. Explain the purpose of the various 2. Select a relevant situation for stu- Variety lithe steps. dent participation involving one 5. Provide clarifying material to the main idea or issue. This could in- Classroom students. volve personalities reiated to an 6. Hold the attention of the students. individual's beliefs, hopes, and MARY SUTHERLAND is a master df pub- 7. Provide sufficient opportunity for aspirations. lic health student at the University of Ten- student questions. 3. Select students who are well in- 8. Give clear answers to student formed on the issues and are self- nessee, Knoxville, Tennessee 37916. confident in performing before WILLIAM HEMMERis an associate profes- questions. sor in the Department of Health Science, 9. Evaluate the success of the demon- theft peers. StateUniversityCollege-Brockport, stration by eliciting student feed- 4. Prepare the class in what to look Brockport, New York 14420. back. for in the dramatization, e.g. behaviors, feelings, etc. As in any lesson, the teacher must 5. Actively involve the students in In developing an evaluation proce- begin by catching the imagination of the dure for assessing student teacher com- the dramatization, but maintain students so they will begin to pay atten- orderly direction toward fulfill- petencies in a competency based teacher tion. Students should know why this education program, checklists of what ment of the objectives. idea is being demonstrated. Logical 6. Evaluate the dramatization as it re- the student teacher is expected to do order is important so that students can using a variety of techniques have been lates to the objectives by means of follow the procedure and understand review, discussions or question- developed by a consortium of teachers, the reason for each step, as well as, administrators, and college supervisors a nswer sessions. what is happening at each state in the Again the teacher must have a device of the State University College at demonstration, Thus, an explanation of Brockport school health program. The for getting students' attention before the, 4 the steps as the demon- starting.Ifthesituationtobe field testing of this instrument was con- stration pru;eeds is helpful as are any ducted with approximately 30 supervis- dramatized is familiar and important to clarifying materials. Clarifying materials the students, if somehow the students ing teachers and student teachers. The can be anything from references to participants provided many suggestions can relate to one or more of the charac things in the students' own textbook to ters, interest can be sustained. Usually for the improvement of the assessment definitions written on the chalkboard. instrument, adding components and situations or ideas which relate to their The teacher should keep things mov- values, beliefs, or hopes are .7onsidered subtracting others. ing along so students' attention does All the clues to the qualities of a good relevant topics by students. not wander. This requires enthusiasm, In selecting the actors and actresses lesson are provided for the student showmanship,andhamacting. teacher before the lesson is planned. for a dramatization, whether it be im- AnotherthingthatbreaksthP promptu or prepared ahead of time, it is Since the clues can be built into the les- monotony of the teacher's voice and son plan the lesson will be better than if important to use volunteers who are helps to hold interest is encouraging self-confident in front of their peers. student teachers are left to their own student questions as the demonstration devices to develop a good lesson. There- Nothing kills a dramatization like a shy moves along. There is nothing like clear, student who mumbles a few words and fore, the Competency Evaluation Packet concise answers to encourage more helps the student teacher prepare quickly tries to sit down because he questions which means the teacher would rather be almost anywhere ex- sound, well-planned lessons which will must be well prepared to field the types succeed in the classroom. cept in front of the classroom. The par- of questions which may arise. At the ticipants in the demonstrattim should Supervising teachers found that they end of the demonstration, the teacher were able to benefit by the checklists of also be those who are well informed on will want to elicit student feedback, the issues presented and who can easily expectations developed and found that probably with a few questions, such as: th?ir teaching improved because they visualize the situation to be dramatized. What do you think has happened here? This is especially true in impromptu role were conscious of the essential ingre- Why? Do you agree with this explana- dients of a particular type of lesson. A playing. tion? Why do you suppose we did (this) Students in their seats should be checklist of the qualities which the instead of (that)? What might have hap- group felt would ensure success for given a charge by the teacher to look for pened if we had done (this) at (step 1)? certain behaviors, feelings, or whatever. three types of lessons follows with a Why? discussion of the checklist items. The audience should be given an impor- The teacher evaluates the success of tant evaluative or observer role so they the lesson by probing the depths of the will not feel like passive observers, but Demonstration Lesson students' understanding of what has co-participants in a class enterprise. happened in the demonstration they The teachers should demonstrate suc- Objectives should be made clear to cessfully, all of the following. have just seen. students so they will know why they are 1. Arouse students' interest and at- doing this dramatization. At the end of tention before starting. Dramatization Lesson the lesson, the teacher should evaluate 2. Explain the purpose of the demon- Teachers should be able to demon- the dramatization in light of the objec- stration. strate successfully, all of the following. tives. Again, a five or ten minute dis-

12 26 cussion of what happened may be cru- teacher should first explain to the stu- seems to be saying, "Here it is folks, this cial in getting the main point of the les- dents why they are being asked to look/ is the way itis,there's no argument son across to students. The teacher, for listen to it. In other words, the lesson possible with these facts." Students, not example, might ask: Was the dramatiza- objectives should be made clear. To in- being subject matter experts, are usually tion realistic? Why or why not? Do you volve students and support the purpose in awe of straight factual presentations think (the protagonist) acted realisti- explained, ask students several ques- and are not able to challenge this type of cally? Why? Would you have said (or tions in advance, keyed into the objec- presentation effectively. acted) as (a character) did? Why? If not, tive. One or two questions given in ad- If the media has audio or printed how would you have acted in this situa- vance are generally all that students can components, the teacher must make tion? How could the dramatization have keep in mind. An alternative is for the sure the vocabulary level is appropriate been improved? Did you ever see any- teacher to pose the questions one at a for the studentsnot too simple or too thing like this happen in real life? time during the presentation of the au- hard. 1Vhere? flow? diovisual material. The teacher will want to help the chil- The important thing is to get the stu- dren conceptualize the main objective of Audiovisual Lesson dents to think critically or to inquire the lesson, usually by folowup ques- about the material being presented, tions that help students understand and Teachers should be able to io all of both during the presentation process evaluate what they have just seen. the following. and afterward. Of course, for worth- These followup questions will also help I.Explain the purpose of using the while thinking to be stimulated, the au- to summarize the main instructional audiovisual material to the stu- diovisual material must be carefully purpose of the media piesentation. dents. selected to focus the students' attention 2. Pose questions for students to on the objective desired and to foster Conclusion seek answers to during the pre- learning of the ccntent of the cur- sentation. riculum. Teachers who wane to do demonstra- 3. Use questions to get students to The questions and the teaching pro- tion, dramatizations, or audiovisual les- think about material during or cedures used should be designed to in- sons for added variety in their class- after the presentation. volve the students in interpreting the rooms will find these checklists an aid in 4. Select audiovisual material which media's message. This involvement remembering all the fine points that are will increase the students' depth should encourage creative solutions essential for making a lesson click with a of understanding and learning of to problems and interpretation of class of students. The checklists can be the curriculum content. phenomena and events depicted. The applied profitably both before and after 5. Involve stuuents in the interpre- opportunity to use creative abilities the lesson. Before the lesson, they can tation of the message presented sparks the interest and enthusiasm of be used as a guide in planning so that all in the media. the students in the project at hand. If necessary components are built into the 6. Relate the media's message to the possible, the teacher must skillfully lesson. After the lesson a teachercan curriculum objective. allow the media's message to be related use this same checklist as a thoughtful 7. Select media which present the to the curriculum objective by the stu- means of evaluating his/her perform- message in an effective manner. dent instead of by the teacher. ance in the classroom. In the light of this 8. Select media with appropriate vo- The media which present the message evaluation technique, apparent weak- cabulary level for the students. effectively are usually best for stimulat- nesses can be shored up by extra effort 9. Help the children conceptualize. ing student interest through the use of in the planning stage the next timea 10. Summarize the main instructional open ended questions. A straight fac- particular type of lesson is attempted. purposes of the media. tual presentation makes student in- Whether filmstrip, 16mm film, film volvement difficult since the media loop, slides or large poster pictures, the

2 7 13 7 TEACHING IDEAS

Health Science Fairs

HENRY A. LASCH is professor of community as a whole. Greater un- health science, Department of Phys- The health science fair is one type derstanding of the importance and ical Education, New Mexico State of activity that will add new dimen- scope of health in a changing world University, Las Cruces, New Mexico sions to school health education. It can be gained from this type of en- 88003. is similar to the traditional science terprise. Students may discover new fair except that iti hmited to proj- interests and meaning in healn and ectsandexhibitswhichportray unlimitedopportunitiesexistfor Science fairs have been a tradi- health as the central theme. Schools creativity in all areas of health. Stu- tional project in many school dis- that may not want to .;ponsor sepa- dents who exhibit genuine interest tricts throughout the United States, rate health science fairs could desig- and enthusiasm may show promise reaching a peak of interest after the nate health as the main topicin for careers in one of the many allied space-age touched off afervor of their regular science fair. Whatever health and medical professions. It is activity in the mathematics and sci- route is taker., the end results should quite conceivable that some of the ence curricula. be worthwhile. criticalhealth manpower shortage We are now on the threshold of In organizing health science fairs could be reduced if students were a new era in the health sciences. The itshould be recognized that any provided opportunities to develop crises brought on by drug abuse, the type of project can be included as their interests and creative talents in venereal disease epidemic, smoking, long as it pertains to health. It may the field of health at an earlier age. alcoholism, destruction of the en- cover anything ranging from per- As plans take shape for a health vironment, and other problems have sonal :Ind community heahh affairs science fair, students should become increased public awareness in health. to world-wide health problems. Spe- aware of the multitude of topics and Although itis deplorable that most cial emphasis should be given to programs which comprise school schools and communities waited for projects related to health and medi- health, public health, and interna- crises to develop before they real- cal research and current, scientific tional health. A health science fair ized the importance of a compre- developments affecting man's health permits greater student involvement hensive health program, we are on and longevity. in current health affairs.It can also the brink of one of the greatest ex- serve as a valuable tool to publicize pansions in health in the history of Why Sponsor a Health pair? health among all segments of the publiceducation.Everypossible The health science fair presents community. Education must search means must be employed to convey an unrivaled opportunity to promote forbetter ways to challenge and the message of school health to the greater health awareness among stu- stimulate the minds of youth in the public. dents, school personnel, and the diversified fields of health.

14 Organizational Committees The health science fair is an effec- 2.Students should select their own A health science fair will have a tive way to gain respect for the en- projects as long as basic rules greater possibility of success if com- tire discipline as well as a means of andguidelinesarefollowed. mittee responsibilityis clearly de- securing more public support for These should be clearly estab- fined and overlappingisavoided. health as a separate subject in the lkhed by students and faculty. The general administration of the secondary schools. Certain projects 3. Projects should be designed by fair can be handled by a steering can focus on health hazards and de- the students, who should be ex- committee. Other suggested com- ficienciesinthe community, thus pected to do their own construc- mittees are: publicity, design and providing students with a challenge tion and assembling. construction, finance, facilities, and to assist in the solution of current judging Additional committees may health problems. 4.The general plan of the projects be added as deemed necessary. should be approved by a com- Final success of a health science Guidelines for Projects mittee of students and teachers. fair will depend upon the coopera- 1.All projects entered in the fair 5.Both individual and group proj- tion of all committees, the enthusi- should center around some area ects should be encouraged. asm of those who participate in the planning, the motivation of student of health. The theme of the proj- 6.Participants in the fair should be ect should be clearly defined and limited to one project in order and public interest, time allowed for described. to strengthen the quality of en- adequate preparation of projects, selection of a desirable site, and the tries. continuous publicity given the entire project.

2 9 15 8 TEACHING IDEAS

THE OPEN CONTRACT A PROGRAM OF INDIVIDUALIZED STUDY

B. E. PRUITT is a staff member at Lewisville Ugating his OW11 thinking in the areas of High School, Lewisville, Texas 75067 Selection of Topics studv. The positirm papers are graded a(- Participants in the open contract pro- mrding to how well the selected topic gram are free to select topics for investiga- relates to the area ot study. the topicis

A...M=111.1Y tion, but they are restricted in two ways. mvered. the arguments are presented. They must ( hoose topic s within the areas and its general tidiness. The maximum of study established at the beginning of value tor any position paper is list, points. the program, r :meragy corresponding to Critique: The ( ntique ( a tegors is pro- the basic areas re«)mmended in the vided so the student investigator ( an re- Texas1. dt.1( ation Agent y's Bulletin 691, «,ive t redit for analvzmg the varlets. (it Se«mdary Sc hot)! Health I ducation Cur- intormation found in the health field. ncuhun Guide. The se«md restri( ti(in is Newspaper and magazine arti( les, books. that ea( h sele( tion must be appropriately films, television programs, or personal in- limited to be elle( tively dealt w ith terviews all provide opportunities for de- through investigation pro( edures estab- veloping 1 rniques. The student is en- lished by the investigation c ategories. A couraged to produce a pie«, ot ( realm, topit such as "food- is obviously too evaluation DI b)th the intormation and broad to be eftet tively investigated, bllt a the information source. fat h ( ritiqu(' is topic suc h as -food tads" is more appro- salued at eight points and is graded ac priate. The tea( her never decides what ording to how the information relates to As a multidisciplinary topic, health topic s are to be studied, for in doing so he the area of study, how a summary of the ethic ation can offer an exc client oppor- would risk losing the individual emphasis information is presented, how an analysis tunity to make classroom experiences of the program. Rather, he establishes of the information is c arried out, how the germaine to individual life styles. Unlike boundaries within whit h the student is sour«, is identified (usually through a many other areas of study, health edu( a- enc ouraged to sele( t any topi«)r prob- bibliographic note) and its neatness. tion is not obligated to concentrate on lem of personal interest. Correspondence: In eat h six-week fragmented tools which may, or may not, period, students have three opportuni- be used to affect life quality. Instead, Selection of ties to ret eive credit for corresponding classroom health offers a cham e to ex- Investigation Categories ss ith various publichealth agencies or perience concepts of living--the "big businesses concerning health-related in- ideas- of responsible personal health. On( e a student has ( hosen a topic tor formation. 1 his optional investigation At Lewisville High School, we have re( - study he must then sele( ta method of ategory exposes the student to the vari- ognized this opportunity and are attempt- investigation from the investigation cate- ety of agencies, businesses, and associa- ing to offer classroom health to our stu- gories established by the teacher at the tions whit h are concerned with the dents to not only provide them with in- beginning of the program. They must vary health of their clientele and helps the formation about healthful living but to do in degree ot diffic ulty arid value so the student encounter samples of literature this in a learning environment which em- student has several choices. A more dif- provided by such service organizations. phasizes individual application of health fit ultategory may be valued as mu( h as Students are provided with alist of related information. We have developed 10 points while a simple category is worth appropriate agencies with which they a program of individual study, the "open only S poil.(s. When selecting an investi- may wrrespond. Each «mespondenc e is contract." The goal of the open contra( t gation c ategory the student must wn- valued at five points, ( redited when evi- program is to provide an environment in skier how muc h work he wishes to do dence of the wrresponde riceis pre- which each participant suc«,ssfully iden- ss Oh the topic, how many points he sented. As long as the information re- tities topics or problems within spec di( wishes to earn, and whether the topic arid quested relates to the areas of study, full health-related areas, acquires informa- the method of investigation are compati- redit is given. tion about them, and, by analyzing the ble. xamination : Three optional examina- gathered information, proposes possible f ollowing are several examples ot pos- tions worth up to eight points eac h are means of dealing with suc h topic s or siHe investigation ( ategories, designed provided every six weeks. Questions are problems. The ambiguity of this goal is tor the ninth grade level and c urrently a usually essay and deal with clavi ac- necessary if the vast range 01 individual part of the program for Health I students tivities, suggested readings, or general in- differences and needs is to be «insid- at Lewisville High Sc hool. (With a more tormation to which the student may have ered. advanc('d student, more involved inves- been exposed. What might seem to be a tigation pro( edures would be appro- misnomer in referring to examinations as priate.) Thesix examples will be one of the investigationategories is not Parti( ipantsri the open «ultra( t pro- explained in relation to the open «mtra( t so when examinations are looked upon as gram are employed as student inves- design. individual investigations of personal tigators for 18 weeks. During that time Position Paper:I ac h six-week period knowledge. Students are encouraged to they are «msidered free citizens within Inc ludes three opportunities tor the stu- write examinations with this in mind. the program. They assume three primary dent investigator to express opinions on Individual Project: The ( a tegory "indi- responsibilities: selection of topics or ontroversial topics. This expression is vidual prolecr gives the student inves- problems for study, selection of meth- done in the form of a position paper. tigator a ( hance to express his ( reativity, ods of investigation or investigation Suc h statements of personal opinion expand his knowledge in a health-related categories, and selection of grades. allow a student to re( eive ( redit tor inves- topic, and receive ( redit at the same time. 16 BEST COPY AVAILABLE 3 The design and means of development of pending on the amount of improvement the prole( t are entirely up to the student. Selection of Grades necessary. Any time less than the max- Bulletin boards book reports, or spec ial imum number of points are awarded, the notebooks are wminon projects. Origi- If a student investigator chooses to student has the option of accepting the nality, however, k encouraged. Up to ten complete an invesogation option, he points awarded by placing the paper on points credit may be earned eac h six- does not automatically receive full credit. file, or of rejecting the points, making the week perioo by the completion of this But, points are never subtracted from a indicated improvements, and resubmit- investigation c ategory. student's grade. This evident contradic- ting the paper to be graded again. If a Committee Pmjec t:If three or nlore tion leads us to one of the most important student is not satisfied with this grade the udvnt investigators w is!) to work to- aspects of the open contract program paper may be reworked once again. gether on a projec t, they may c hoose to the grading technique. Usually when students rework a cate- ornplete the t ategory ommitttp pro- A major criticism of the traditional gory, they improve the number of points le( t." Thy only restric !ions are that only classroom environment involves the ex- earned. If, however, a second presenta- one prole( t may he completed during any tremely negative approach used in grad- tion receives a lower grade than the first, Um. sixw eel( period and the selected ing. When averaginE, is used, one poor the student may ask that the first be filed topic must relate to the area of study. grade may destroy all incentive. The open and the original points awarded. Once h member ol a committee may rec eive points are recorded they must not be sub- a ma \imum ot ten poink torprowt t. tiacted. The student is encouraged in Most, hut not all, points are earned every way to earn the highest grade pos- through investigation pro«%dures. Up to sible. 30 points may be earned eac h six-week Final grades are determined by the total period through c lass partic ipation. Regu- number of points accumulated during the lar tivities are planned whic h involve 18 week session. A student receives a group work, role playing, or guest speak- good grade after completing a certain ers so that intormation is provided over number of investigation categories well. areas ot study. Many activities are de- A poor grade is given when the student sigcwd to help students with their investi- chooses to complete fewer investigation gations, or tor the sole purpose ot having categories. The option is available to tun with health. The credit available en- complete no investigations and fail. This courages students to take advantage of too is considered a respectable choice the activities or to make use of the class because the student is held responsible time provided for investigating chosen for his decisions. topics. This totally positive grading technique is essential to the success of the open A progress record is used to maintaina contract program, on the other hand, in- running account of the number of points volves a completely positive approach. contract program. The student must feel earned by each participant in the open When an investigation is graded itis responsible for his own grade and he can contract program. An official and an unof- awarded points for things done well; no feel that way only if he is allowed the ficial progress record is kept for each of points are subtracted 'or mistakes. For option of correcting and improving his the three six-week periods during the example, if a student completes the in- work in each category to a point of per- program. The unofficial record is kept up vestigation category "critique I," he may sonal satisfaction. to date by each student investigator so receive up to 8 points. When grading the Most participants in the open contract that he is always aware of where he presentation the teacher notes any areas program have responded positively to stands. The official record is placed in a in which the critique may be improved. If this individualized motivational ap- file and kept up to date by the teacher. the teacher fe^!s that the paper is well proach. They have become deeply in- Official credit is recorded at the time in- done then a full 8 points may be awarded. volved in a variety of health-related areas dividual investigations are placed on file. If the teacher sees ways for improvement and, in general, have increased under- At the end of each six-week period, the he may award 4 points or 2 points, de- standing of numerous concepts of health- total of all points recorded on the official ful living. Perhaps more importantly, record is determined, and the resulting however, participants have enjoyed their number is the six-week grade. health education experience.

3 1 17 9 TEACHING IDEAS

THE MANY FACES OF ROLE PLAYING

LYNN TEPLR-SINGER is an assistant pro- X:role players/ 7.x x Discussion questions may include: fessor in the Departments of Health Sci- x Ax N How do you feel when your parents ap- ence, Physical Education, and Guidance x x proach you in this manner when they dis- and Counseling at Long Island Univer- x F x approve of your behavior? For what rea- sityThe Brooklyn Center, Brooklyn, sons do you believe your parents respond New York 11201. in this way? How would you approach your child if you were the parent? Role playing as a classroom technique x x has provided a marvelous environment 2. The class may discuss their reaction x E x to each group's performance. for the exploration of health concepts. In 3. The teacher may present questions the February 1971 issue of School Health x x Review a step by step procedure of the for the small groups to discuss based on traditional role playing situation was x D x the diverse material that the teacher has presented in an article entitled, "Role Situation: Student arrives home to a been jotting down during the different presentations. For example: Playing as a Tool in Mental Health Educa- family that has discovered a "stash" of Describe the ways in which the person tion." Briefly the steps included: drugs hidden away M his/her room. caught responded. Roles: Each group will enact the follow- 1. Sensitizing the grouppresent a For what reason do you believe people situation where the class discovers that ing roles spontaneously without prepara- each person perceives a given situation tion other than deciding on a role. would respond in this way? differently based on past experience, as- Mother and/or father, brother and/or sis- What information about drugs do you believe was false, which was factual? sumptions, and expectations ter, student. What are the penalties for breaking 2. The Warmupdescribe the role Procedure: In sequence each group drug laws? playing situation with limited information performs their presentation of what they 3. The Enactmentspontaneous dra- What was your reaction when alcohol think will happen. (Group A then B then was mentioned as alright for the adults matization C, etc.) Generally e-n 1 oroup has a differ- but -pot" was put down? 4. The Replaythe same people ent approach. The r.lather may stop the switching roles group and go on t,) the next group at any 5. Student Observation--discussion point. Example II by the students about their reactions Discussion: After all groups have 6. The Evaluationdraw conclusions enacted their presentation, the teacher Structure: Single group performance At this timeI would like to present will have several options for proceeding with stop action directorship by the class. three alternative approaches to role play- with the discussion depending upon the The performing group presents their ing. Although any area in mental health material presented. Some possibihties interpretation of the situation in front of can be explored through these proce- include: the class (the directors) who are sitting in dures, the following are examples for use a semi-circle around the classroom. in drug education. 1. The class may form new groups x- role players based on the behavior displayed by the o- directors parents. Students who think their parents 000 would behave as the role was played, 0 would group together with the role X o Example I players. For example: parent who cries X Structure: The class is divided into "How could you do this to me"; parent groups of four. Each group sits in a small who kicks child out; parent who ques- oo circle within a large circle that the groups tions with concern; parent who lectures 000 form. and does not allow a response, etc.

18 Situation: One student is trying to con- x-role player feelings, thoughts, and attitudes? vince three friends to smoke a joint. Ro/es: Person who does the convinc- o- classmates ing, person who refuses, person who is X 0 0 0 When teachers present role playing undecided, person who accepts. situations it is most important for them to O 0 have a facility for questioning so discus- Procedure: The group begins their O 0 sions are meaningful. The teacher's re- enactment. At any point any member of O 0 sponsibility in role playing is essentially to the class, as well as the teacher, may stop O 0 help students identify and define what the action by calling out "Stop Action" they are experiencing, as well as to help and 0 0 0 them investigate their feelings and reac- 1. ask a question of a performer about Situation: The forces (feelings and at- tions. A non-judgmental setting is there- how that performer feels at the moment. titudes) within the person that motivate fore a must. 2. assume the role of any of the players him to use drugs versus those that influ- with a different approach. ence him to refrain from using drugs. Roles: The role is the dichotomy that exists within us that determines our decisions. Procedure: The student holds up two hands (puppets may be used if appropriate for the age group). One hand is first used for emphasis "On the one hand why shouldn't I use drugs, everyone is doing it?" The other hand is then used "But on the other hand just because others do it doesn't mean I have to follow their example." The alternation of hands is repeated with each feeling and thought for or against the use of drugs. Discussion: Questions for discussion may include:

3. ask the present players to switch Suggestions for questioning: roles. Discussion: Questions for discussion 1. Avoid questions that merely yield a may involve aspects dealing with group yes or no response or that call for judg- pressure and the decision-making proc- ments such as good or bad, should or ess. shouldn't. a. In what ways were the situations 2. Explore several ramifications of questions: realistic or unrealistic? b. How do you feel when someone Clarify a point: If I understand you, you tries to convince you to do something said. . . . that you really don't wish to do? Seek additional information: Would c. What feelings do you have when you you tell us more about this? want to convince someone to do some- Evaluate: What do you think this might thing and they refuse? mean? How does the rest of the class feel about this? Conclude: What happened? Why is this a problem? How could the outcorde Example III be altered? 1.In what ways are your feehngs simi- 3. Provide an atmosphere where ques- Structure: One individual sitting on the lar to and/or different from those pre- edge of the circle who will enact two options arise from and between students as sented? well as from you. posing aspects of himself while the re- 2. What is your response in other situa- maining members of the class listen. tions wlwre a conflict exists between your

19 10 TEACHING IDEAS

EXTRA CREDIT MAKE IT MEANINGFUL

GEORGE F. CARTER is an instructor in the to the students so that misunderstanding 4. Students may visit any health agency Department of Health and Physical Educa- is held to a minimum. or health related agency to get printed tion, Triton College, River Grove, Illinois So students understand how they are to material for distribution to the class. (2 60171. be evaluated in health class, students are pts.) told the objective criteria used in evaluat- 5. Students may bring a cassette, record, ing their effort. Every effort is made to or other audio-vis.ial material to class that present the student with the Opportunity pertains to the subject under class discus- to earn points toward his eventual grade. sion. All arrangements for the presenta- All assigned work is given a numerical tion must be made with the instructor one value and students are made aware of the week prior to the presentation. (4 pts.) point value for tests, term projects, 6. Students may review a film, cassette, abstracts, oral reports, attendance, etc. videotape, or other medi? production Extra credit is not used to replace regu- from the Triton College Learning Re- lar work but to increase opportunities for source Center collection. The student willing students. The information given to must make all the arrangements to review each student enrolled in Science of Per- the material and submit a one page sum- sonal Health as a handout is shown here. mary of the material in proper manuscript Over the last several years this handout style. (5 pts.) has been revised and it will be continually 7. Students may make arrangements to revised. There is no longer the urgent have a guest speaker come to class to need for an extra credit project; the extra discuss the subject under study. Prior ap- credit must be carefully planned and con- At one time or another most teachers proval must be granted a minimum of one tribute to the learning experience of the week in advance of the presentation. The from the elementary school through the student. university are confronted by students de- student will introduce the speaker. (5 siring to do an extra credit paper or proj- pts.) ect. Many times the student requesting EXTRA CREDIT OPPORTUNITIES 8. Students may arrange an interview the opportunity has fallen behind his Science of Personal Health with some person involved in health care classmates in regular assignments and Dr. George F. Carter, Instructor service. A written summary of the inter- would like to make amends through extra Studeos who are interested in improv- view with appropriate data must be effort. In other words, the extra credit ing their information and skill level are turned in prior to the coverage of the becomes a make-up which often causes invited to submit extra credit projects. All material in class. (5 pts.) problems for the instructor at or near the projects must conform to the established 9. Students may make an oral report of an close of a term. guidelines for compensation. All points interview with some person involved in During the last nine years, many of my earned through extra effort will be added the health care delivery industry. This ma- students at Triton College have requested to the previously earned point total. Gen- terial must be useful to class discussion extra credit in Science of Personal Health erally speaking, first come, first served on and approved by the instructor. (3 pts.) courses. Reasons for the request vary topics. All work must be in good form to 10. A student may submit a proposal for from the desire to achieve an A rather be considered. extra credit to the instructor. All pro- than a B, to pass ra mer than fail. Most 1. Students may report information posals must be approved a minimum of requests have been made in the last week gleaned from reading a newspaper or two weeks prior to the due date. Point or two of the semester with little thought magazine article which covers the subject totals will range from 1-5. Suggestions for given to the learning experience. As a being dil,cussed in class. The student extra credit are: review a book, movie, teacher, it is always encouraging to have a must have a copy of the article to present play, or meeting; attend a seminar or student request to do something extra clinic; critique a popular .ecord or tape, a but not under these circumstances. On to the instructor and give a brief account of the information to the class. Art;cles television program on a health related the other hand, it is undesirable from an not pertaining to the day's lesson will not subject; visit a nursing home, mental instructional viewpoint to deny a student hospital; or send for health information a second opportunity, especially when count as extra credit. (2 pts.) 2. Students may visit a local, county, or which would benefit the class or the per- they have requested the chance. son. In the competition for grades, class state health agency and make an oral re- rank, and as an opportunity to promote port to the class about the visit. In addi- The handout has been of immense help learning, the extra credit assignment tion, a one page summary of the visit, in answering questions and at-signing should be used as a teaching strategy and person visited, and other pertinent in- extra credit projects. Since my work is at should be open to all students. The na- formation should be typed and turned in. the community college level, these ac- ture of the assignment and appropriate (5 pts.) tivities attract student involvement. Per- grade compensation should be in keep- 3. Students may visit a local, county, or haps you might desire to adapt the guide- ing with the regular course evaluation state health agency for the purpose of lines to your school environment but my procedures. Everything pertaining to explaining the role of the agency. A brief experience has been an increase of inter- extra credit should be carefully explained report to the class is required. (3 pts.) est in extra credit.

20 r'rjaw STcol' ""tialg! 11 TEACHING IDEAS

display can be incorporated into a mul- suggest to make the experience less negative timedia presentation using audio-tape or for those who need their services? Promoting Experiential any other appropriate media. For example, you might produce a tape-slide show on eat- 10. Interview a person or persons who Learning ing habits of college students, study habits, smoke heavily (yourself if you fit the cate- recreational habits, dating habits, marriage gory). Get a profile on their smoking habits, from the woman's point of view, people try- when they smoke, for how long, how it af- ing to make conversation, children's ideas fects them, why they think they smoke, about death, etc. comments of family and friends about the smoker. Have they ever quit? Why? Why did 2. Prepare an audio-tape collage. Tape they resume smoking? MICHAEL HAMRICK is associate profes- many songs, poems, readings or sounds sor and head, Division of Health Science around a particular theme. The theme might and Safety Education, Memphis State be aging, drugs, self-identity, or sexuality. 11. Go to a setting unfamiliar to your lifestyle and report your reactions, feelings, etc. University and CAROLYN STONE is pa- Try a walk through an inner city neigh- tient education coordinator, City of Mem- 3. Select one of the health habits/behaviors that you are concerned about and borhood, attend church services of a dif- phis Hospital, 860 Madison Avenue, ferent religious group, go to an adult movie Memphis, 'Tennessee .3810.3. would like to work on. Develop a plan of action which focuses on the desired behav- or bookstore, a gay bar, or shop at a small ioral change. Use a behavioral modification country store. Getting students involved in health plan as described in class. Keep a log on the education experiences outside the success/failure of the plan. Follow up with an 12. Spend an evening in a local hospital's chssroomexperiential learning-- analysis of the plan and the behavior and intensive care waiting room. Listen, ob- continues to be a pressing need in what you learned. serve. If you feel comfortable, talk with the health education. The purpose of this families waiting. Record your reactions, article is to promote experiential learn- 4. Pair up with someone else to form a what you learned medically as well as emo- ing in health education by providing a health "therapy" dyad. The purpose of the tionally. list of projects to encourage out-of-the- partnership is to have someone with whom the health habit/behavior can be discussed. classroom learning. While this list was Meet with your partner several hours a 13. Spend a morning making rounds with developed for use in the personal health week. See if you can develop a plan for a public health nurse, food sanitation in- course, similar lists can easily be devel- achieving desired behavioral change. Keep a spector, rat control investigator, or environ- oped and implemented in courses log of your meetings. Use your partner both mentalist. where itis important to broaden stu- as a sounding board and as a monitor to dents' experiences and to facilitate keep you honest. 14. Go to a community health center and awareness of attitudes, behaviors, and take a seat in line. Examine the attitudes of lifestyles that are difficult to accomplish 5. During the semester, keep a log of the the staff who work there. Talk to some of the in the classroom. behaviors/habits you change or modify. patients. Find out how adequate they think These projects are designed for the Examine the circumstances of the changes. their health care is, what problems they have Can you identify a pattern to the changes getting to see a doctor, etc. student, not the teacher. Therefore, we made? What did you learn? Report results. suggest that the list be duplicated and distributed to students. These projects 6. Keep a journal. Record reactions to oc- 15. Conduct a health campaign. Select a should be structured into course re- currences related to some topic or activity. health topic and conduct an educational yuirements so that points or some kind The journal could chronicle a physical fitness campaign such as anti-smoking, hyperten- of credit can be earned. Since the proj- regime or dietary pattern or an encounter sion, sickle cell anemia, cervical cancer de- ects vary in the amount of time, effort, group experience running throughout the tection, population control, human rela- and involvement required, possible semester. tions. points/credits should also vary. Some projects require several months to 7. Prepare and implement a research pro- 16. Visit a health foods store and make a finish while others may be completed posal. Some of you may have ideas for exper- list of what you see. Intervi w personnel in a 30 minute interview. Students iments such as the effects of various quan- who work there about their philosophies on tities of alcoholic beverages on reaction time, eating. Compare prices of similar foods in should be encouraged to pursue areas food tasting experiment, survey of attitudes. grocery stores or pharmacies. of personal interest and to take advantage of their talents. Some projects require skill in journalism, photoa°raphy, 8. Conduct a health demonstration. Some 17. Spend one weekend evening sitting in topicsmay lendthemselvesto a a public hospital's emergency room waiting movie production, art, research, etc. area. The same evening, spend the same Students should be encouraged to select demonstration-- the effects of smoki -g on heart rate, blood pressure, body temperature amount of time in a private hospital's E.R. only those projects which offer a new or how a medical test such as EEG or EKG Compare the two physical surroundings, experience for them. Finally, guidelines works and what it shows. personal attitudes of the staff, the patients should be developed which specify you see, their families. How comfortable/un- how and when projects are to be re- comfortable would you be if you were a pa- 9. Go to the Health Department, Venereal tient? ported. Disease Clinic as if you were a client seeking Experiential Learning Projects help for V.D. You may use a false name if you prefer. Report what you learned. Hoe: 18. Write a letter to a newspaper or maga- were you treated? What did you observe in zine about a current health-related issue that L Do a film. Compile either an 8mm film the waiting room, the treatment rooms? really gets your dander up. Turn in a carbon or 35mm slides focusing on some topic. This How did you feel? What changes would you copy.

3 5 21 19. Visit a health spa. What practices which interests you. Write a two page typed Administration and identify an example of seem valid? What claims are made which review of the major points of the article. In- quackery. What is the claim of the product? seem unrealistic, unhealthy, deceptive, eva- clude your opinion. sive? What do you get for how much money? What does the FDA say about the product? 30. Survey 5 "lay" magazines 20. Go to a free lecture on transcendental (Mc Calls, 40. Tape a radio or TV commercial and meditation. How do you think it works? Ladies Home Journal, etc.) and write a de- bring to class. What kind of propaganda scription of the ads which contradict good strategy was used? How is it misleading? What are the benefits claimed? What sort of health practices. You might want to look at impression did you get from the whole experience? magazines such asCosmopolitan, Playboy, 41. Conduct a demonstration to test com- Oui,which emphasize attractiveness and mercial claims of a health product. 21. Talk with relatives who have planned appeal. Include a synopsis of the ads' under- a funeral. What were their impressions of lying messages. 42. Write a company for verification of the funeral business and the people who as- claims made in advertising. Turn in carbon sisted them? What details must be attended 31. Attend lecture of guest speakers in- copy of letter and indicate company's re- to when planning a funeral? What legal prob- vited to a local university to discuss their sponse. lems did they run into? views of heal'h related topics. Example: Life after Life le e, rape prevention demon- 22. Find out resources for contraceptive stration. Sun the presentation. 43. Write a brief summary reporton the information. Make a list and include costs, if published article on chiropracticsora re- any, for the services and/or the contraceptive 32. Attend heL.in education meetings, port on any other health related article in- materials. List at least ten resources. fairs, programs sponsored by variouscom- cluded in the monthly publication of Con- munity agencies. Summarize presentation. sumer Reports. 23. Go to the local Unemployment Of- fices. Sit in the waiting room and listen to 33. Send in health assessment from back 44. Tell about the decisions a heart attack the talk around you. Describe the place. of textbook. Summarize what you learned victim or cancer victim makes in going Read the notices on the board. Describe any about your health status, risks and behav- through treatment, surgery, rehabilitation. contact with the employees. Wear old iors. Takes about 4-6 weeks to get it back. Comment on length of stay, financial as- clothes. As a variation two people can go to- pects, steps in rehabilitation, changes in gether, one dressed in old clothes and one in 34. Get a test for diabetes through the lifestyles, etc. really good clothes. Describe how individu- Health Department mobile unit, or get a Pap als differed in their reactions to you. test. Bring. the results to class with a written 45. Write a summary report on an article report of how it was done. Ask questions of published during the past calendar year on a 24. Go to any of the pregnancy counseling the personnel as they perform the tests. Try disease. Compare the information with that resources and ask to have a free pregnancy to find out how many people are detected in the text and comment on the differences. test. Describe the place, the people, how through this system. they treated you. If you are male, you can 46. Develop a skit or role playing situation carry in a urine sample saying it is for your 35. Write a summary report on the rela illustrating some attitudinal or behavioral girl friend. tionship between personality, emotional aspect of a disease. For example, simulate state, and cancer . the typical reaction of a person observing a 25. On a given night watch TV programs diabetic in insulin shock; the reaction of during prime time hours and count the inci- someone to the news that he or she has a dents which exploit sex, race, religion, 36. Using a very large map of your city, chronic disease. minority groups, occupations, etc. designate the distribution of doctors in the city. Which areas are heavily populated' 47. Write a position statement on some 26. Look in the want ads for jobs which Which have only a few? Which are under- controversial aspect of various diseases and routinely hire only men or women. Call and supplied? You might want to use colored be prepared to read to class. The position inquire about the job if you are of the oppo- pins to designate different types of physi- does not necessarily have to be your own site sex. What attitudes did you perceive? cians. Do the same with dentists. Write your A Epileptics should haye limited L.r.ving Quote any remarks made about sex require- recommendations. privileges. ments for the job. Sex discrimination is now B. Medical science is going too far with against the law in hiring practices. Variaton: 37. Bring an advertisement to class. List heart transplants. Work with a person of the opposite sex Both its claims. Analyze it for emotional appeal. C Government restrictions in the form of call and inquire about the job and record the Are its claims supported by facts? In what laws, penalties should be imposed on results. ways is the advertisement misleading? De- persons with genetically related diseases. ceiving? D Marijuana should be legalized for use by 27. Interview a relative or family friend glaucoma victims. who is retired. Find out how they spend 38. From the list of health products invest- F. The government is restricting distribu- their time, what they like about being re- igated by Consumer Reports and published in tion of laetrile because of loss of profits tired, what they dislike. What attitudes The Medic-me Show, select one and sum- and government grants in research. about being considered "old" do you pick marize the findings of Consumer Reports up on? Does the product render any medical or health benefit? What conditions, if any, 48. Interview a person who by nature ot 28. Arrange for the class to "interview" must be met in its use? What brands are rec- his her job observes death and dying (police you about a life crisis you have experienced ommended by Consumer Union? officer, mortician, war veteran, physician, such as divorce, marriage, childbirth, etc. nurse). You do not have to answer any question you 39. Refer to the magazine, FDA Papers. a don't want to. State any limitations before monthly publication of the Food and Drug 49 Develop a skit or role playing situation the interview begins. illustrating some aspect of death For example, how people act at a funeral home. a fam- 29. Read an article in a health journal ily making funeral arrangements.

3 6 22 50. Write a position statement on some C. to have or not have children 67. Attend a meeting of the LaLeche controversial aspect of death and dying. D. responsibilities of partners in child care League, the crganization that helps women A. Too much money is spent on funerals. E. obligations and rights regarding separate breast-feed their children. Record what you B. Young children should be taken to careers saw, heard, learned. funerals. C. Being dead is more honorable than being 68. Compare costs of 15 common prescrip- invalid. 60. Conduct a survey on some aspect of tion drugs among several local pharmacies. D. Burying bodies is a waste of good, pro- sexuality. For example, married couples of Include a chain-owned pharmacy, a small ductive land. different ages could be asked to answer the neighborhood one, and a hospital-owned E. There is too much death in movies and on following questions. pharmacy. Include the attitudes of those you TV. A. What do you see as the purpose of mar- questioned. riage? 51. Visit an Alcoholics Anonymous meet- B. Who controls the finances in your family? 69. Compile a list of local psychiatrists. ing and report your experience. C. What effect has the women's movement Call and ask for information on: fee scale, had on marriage today? training, group or individual therapy, type 52. Write one page position statement ex- D. What are your views on early marriage? of therapy (psychoanalysis, primal therapy, pressing an extreme point of view on al- gestalt, electroshock, etc.), hospital affilia- cohol. The position does not have to be your 61. Write a story in the "true confession" tion. own. Read to class, time permitting. style that deals with issues of reproduction, birth control, marriage, parenthood, sex 70. Contact the local organization for wife 53. Conduct a genetic experiment in class roles, etc. The story may be discussed in abuse. What are their findings regarding demonstrating dominant-recessive traits. class. wife abuse locally, their services, future For example, obtain small crystals of phenyl- plans? thiocarbamide or PTC test papers. Conduct a 62. IVrite a position paper on one of the raste experiment distinguishing between following statements. 71. Interview someone who Byes in what bitter tasters and non-tasters. What are the A. A couple should be encouraged to choose would be considered an alternative lifestyle: expected results? the sex of their baby communal setting, couple who chooses not B. A single person or gay couple should be to have children, unmarried couple living allowed to raise a child. together, homosexual couple living together. 54. Write a case history or biographical Question each person involved. sketch on a person with a genetically related C. Men should assume the responsibility of disease or condition. Describe the hfestyle of birth control the person and how it differs from "normal- D. No one should have more than two chil- 72. Collect drawings/paintings from ity." Describe the effects on the family. dren young, preschool children depicting their E. Marriage contracts should become the impressions of sexuality. Check with parents first! These could include their concept of 55. Find out what kind of genetic services form of marriage law and counseling are available locally, the F. A couple with hereditary disease should anatomy, birth, sex roles, etc. Show these to not have children class with your observations and comments conditions for service, prerequisites, costs, made by children. If you have small children location, etc. Report to class. F. Abortion on demand is a basic human right you may use their artwork. 56. Take a copy of the state penal code H Unlimited availability of contraceptives encourages promiscuity 73. Write a report on some new medical from the library and extract the basic crimi- "gadget," such as mammography, CAT nal statutes relating to sex offenses. Note 63. Conduct an experiment/demonstra- scanners, fetal monitoring. Include any criti- particularly those describing such acts as tion in class which focuses on the effects of cism the technique has received as well as its rape, seduction, carnal abuse, cohabitation, air pollution, water pollution or noise pollu- benefits. adultery, indecent exposure, loitering, tion. molesting, and vagrancy. Notice, too, laws 74. Interview a couple who has experi- relating to marriage, (consent, ceremony, 64. Draw a cartoon series which illustrates enced "natural childbirth" (the Lamaze verification) contraceptives, pregnancy, any health-related topic for example: method). abortion, and venereal disease. Report to A. transmission of venereal disease class. B. use of contraceptives 75. Write a self-help guide to common C. access to medical care/physician vaginal infections. Include symptoms, 57. Develop a skit or role playing situation D. medical terminology or technology treatment, preventive measures, if any. Al- On some aspect of sexuality or sexually re- Design it to get a point across to college level ternative topic: insomnia, urinary tract in- lated behavior. students. fections.

58. Select two newspapers (only one from 65. Demonstrate in class how to test for 76. Give blood at one of the hospital blood your city), observe and rec rd for one week blood type; how to test for sugar in urine; banks. Bring proof of the donation. Include the newspapers' statistics on marriages, di- pregnancy test; T.B. skin test; test for sickle written report of how community blood do- vorces, and annulment. Graph the results. cell anemia. Be sure you understand the nation plan works. Include in the graph a breakdown on whys and hows of what you are testing for grounds for divorce. and not just the procedure itself. 77. Visit a Weight Watchers meeting. Re- cord your experiences along with a descrip- 59. Construct a sample marriage contract 66. Interview several women who have tion of their program. Include a description for yourself with provisions for faccts of mar- experienced menopause. What were their at- of "case histories" you might overhear or ital life you consider particularly important. titudes about it before they experienced it? learn about. How does their plan work? You may want to consider some of the more After they experienced it? What myths about common features found in marriage con- menopause were true/untrue for them? How 78. Write an analysis of mibraine head- tracts today. did it affect their families, their marital rela- aches: what causes them, what happens A. division of assets held pfior to marriage tionship? Was any medical treatment given? when they occur, treatment, new ideas of B. division of inconw after marriage What were the attitudes of their physidans? therapy.

3 7 23 79. Interview an acupuncturist or an os- barriers of discomfort. The aims should be to 85. Take the results of the health knowl- teopath. Thoroughly document their train- decrease tension about being in a new, edge pretest which was administered in ing programs and the usefulness of their strange group and increasing knowledge class and complete a profile sheet and valida- skills. about each other. Include factors such as: tion exercise. time needed, materials needed, goals, 80. Put together a first aid kit designed for facilitators roles and responsibilities. 86. Preview health related films available a specific purpose (camping, boat, work- at local libraries and community agencies. room, etc.). Bring to class and explain whys 83. Collect at least five health pamphlets Write a summary report. of the contents you chose. from community sources and critique them as to their usefulness, their appeal. Redesign 87. If none of these projects grab you, 81. Find out and record 20 people's views them to make them more "zingy," more ap- think of another. Write a plan of action and on raising the mandatory retirement age to pealing. turn in for approval. Points will be given 70. Choose a mixture of ages for your sub- after reading project description. jects. 84. Review filmstrip/tape on one of three consumer products (shampoo, acne treat- 82. Design a sensitivity exercise to help a ments, aspirin) and write a critique of it. In- group such as a new class break down initial clude at least five ads for the product which make misleading statements.

24 38 12 TEACHNG IDEAS The HospitalasMotivator for Health Learning Saul Ross is assistant professor of physical educa- My first step was to find out what parts of the tion, Schoo/ of Physical Education and Recreation, health education curriculum had been covered. University of Ottawa, Ottawa, Canada. Previously Each boy was invited to tell me and his classmates he was a teacher and physical education depart- what areas he had studied or what he could re- ment head at Outremont High School in Mon- call from previous years. The topics mentioned treal, Quebec, and instructor of health and physi- were numerous, and the interest in each one var- cal education at the High School of Commerce ied. considerably. There did not seem to be a in Ottawa, Ontario. clear pattern, nor an exact core of subjects covered, and this assessment applied equally to both my classes. Pondering the problem, it occurred to me that The problemconfronting me was written one area had been omitted completely; ..s an clearly in the faces of the ninth grade boys star- area not covered in the textbooks used 4, health ing up at me from behind their desks. A number education. The hospitalthe largest, most visible of factors were operating to produce those defiant health institutionwas a topic ignored complete- looks. Some of the boys were repeating grade 9, ly in their health education courses. and almost everyone in the class had repeated My next problem was how to present this topic one or two school years previously, either in ele- to really motivate the students. One entire class mentary school or in junior high school. The ages period was devoted to having each boy relate his of the pupils ranged from 13 years to 17 years. experience with a hospital, be it a visit to a friend Their attitude also reflected the low status of or relative, a stay in the hospital, or contact with health education, confirmed by the fact thatit the institution through service in the emergency was assigned only one period per week. The low department or in one of the clinics. The fears, mis- opinion they had was also the result of some conceptions, and negative feelings that emerged prosaic standardized teaching approaches to this confirmed my thinking about the importance of subject in their previous schooling. delving into this area. The challenge was obvious. How could we After every pupil had talked,I asked them to change their attitude to health education? How write as many questions as they could think up would we create interest and excitement? What about hospitals. This was something new to them, new method could we find that would involve and after a few protests about not being able to the students directly? What new area of the cur- think up any questions, they set to work. Each riculum could we investigate that would meet the student was asked to prepare a list of 15 ques- following criteria: not covered before in previous tions for the next lesson. The assignment seemed grades, interesting to all the boys, and something tough, but the interest was there. to which they could all relate readily? Plans for the next lesson called for dividing the Before relating how the challenge was met, it class into small groups of 4 or 5 boys. Each group is important to describe the school setting. The selected its own chairman and then set about the High School of Commerce is a beautiful new task of analyzing the lists of questions to consoli- building, constructed as part of an urban renewal date them into one questionnaire. Questions project to meet the needs of the people in the could be combined and, a:, discussion took place, immediate area.Itis situated in a low-income, new questions were added. Each class handed me inner city area, amid government office buildings, 5 question sheets, a process that lasted for two and close to a large area that has been scheduled lessons. The questionnaires were mimeographed, for urban redevelopment for some time now. t3e- with adequate space for answers, ready for use cause the curriculum is geared to commercial sub- well before our trip to the Ottawa Civic Hospital. jects, over 75% of the student population is fe- contacted the Ottawa Civic Hospital and ar- male. Few of the students aspire to university; ranged for both classes to have a tour of the hos- most hope to land a good job after graduating pital. Copies of the questionnaires were sent to from high school, fairly confident that the com- the Hospital, to help the people there in planning mercial education they received will qualify them our tour. The Hospital had never had such a large for many office jobs. The boys aspire to jobs as group (25-30 boys) take atour, and so they office clerks, retail salesmen, management train- planned an itinerary to take into account the large ees, or junior positions inadvertising depart- number as well as the interest of the group as ments; some hope to join the police force., indicated by our questionnaire. 25 3!) Arrangement; were made with the school office flected a real need. The boys explored a new to free the classes for the afternoon. The cost of world on the tour of the hospital, a world few transportation was paid by the travel budget of peopleinthe community had seen or even the Physical and Health Education Departme thought about. The tour included visiting the admissions office, Two important questions need to be asked. records office, emergency department, furnace Did students learn? What did they learn? They and boiler rooms, laundry, kitchen, repair rooms, certainly learned about the operation of a hospi- storage room, and underground passageways. Be- tal and became aware of parts of the hospital that cause of the large lumbers of boys, laboratories most people don't know exist. This new knowl- and wards were omitted. The tour ended in a lec- edge gave them new insight into the complexity ture theater where we heard two speakers. The of the institution and made them aware of many head nurse of radiology explained the use of new employment categories. They were afforded X-rays and showed one of a clearly visible frac- an opportunity to look into a world unto itself, a ture. The supervisor of orderlies explained the complex and vital institution in our community. functions of an orderly and detailed the training This new knowledge led to understanding which program he underwent. Each pupil had a ques- in turn helped to change the negative feelings tionnaire with him as we toured the hospital and the boys had to the institution. Career possibili- busily wrote answers as they were provided by ties in the hospital, specifically the position of an our guide. At the end of the tour the boys made orderly, was important new information. Inciden- their own way home from the hospital. tally, the tour also pointed out to the hospital The next few lessons were devoted to follow- staff the need to embark on an educational and ing up what we had learned. The discussions that public relations program designed to modify the were held pertaining to the various functions of feelings of people in the community about the the hospital indicated that students had gained hospital. new insights and attitudes. Heart transplants was While attitude k difficult to measure, andcer- a subject of current interest and provided us with tainly no scientific effort was made toassess this a natural and logical lead-in to the next topic-- area,I sensed a new interest 'n health education study of the heart and circulatory system. on the part of the students. By using this experi- In reviewing this unit in our health education ence to launch the next topicheart and circula- course, I felt the challenge had been well met. tory systemthe progression was natural and The students were involved. They madeup a logical as compared to previous years wherenew questionnaire, which truly indicated what they subjects were introduced artificially, merely be- wanted to know. By using the smallgroup proc- cause they were listed next on the collrse of study. ess to promote interaction, more questions ap- Did they learn? What did they learn? By form- peared than with a simple compilation of all the ing the questions they learned about the thing original questions. Interest was high andwas sus- they wa.ited to know, pinpointing theareas they tained during the creation of the questionnaire were most interested in. By constructing the ques- and during the actual visit. There was consider- tionnaire, they learned to evaluate and discrimi- able excitement about visiting the hospital and nate. Perhaps most important, they were directly being guided on a special tour. The interestre- involved in the entire process.

26 4 0 13 TEACHNG IDEAS

crease learning on the field trip. Ar- the students should seek answers for, Re id Trips rangements for chaperones, transporta- reviewing standards of conduct and tion, and finances must be made well in safety for traveling and while at the site, advance of the trip. identifying any possible allergens or /.4.41ES H.PRICF assocrate profes:or of special problems students might en- Alhed Health Sciences at Kent State (Iniver- Prepare the students for the trip by counter (poison ivy, for example). in- say, Kent, Ohio 44240. reviewing the objectives for taking the form students of special needs, such as trip, giving appropriate bak_kgrounci in- clothing, notebooks, expenses, lunch, Even though field trips are "old" formation, identifying specific questions etc. teachingtechniques, thereare Teachers should take along a first aid thousands of teachers who wver leave kit if the trip is going to be all day or if the classroom. The community is filled the visitation site does not have first aid with health resources, and all health supplies. Other items for consideration teachers should make a 'ist o agencies to take along on the trip include: plastic and places to visit which are related to bags in case someone gets carsick and health education. bags for waste disposal (especially if the The major objective of a field trip is to students take their lunches). give students firsthand and accurate ex- The group should be kept to a man- periences not obtainable in the class- ageable size, by either limiting the room. Trips should be taken only when number of students who can go or by they can contribute to the objectives of increasing the number of chaperones the course. The following questions and making subgroups. Take along a list shouki be answered before the field trip of names of all students on the trip and isplanned. Will the students be count heads frequently. Other aids are gt.nuinely interested in the trip? Will to assign partners for the trip and select certain concepts be more clearly under- a place to meet if a student gets lost. stood as a result of the trip? Vill the Above alldon't panic! The trip will tinw and trouble be wortl A tiamount require a teacher who is enthusiastic, of learning produced? Is the trip truly alert, and flexill/e! representative ot the unit objectives? Upon arriving at the site, if you are to Preliminary planning for a field trip have a guide, introduce him or her and takes considerable work and should be get the group moving along as quickly scheduled well in advance ot the trip. as possible. Try to stick to the time Anytime the class goes exploring in the schedule while still answering all the community there is the possibility ofat:- students' questions. When leaving, cident, but caretul planning with atten- check the class list, thank the guide. and tion to details can help eliminat many depart promptly. If a problem should of the haiards ot a field trip. Properk arise which will cause the group to be super-sed held trips, authonied by the late, telephone thschool and let the appmpriate school authorities. usually principal know. I i reduces the anx- involve the same legal habtlity condi- iety in principals and parents who may tions as anv classroom actrrt I eacher be waiting for the returning students. should find out it their state has special Plan for followup activities after the rest ric how, Both administrative a nd pa- field trip. Some ot the most important rental perm.ssion cc ill need to be ob- learning will come from sharing im- tainedI he parents' permission slip pressions and discussing events which should identity the vs hovs hat,vs hch, occurred on the field trip. Further read- c, here. and %clic. ot the held trip and ing. cvriting, and class projects could larth ho ikga% repoh,ohle tor in- grow out of the well-planned field trip. surank e co\ erage ot the student Followup classroom activities will he teacher shouldisit the site prior likely reveal to what extent your field tu the tr:p and plan the observations trip objectives were met. The class and ak:R ities that vs ill best k ontribute to and/or the teacher should follow up and theinit obiectix t'sBe sure that rest- write a thank you letter to the visitation 100,s.eating accommodations. and site. A final evaluation of tlw trip should tirst aid stations have been identihed be formallv cvritten and put on file in the I he development ot a route map with main office. Then %Olen other teachers points ot interest marked can help in- consider visiting the same site, they will have all objective evaluation by one ot their colleagues.

27 14 TEACHNG IDEAS

HEALTH GAMES more than anyone else was viewed as a A recent publication presents learning games in several health education content sign of virility. 'This is partly due to the areas.' A drug game and an alcohol game from that source are presented here. fact that the alcohol he consumed affected his muscles first. 'In Woody's without a doctor's prescription? case, the alcohol also acted as an aph- rodisiac, as alcohol consumption usually What's On My Rack does. 'With these two factors contribut- Slang terms for "street drugs" are Drinking ing to his virility, one can plainly see why commonly used. However, the actual Alcohol consumption is a widespread he was pursued. drug, its action, its effect, and correct practice among all age groups. Alcohol name are often not known. This game will education is one means of correcting the '°Woody is a fairly bright guy and has familiarize students with the names, the misconceptions many people currently established guidelines for his drinking type, and the effects of drugs. Index believe and/or practice. This game is de- behavior. " First, he always drinks vodka cards, felt tip pen and prizes are used. signed to help students discriminate be- to prevent rapid absorption. "Second, he Place a slang term, correct name, and tween fact and fallacy about drinking. seldom eats any food before he drinks long term effect on separate cards using Description for Playing: One story is because it fills his stomach and he cannot the list r h own here. given to each student. Intertwined in this hold as many drinks. ''After all, if it's free i)P.,.ription for Playing: Pin one card on story are misconceptions and/or false booze he wants to get all he can. "Third, the bad of each student without them statements. Each sentence begins with a he drinks slowly instead of gulping his seeing it. number. Circle the number of those drinks to prevent getting intoxicated. Instruct the students that they must go statements which are not true. to other students and ask for a clue as to 's Since he is physically a big guy, he really can drink as much as he wants because he has more body tissue and fluids to dilute Name Slang Name Effect the alcohol. Amphetamines bennies, dexies, Alertness, actively paranoid, pep pills, uppers, loss of appetite, delusions, '6As the evening progressed (3 hours), hearts hallucinations. Woody collaumed six mixed drinks (11/2 Barbiturates barbs, blue devils, Euphoria, physical depend- oz. alcohol per drink) and the only ob- downers ency with dangerous with- servable sign he showed was a slight in- drawal symptoms. tensification of his talkative personality. Cocaine coke, snow, snuff Excitation, sore nose, paranoia, depressive rebound "As the party continued, he talked with on withdrawal. friends, danced and asked Joey, an attrac- Codeine Euphoria, physical depend- tive girl clad in jeans, if he could drive her ence, constipation, loss home. "Of course, Joey answered yes, of appetite. and they left the party. Heroin H., horse, scat, Euphoria, physical depend- junk, smack, ence, constipation, loss hard stuff of appetitu. " Should Joey have more carefully con- LSD acid, sugar, Insightful experiences, sidered the possible consequences of sunshine distortion of senses, may leaving with Woody? 20After all, he was intensify existing psychosis, only drinking moderately and there are panic reactions, "flash- no risks if he drinks moderately. " He backs." wasn't acting "funny; " the alcohol he Marijuana pot, grass, Outside stimuli more vivid, drank stimulated himthat's the primary tea, M), weed relaxation, euphoria, physi- effect it has on a person. "And because cal dependence. both his parents are alcoholics he proba- Methadone meth Constipation, loss of bly has inherited alcoholism from them. appetite. "Oh well, why should she worry? Morphine white stuff, Euphoria, physical depend- morph ence, constipation, loss of appetite. "The simple truth of this story is that 4ME Joey is the alcoholic and not Woody. 'Woody, age 20, resides with his par- 25 Everyone knows that there are more "What's on nback" such as an effect, women alcoholics than men. drug name, or slang term. ents in Mt. Pleasant where he is a sopho- more at the university. 'The females on After a person correctly guesses what Questions: Which statements are false? campus find him very attractive; 6 feet (6, 7, 8, 11, 12, 15, 16, 20, 21, 22, 25). his card says I e then finds the other stu- tall, 175 pounds, blond curly hair, and dents with the rest of the information per- bright, blue eyes. Important Considerations: The instruc- taining to a certain drug. The first group 'Final exam week has brought about tor should carefully explain why the with the correct cards wins a prize. the u,sual stress, and anxiety many college above statements are incorrect. This students experience. 'In an effort to al- exercise can be used as a pretest prior to Discussion Questior.: 1. What are the leviate the stress, Woody attended a discussion or as an evaluative tool after immediate effects of each drug? weekend party. s It was the usual kind of discussion. 2. What are stimulants, depressants or party he attended with a lot of women, hallucinogens? booze and loud music. Many of the 'Ruth C. Engs, ed., Eugene Barnes, and females at the party were in constant pur- Molly Wantz, Health Games Students 3. What is the legal, social, physical suit of him because his ability to drink Play (Indiana University: Bloomington, danger of many of these drugs taken Indiana, 1974), pp. 13-23.

28 4 2 15 TEACHING IDEAS

High School Post High School Drug Grouping Game lean Games, heroin psilocybin This game is adapted from the game, codeine penicillin "Birds, Beasts, and Fowl," by George LSD 'Mc Widow and gin methadone Enell, Kay Hardman, and Noreen Dres- Midol Valium ser (1977). It can be used as an offshoot Achilles Ex-lax Librium of the drug knowledge game or on its Contact hallucinogens own. hashish methedrine With a drug name card pinned to DAVID E. CORBIN is in the School of wine peyote their lapels, students group themselves HPER, University of Nebraska, Omaha, Bufferin alcohol according to their cards without talking Nebraska 68182 and DAVID A. SLEET is cocaine nitrous oxide to each other. The teacher should not opium PCP director of the Center for Health Games and morphine tell the students how to group them- Simulations, College of Human Services, amphetamines selves at this point. San Diego State University, San Diego, mescaline After the students have settled into California 92182. groups, one student from each group leaves the room. The teacher now asks Games and simulations are widely Next, pin a drug card on the back of members oi different groups what their used as teaching aids by classroom each student making sure the student group is. After they are in agreement, teachers across the country. We think does not know what is written on the the person outside the room returns and this attests to the potential of simulation card. The object of the game is for stu- gives his or her perception of the group and gaming activities in instruction. The dents to guess the name of the drug or to see if it is the same as that of the rest Center for Health Games and Simula- drug group pinned on their own backs of the group. tions at San Diego State University by asking questions of fellow students. After this exercise is over you can give houses the largest single collection of Students should stand up and mingle more specific instrut tions for the next health games and simulations and in a cleared area of the classroom. segment. For example: Group your- serves as a resource center for these ma- The rules are as follows. selves into two categorieslegal and il- terials. 1. Ask only yes or no questions. legal; or five groupsstimulants, de- During the past five years, we have 2. Limit questions to three per per- pressants, hallucinogens, narcotics, and collected, cataloged, and evaluated son. This forces students to seek infor- others. You can experiment with many games in health for the benefit of con- mation from people other than their possibilities, all of which will help the sumers. We have found that materials friends. students learn about drugs and various vary enormously in content, complex- 3. Approach the game cooperatively classifications. ity, and priceranging from one-to- not competitively. Once a person gues- After each grouping exercise, check to one patient education games for under ses his or her own drug card, pin the make sure all students are in the proper $5.00, to computerized simulators for card to the lapel. That student continues group. If they are not, ask tlclass if over $500.00. to mingle answering questions for other they can find the person or persons who The purpose of this article is to give students. If time is a problem, set a should change groups. Some can fit into examples of games which can be con- limit. more than one group, for example if the ducted with little cost or preparation Variation: Once the drug is guessed, groups are legal and illegal then barbitu- time. After experimenting with these pin a second card to the student's back rates could be in either, since they can suggestions, you can decide if you want for the student to guess. be prescribed or sold illegally. to pursue more formal and expensive Use: This game can illustrate how Remember, students may not talk commercial products. much or how little students know about while grouping themselves, they must drugs. Students will find they have rely on reading the drug cards and Drug Knowledge Game been given conflicting information. It "body language" to determine where will also show some of the problems en- they belong. Print the names of different drugs on countered in the drug culture; for index cards, one per student. Be certain example, buying drugs on the street is to use terms that are appropriate for the not very reliable. A drug may be substi- Reproductive System Terms Game grade level you are teaching. See the fol- tuted for another without the buyer's lowing examples. Notice that group knowledge. Sometimes the seller does This game is played in exactly the names, brand names, generic names, not know the difference between drugs. same manner as the drug knowledge and common names are used. This game can help reinforce theidea game only cards with names of the male that peers are not always reliable and female reproductive system parts Elementary Middle School sources of information, nor are the sel- are pinned on the backs of the students. cough syrup marijuana This is an excellent activityfor teachers aspirin lers of drugs. nicotine This game can also help improve who will be teaching sex education, beer caffeine s;nce it helps them to talk freely and tobacco glue questioning skills and reasoning. If the coffee antacids questions start out general and then be- openly about terms having to do with Turns Nytol come increasingly specific, students will reproduction. It is not recommended for Rolaids Sominex be more successful in guessing their generalized audiences. Like the drug whiskey cards.Herearesomesample knowledge game, it helps to illustrate Anacin questionsAm I an upper? Am I legal? the misinformation that abounds among milk of magnesia Am I injected? peers.

,1 3 29 Cards cal- include any of the follow- Ask the students togroup into foods Examples: ing that are high-risk for dental disease and foods that are low-risk for dental dis- Foster Brooks"Lady Sings the Blues" hymen labia majora ease. Dean Martin Betty Ford testes Bartholin's Ask the students togroup into high- Andy Capp Alice Cooper glands risk, neutral, and low-risk for cardiovas- Ed McMahon "Streetcar Named Desire" epididymus urethra cular disease. Hagar "All in the Family" seminal vesicles glans Experiment with other groupings. Janis loptin "Days of Wine and Roses" fallopian tubes labia minora After this exercise, students W. C. Fields Wilbur Mills ovaries Graafian can easily follicle see that there are many different aspects foreskin cervix to consider in selecting foods. Just be- After trying any of these games, you uterus clitoris cause a food may be low-risk for dental may wish to try some of the other games prostate seminiferous disease, does notmean it is necessarily on file at the Center for Health Games vas deferens tubules low-risk for cardiovascular disease. We and Simulations. For more information vagina also like to add foods suchas pizza or on the use of games and simulations in bulbou reth ral or health instruction, the reader is encour- Cowper's glands hamburger which don't fit neatlyinto penis any single group. aged to consult the suggested readings. Note: "urethra" is part of the male and female anatomy, but, of course, Originally presented at Association for onlyinthemale's reproductive Advancement of Health Education Meeting, systemthis may make it a more dif- New Orleans, LA. March 1979. ficult term for some. "Drunk" Synonym Game Thereare,reportedly, more Food GroupingGame synonyms for the word "drunk" than for any other word in the English lan- This game is very similar to the drug guage. These words say something grouping game and is also adapted from about how ingrained and accepted al- "Birds, Beasts, and Fowl." Instead of cohol is in our society. To beglii this name tags cut out pictures of different game open the floor to any and all foods from magazines. Be certain that synonyms for the word "drunk." As the you select different foods from all food students call them out, write them on groups and pseudo-foods such as al- the blackboard. coholic beverages, salt, pepper, condi- Examples: ments. Place all the pictures into a paper bag then have students remove one juiced inebriated food cutout without looking and pin it plastered pickled on their lapels. From this point on, the polluted under the table progression is the same as the drug zonked smashed grouping game. Remember, students biuted loaded always group themselves without talk- tight intoxicated ing to each other. Variations: Ask six people to leave the To better see how our society views room. Ask the rest of the class to re- drunkenness, make another list in group themselves according to their categories. This cm be done as a class or tags this time according to a specific di- as an assignmen: for each individual. rection, such as foods high in sugar, a The r ttegories could be: technical- balanced meal, high protein foods. 1).1, funny-happy, tragic-sad, and When the other students come back into trAl. Discuss the implications. Invar- the room they try to guess upon wha ..s.f the funny-happy category is the basis the groups have been formed. ,hirgest. Ask all students to form the four 'to extend this activity, students cart basic food groups (or the basic seven). name plays, movies, comic strips, TV Make necessary corrections by asking shows, and people in which (or whom) the class as a whole if everyone is in the alcohol plays an integral part, then correct group. If they don't know, help categorize them the same way they did them. the synonyms.

44 30 16 TEACHING IDEAS

LEARNING GAMES

Getting To Know Listening Practice Family Drawings One Another Students are formed into groups Oftenchildren'sinsightsinto There are several interesting ways of three for the purpose of discuss- their family lives are not such that for students to getto know one ing a question. Questions may range the roles of the family members are another better.Even though they from "How does someone make readily accessible to them. Percep- are in the same class, some students friends?" to "What's the safest way tions of familylife are oftenre- never converse with or know much to ride a bicycle?" During the en- pressed and hidden. An activity de- about many of their classmates. The suingdiscussion,inorderfor a signed to bring to the surfacea following exercise providesfor a member of the group to communi- child's feelings about his family is discussion of content within a proc- cate verbally,that member must one in which he draws a picture of ess designed to expand communi- paraphrase, tothe satisfaction of his family ina group activity or cation in the classroom; it thereby the previous speaker, what was last some other context. At the conclu- alsoincreases a senseoftrust said.Ifa paraphrase is attempted sion of this activity, drawings are among class members. but is incorrect, the person who is exchanged among all members of being paraphrased repeats what he the class until each classmate has Eachpupilisaskedtoselect another pupil with whom to discuss said and the paraphraser again at- had the opportunity to review each one of severallistedtopics. The tempts to paraphrase his comments. drawing. Pupils write a one sen- partner selected, however, should The purposes of this exercise are: tence comment, which expresses their reaction, on the back of each be someone whom theselector 1. To provide a framework for class- doesn't know very well. Before dis- mates to talk in small groups and drawingtheyreview.Comments cussing the topic, each pair get'. to get to know one another. shouldrelatetothe family asa know each other better by discuss- whole, or to individuals depicted. ing their aspirations, feelings about Next, drawings are returned to the artists with time provided to read the class,family history, or other 2. To emphasize that we are often the comments of their classmates. matters personal to their lives. After thinking of what we want to say A discussion follows of the objec- thisdiscussioniscompleted, the and not listening to what others tives of this exercise. content topic is discussed. Twenty are saying. minutes should be allowed for this phase of the exercise. 3. To discuss fully the topic at hand Lost on the Moon inaninteresting and effective to Possible topics for discussion are. Thisactivityhelpschildren manner. compromise and take part in con- Foods that I like to eat. (Nutri- 4. To underline that communication sensual decision making processes. tion) is often impeded by emotional Each child is supplied with a copy How to make our homes safe. involvement in the topic, some- of the following problem: (Safety education) one who talks for a long period You are in a space crew originall of time, someone who presents a a How girls are different from boys. scheduled to rendezvous with lot of ideas all at once, serious mother ship on the lighted surface (Sex education) biases, or a poor facility in which of the moon. Mechanical difficulties, totalk and listen. Any of the however, have forced your shipto Next, each pair chooses another above can, and often do, create crash land at a spot some 200 miles pair whom they don't know very difficulties in hearing accurately from the rendezvous point The rough well, and the process k repeated. what is being communicated and landing damaged much of the eguip rnent aboard. Since Nurvival depends This time, however, each pupil in- can cause difficulty in paraphras- troduces his partner to the other on reachingthe mother ship,tlw ing. most critical items available must be pair anda general discussion of If tHs exercise is conducted for a chosenforthe200-miletrip.The pupil's backgrounds, etc. precedes fifteen items left intact after the land- twenty minute period and then dis- the content-related discussion. The are listed twIciw. Ycair taskiN to group of four can then be com- cussedfully,pupilswill become rank them in terms of their impor- bined with another group of four to aware of their listening skills and tance to your crew inits attempt to make eights and eights can be com- attempt to sharpen them. A periodic reachtherendezviluspoint Place bined to make sixteens, etc. repeat of this exercise will provide number 1 bythe most important feedback on progress in develop- item, number 2 by the second most ment of listening skills. important, and so on throughthe least important, number 15.

31 Box of matches 2-5 gallons of water (replenishes resultin a ten-yard gain; and the Food concentrates loss by sweating, etc.) lastset of questionsis worth 15 50 feet of nylon rope 10Signal flares(distress call within yards. The toss of a coin decides Parachute silk line of sight) which team begins the game with Portable heating unit 7--First-aid kitcontaining injection the ball on the fifty-yard line. Team needles(ot.,'pillsorinjection Two 45 caliber pistols members decide, previous toat- medicine valuable) tempting to answer the question, One case dehydrated milk 5Solar-powered FM receiver-trans- _ Two 100-pound tanks of oxygen mitter (distress signal transmitter, from which set of cards the ques- Stellar map of the moon's con- possible communication with tion should be selected and thereby stellation mother ship). how much ofa gain will be at- _life raft containing CO2 bottles tempted. Teams alternate answering _ Magnetic compass Each child ranks thefifteen questions and the team thatputs items in terms ofimportance. _ 5 gallons of water the ball over the opponents' goal Groups of six to eight students are line is the winner. Only one team _ Signal flares then formed torankthefifteen member isallowed to answer the First-aidkitcontaining!nip( tion itemsas a group,utilizingcon- question and may not receive help needles sensual decision making rather than from his teammates. __ Solar-powered Fm receiver-trans- voting. No one group member's mitter opinion is allowed to override the Below are the correct rankings as group's decision. A comparison of determined by National Aeronautics individual and group opinions evi- Written Conversations and Space Administration: dences the advantage of consensual Thisactivity serves tocorrelate decision making.Thisanalysisis language arts with health instruc- 15Box of matches (little or no use conducted by computing the dif- tion and, in particular, family living. on the moon) ference between the NASA rank- The classis separated intopairs, 4Food concentrate (supplydaily ings and theindividualrankings one person assigned theroleof food required) firstly, and the NASA rankings and child and the other the role of par- 6-50 Feet of nylon rope (useful in the group's rankings secondly. The ent. A situationis described, e.g., tying injured, help in( limbing) differences for the individual rank- the child wants toplay outdoors 8Parachute silk(shelteragainst ings are totaled, as are the differ- with his friends while the parent sun's rays) ences for the group rankings. The insists he stay indoors arid complete 13Portable heating unit (useful only lower the score, the more accurate his homework. Each pair then en- if party landed on dark side) the rankings.' gages in a written conversation re- 11Two .45 caliber pistols (self-pro- corded ona sheet of paper. No pulsion devices could be mad(' verbalizing is permitted. Thesepa- for them) Cognitive Football per and pencil conversations should 12--One case dehydrated milk (food, last approximately twenty minutes mixed with water for drinking) A football fieldis drawn on the atwhich timepairs volunteer to 1Two 100-pound tanks of oxygen blackboard, and the class is divided read their conversations to the class. (fills respiration requirement) into two teams. A content area in Each conversation read is analyzed 3--Stellar map of the moon's con- healtheducationis selected,for with access to "replays" since the stellation(oneofthe principal example, nutrition. The teacher has conversation has been recorded on means of finding direction) three sets of cards which contain paper. 9Life raft(CO2 bottlesforself- questions pertaining to the content propulsion across chasms, etc.) Gene Stanford and Barbara Stanford, area selected. One set of cards con- I earn, ng Disc uccion Skills 1hmug 14Magnetic conlpass (probab:y no tains relatively easy questions, which Games (New York: Citation Press, 1969, magnetized poles; thus useless) when answered correctly, result in pp. 44-47. a five-yardgain.Another setof questions, somewhat more difficult,

4 6 32 17 TEACHING IDEAS

HORSE RACING IN THE __I CLASSROOM

PHILLIP HOSSL ER is a teaclwr of health and physical educatum and trainer for all sports at the Madison Township High School, Old Bridge, Net.% Jersey 08857.

One of the difficult problems faced by high school educators today is motivating their students, especially in required courses. The problem is convincing students that just because they have to be in must researc h much material in a short the class is no reason why they can't enjoy Then I give the class 10-15 minutes to look period of time, so the notes are delegated it and learn something at the- same time. through the books and pamphlets that I Giving stars or lollipops for answering a have brought to class or ones they have to eacli of the jockeys on the horse so that difficult question or solving a problem is gotten themselves to discover what I one might have the answer to a note that not successful in high school, because mean by each of these short phrases. the other jockeys didn't have time to find. older students feel their performance de- Each of the horses is questioned to ex- After eac h horse has given me an an- Iwrite the serves a more beneficial reward, such as plain my own notes to me. I speak to a swer explaining the note, the improvement of their grade. In many different jockey each time so that points awarded on the overhead next to required courses the students may only everyone is involved at some point. their horse's name amid cheers and do that which is required to pass the Each of the phrases is worth a certain groans from the jockeys. Then I tell them course. Clearly what is needed is sonic point value, usually 1 point. If only one exactly what I was looking for and give them time to write it in their notebooks sort of activity where the older students horse gives the correct answer, that horse are able to feel they are properly reim- would get the full point;if two horses before going on to the next note. The order in whic h the horses respond varies bursed for their endeavors and still learn give me equally correct answers they something in the process. would each get one-half point and so eac h time so no one horse gains an advantage by being the last to answer each I initiated an activity in my health forth. The points that each horse receives classes wherein the students researched, determine its position around the track. It time. in class, answers to questions and expla- takes a total of 12 points to run the length nations to the notes that Iplanned to of the track. The race continues until all the horses cover that day. This activity took the form For example, if horse #1, Sugar Daddy, have finished the course. If horse #1 tin- of a horse race. To start class when I use tells me that skin-to-skin contact is the ished first the jockeys cannot sit back and the horse race, I blow a whistle or ring a method of transmission when speaking do nothing; they must still answer ques- bell. I have signs in the room saying "Sta- about venereal disea3L, he would be cor- tions to ensure that another one of the bles," "Race Tips," "Cashier," "Grand- rect. If no other hcrse was able to give me horses doesn't earn more points and stand," etc., and have long strings of col- this answer Sugar Daddy would receive "nose them out at the wire." ored flags hanging in the room to add the full point.lf, however, horse #5, If there are six horses running, the jock- authenticity and show the class that I too Carmel Corn, told me that skin-to-skin eys on the winning horse each get six have enthusiasm and enjoy what I am do- contact was the method of transmitting points, the second place jockeys each get ing. venereal disease and that coitus was the five points, and sc forth. These bonus Eac h group of tour students is a horse, most common form of skin-to-skin con- points are used at the end of the marking so there are four joc keys to each horse, tact for transmitting VD, Carmel Corn period when grades are determined. and each horse has a name. The first day I would receive three-fourths of a point or This method of teaching requires more put on the overhead projector the draw- he might even steal the full point away time, because the amount of material ing of the oval track with the grandstands, from Sugar Daddy since Carmel Corn covered each day may not be as much as flags, and finish line drawn in.In the gave me the more complete answer. The with the lecture method. It?quires a center of the track Iwrote "Hossler's students become involved with the race teac her who is able to instruc t and still Happy Healthy Horse Sweepstakes." because of the constant advancing and maintain control of the class amid mild Next I showed on the overhead the ideas I falling behind on each question. After chaos, much laughter, and student en- planned to cover that day. For example, two or three notes, I write the position of thusiasm. I have found that the grades on when the class starts the study of venereal the horses on the track. The jockeys then the tests after using this method are the disease, the notes might look like: begin to dig a little deeper the next time highest grades of the marking period. Intro to VD for that bit of extra information that will I personally enjoy using this method of Venus give them the edge over the rest of the teac hing. I don't use it for the entire mark- skin-to-skin contact pack. ing period; instead I tell the class about it pox, clap I have also found that res?arc hing an- in the beginning and then save it until cause swers develops t .amwork arid pride last, This also helps to build enthusiasm damage to infected among the joc keys on eac h horse. They toward the ac tivity. 33 BEST COPY AV:A:Z:1 d 7 18 TEACHNG IDEAS

1. Ask the participants to close their Use your own imagination with this FANTASY GAMES eyes and get as comfortable as possible. game. After you are through give the They may sit in their chairs or sit or lie on group several minutes before they open the floor. Then say the following:I am their eyes and disclose their trip to the RALPH BATES is in the Department of going to take you on a fantasy trip. I want group. Health, Physical Education and Recrea- you to do exactly as I say and be aware of The following questions may be used tion, Ohio State University, Columbus, nothing else but my voice. for discussion: Ohio 43210. 2. The following questions can be used 1. How was your fantasy trip? for the rosebush. You will have to adapt 2. Where were you? I have used fantasy games with young these questions to the other games. What 3. What were your surroundings like? children, older children, and adults and are you like as a rosebush (object)? What 4. What were some of the feelings you have found them to be very successful. are your roots like ... your stem .. . your experienced? Participants become more aware of how leaves . . . your thorns . . . your flowers? 5. Could you feel the different textures they perceive themselves, what they are What are your surroundings like? What of sand? like as people, their strengths and weak- season? nesses and, most important, they can be- 3. Now proceed with the following: In come aware of emotions and deeper feel- several minutes Iwill ask you to open your eyes then tell us what you are like as Fantasy Dream (This exercise is also di- ings which normally would not be dis- rected toward older groups of children.) closed to individual or group members. I a rosebush. Have each member select a group member after he has described Close your eyes and become as relaxed have also found that fantasy is relaxing, as possible. I am going to take you back to helps develop better listening skills, and himself to the group. The following questions may be used for discussion. your early childhood to a recurring dream leads to closer, more meaningful rela- that you used to have then, a dream that tionships among participants. 1. What did you learn about yourself? 2. What did the group learn? you are going to have again. In this paper I would like to share sev- Don't be afraid. Just concentrate on eral of these games, to use with groups of 3. Nosy does this relate to disclosure, listening, feedback, communication, and what I will tell you, and on your experi- children as a means of relaxation and to ence as my words are spoken. At night, help them learn more about themselves. I fantasy? (Adapted from Stevens, Aware- ness.) while you are asleep as a small child, the will indicate the method I use in present- dream would occur over and over again. ing these games, and the reader can adapt The dream would begin in the same way. each one according to individual needs. You would get out of bed and walk across The books and articles in the bibliography Ocean Trip the bedroom to the closet. There is now a are excellent resources for fantasy games door behind the closet, a door which you as well as other communication skills for Obtain a record or tape of ocean could never find while awake. As you ap- both children and adults. sounds such as Environmental Sounds, or proach the door in your dream it now Make A Person a tape recording from a radio or TV com- opens. munication center. As you stand in the door you look down I have found this game to be effective 1. Have the group relax at their desks an ancient looking stone staircase. In the with children to help you learn what they or lie on the floor. dim light you begin to descend the stair- are like as people. 2. Tell them the following: I am going case, nOt at all afraid, down a step at a 1. Ask a group of children to think of a to take you on a fantasy ocean trip. I want time. As you approach the bottom of the person's name and write it on the board. you to close your eyes, relax, and concen- staircase you stop and hear the gentle 2. Using the general background of the trate on what I say. Imagine yourself ap- group as a guide, and the age of the sound of water lapping against the rocks proaching a beautiful vacated beach. . . . below. You approach the water's edge. A children you are dealing with, establish You begin to walk in the sand.. . . Stop small boat is tied to the rocks. Sit in the same criteria for this person. Example: and take off your shoes. As you stand "Billy is 14 and lives at home with his boat and untie it. Just lie back in the bot- there, feel the sand on the bottom of your tom of the boat and let it take you where it mother, father, brother, and sister." feet, the grains of sand sifting through wants to go. Sit there, relax, and listen to 3. Ask the children the following: With your toes.. . . become aware of that feel- the water lapping against the beat and help from each one of you, I would like to ing. Begin a stroll toward the water's rocks, as you gently rock back and forth, find out more about Billy. What is he like edge.. . As you continue your walk, be- back and forth, as the boat drifts down as a person ?What is he like at home? How come aware of the sun beating on your the stream. does he do in school? What does he like face, smell the salty air, hear all the As you lie there enjoying your trip you to do? How does he feel about himself? sounds around you. Find a spot ahead of notice a small opening ahead of you. As With these general questions as a guide, you and sit down in the sand.. . . Hold you approach the opening it becomes obtain several responses from eac h child some sand in your hand. .. . Feel the larger and larger. You come out of the and write them on the blackboard. If you individual grains of sand sift through your opening into a new environment which listen carefully, you will be surprised fingers. Stand up and continue your stroll you will now experience. Continue to about how these children feel about toward the water's edge. . . . Before you keep your eyes closed and become aware themselves, their peers, and their reach the water, stand (and sit) in the wet of the new environment. Where are you? families. Follow this through with a group sand. . . . Feel your feet sink into the wet . . . What is it like? . . . What will you do discussion. sand. Grab a handful of wet sand.. . . Be next? ... What sights,odors, sounds, aware of the difference between the wet and movements are you now experienc- sand and the dry sand. Stand by the wa- Rosebush and Object Identification ing? . . . etc.. . , Now open your eyes and ter's edge. . . . Feel the water gently flow- This game is directed more toward disclose your experiences to the group. ing under your feet and around your (Adapted from Masters, Mind Games. older children. You may use the same ankles.... Stand there and smell the salty format for younger children by substitut- air, feel the wind blowing in your face, ing a flower or animal for the rosebush and be aware of all the sounds around and object. you. . . . (cont'd). . .

34 4 8 19 TEACHING IDEAS

One of my beliefs is that the way one Questions ma% be raised tor classes feels about oneself is reflected by the that will help students tie in their expen- CHOICES hokes one makes and the behavior that em es to making c hoR es. The following IN follows these choices. Therefore, one of one way that this c an be explored. the ways I gain an understanding of the I) What were your teelings: when I individuals within my health classes is by told Yon what the initial task would he: observing their behavior in here and now while you were mos ing or antic loafing situations. Then, by exploring the motiva- someone else s mme: alter the task w as LYNN TEPER-SINGER is an assistant pro- completed? fessor in the Department of Health Sci- tions behind their actions, the class takes ence, Physical Education, and Guidance part in understanding their decisions. (2) How did you decide': tat who you andCounseling at Long Island I have found that the following tech- would like to know better; (b) how you Universtty----the Brooklyn Center, Brook- nique arouses strong emotional re- would show that person how you feel; (c) sponses while dealing with making deci- lyn, New York 11201. whether or not you would act on your sions: teeling? (3) Outside lite experiences m the Have your class stand in a cm le and classroom: (recommended for small look around the room at their classmates groups) pic king out one person they would like to Under what other c irc umstances have know better. At a signal from you, their you experienced similar feelings to those task will be to go over to the person at you felt here today? their choice and nonverbally show that What decisions did you make under person how they feel. Often no one will those circumstances? move initially. It this occurs yen may wait, What correlations can you make that or you might em mirage them further by will help you understand the patterns of saying. "You mean no one here wants to your choir es? know anyone better.- This may be met What other alternatn es do you believe with a display of discomfort or laughter, are open to you? and at this point itis best to investigate How do you see your ability to make what the students were feeling by dis- dec isions as a reflection ot your selt c ussing then objec lions to moving. f ven image? it no one in the class responds to the During experiences ot this sort within initial experiment, reactions are taking classes on both the high s hool aridal- pla« within each person. Some mem- lege level,I have tound that itis imma- bers may he «in tused about Who they terial whether or not the class moves at would c house or how they would show your signal In both c ases, students have their teelings and therefore nught not be disclosed feelings about:(1) being re- able to make a decision. They may have jectedthe feeling that the person they thought it over and decided to do noth- choose may not be open to them. (2) ing. Sonie people might have hoped that Being nusunderstood--someone might someone would make a dec ision to coine interpret their action (to the same or op- over to them, relies mg them of !lasing to posite sex) as one of sexual interest. (3) initiate the ac hon. Being spec al --hoping sollIV011e would slmw them their feelings first. 141 Being risk-taker -in spite ot !lasing all the above feelings the person may dec ide to move. Some students claim that they like the opportunits to let their feelings be known and are more «mitortable showing their feelings than telling someone ,thout them. This ter hnique is multilac eted. The «milu I that takes pia«, within ear h person mien deals with both the leelings the person has about what he wants or doesn't want to do and the f eel! ngs atmut w hat others want or expo( tof lum. Another area for disc ussion, thei (lore, c an inc luck's\ hal elle( I other people has e on the dec ision-mak rig pm( ess %%ohm

ll isms opinion that those tear heis make them own dec ision to us this tecii moues% ill mid it to be an excc'llent tool tor helping sludruts to dimmer and under stand the dec ision-making pro( ess and their molls df ow. behind the c hon es they tnake

49 35 20 TEACHING IDE AS

I. Con Outing an 4 Educational Ge '41 I

SALLYL. EASTERBROOK isan instructor of health education, Department of Health Sciences, Towson State University, Balti- more,Maryland 21204.Thisarticleis adapted from a presentation given to the Maryland AAHPER Convention in October 1976, Largo, Maryland.

oft__ rn. f/': 11.. There are numerous types of games 1 which can be used ina classroom. f..43 X14`.. Among these are the commercially pro- _ r duced game, teacher adapted game, teacher made game, student adapted involved in game play? The construction of directions falls game, and student made game. The last If not all students are involved, what into this step also. Directions should be four are the least expensive. An addi- can the rest do? as uncomplicated, clear, and concise as tional advantage is that they can be con- How much competition should be pocsible. The object of the game should structed to meet specific needs. Steps encouraged through use of this par- be stated and allpossible situations for developing an educational game for ticular game? should be included.If questions are classroom use follow. How much time needs to be set aside asked during the game, an answer for the playing of this game? booklet providingallacceptablere- 1. First,itisessertialto know the sponses should be provided. capabilities of the students who will be 5. Next, the constructor needs to decide using the gametheir abilities, atten- what type of game to createa board tion spans, and reading levds. game, a word game, a team game, or 7. The last step in game construction is some other format? What types of ques- a trial run. A group ofstudents should 2. A prerequisite in game building is to tions may be open-ended; basedon play the game on their own. From ob- outline clearly the specific purpose of choice, or short answer? Some ques- servations made during this session, the game. The constructor should know tions may be opened ended; based on modificationsof time requirements, exactly how it will be used in the class- student answers, the players will have rules, directions, and wording of ques- room. to make certain decisions (branching). tions can be made. Games can be used: to introduce new topics, which creates a "sct" for the learners; to illustrate an idea; or to re- 6. Actualconstructionof the game view a unit. Some games may be used comes next. Parts should be kept to a Development, construction, and use as pretests and then adapted to serve as minimum to prevent the loss and neces- of an educational game can be bodi a a posttest at the end of the unit. sary replacement of pieces. If a board fun and profitable way to spend class- game is being constructed, the board room time. Games can be pr6duced for 3. Once the purpose of the game has should be neat and colorful. All parts a wide variety of purposes and to meet been formulated, the specific content should be safe and durable. Covering the particular needs of students. If you ca n be outlined. parts with clear contact paper decreases haven't yet used this technique, why "wear and tear." not give it a try? 4. The constructor must then answer some questions concerning the classroom atmosphere during the game. How quiet or disruptive should the game be? How many st,identi will be directly

36 5 21 TEACHING IDEAS

of correct answers in each column, hori- 30. Health related journals Health 4 Fun: zontally and vertically for a maximum 31. Health book titles score of 32. 32. Health authors A Game of Knott/ledge 33. Famous healthpeople,past 34. Famous health people, present 35. Health organizations or societies RAYMOND NAKAMURA teaches in the Here are some suggestedhealth 36. Health agencies, offices or departments programs in physical education, School of categories. 37. Health related professions 38. Environment: mountains Education, DePaul University, 1011 W. Bel- 1. Body systems, organs, and glands 39. Environment: extinct animals or birds den Avenue', Chicago, Illinois 60614. 2. Bones or muscles 40. Environment: endangered species 3. Fniits and vegetables 41. Environment: rivers and lakes From time to time, as a diversion from 4. Meats, nuts or fish 42. Environment: national parks standard methods, educational games 5. Dairy products 43. Bakery products 6. Ice cream flavors canbeexcellenttoolsfor learning. 44. Famous restaurants 7. American foods 45. Kitchen utensils "Health 4 Fun" has been a successful 8. Foreign foods game because it requires a lot of knowl- 46. Health related household items 9. Diets 47. Things commGnly found in the medicine edge and provides some fun. It can be 10. Fitness: names of sports cabinet cooperative or competitive and can be 11. Fresh and saltwater fish 48. Health related words over seven letters used to develop research skills in dic- 12. Types of transportation 49. Breakfast cereals tionaries,encyclopedias,almanacs, 13. Types of fuel 50. Famous physicians textbooks, journals, etc 14. Pollutants: cigarette names 51. Chemicals found in the body The purpose of the gdme is to fill in 15. Pollutants: automobile names 52. Articles of clothing 16. Environmental pollutants 53. Plant names the blanks of a play sheet with words or 17. Germs or bacteria phrases that fit into pre-selected health 54. Flower names 18. Medical laboratory apparatus 55. Category of your choice categories. The filled-in words must 19. Human diseases begin with certain letters which are cho- 20. Communicable dieases The degree ofdifficultyofthese sen at the beginning of the game. 21. Non-communicable diseases categories shouldberelated to the The health categories chosen must 22. Drugs, medicine tradenames academic level of the class. Many a be suit the level of the class. Each one is 23. Slang for drugs or medidnes refined to offer greater difficulty. For written on a separate 3x5 index card. 24. Over the counter drugs example, a generalized category like The cards are shuffled and placed face 25. Pollutants: detergents 26. Wines prescription drugs can be limited to down; four cards are drawn from the 27. Beer barbiturates. However, I have found it pile.As eachselectionisread,all 28. Soft drink tradenames necessarytoinclude some easy players write them down in the four 29. Hospital names categories to ensure some success. category blanks on the play sheet. Letters are written on another set of index cards, one per card. These are shuffled and four are drawn from the pile. The chosen letters are written in Bohes AtA+0 Medial the appropriate blanks on theplay Ca19ory11)+!4mbn and Tieult sheet. t4arrieSsAirfal°4 , 62etseMuse-Its 4 The Game 16r. -1,e14o;e1>clicIi Wor Each player tries to think of a word or LiP;f44`fria phrase in each of the 16 blanks on the play sheet that fits the category at the t4kooriA3 top of the column and begins with the ...1 . selected letters. An example of a filled- in play sheet follows. To add excitement, a time limit of 2-5 minutes can be ,n,i_61.t511 put on the game. 1 Tibula r rurs The game can be played as a form of :D;seast solitaire or by the whole class. Teams , can be made for more competitive or cooperative games. . At the end of the game, players 10 41)14 UYNC0111 Le-h5 should research the answers they could _ XL notfillin. Discussions often develop when students come up with words or czA phrases that the others are not familiar with. Answers may be challenged; tlwn they must be verified by research. In competitive games the play sheets can be scored by adding up the number 37 5 1 22 TEACHNG IDEAS

School Health Bee

Bernard S.Krasnow isassistant principal and supervisor of health education at Arturo Toscanini Junior High School in Bronx, New York. was able topressa buttonto make alight flashinfront of him. Mr. Pluchik servedas moderator and asked the questions. Three other teachers acted as judges. The questions for the final quiz were selected from among those in the initial survey and the run-off examinations. There was great anticipation on the part of the contestants and the student body. Publicity had been extensive through public address messages, posters, and class announcements so that most of the students were eagerly awaiting the program. The contests were well received by the audience and seldom has there been more audience en- Health education took a dramatic turn lastyear thusiasm. The excitement was, in fact, so great at Toscanini Junior High School in Bronx, New thatmany timestheaudienceinadvertently York. Our schoolinaugurateditsfirstannual shouted out the answer. (We did, in fact, throw health bee in order to stimulate greater partici- the questions to the audience if they were not pation and interest in health education and in answered correctly by the contestants.) The scor- current health topics. ing was conducted by awarding one point for The project was created out of a desire to each question answered correctly. Each contest- change the traditional assembly program so that ant had his own personal scoreboard thatre- an atmosphere of excitement would pervade the flected his current total. This kept the audience audience. The health education department held posted on the current scores. a conference devoted to this idea andit was Each auditorium program was concluded by decided to promote a school-wide health knowl- awarding a trophy to the health quiz winner of edge quiz. This would culminate in a series of each grade, and the finalists received honor certifi- grade auditorium programs designed to dupli- cates. The school photographer was there to take cate the fun and excitement of television quiz pictures of all the winners and we plan to display programs. these for publicity purposes. The school's health instructor, Mr. Pluchik, was Our original idea in initiating this project was designated as the teacher-in-charge for the proj- to focus on health education and current health ect. He constructed a health knowledge test from topics. We are sure that this school-wide program our own curriculum which was administered to did just that. We are, however, promoting follow- all the students during their health or science up activities so that our initial efforts are long- periods. The students who scored highest on this lasting. Some of these activities include: establish- initial survey test were invited to a class winners' ing a health information reference center in our run-off. Fifty-five class winners appeared for the school library, publicizing the health quiz in the run-off test which was held after school. Those community, establishing a health award for gradu- with five highest scores in each grade were then ation, and promoting health topics to be taught designated as finalists and invited to participate as part of the curriculum in other subjects. in the auditorium quiz programs the following We are also hoping that we can motivate other week. They were given extra resources in the form schools in our district (District 9) to conduct their of textbooks, pamphlets, etc., to study from in own Health Bee and, perhaps, even a city-wide preparation for the contest. contest. We think thatitistime to stimulate The auditorium program was modeled after a nationwide excitement for hedlth education. Who television panel quiz program. The industrial arts knows, aNational Health Education Bee may department constructed an electricalresponse someday stand right alongside our National Spell- board so that a contestant who knew the answer ing Bee. 38 5 2 23 TEACHNG IDEAS

Not Merely Nostalgia

RALPH EDWARDS is pmfessor of health education and dean of adminiOratiini and planning, Kingsborough Connnunity Col- lege, City University of New York, Brook- lynNlew Yorh 11235.

In moods of nostalgia, 1 am reminded of my elementary school days when we studied health heroes which, if memory serves me, were offered us in pamphlets published by Metropolitan Life Insur- ance Company. Tales of great exploits by leaders of science and health, including Madame Curie, Louis Pasteur, Flor- gled out for their contribution to under- ment; Karl Landsteiner discoverer of ence Nightingale, and Walter Reed, set standing health. Aesculapius and Hip- four blood types; Jonas Salk and Albert an example for a generation of youth for pocrates were the heroes of ancient Sabin, researchers and developers of concernfor human wellbeing and a Greece; Celsus and Galen of Greco- polio vaccine; C. Walter Lillehi, Arthur searchfortruth,and ^.annotbe Rome; Rhazes, Avicenna, and Moses DeBakey, Denton Cooley, pioneers in minimized or ignored. Studying the life Maimonides of the Byzantine era; artificial heart devices; Linus Pau ling, history of famous individuals is a desir- Paracelsus, Vesalius, Pare, Harvey, of chemist of molecular structure and ad- able teaching tool and certainly well- the Renaissance; Lind, Hunter, Pinel, vocate of vitamin C; Rachel Carson, known to our academic colleagues. The Rush, Bright, Braid were the 17th and who inSilentSpring (1962) documented fact that a famous Hollywood star or an 18th century heroes of the Enlighten- the effects on the environment of syn- athlete uses a particular deodorant, ment. The 19th century was full of in- thetic organic insecticides (DDT) and travels on a particular airline or dresses dividual efforts of Europeans as de- herbicides; John Rock and Gregory Pin- in a particular garment is valuable where picted by Claude Bernard, John Snow, cus developed a synthetic fertility hor- it counts heavily in this societyin the Ludwig lgnaz Semmelweis, Rudolf Vir- mone; Rene Dubos, biochemist and ad- pocketbook. Health educators might chow, Florence Nightingale, Louis vocate of antibiotic therapy; and, Hans seriously consider turning back the Pasteur, Joseph Lister, Richard Kraft- Se lye, endocrinologist and exponent of clock, for at least part of their instruction, Ebbing,Robert Koch, PaulEhrlich, the "stress theory" of disease. to the Charles Atlas, Babe Zaharias era, Sigmund Freud, and Havelock Ellis. We can add to thelist above the to get the attitudinal value and matura- Americans are well placed in the health yearly Nobel Prize winners in rhemis- tion for us in education. hall of fame of the 19th century by such try, medicine, and biology. We do have Some may have seen a recent news luminaries as William Beaumont, Eph- a large assembly of heroic figures who item concerning Richard M. Eakin, Pro- raim McDowell, James Marion Sims, have spent their professional lives work- fessor of Zoology at Berkeley, Dr. Eakin, William Morton, Clara Barton, William ing to keep man healthy and fit. Their in order to make his subject alive and Os ler, William Welch, Walter Reed, Wil- accomplishments can be recognized as a more interesting, has developed a tech- liam Halsted, Simon Flexner, and Wal- teaching device and as a technique for nique of dressing up in the costume of ter Cannon. valuable discussion. Their efforts de- famous lecturers in areas of zoology. American contemporaries of the 20th mand applause even in an era which Gregor Mendel, William Beaumont, century do not pale when we mention glorifies the anti-hero in fiction, movies, . Charles Darwin, William Harvey, Louis them in comparison to earlier heroes. and television. Acknowledging the con- Pasteur are among "guests" that Eakin Howard A. Rusk spent a lifetime treat- tribution of real heroes and placing brings to his students. While teachers ing the physically disabled and educat- them in a setting of everyday living is an cannot be expected to be actors, cer- ing the public about the importance of important contribution to the student of tainly the impressions made by this in- rehabilitation; Will and Charles Mayo health education and to the average citi- structor and the favorable response of developed the model for cooperative zen. the students suggests a new slant on an group medical practice; Paul Dudley old approach to content and impact. White, cardiologist, exercise proponent In bringing the heroes forward, it is For some time I have introduced and physician to a president; Benjamin not so much a question of what we can courses in health education with a his- Spock, baby doctor, child care expert, contribute to their memory, but rather torical perspective. Within these histori- socialcritic;Carl and William Men- what remembering them can contribute cal perspectives, individuals were sin- ninger, advocates of psychiatric treat- to us and our teaching.

53 39 24 TEACHING IDEAS WEN= 111111MIIIIIND

Health in Concert

This article was submitted by the Senior Health Education Seminar, spring quarter 1976, Bowling Green State University. It was edited by CLAY WILLIAMSissistant professor of health education, Bowling Green State University, Bowfin.? Green, Ohio 43403 and JUDY SCHEER,ssistant professor of health education, L liversity of Toledo, Toledo, Ohio 43606. What do "Puff the Magic Dragon," "Dead Babies," and "Junkfood Junkie" have in common? These and other such popular songs are a fantastic means of ailowing occasional indulgence in junk Alcoholism learning about current health issues. A foods without fear of weight gain. "What Can A Family Say" America "health concert" is a means of develop- Peter, Paul, and Mary's song "Puff the "Social Disease" Elton John ing health concepts by capitalizing on a Magic Dragon," can be focused on "Another Try" America popular pastime of today's youth-- marijuana, mental health, value clarifica- Safety music. tion, and understanding one's self and "Convoy" W. C. McCoy Music has much appeal for the young relationship with others, creating an op- "Dead Man's Curve" Carpenters and old alike. It can have a calming effect portunity for lively discussion as students Mental Health as well as an energizing effect. The topic are challenged to search for the numer- "Sweet Surrender" John Denver range is as diverse as the performers ous interpretations that are provided in "Twisted" Joni Mitchell themselves. Some approach life with sin- the lyrics. Interesting comparisons can be "Leave Me Alone" Helen Reddy cerity and heartache while others em- drawn when students are asked to inter- "Brain Damage" Pink Floyd phasize humor or entertainment. Listen- pret these lyrics both before and after Environment ing to music of entertainers like John appropriate health units. Students could "Where Will the Children Play" Cat Ste- Denver can create a greater understand- also be encouraged to express their feel- vens ingof human emotions, actions, ings and knowledge, individually or col- "Big Yellow Taxi" Joni Mitchell philosophies, and lifestyles. By bringing lectively, in song. Nutrition music into the classroom students and "Junk Food Junkie" Larry Grace teachers have the tools to elaborate upon "Savoy Truffle" Beatles the relationship between music and Another application would be to de- Venereal Disease health. velop a mood chart based on the stu- "You Left Me Sore" Todd Rungren Songs can be used to introduce a unit dents' feelings after listening to the song. Contraception cr to maintain interest during the course From this exposure, a discussion could be "Unborn Child" Seals and Croft of a unit. For example, by using a song focused on using alternatives as a means "The Pill" Loretta Lynn like "Junkfood Junkie" as a part of a nutri- of achieving highs. After such dis- Sex Education tion unit, a teacher could easily develop cussions, one could give the students a "All the Girls Love Alice" Elton John several followup activities relating to the video camera and allow them to express "Sweet Painted Lady" Elton John theme of the song. This song touches on visually and to share various oppor- Aging the sodal aspects of America's eating tunities for achieving natural highs. "When I'm Sixty Four" Beatles. habitsthe fast food craze, health foods, Examples of additional health units and "Old Folks" (from Jacques Brel is alive and junk foods, vitarnin supplements, and some songs that might be used in each well and living in Paris' convenience foods. category are as follows: "Today is the First Day of the Rest of My Using this song to introduce a unit, Drugs Life" John Denver challenge students to see how miy nu- "Mother's Little Helper" Rolling Stories Suggestions to help make your health trition concepts are in the lyrics. Their "The No No Song" Ringo Starr concert an effective learning experience lists of concepts could then be used as "Momma Told Me Not to Come" Three are: guidelines to develop an overview of the 1. Use quality audio equipment unit. The song could also serve as a Dog Night "The Needle and the Damage Done" Neil 2. Screen the songs before they are springboard for group activities or indi- played to the class vidual projects to develop the practical Young Personal and Social Relations 3. Make copies of the lyricis for the stu- aspects of nutrition. Students may want "At Seventeen" Janis Ian dents to survey local fast food chains to obtain 4. Be open to a variety of interpreta- data enabling them to compare quantity "Looking for the Right One" Elvis Presley "Everything I Own" David Gates tions and nutritional value for the consumer 5. Be aware of miscomeptions that dollar. They could also research nu- Death "Patches" Clarence Carter may be conveyed in a song tritional information about foods men- 6. Try to use current or well-known tioned in the song. Others may want to "Ode to Billy Jo" "Run Johnny Ri 1" songs so the students can identify with construct low calorie meal plans which them would provide essential nutrients while 7. Do no overuse the strategy 40 25 TEACHING IDEAS

Tuning In To Health Education

is.

WARREN L. McNAB is assistant professor example of how we applied and inter- emotional problems that are dealt with in of health education, Department of preted the three situations to the song. a crisis such as suicide, death, or divorce. Health and Physical Education, University Followup questions which are brought up of Houston, 3801 Cullen Blvd., Houston, Line 1Whatever it isit'll keep till the can be directly tied into their discussions, morning Texas 77004. for example: How do you feel after listen- Suicide: Things right now seem unbeara- ing to the song? How do emotions affect Music can be used effectively in health ble, but perhaps we can iron out the one's life? How can emotions be benefi- teaching because today it incorporates problem tomorrow. Give it one more cial in one situation and destructive in what is taking place in "real life" and chance. another? Can music relieve or create stimulates moods in both young and old. Death :If we can just get through todays stress and tension? Wha, emotions are Lyrics tell of death, love, life, human rela- sadness and grief, tomorrow will be elicited from you by this song in relation tionships, sorrow, happiness, and many better. to suicide, death, divorce? How do emo- other emotional experiences. tions affect one's behavior? How does In health education these particular Divorce : Can't our differences be settled one's mental/emotional health affect topics, as well as several others, are dealt tomorrow? Let's sleep on it and we may one's physical and social health? with in the physical, mental/emotional, change our minds. These are basic questions that are dealt and social makeup of health. Interpreting Line 2Haven't we both got better things with in the topic of mental health, but the music in conjunction with the health to do? use of music allows students to relate to education discipiine requires students to Suicide: You have a purpose in life, you this information and apply it in a relevant critically analyze and describe for them- can be somebody, you will hurt others manner. In addition, environmental in- selves, based upon their own interpreta- by what you are doing; there is much fluences of one's mental health, and how tion of the song and lyrics, what message more in life to experience. music does indeed affect one's emotional or mood is being conveyed. Death : One must go on in life; death is health in both positive and negative as- One way in which we used music in part of living. pects of life can be discussed. .1 education was to have students Divorce: Can't we try something else be. .-rpret a song sung by Melissa Man- sides divorce ? ( ester entitled "Midnight Blue." Before p:aving the record divide the class into Line 3Midnight blue Other song possibilities and their re- grc, ips of four or five and give each stu- lated topics are "When I'm Sixty Four" (by Suicide :Darkblack, fearful, mysterious de,./ a copy of the lyrics to the song. The Death : John Lennon and Paul McCartney) for ag- time'ofone's life groups read along and listen carefully to Divorce: ing, "Lighting Bar Blues" (by Arlo Guth- 'the lyrics and interpret what is said by rie) for alcohol use, "I Love You" (by applying the song to a specific situation. Olivia Newton John) for human relation- The three situations are: (1) A friend is Line 4Even the simple things become ships, "Poems, Prayers and Promises" (by contemplating suicide .:nd is on a ledge rough John Denver) for mental health, and ready to jumpyou .,e there trying to Suicide: Everyone has problems in life. At "Junkfood Junkie" (by Larry Grace) for persuade this person to stop his/her atany one time we may think life is not nutrition. tempt; (2) there has been a recent death worth living, but we can adjust to most Students can also be asked to bring in a in your immediate family; (3) you and problems. Suicide won't resolve these record which they feel has a health mes- your husbandrwife are contemplating, or problems. sage or could be applied to a health topic. are on the verge of getting a divorce. Each Death: Even though we know death is This particular method of teaching allows group is given One of these situations. coming, itis extremely difficult to actor individual thinking, a sharing of ideas, Based upon their 1. .rticular situation each cept. and it stimulates students making health group is to relate and interpret what the Divorce : Every little thing hurts at times education a fun, relevant and worthwhile song's lyrics mean and how it can be tied like this; there is no simple solution. experience. into the topic of mental health. The song is played and the groups are given ten minutes to decide what the lyrics mean in relation to their assigned topic and how This approach to teaching allows stu- each situation deals with mental/ dents to interpret the message stated in emotional health. These ideas are then the song and through individual and col- shared in a class discussion. lective thinking apply their interpretation The following lines from Melissa Man- and feelings to a health related situation. chester's song "Midnight Blue" and the "Midnight Blue" is effective in looking at Permission for duphcation granted by Rumanian studentsinterpretations serve as an the different, and yet similar, mental/ Pickleworks. Inc.. Ness York Times MusicRMI.

r 41 26 TEACHING IDEAS

Ideas for Successful Health For this to happen, itis necessary to homosexuality, sexual inter- Teaching* for the teacher to create an atmos- course, or fellatio. phere of freedom without external Within the last few years the song "I LOREN B. BENSLEY, IR. is associate threats. The fourth essential point Never Promised You a Rose Garden" professor of health education, Cen- in teaching health education is the became very popular. This song could tral Michigan University, Mt. Pleasant, need for the teacher to know his be played in class and discussed in rela- Michigan 48858. students. Thispointcannotbe tion to mental and emotional health. stressedenough.Inorder for a The discussion could center around the health teacher to experience suc- fact that no one promises youevery- As a professor of teaching cess to any degree,itis necessary thing and you must work for much that methods,I am a great believer that that he design the course with a full you receive in life. For a unit on mental how you teach is just as important understanding of the students' health the author has experiencedsuc- as what you teach. Many times, we healthneedsandinterests.The cess with a ninth grade health education teach the way we weretaught, health educator must gather data class using some of Simon and Garfun- rather than the way we were taught on the personal health habits, atti- kel's work, notably, the songs "Bridge to teach. In order for health teach- tudes, and behaviors of those stu- Over Troubled Water," "A Most Pecu- ing to be successful, it is of utmost dents heisteachingatany one liar Man," and "Richard Cory." The lat- importance that the methods used time. be creative and originalin every These four points are only a part possible way. By doing this, the sub- of successful health teaching; they ject will be more interesting to the are mentioned here because often- students and enhance the oppor- times teachers ovedook what might tunities for behavior change.Itis be considered the obvious items in importantthatthematerialpre- teaching. With these points in mind, sented to the students be student Risinterestingtoexplore some centered rather than subject cen- different ways to teach health edu- tered. cation to secondary school students, in the past ten years of teaching such as the foHowing two methods health education to secondary I have found to be successful. chool and universitystudents, I have discovered four essential points for successful health teaching.First, learning must be enjoyable. If the students find that learning health can be fun,itis then Using Popular Music In correctto assume that they will Teaching Health enter into the learning experience with a great deal of enthusiasm and Much of today's popular music excitement. Second, students must has a great deal of meaning behind become emotionally involved in the the strange sounds and muddled learning process. This can be done voices. By examining some of the rather easily in teaching health edu- music subscribedtobytoday's cation; one's healthisa personal youth,theteacherwilldiscover thing and to become involved emo- that muchiswritten about drug tionaHyinthe subject matteris abuse, humansexuality,environ- almost automatic. The third point mental conditions, and mental and to consider in teaching health edu- emotionalheaRh.Itissuggested cation is that the student should be that the teacher listen to some of granted a degree of academic free- the songs from the very popular dom toexplorehis or her own and successful rock musical "Hair." health needs and interests. By so do- The song "PoHution" is concerned ing, the student experiences health with air poHution, whereas the song learning as something which be- "Sodomy"refersto humansex- comes relevant and has a purpose. uality. This topic isalso discussed in the lyrics of music composed by current popular artists such as Mick Jagger and the Rolling Stones, in *The information in this article is based "Live With M," or "Let's Spend the on material which appeared originally io a column entitled "Ideas for Success- Night Together." The group called ful Health Teaching" published in the The Rare Earth also sings about sex- Journal of the Michigan Association for uality in their song titled "In Bed." Health, Physical Education, 3nd Recrea- Music about sexuality is extensive, tion. The MAHPER Journal editor, Joan and the health educator can be se- Nelson, granted permission forits use. lective in choosing songs pertaining 42 5 6 ter two are pertinent to the topic of Using Current and Popular character of the story. When dis- suicide. The students' favorite song per- Literature in Teaching Health cussing the topic of love and pertaining to mental health, however, is sonal relationships, the ever popu- "Walk a Mile in My Shoes" by Joe Just as effective as using popular lar novel Love Story is suggested to South. music in teaching health education the students. This particular story, The teacher can also talk about musi- is the use of popular literature. Are about two young people who fall cians or musical groups and center the there any books you have read in in love and marry, is good because discussion around the use of drugs. For the past year which could be used of the deep, meaningful feeling the example, several years ago two very to teach about health? Often there couple have toward each other.It popular musicians died of an overdose is a novel, fictional story, biography, is essential when discussing emo- of drugs. The class might discuss the or some piece of iiterature that con- tions in regard to human sexuality questions why Janis Joplin and Jimmy tainsinformationpertinentto a thatmature love be understood. Hendrix used drugs and eventually took health education class. When dis- The boo!. Love Story brings this out. an overdose. cussing drug abuse, students may There are hundreds of books that The use of popular music as a read the book Valley of the Dolls, could be used for discussion pur- medium to teach health has been a story about barbiturate addiction poses in a health education course. extremely interesting to me and my and the eventual death of the main The important things when consid- students. One reasonisbecause ering this method are first, that the the teacher isu 'ng asignificant teacherselect a book which is object of the teenagers' lifehis suitable to the subject at hand and, music.Itis,ineffect,a way of second, thatithas appeal tothe reachingstudents throughtheir students. Itis both a real challenge own medium. and an enjoyable way of teaching.

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43 27 TEACHING IDEAS

The Student dents and the individuals who conducted Interview #2 the interview will tell what they discov- Instructions: ered. Interview Interview two individuals in your class. I have found that there are a variety of t\v() in_ ways one can use this technique. Each You are not to give more than Technique teacher should choose that method terviesvs, which best suits his/her situation. The Questions: interviev. can be specific, (drugs, alcohol, MARC E. MEYER is a health education Name? sex education, mental health) or general, What three things do you rrize most? teacher at North Rockland High School, asking questions as presented here, Hammond Road, Thiells, New York 10984. It you could visit anywhere in the world, which explore a variety 01 ideas and val- where would it be? ues. As health educators we are always look- If you could divide $5,000 between two By implementing activities such as the harities, what would they be? ing for ways to encourage class participa- "student interview technique," students tion. One method seems to work quite When was the last time you were come away from class with a better feel- punished? wellwithin my healtheducation ing; most were eager to participate and classesthe "student interview tech- Why were you punished? most had a p learning experience Do you have many friends? nique." which they will not soon forget. This technique works well hecause it What do you feel was the best mo,,ie you has certain qualities which help students Interview #1 ever saw? What is important to you? in a variety ot ways. First, the technique is Instructions: flexible, each teacher can use the inter- When was the last time yoll gave advice to view for a particular unit or simply for a Interview two individuals iii your class. someone? change of pace in daily routines. Second, You are not to give more than two in- Did he.'she ask for your advice? it allows each student to communicate terviews: his/her ideas to others. It helps develop

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the ability to communicate and to listen, Questions: Interview #3 as well as to stimulate class discussion. Name? Instrt.ctions: In speaking with my students, a What was the happiest time of your life? Interview two individuals in your c lass. number of them have said that they find What do you like to do with your free You are riot to give more than two in- the student' interview, "interesting," time? terviews. "makes time go faster," "gives us a Favorite musicei group? chance to learn more about our friends," Questions: Things you . best about being in high and it is "fun." Of the many activities and school? Name? options available to my classes, the "stu- Brothers and sisters ihow many)? What time do you get up ee.:1 day? dent interview technique" allows for a Where do you like t,1 go with your What time do you go to sleep? great range of communication and in- friends? Favorite .IV program? teraction within the classroom. What is your favorite food? When was the last time you gave some- Below are examples of interviews used If you had a million dollars, how would one a comphment? at different times throughout the semes- vou spend it? Is it difficult to give compliments? ter. The interview sheet clearly tells each What your favorite sport? Is ''time" important to you? student to interview two individuals What was the most frightening movie you within the class. No student is to give ever saw? more than two interviews. Upon comple- Which was the saddest movie you ever tion, the teac her can simply call on stu- saw? 44 58 28 TEACHNG IDEAS

Positive Peer Influence: School-Based Prevention

AIDA K. DAVIS is a research assistant and and behaviors are learned are as varied tional needs. Historically pupils helped JOAN M. WEENER is a project assistant in as the social, religious, educational, oc- or taught other children in order to al- the Addictions Preventimi Laboratory and cupational,andpsychologicalback- leviatetheresnonsibilities and time ROBERT E. SHUTE is assistant professor grounds of the user, many writers are constraints of toe teacher in the one- of health education. They are all at Pennsyl- now emphasizing the critical role of room schoolhouse. Later, the idea of vania State University, University Park, peer influence as a variable which may students hs:lping each other proved to be Pennsylvania 16802. override many of these considerations.' a promising alternative in traditional Researchers in high schools and col- schools. The trained tutor was able to Peer pressure is often considered a leges have found that the likelihood of psychological force--a direct attempt establish a personal relationship with personal drug use correlates highly With other students and could assist them by a group to influence personal behav- the drug-using activities of one's peer iorsof group members. However, with their school work for both remedial group. This fact has influenced the de- and standard purposes. The learner was Kies ler and Kies ler' have a somewhat velopment of a variety of school-based able toreceive help in a variety of broader view which acknowledges un- peer programs related to student per- planned, but nevertheless, highly con- academic areas, while the tutors found formance and student attitude toward that the teaching provided a powerful trolling influences of groups: "All that is teachers, school, self, and others. The required is that the group expect the learning experience for themselves as underlying assumption is thatif stu- well. person to act or believe in a certain way, dents have a healthy self,concept, a fa- or that the person think such things are Tutoring programs vary widely in re- vorable attitude toward their teacher lationship to the age differences which expected of him." and schools, a number of satisfying and Whether peer influence is defined as exist between tutor and pupil. "Peer enhancing interpersonal relationships tutoring" connotes that tutors are the psychological forces or group sanctions, with family and friends, and are com- the mechanisms and effects are inextri- same age or are enrolled in the same fortable about their values and abilities course as the learners, whereas older cably bound to the operations of social to make decisions, then they are much influence,whichincludeteaching, students or students who had com- lesslikelyto succumb to pressures pleted the course or were not enrolled learning, imparting ideas and skills, which encourage self-destructive be- generating enthusiasm and purpose, in it at the same time as the pupils were haviors. defined as "cross-tutors."3 and even the application of force. Peer Several school-based programs have influence and the conformity it engen- Tutoring techniques have been pro- evolved which draw on some of the pos- moted as a means of enhancing the ders is part of a much larger context of itive aspects ofpeer influence.For cognitive and motivational processes re- learningof both tutor andlearner, example, peer and cross-age tutoring though some researchers have urged lated to social learning. and peer counseling, while not specifi- While any social interaction is poten- caution in making this claim.4 Tutoring cally oriented toward prevention of responsibilitits and establishing a close tially influential the greatest power to drug and alcohol abuse, seek to reduce dispense social rewards and punish- personal relationship with the learner behavioral problems and bridge the gap are important affective gains for the ments to the individual member is at- between student and teacher (or par- tributed to peer group interactions. It is student tutor. Opportunities for creat- ents) by providing individualized in- ing constructive, social, and positive within the peer group that the effects of struction,personal interactions, and social modeling and behavioral shaping roles,greatly enhancethetutor's counseling.The school can include school experience.5 The learner's gains tend to be most concentrated. Especially exercises which help students discuss for adolescent and college-aged people, in academic skills and understanding and understand the "mechanisms" of seem to promote self-esteem. the peer group is often cited as the pri- peer influence and help them develop mary reference groupforattitudes, Tutoring as a preventive approach to skills to deal with influential situations. drug and alcohol abuse relies on the values, and behaviors; it is within the All of these programs or strategies are peel. group that outside influences (par- concomitant de velopment ofskills meant to develop the individual's sense which ultimately enhance the student's ents, the law, the schools, etc.) are dis- of personal competence and responsibil- cussed,judged. and mediated.Ac- personal satisfaction withlife. These ity.Following are several workable skills include intrapersonal aspects such quiescence to direct or subtle pressures strategies and resources for involving in peer groups has been linked to some as improved self-concept, as well asin- peers in iirevention activitiesin the terpersonalskills--effective communi- forms of juvenile delinquency, truancy, school setting. malicious mischief, sexual experimenta- cation with others, sharing personal dif- tion, drug use, and other types of mis- ficulties, etc. behavior directed against self or society. Peer/Cross-age Tutoring Resources.Many aspects involved in While the motivation for initiation Peer and cross-age tutoring has been designing and implementing a tutoring and continuation of drug use and the included in school programs for a long program are discussed in a variety of conditions under which drug attitudes time as a way cf meeting special educa- training guides available to schools. The

45 National Commission on Resources for primarilyof supervised seminars or thors provide a detailed account for in- Youth under the direction of Mary workshops for selected student volun- terestedadministrators andpartici- Kohler has developed a tutoring project teers.In some schools thetraining pants. The Balancing Head and Heart called 'Youth Tutoring Youth." Several courses are given for credit, others pro- series notes the benefits for both coun- hundred programs have been started in vide training on an extracurricular basis. selors and con nselees in com mu nication schools and by community agencies A number of programs have established skills, self-confidence, and self-esteem. across the nation. Over 3,500 persons a general "rap room," "drop-in center" Newsletters such as the one distrib- have been trained in the techniques of or "unwinding room" where students uted by the National Resources for tutoring through this flexible program are welcome to come and talk about Youth" cover a number of projects in which can be adjusted to meet the their concerns. Appointments can also which teenagers counsel their peers. A needs of school or community groups.6 be made for private sessions with one of prevention resourcebulletin,"Pyra- the peer counselors. This type of pro- mid," sponsored bythePrevention The Ontario-Montclair School District gram expands available counseling re . Branch of the National Institute on Drug in California has developed a cross-age sources and makes it easier for students Abuse reviews and reports on peer teaching manual designedtohelp to discuss problems on a less formal tutoringand counselingprevention teachers or administrators organize and basis. Counselors are trained to recog- programs." A manual entitled Teen In- implement a tutoring program. This nize and refer students with serious volvenwnt: A Teen Counselor Training manual describes agendas for training problems to professional counselors. Manual by Gladys Conroy contains a seminars and the matching procedure Resources. A variety of training mate- number of ideas for training teen coun- for older and younger students as well rials are available for help in implement- selors to work in the area of drug and as describing scheduling, types of ac- ing peer counseling programs. Samuels alcohol abuse prevention.'3 tivities, and cost considerations.' and Sanniels' book is a thorough review A further guide to tutoring isin- of rationale, needs, organization, and Integrated Classroom Experiences cluded in volume two of Balancing Head evaluation of peer counseling.10 The au- and Heart: Sensible Ideas for the Prevention More informal, planned interventions of Drug and Alcohol Abuse. 8 These books in the classrooms, which integrate nor- were produced for Pennsylvania's Gov- mal lessons with oppoi tunities for stu- ernor's Council on Drug and Alcohol dent growth in dealing with situations Abuse and contain a general rationale involving peer and/or social influence, for primary prevention along with de- offerattractive,inexpensive starting scriptions of eleven school-based ap- points for peer prevention program- proaches to prevention of drug abuse, ming including peer tutoring and peer counseling. Sensible guidelines for implementing strategies and providing resources make this publication a handy reference guide.

Peer Counseling Another activity, defined by M. G. Sussman, which capitalizes on the positive effects of peer influence, is peer counseling: "a process in which trained and supervised students offer listening,h.: support, and alternatives and other verbal and non-verbal interaction, but *' little or no advice, to students who refer themselves."9 Peercounselingpro- grams are usually designed as supportive programs which complement or supplement existing guidance programs intheschools.Whileincluding academics, peer counseling programs are generally aimed at clarification of feelings, ideas, and valtfes in order to enhance personal decision-making and resolution. Trained students provide a climate of acceptance for those fellow students who would rather share problems with a peer than with an adult. Junior and senior high school students are trained in reflective listening skills, problem solving, and providing information or referralif needed, by school counselors, teachers, or psychologists.Training methods consist 46 GO Alternative Peer-Related Activities Peer Influence "Convince Me" Time: 35 minutes A number of other peer-related activities such as drop-in centers, alterna- Purpose: To have students develop an awareness of how they influence and are influenced by tives-for-youth programs, vocational their peers. skills training, and youth service pro- Materials: One mimeographed sheet for each student in the class. Half of the sheets should have grams have been developed in both the following written on them: school and community settings. These programs encourage activities which Role AYou' ve just left a home basketball game. Your older sister, who's obviously drunk, provide meaningful alternatives to drug pulls over and says she wants to show you and your friend how fast her new car can go on a back road near town. You love the feel of speeding and are anxious to accept her offer, so and alcohol use. Program goals ma:, although you think your friend is probably chicken, you try to convince him/her that he/she range from developing clearly defined would be a fool not to go along. skills, such as photography, macrame or dancing, to experiencing and sharing in- The other half of the sheets should have this written on them: sight and ideas with peers and becoming Role B You're a fairly shy person and don't want to have anything to do with what your friend involved in service to others. The con- suggests. cept of service to others as a developmental goal for schools has been ac- Procedure knowledged by Kohler: 1. Pass Role A out to half the class, Role B to the other half of the class, asking students to keep Our schools are no longer filling the needs their role secret. of our children. A generation ago, living 2. Have each student with a Role A sheet pair up with a student with a Role B sheet. if there is an itselfprovidedopportunitiesfor uneven number, have the extra student watch two others role play. youngsters to be with adults, to grasp the 3. Give students about five minutes to play their roles. satisfaction of work. Today we stick kids in 4. Now have students trade roles and again spend about five minutes playing the opposite role. a world of their own and tell them to stay 5. Ask students to return to their seats and have a class discussion about how they felt in each role. where they are until we need them. De- 6. Discussion hints: spite the increased number of "people a. How did you feel in each role? needs" in our complex society, adoles- b. What did your partner do to make you feel that way? cents aren't given a chance to "help out." We must link the teen-agers into the sys- c. What are some pros and cons of trying to get others to do things we want them to do? temand give them opportunities to help d. Under what circumstances would you try to convince a friend to do something? meet human needs." e. What do you gain when you give in? What do you lose? Alternative projects for peers, along Adaptations: with peer tutoring, peer counseling, and 1. Add more roles so that two or three students can try to convince classmates to do something classroom activities, draw strength as they do not want to do. Have the students rotate roles within the group. prevention activities by using positive 2. Have three students try to convince three other students to do something they do not want to peer models rather than focusing on a do. The activities can be modified e.g., taking drugs; going swimming in cold water; etc. specific social/or health related problem. Resources. For those who wish to be- Integration Suggestions: Role playing is so versatile and enjoyable Phat you should find students come more familiar with alternative peer eager to participate and initiate suggestions. A few possibilities are: and prevention approaches the follow- 1. MathematicsDevise roles for students so they may try to convince others of the "best" way ing publications are recommended. Al- to invest $10,000. The setting could be a board of directors meeting for a small business. ternative Pursuits for America's 3rd Centunj: 2. ArtDevise roles for the artist, the merchant, the buyer, and the skeptic. Have the artist try to A Resource Book on Alternatives to Drugs convince the merchant to display his creation. Have the merchant try to convince the buyer to buy it. Have the buyer try to convince a skeptical friend that he/she has made a wise purchase. provides a guide to possible projects. A funny painting or sculpture would be an asset to the exercise. Discuss the motivation of each The section entitled "Alternatives" in person in the role-play scene. the Balancing Head and Heart series offers Contributed by Liz Kramer and Robert Shute ideas for teenage projects. Youth Alterna- tives, the monthly newsletter of the Na- tional Youth Alternatives Project, offers We know of no other compilation ot descriptions of programs as well as fund- During the past year, a review of the strategies similar to the one being de- ing opportunities and legislative action research and existing curricular re- veloped for the Peer Pressure Project. reports.16 sources which relate directly to aspects Certainly, many excellent ideas for inte- The encouraging research and proof peer pressure/peer influence was grating peer influence study can be gram evaluations point toward the effi- conducted as a task of the Peer Pressure found in recent texts, curriculum guides, cier.cy of using peers as change agents Project (funded by the Addictions Pre- and audiovisual materials on related for the prevention of drug and alcohol vention Laboratory and directed by Rob- topicsaffective education, humanistic abuse. Likewise, the translation of the ert E. Shute). The project staff will have education, developmental education, "positive peer influence" concept to adapted a number of flexible lesson and confluent education. Several peer- other health related or social problems plans from existing resources or will rela ted exercises can be adapted from the such as contraception behavior, smok- have created new ones when the project vealth of existing materials which ing, reckless driving, etc., should be is completed." These lesson plans will schools can use to enhance learning, im- seriously considered when planning form one section of a teacher resource prove decision-making skills,clarify school or community prevention pro- package for integrating peer influence values, etc.,at all educational levels. grams. lessons into a classroom. A sample les- Generally, these have come to be highly son with integration suggestions is pre- regarded as valid enhancers of the edu- 'Mester, C. and Kiesler, S. Conformity. sented here. cational experience. Reading, Mass.: Addison Wesley Publ., 1969. 61 47 2Dumont, M. "Mainlining America: Why D St., Ontario, Calif., 1971. "Conroy, G. Teen Involvement: A Teen the Young Use Drugs." SocialPolicy, slialancing Head and Heart: Sensible Ideas for Counselor Training Manual. New York: Holt, November/December 1971, pp. 36-40. the Prevention of Drug and Alcohol Abuse, Rinehart and Winston, 1972. 3Deterline, W. A. Training.111 Management Pacific Institute for Research and Evaluation, 14Shute, R. E. Explorations in Social and Peer of Student Tutors. ERIC Docunwnt Reproduc- Suite 201, Quail Ct., Walnut Creek, Calif., Influence: A Resource Manual for Teachers tion Service, No. ED 048 133, 1970. 1975. Grades 7 -10, 1977. 4Willis, J. and Crowder, J. "Does Tutoring 9Samuels, J. and Samuels, D. The Complete "Alternative Pursuits for America's 3rd Cen- Enhance the Tutor's Academic Learning?" Handbook of Peer Counseling, Miami,Fla.: tury: A Resource Book on Alternatives To Drugs, Psychology inthe Schools,1974,11(1),pp. Fiesta Publ., 1975, p. 41. NationalInstituteon DrugAbuse, 68-70. Washington, D.C., 1974, p. 2. sGartner,A.;Kohler,M. C.;and 11Resources for Youth, National Commission ,6Youth Alternatives, National Youth Alter- Riessman, F. "Every Child aTeacher," on Resources for Youth, 36 West 44th St., natives Project, Inc., 1346 Connecticut Ave., Childhood Education, 1971, pp. 12-16. New York. NW, Washington, D.C. 6YouthTutoringYouth: A Manual for "Pyramid, Pacific Institute for Research Trainers. National Commission on Resources and Evaluation, Walnut Creek, Calif. for Youth, 36 West 44th St., New York, 1970. 7A Cross-ageTeachingResource Manual, Ontario-Montclair School District, 950 West

48 6 2 29 TEACHING IDEAS

make their parhcular system fit into the spools, balloons, cloth scrap, body. glue, and toothpits. The skeletal system included the pel- We made solve oc our bones out of vic bone, upper and lower bones of the sticks covered papier mache, and arms, finger bones, upper and lower leg others with my roloam cut into the LILLIAN D. FESPERMAN is a graduak bones, the kneecap, the sternum, col- shapes of the banes we wanted. The assWant in health and physical education, larbone, and back vertebrae. The ner- bones were. attached to the body frame Miami University, Oxford, OhM 45056. vous system had the brain and spinal first along with the trachea, which cord, and nerves. Our digestive system we made from a cardboard cylinder Are you tired of teaching digestion, was made up of the tongue and wrapped in yarn for the cartilage, and respiration, drculation, the body sys- esophagus, spleen, liver, stomach, the bronchial tubes, which were made tems and functions the same way year small intestine, large intestine, and the from clay. The digestive system was then after year, class after class? Or are you rectum. The nasal cavity, trachea, attached. The tongue was a small, semi- an inexperienced teacher looking for a bronchial tubes, and lungs (one open inflated balloon; the esophaguswas a new approach for old, unchanging yet and one closed) with alveoli were the small cardboard tube fitted inside the vital material? In either case, here is a trachea. The stomach and large intes- successful, exciting, beneficial solution tines were papier mache wrapped over which can motivate your students blown up balloons. The balloonswere When I as teaching health at Alex- then deflated and the papier macheor- ander Graham Junior High School in gans cut in half to make a flat surface to Charlotte, North Carolina, I was a first mount on the plywood body. The small year teacher willing to try just about intestine, liver, and spleen were made anything that would motivate my stu- out of clay which was dried and painted, dents. I had to present a unit on the then nailed or glued onto the frame. The systems of the body and wanted to try a nasal cavity was cardboard cut into new, creative approach. After evaluat- shape, the bronchial tubes were clay, ing possibilities, I came up with the idea and the lungs were styrofoam. One lung of constructing a body in class. was painted as if it were closed, the other Selling my idea to the students was lung was constructed as if it wereopen. extremely easy and well-received; The capillaries were drawn with magic everyone wanted to "build a body." We irker and little pieces of sponge glued first got basic background information it to show the alveoli. on the systems of the body and gathered our ideas and materials for The heart was made by cutting the building a body. We included five shape out of a thick sponge, with veins systemsdigestive, skeletal, respira- and arteries drawn into it. The pulmo- tory, circulatory, and nervouson our nary vein and artery and the aorta were body. Since there were five seventh inserted into the sponge with big red grade health classes, each class contrib- "Ernie", created by seventh grade students. and blue wires. From the heart came red uted one system to the body. and blue arteries and veins made from Information about systems was cov- parts of the respiratory system. The circulatory system consisted of the heart, wire and thread. Veins and arteries not ered in class by a series of handouts, aorta, large and small veins, and ar- made of wire or thread were drawn on lectures, discussions, pictures, and teries. the body with red and blue pens. The films. Students were required to keep a nervous system was done with various notebook related to the systems which We needed a base on which to mount colored wires for the nerves leading all they handed in at the end of the unit. To our body parts. After considering the throug:1 the body to the fingers and further instill interest in the students, as possibilities of cardboard, wood and feet. The spinal cord was made of yel- we discussed the systems I mentioned other hard material, we decided to use a low yarn leading from the brain, which ideas and suggestions about the body big sheet of plywood so we could attach was a piece of plastic cauliflower since that we could try. We ail knew we were the organs and have them stay in place. the bumps and shape were similar. We working to gather enough information The plywood (about 5' by 3') was cut the cauliflower to make a flat back to construct a life-size body out of a supplied by one student's parents. We surface to fit onto the frame. It was defi- variety of "raw" materials. cut out a body frame from paper, glued nitely an authentic-looking part of the After completing the general back- it onto the plywood and started as- body. ground information, a system was assembling organs and parts. An of the parts were eitlwr glued, signed to each class and that class was The materials brought in by the taped, or nailed into place on the body responsible for bringing in any materials classes for use included chicken bones, frame. The bones were mounted first related to their system. They were also styrofoam of all sizes and shapes, with the trachea, esophagus, and required to read books and study pic- sponges, thread of assorted colors, wire bronchial tubes. Then the lungs, heart, tures and charts related to their sys- and plastic-coahzd wires of various col- and digestive system was fitted into tems. Specific tasks were assigned to ors and sizes, clay, newspaper, paints, place. The veins, arteries, and nerves small groups, who worked together to cardboard cylinders, empty thread were intertwined into place last, making

63 49 our body complete. The classes then ping-pong balls for eyes? Other ideas had to explain the operations of the named our project body "Ernie." may be to use false teeth or plastic ears organ or part. They benefited greatly Other suggestions for materials that to make your body more complete. from this project by learning about the we did not include in our project that The project was stimulating and inhuman body and working together and could be added to yours are a mop for teresting to the students. The students had fun doing it. It is an excellent idea to hair, or maybe garden hose for intes- responsible for making system parts try in your own classroom. Why not tines. Or how about bottle caps or and placing them onto the body also create your own "Ernie"?

50 Focuson Content

f ; 30 TEACHNG IDEAS

Addictive Behaviors

Procedure 2. What did not doing the activity feel like? Did you miss it badly? Did you get Have students pick one or two ac- angry? frightened? miserable? grouchy? tivities which they would find very bored? frustrated? difficultperhaps impossibleto stop 3. Did your relationships with other doing. Then have each student agree in people change? For example, did you a written contract with the rest of the avoid certain people, or people in gen- PETER FINN is senior Equiation and train- class to forego the activity for at least a eral, spend more time than usual with ing analyst at ABT Associates, Inc., 55 week, but preferably for a month. It certain people, or with people in gen- Wheeler Street, Cambridge, Massachusetts migf-. be more enjoyable and educa- eral, or relate to people differently such 02138. tional for students to experiment with a as, arguing more than normally? friend or small group, with each per- 4. Did talking or being with other son renouncing the same activity. students who were refraining from the Most people who have never experi- Depending on their "passions," stu- same activity (or a different activity) enced a major addiction such as, al- dents might: help you resist the temptation to give coholism, drug dependence, compul- use no salt or sugar in their food in? Did you ask for, and get, help from sive eating, or cigarette smoking, have give up cigarettes other people in your attempts to forego little understanding and often many stop sceing or talking with a close the activity? How did they respond? misconceptions about what it feels like friend How would you have liked them to re- to have a persistent and irresistible not kiss or touch their girlfriend, spond? craving for a substance or activity. An boyfriend, husband, or wife 5. Did other people change their be- addiction is defined here as a craving for not make or answer any telephone havior, attitudes, or feelings toward you a substance or activity which a person calls as a result of your experiment? How did cannot at the moment resist consistently get up M 4:00 a.m. every morning (not you feel about and react to that? or for a sustained period of time. In the sleep late) 6. Did you start doing things that you following learning exercise, s;:udents stop watching television or listening don't usually do, such as forget things, gain insight into the nature of addic- to the radio become less observant, overeat, or de- tions by refraining for an agreed-upon give up Coke, coffee, or anotlwr fa- velop physical symptoms such as head- period of time from an activity they vorite beverage aches, stomach aches, tics, loss of appe- have found extremely enjoyable for give up a favorite sport or other form tite, insomnia, or unusual fatigue? some time. As a result of this period of of recreation 7. Did your other activities change at "abstinence," students may be better stop chewing gum all? Did you compensate for the lack of able to appreciate what an addicted per- It may be helpful for the students to your "forbidden" activity by partici- son feels like and how they can best keep a diary of their behavior and feel- pating more in some other pursuit? Did help relatives and friends who may ings during the experiment to jog their the substitute activity help take your have a dependency. memory when they relate their experi- mind off the thing you wanted to do? The exercise may also enable some ences to the class. Students can also talk Did your efforts at compensation affect students to realize that they have a into a tape recorder at the end of each any of the people around you? strong and perhaps ungovernable urge day and play back excerpts to the class 8. Were you confronted with an op- for a substance or activity and to con- at the conclusion of the experiment. portunity to "lapse," and did your sider whether their compulsive behav- willpower diminish in the presence of ior is healthy and what causes it. The Follow-up Discussion the forbidden activity or object? Were exercise can foster insight into why other people considerate in not men- everyone feels dependent on some ac- After students have refrained from tioning the activity or substance, or tivities and provide an inkling of how their activities for at least a week, have helpful in suggesting a substitute? the students may feel if they are some the class recount their experiences, then 9. Did you go out of your way to day deprived of a substance or activity answer the following questions. avoid the activity or substance, or things to which they have become accustomed 1. How many of you succeeded in re- that might remind you of it? Didyour or addicted. fraining from your activities for the en- avoidance behavior help reduce your This exercise has been used many tire period of time stipulated in your craving? times by me at the junior and senior contracts? How soon did those who 10. Did you cheat at all? If so, did you high school level. However, it probably failed give in? How do those of you who try to engage in your activity just a little would be successful with elementary failed give in? How do those of you and find you couldn't resist resuming it school students and adult groups, as who failed feel about yourselves completely? Did you bother to hide your well. disappointed? angry? indifferent? re- lapses from other people? If so, did lieved? How do those of you who suc- anyone catch you cheating? How did ceed feelsuperior? sympathetic? re- they react? How did you feel about sentful? neutral? being discovered? 53 11. When you finally did go back to resume their activity with impunity at realization that it was only temporary. the activity, how did it feel? Did you try the end of tlw test period, while an al- Finally, focus specifically on how the to "make up for lost time"? coholic, who has stopped drinking or an students feel about addicted people. Do Obese person who has begun dieting they feel the same way about a 'coholics After the class has explored the issues knows that to revert to their former be- or drug addicts as they felt about them- related to these questions, students can havior is to court disaster. selves during their experiment? Should discuss how their actions and feelings Students may also erroneously con- they? Did they gain any new insights might be similar to those of an alcoholic, clude, based on their own success, that into what it feds like to have an addic- drug addict, cigarette smoker, compul- addicted people should be able %ith rel- tion and how addicted people can best sive eater, or other addicted person. The ative ease to reject their self-destructive be helped to !;hake off their depen- group should also consider how its ex- practices. The students' experience may dency? Were the students able to iden- periences may have been different from have misled them because their own tify any compulsive behaviors of their those of truly addicted people. For craving was a comparatively mild one Own and gain a better understanding of example, the students knew they could and made even more bearable by the how to evaluate and cope with them?

Ay/ ./////

54 :EST CCM AMBLE 6 7 31 TEACHNG IDEAS WINNE

Addictive Behaviors

and subsequent blood alcohol level.I blood alcohol level after a certain number of use the following chart to have students drinks in a certain time period. calculate what their blood alcohol level 8. Refer to the chart to see what the effects might be after a certain number of of this bkxxl alcohol level might be. drinks and the number of minutes b.nce Thefollowingexampleillustratesthe they first started drinking. Most stu- steps. dents know their body weight, but if A 180-pound person consumes 4 drinks in not, a scale can be brought into the two hours. room for them. They follow these steps Steps 3 & 4: .083 blood alcohol level from the to figure their blood alcohol level. chart. 1. Emphasize that this chart is a guide and Step 5: 2 hours = 120 minutes. not a guarantee. Remind the class of the vari- Step 6: (a) total # of drinking minutes ables that have been listed. = a 2. If your weight is between two of those 40 minutes shown on the chart, use the lower weight. 120 mi nutes 3. On the chart, look up the blood alcohol a = .-..- 3 level associated with your weight and the 40 number of drinks that would have been (b) a x .01% = correction figure for drunk during a certain time period. One ;iver metabolism of alcohol drink equals 12 ounces of beer, or 5 ounces of 3 x .01% wine, or 11/2 ounces of 80-100 proof whiskey. Step 7: .083 blood alcohol level from the 4. Write down the blood alcohol level from chart 030 correction for liver 5. Write down the total number of min- metabolism for alcohol utes that would have elapsed between start- Now Much Can I Drink? ing to drink and leaving the party two 053 estimated blood alcohol level hours or 120 minutes. for 180- pound person drink- 6. The liver is continuously metabolizing ing 4 drinks in 2 hours. H. RICHARD TRAVIS is assistant profes- alcohol so we have to make a sut-traction from the blood alcohol level from the chart Step 8: The chart indicates that at .05 driving sor of health science, lanws Madison Uni- becomes increasingly dangerous. versity, Harrisonbuig, Virginia 22802. depending upon how long we have been drinking. The correction factor is calculated This activity has been used in the by first dividing the total number of drinking classroom and %vas also set up as a Iteach drug education courses and minutes into 40 minute segments and then for a frequently, when discussing alcohol, multiplying that answer by .01%. This is the booth campus-widealcohol awareness day. The students found this students will ask how much a person correctionfactorfor the alcoholthatis a candrinkbeforebeingconsidered metabolized by the liver. meaningful way to estimate how drunk. I point out that there are many 7. Subtract the correction figure from the many drinks they could have and the variables that influence the extent to blood alcohol level that we obtained from the relationship this would have to their chart in step three. This is the approximate blood alcohol level. which an individual will be affected by Blood alcohol levels (percentage) alcohol. 1. Some people are affected more than Body others because of their biochemical make-up. Weir Drinks" 2. The attitude or mood of the individual at the time of drinking as well as the envi- 1 2 3 4 5 6 7 8 9 10 11 12 ------ronment in which alcohol is drunk influence - - -- 100 lbs. .038 .075 .113 .150 .188 .225 the effect. .263 .300 .338 .375 .413 .450 120 lbs .031 .063 .094 3. Food and liquid in the stomach dilute .125 1,.,156_.188 .219 .250 .281 .313 .344 .375 140 lbs. .027 .054 .080 .107 .134 1 .161 the alcohol and slow down its absorption. .188 .214 .241 .268 .295 .321 160 lbs. .023 .047 .070 .094 1.117 .1411 .164 .188 .211 .234 .258 .281 4. The carbon dioxide in carbonated al- 180 lbs. .021 .042 .063 .083 .104 .125 .146 L.1A7 .188 .208 .229 .250 coholic beverages tends to hasten the move- 200 lbs. .019 .038 .056 .075 .0941 .113 .1131 .150.169 .188 .206 .225 mentofthe alcoholfromthe stomach 220 lbs. .017 .034 .051 068 .085 L.102 .119 71_ .153 .170.188 .205 through the pylorus to the small intestine 240 lbs. .016 .031 70:4-7-1 .063 .078 .094 j .109 .125 .141 1 .156 .172 .188 where the majority of alcohol is absorbed. .-- - _ - - 5. The blood alcohol level reached in the Under .05 .05 to 0.10 .10 to .15 Over .15 body isrelated to the individual's body weight. A larger person has more body fluids Driving is not seriouslyDriving becomes Driving is Driving is and blood to dilute alcohol than a smaller impaired (although increasingly dangerous very dangerous person. The more alcohol in the blood, the some research indicates dangerous more that can diffuse into the cells of the fine motor skills may be Legallv drunk Legally body. Most states set 0.1% as the blood al- impaired at .02 or .03 .08 is legally in most states drunk in cohol level at which a person is considered level) drunk in Utah any state legally drunk. A number of charts are available in textbooks or from state divisions of "One drink equals 1 ounce of 80-100 proliquor or 12 ounces of beer or 5 ounces of wine. mntor vehicles which relate the number Reference: New Jersey Department of Law and Public Safety, Division of Motor Vehicles, of drinks a person consumes to weight Trenton, New Jersey.

4 55 32 TEACHNG IDEAS

Addictive Behaviors Tobacco Company ExecutiveAs compromise when necessary but they Swathe Nogwash vice president of Brown and Jones to- try to push through their own ideals bacco company this committee member whenever possible in order to develop believes the claims of health hazards recommendations for the future of to- MICHAEL YOUNG is at Auburn Univer- due to smoking are unproven. He is not bacco in the United States. sity, Auburn, Alabama 36830. really concerned with health anyway, but with promoting tobacco sales. He Options With a little imagination educational believes that government interference games and activities can be used to in this area would be a blow to the en Students not assigned a committee promote learning that does get students tire free enterprise system of our na- role may be members of the interested involved. The objective of one activity tion. public attending the committee meet- may be to introduce factual information Satisfied SmokerThis smoker ening. They may wish to ask questions of while another may promote discussion joys his cigarettes and has no desire to the Senator and members of the advi- or enhance decision-making skills. quit. He proclaims that smoking is a sory committee. The instructor may Whatever the overall objective, educa- fundamental right guaranteed by the wish to appoint more than one advisory tional games and learning activities can Constitution and wishes that folks committee. These groups could present provide ways to make learning fun. A would just let him smoke in peace. He their recommendations, which may be simulation game designed especially feels that smoking is probably not bad quite different from group to group. for smoking education is "Senator for his health, but even if it is harmful, Students who are not members of an Hogwash and his tobacco advisory everyone has to die from something. advisory committee may be designated committee." Tobacco FarmerSince tobacco pro- Senators and appointed to the Senate Simulation games can be used to help vides this farmer with a major part of Committee on the Future of Tobacco. clarify values or to introduce factual inhis income he is vitally concerned with Advisory committees could present formation along with examining at- government plans in this area. He their recommendations to the Senate titudes and/or behaviors about a certain would like to see price supports and Committee. Senators could then discuss issue. "Senator Hogwash" can bring other government programs increased. which recommendations they would out not only the health hazards of smok- He would hate to see anti-tobacco legis- like to see incorporated into future ing but can also show that there are lation passed. If that is what the future legislation. many economic, social, and political holds, however, he hopes marijuana Students should be introduced to the forces that make quick elimination of will be legalized so he will have another health aspects of smoking ankother is- cigarette smoking unlikely. cash crop to take tobacco's place. sues through lecture material and/or Nonsmoker's Rights AdvocateA reading assignments. They should not Game Overview nonsmoker whose father recently died be expected to begin play "cold." Fol- of lung cancer, this man has led the lowing play, which could run from 30 St,:or Hogwash is head of the Sen- fight for nonsmoker's rights. He is minutes to one hour or more depending ate Committee on the Future of To- upon the teacher and student interest, a bacco. To obtain citizen .input, and completely against all forms of smoking and eels some type of government in- teacher directed discussion pericd can make points with the folks back home, be of value in providing comments on he has appointed a citizen's advisory tervention is necessary. Public Health EducatorThis health game play and in restating major is- committee to make recommendations to sues. the Senate Committee. The committee educator, a specialist in smoking and members discuss the issues from the health, knows the hazards of smoking perspective of their assigned roles and and is making every effort to turn us prepart a verbal report. into a nation of nonsmokers. He is for higher taxes on cigarettes and feels the funds raised should be earmarked for Committee Members smoking education and research. Senator!. M. Hogwash ----From Horse Kiss, Kentucky, the Senator serves as an How to Play "advisor" to the advisory committee. The instructor assigns students to He has heard ugly rumors of the health play the roles of various committee hazards of tobacco. He knows that to- members. Senator Hogwash, played by bacco means money to Kentucky and the instructor or a student, introduces other tobacco states. He wants to do committee members to each other what is best for all the people he repre- (players may want to wear name tags) sents but is unclear as to what his posi- and outlines the committee's task. The tion should be. committee members discuss the various Medical DoctorThe good doctor aspects of the tobacco issue (health once smoked two packs a day bat quit hazards, smokers and nonsmokers' smoking abou, a year ago. He has rights, economic impact of a possible kicked the habit for good, he hopes. He tobacco prohibition, government's role hates to see anyone smoke because of in tobacco research and promotion, the craving for a cigarette he still gets etc.) from the perspective of their as- whenever he sees,.neone light up. signed roles. Committee members may

56 69 33 TEACHING IDEAS

Addictive Behaviors Student-to-Student Teaching About Tobacco Smoking

Lorraine J. Henke is a health educator at the of cigarette. Safety precautions to prevent tobacco Eugene Burroughs Junior High School, Accokeek, smoking related fires, why people smoke, and Maryland. how to quit smoking are presented. The audience For the past three years, the decision to smoke is encouraged to join in the discussion and to or not to smoke has been the subject of formal ask questions of the panel members. Following the panel presentation, the elemen- discussions between eighth grade health educa- tary students are diiiided into groups and each tion students from Eugene Bui loughs Junior High eighth grader leads d group in discussing the ad- school and elementary students in the fifth and vantages and disadvantages of tobacco smoking. sixth grades in various schools of Prince George's During these discussions, the eighth graders en- County, Maryland. The project was designed to courage the elementary students to ask questions, explore the impact of presenting the smoking to voice honest opinions, and to continue to aspect of health education between students of keep up-to-date regarding the facts about tobacco close age groups. The assumption was that the smoking. fifth and sixth grade students would enthusias- At the conclusion of each instruction program, tically accept and comprehend the presentation the visiting junior high school students distribute and interchange of health education information leaflets stating the facts about tobacco smoking. with their junior high school student contem- These leaflets are contributed by the American poraries. This assumption was proven to be valid. A typical student-to-student teaching experi- Cancer Society, the Tuberculosis and Respiratory Disease Association, and the U.S. Department of !:nce consists of a group of seven or eight junior high school health education students visiting a Health, Education, and Welfare. Also contributed fifth or sixth grade class (frequently a science by these organizations for use in the presentations are posters, research data, and other printed ma- class). The eighth grade students first present the terials on tobacco smoking, including the book- facts of smoking as a panel, then each of them let from HEW explaining how to construct the leads a small group of elementary students in a machine which the students used in their presen- discussion about the decision to smoke or not 'o tation. smoke. During the panel presentation, the junior h;gh Several points of interest, noted over the few school students discuss the effects of tobacco years of being involved with the student-to-stu- smoking on the body utilizing a machine (con . dent teaching program, are as follows: strur*ed by the students., which simulates the 1. Elementary students who plan to attend the eff on the human respiratory system. A filter junior high school represented by the panel tip and nonfilter tip cigarette are both "smoked'. group respond more enthusiastically than do by the machine. The tar from each of the cig- those who are not going to attendthat arettes is passed through hollow glass rods repre- school. Following this revelation, we have senting a person's mouth and throat. The tar that encouraged elementary schook to seek the did not adhere to the glass rods then travels to services of the junior high school their stu- glass test tubes constructed to represent a per- dents expect to attend. son's lungs. The presence of tar is always clearly 2. Presentations made to large groups (over visible, enabling succinct comparisons of tar con- 50) of elementary students are not as suc- tent to be made between th t!cigarettes, along cessful as those given to smaller groups. with analyses of tar content regardless of the type There appears to he less satisfaction for both

7 0 57 taMe Eighth graders make effective teachers for sixth graders--and especially when they come from the junior high school their audience I. will attend, when there is a good mix of race, sex, and personality.

Nr- :ft

71106;

the junior high school student teachers and the elementary school students. Where do we go from here? Weare constantly seeking other effectiveteaching aidslikethe 3. When the make-up of the panel of junior smoking machine in an attempt to improveour high students includes a variety of students presentations. We are investigating the student- (in regard to sex, race, personality, and aca- to-student teaching of other aspects of health demic achievements), there appears to be a education. The eighth grade student teachersare higher audience response (a ve.y good rap- invited back each year to relate their experiences port) than if these characteristics were not regarding tobacco smoking as thPyprogress into represented by the junior high school stu- the higher school grades. We seek and evaluate dent teachers. the suggestions of the elementary students and 4. Parents of both the ele7untary and junior their junior high school student teachers. Most high school students involved in the student- important, since the program has been goingon to-student teaching program have responded for the past few years, we have been ableto ask to this form of health education in a very the eighth grade health students (whoa few years favorable manner. ago were elementary students attenlinF our stu- 5. Junior high school students involved in the dent-to-stud,nt discussions) what ettect the dis- program have repeatedly stated that their cussions had on their health itudes and be- experience in teaching the facts about to- havior. At this point suffici lata to make a bacco smoking has reinforced thir decision conclusion have not been c ci and analyzed. not to smoke. The favorable responses ref:..,u from those stu- 6. Repeatedrequestsfromtheelementary dents who had attended the student-to-student schools have been made to initiate a similar discussions, however, please us and spuus on to program for other aspects of health educa- continue and improve. tion, especially drug education.

71 58 TEACHING IDEAS

Addictive Behaviors The Smoking Game

lan Newman is associate professor and chair- school pupils from smoking among the adult pop- man, Division of Community Health Education, at ulation was its illegality, As one student putit, the University of Nebraska, Lincoln. "When the teachers can't see the kids, the kids smoke and when the kids can't see the teachers, In 1964 a new rationale was published to the teachers smoke," This situation was further justify an old ethic. The surgeon general's report comphcated by the fact that machines dispensed on smoking and health reinforced the school's cigarettes to any consumer, regardless of age. Ad- position that it should not allow youngsters to vertising enhanced thepleasuresof smoking smoke in the school building or on the school through subtle inferences. Adults openly violated grounds.Schoolshadtraditionallyforbidden No Smoking signs and ordinances. Even members smoking, but now they had new medical evi- of the Board of Education disregarded the many dence to support their nonsmoking stand. Need- No Smoking signs posted on the walls of their less to say, smoking did not disappear from the conference room. high school, junior high school, or even the ele- At school the rules against smoking applied mentary school. In an attempt to examine the only to the students. Faculty members smoked in school's traditional stand on cigarette smoking by staff rooms and in the locker room office. The its students, a long-term examination was made school appeared to be the only place where smok- to document the actual smoking behavior con- ing was prohibited only for minors. Students saw ducted within the school. This paper describes this as a clear contradiction of principle. They something of the behavior of the young people pointed out, however, that smoking was not the who smoked in the school and the teachers who only item of inconsistence. School regulation ap- attempted to prevent their smoking. Information plying to the length of hair, the color of girls hair, presented here is based on data gathered over a the length of skirts, and the behavior of athletes nine-month period of intensive participant ob- all represented inconsistencies of various types servation. clearly noted and described by many of the students. With these conditions existing, any action The General Setting of the Game on the part of the students appeared to them to The events described in this pa:.er took place he justified, and activities relatedtocigarette in a Midwestern junior high school with 1,800 smoking took on all the dimensions of a game. students.It was assumed that while this school Smokers played the game of attempting to out- was unique, it did have many aspects in common smart the teachers, who for their part attempted with other schools across the country and the stu- to enforce the school's rules and apprehend the dents were, in fact, typical. The school in question smoking students. Achievement in either role was was traditional and authoritarian. Discipline was interpreted as winning. seen as a necessary requirement of efficient administration. The ContestantsStudents At the time of the study on which this report is While smoking patterns differed with each sub- based, an important characteristicthatdistin- guished the act of smoking among junior high ject, there appeared to be a general configuration whichcharacterizedtheregularninth-grade smoker. This is illustrated by the following state- * This material was originally presented to the workshop ment recorded during the course of the study. on educational programs influencing youth at the N3tional After my dad goes to work I usually have one Conference on Smoking and Health, September 9,1970, cigarette, then another one on the way to school. San Diego, California. The work on which this paperis based was perfornwd pursuant toContract numlwr PH You can usually get one more outside the building 10B-66192 of tlw United States Public Health Service, De- before you come in and then after second hour partment of Health, Education, and Welfare; William II. Cres- you can get at least half a one if you hurry in the well,Jr.,principalinvestigator; WarrenI.IlLiffman and washroom upstaiN. At lunch time I usually have

Donald B. Stone, research associates. one outside and then afterfifthhour I have

7 2 59 another one. There's usually a bunch of us who go to the washrooms and there's always someone to and from lunch, smoking required a well- who's willing to stand watch for the teachers. coordinated team effort. To further complicate the matter for the smokers, two counselorswere The ContestantsTeachers assigned to patrol this generalarea. Smoking was illegal for students. Studentswere Those concerned about being caught posted encouraged to be like adults. However, when "guards" outside the washroom towarn of ap- youngsters smokedlike adults--the heavy hand proaching faculty members. Methods utilized by of the school authority descendedon them. It was the guards to convey their warnings varied with difficult for students to see why 40% of their adult the urgency of the situation. The simp:est method faculty could smoke and they couldnot. Teachers, was for the guard to go inside and tell the smok- both smokers and nonsmokers, thought ittheir ers that someone was approaching. However, this duty to apprehend students who smoked. Stu- endangered the guard as he thenran the risk of dents were better at avoiding the teachers than being caught in the smoking setting. Anotherpro- the teachers were at catching the students. The cedure employed by the guardwas simply to kick harder the school authorities triedto catch the the door with his heel towarn of the approaching smokers, the more fun itwas for the smokers, and faculty member. Still another variation of thispro- the higher the status one achieved by foilingthe cedure was to kick the radiator pipe which passed authorities' attempt to apprehend. through the wall. On occasions whena teacher This set the ground rules for thegame. The approached too rapidly,or was unnoticed until risks were challenging. The payoff increasedwith the last moment, the studenton guard would the teachers' increased efforts to catch theciga- open the door for the teacher and greet him by rette smokers. The teachers felt great frustration. name in a loud voice so that those inside would "If only we could cut downa few trees, they'd get the warning. Nonsmokers oftenactedas have no place to hide andwe could catch them," guards, and it was reported that itwas safer to lamented one counselor. have a nonsmoker stand watch. Theywere less The reward to the students was expressed by likely to leave their posts fora few puffs with the one nonsmoker, who said: rest of the group. You know, I get a kick out of it every time Isee a Inside the washroom the smokers took addi- kid smoke and get away with it.It seems there tional precautions to avoid being caught. Itwas a are still a few things around here that you can do common practice for them to stand close to uri- and get away with. It's good to knowwe can still nals, sinks, or toilet stools while smokingso that beat the teachers. it was an easy matter to get rid of thecigarettes. A wet paper towel was often kept readyto snuff Strategks of the Game out the cigarette as a last resort to avoid being Subjects and other informants reported that caught if a teacher entered. Smokers would often smoking occasionally took place in the locker stand on the toilet stools which enabled themto rooms, shower rooms,industrialartsshops, exhale smoke close to the air exhaust ductson the photographic dark room, andeven in the class- wall. This cleared the smoke from theroom. This rooms. However, tile majority of smoking in this also provided for easy disposal of cigarette butts particular school was limited to the washroorns by flushing them down the toilet. and to a specific location adjacentto the school While it was not possible to observe the smok- entrance but hidden from view by four small trees. ing behavior of the girls as closely, informantsre- Because both of these locationswere essentially ported similar practices in their washrooms; how- within range of easy scrutiny by the faculty,nu- ever, fewer girls smoked and the necessity foran merous techniques were utilized to foil detection. elaborate warning systemwaslessimportant. Description of one of these willserve to illustrate While as many as fifteen boys mightcongregate the process of the game. to smoke cigarettes at any on,, time, itwas un- The majority of the smoking inthe school usual for more than five girls to bepresent in a building was dorh? during the luncr hour and be- smoking situation. Girls weremore likely to smoke tween class periods. At lunch time swdents went alone or with one or two classmates. Theywere to the cafeteria in three shifts. During lunch they more apt to smoke when the washroom was empty were restricted to an area including the cafeteria or they avoided smoking in school altogether. and the hallways immediately adjacent to it. This Smoking outside the school building, buton area included boys and girls washrooms, which the school grounds, was le, But again became the centers for smoking activity. Because students developed sophisticatedsystems to avoid this location was heavily traveled by faculty going detection. The most popular location. adiacentto

60 73 the front entrance of the school andbehind a pass; if they do, Ijust tell them so-and-so sent me on an errand and they never report mefor not group of small trees,often produced a two-step communication system to foil teachers' attempts having a passit's rather bad actually. By contrast, a student who was both a smoker to apprehend smokers in the act. and a poor student related the following inddent. Students found numerous ways totesttheir He had been given a signed hall pass to visit the skills of concealment against the teachers' skills office. However, he was apprehended on his way of detection. Students would smoke in the front and finally escorted to his office by an assistant rows of the school movie theater on recreation principal and a teacher, both of whom questioned nights. They smoked in the industrial arts shops the authenticity of his pass. The student's explana- where numerous odors aided in concealment and tion was as follows: in shower and locker rooms which were usually I gave my pass to the teacher and he made some unsupervised. On occasion, when faculty mem- crack about getting out of his c isshe's a good bers supervisedtheloading of school buses, guy, however, y oil know. Then, asI was walking smokers would approach the supervising teacher down thehall(thisleacher) comes Out of his to see how close they could get without being classroom and asks me for my pass.I shows it to caught. Smokers and their friends appeared to hie and he makes some wise crack about forging enjoy the success of such ende6vors. rie's always sticking his nose where it's not wanted. Then, I goes to the washroom and I came out and (another teacher) asks for my pass. lie sayti the pass \Vdti not for the toilet and that I Chances of Changing the Came Plan shouldn't woste time. Just asI came in the door, I Throughout the year the garne varied in inten- stopped for a drink of \voter and she takes my sity. At times the facuRy would win out, several poss and savs it don't look like your writing.I gave smokers would be caught and suspended, and her a NI of hp and whamo, the assrstont principal smoking would appear to subside. This reinforced oppeors. the faculty's feeling that discipline did solve the problem. In reality, the smokers had been forced These incidents and others suggest that teach- to regroup and utilize their most successful strat- ers' attitudes toward certain students became in- flexible. Consequently, any attempt by these stu- egies.For awhile they were more careful and worked harder in maintaining the covert nature dents to mod:fy their own behavioral game plan of their smoking behavior. was met with little recognition and considerable As in any game, learning took place. Students resistance. As one male smoker said: decided on new ploys to outsmart teachers and al I decided I was going 1l/ go good this year.I even times they even chose to quit the game com- quit smoking. I triedrealhard, but they (the pletely; they became nonsmokers. However, to teachers) just wouldn't give me a chance. I gave change roles and become a nonsmoker was diffi- up In the end . It seemed that whenever there trorible they thought I was involved and even cult. when I wasn't they just viouldn't let me he good Teachers s(..emed to react to smokers the same \vay they reacted to students who were failing academically, prObably because they had ob- The Observer's Perspective served that smoking and failing were often asso- !laving watched the game frorn the vantage ciated. Students who were grouped into either point ot aparticipant observer, trusted by the of these two categories tended to be treated dif- students ancl the teachers and not required to take

ferently by most teachers. On teachers' evalua- sides in the contest, I noted several points over tions, for example, smokers were rated lower than the duration of the year. their nonsmoking colleagues. Teachers expected less of these students and tended to he suspicious 1. Cigarette smoking was not an end in itself. of them. As a result, students who were smokers AI this age,it wasn't the taste or the association tended to be offeredlittlelatitude within the with coffeethat encouraged thestudentsto school. By comparison, nonsmokers w ho func- smoke. Smoking was, in fact, just a symptom of tioned successfully within the school were given the larger problem. The majority' of nonsmoking considerahle freedom, which they often ahused. kids thought their friends smoked to "be big" or As one individual, a class monitor and foothall to achieve status. Smokers didn't admit to this, team member, stated: although their actions tended to confirm the motivating forces of status, or at least compensatory You know, I can do just ohout anything I please b eh avior. around here. I get on real good with the teac hers.

I can walk the halk whenever I want. 'leachers 2.Rec.ords showed that young people who let me out of class, monitor,. never ask me for my smoked atthis early age were 011 Lir in IQ to 61 7 their nonsmoking contemporaries. While the stopped harissing the smokers and admitted to its smokers knew what was expected of them, they own hypocrisy, thereby removing the payoff from also knew that they were often not meeting these the game? If at the same time there had been al- expectations. School records showed that they ternative and meaningful activities available to the were correct in their recognition of low achieve- smokers would they have found less encouragement. They were more likely to be (ailing courses, ment to smoke? truant, tardy, and suspended from school than Would new courses, interesting courses that were theirnonsmoking contemporaries.They appealed to these early dropouts, have recaptured didn't participate in the extracurricular life of the their restless spirits to a point where they would school and their fellow students tended to see have at least become a part of the educational them as low social status individuals. They chose process? friends who were hke themselves for supnort. In other words, they tended to group tother as a What new methods could be used and what new ways could be made available to these young r_?am--the peer group team. smokers to find status within the system rather 3. Teachers tendedto type individuals who than being forced to compete for status in the smoked and held lower expectations for them. As smoking game? a result, teachers tended to resist changes in ID( How many poorly planned anti-smoking edu- havior on the part of the smoker. Smokers had great difficulty in casting off the smoking image cation campaigns actually enhance the status of of low achievement and poor behavior if they the smoker by putting him in a position of brave chose to quit smoking. risk takerwilling to stand fast against the statistics, the true games player--willing to gamble 4. As with all games, one left the scene of con- against odds and possibly win? test wondering what would happen if other strate- Smoking has to be recognized as something gies had been employed by the contestants. It more than a dirty habit. It was a practice, complex appeared that the smokers had read the wrong and multidimensional signals. While they still attended school, they had innature, even forthe already dropped out. The school had provided rior high school student. Unfortunately, how- them with few rewards and they looked other .'er, it appeared that the teachers had overlooked places, in other contests, for more meaningful this fact and thought they could win out with a single strategy of firm discipline. It was apparent rewards. that this single strategy game plan was notsuc- What would have happened if the school had cessful.

62 35 TEACHING IDEAS

Addictive Behaviors Making Tobacco Education Relevant To the School-Age Child

one-sided, health-facts unit which lohnR. Sef frith is professor and chairman life (almost always before age twenty of Health and Safety Education and di- and often by junior high school), the could be accurately described as a "thou rector of Operation SmART at Indiana role of school health education, particu- shalt not" approach. Besides being a University, Bloomington, IN 4740.5. larly during the primary and middle "turn-off" for many students, its school years, is of critical importance if greatest weakness was that, in omitting health educators are to reach students substantive socio-political issues, some School health education is faced before they start smoking." Until and of the strong persuasions against taking today with a number of challenging op- unless comprehensive efforts are made up smoking were never developed. portunities to improve the quality of to provide each school child with mean- Thus, millions of children and teenag- life through effective instructional pro- ingful health instruction regarding ers have decided to smoke, at least in grams. Whether it's sexually transmit- cigarettes, the carnage in human health part, because the only disincentive was ted diseases, suicide, teenage drinking, and life is likely to continue. an obscure threat to their health dec- illegitimacy or accidental deaths, most ades in the future. To be truly respon- health educators feel that our discipline sive to student needs and to maximize can and should help ameliorate these the relevancy and potential impact of health problems through sound school Personal Choice and Responsibility our teaching, we must go beyond the health education programs. Effectiveness of instruction is more statistical correlations associating Probably no greater challenge exists related to how we teach than to what we smoking with age-onset diseases. Mor- for school health education today than teach. In the area of personal lifestyle it bidity and mortality figures and facts that of cigarette smoking among youth. is important for the health educator to are not enough. Although the per capita consumption of recognize the pluralism in our society. cigarettes has dropped during the last With the contemporary emphasis three years, the estimated health-care placed on personal rights and values, cost to society because of cigarette- instructional strategies should be tail- Suggested Facts and Concepts induced illness is fifteen billion dollars ored accordingly. Therefore, careful With the knowledge explosion itis annually.What is more important is planning by the teacher is necessary to impossible to teach all the facts in any that at least 340,000 Americans die each provide a balanced as well as scien- area; thus the prcfessional responsibil- year prematurely because they smoke tifically accurate instructional program. ity of the teacher to select appropriate cigarettes.' In the words of Joseph A. For example, in addition to teaching information to develop valid concepts is Califano, former S:cretary of Health, about the health consequences of smok- critical. Following are selected examples Education and We'(are, the unadorned ing, instructional time should be used of content and concepts which Lan be facts clearly shov, that cigarette smok- to explore the reasons why some people made relevant to students. ing is "public :s.ealth enemy number choose to smoke. In short. the teacher Cigarette smoking is our natwn's leading one.'' should develop an objective atmos- preventable health problem. Consensus The cigarette smoking dilemma is a phere in which the pros and cons of exists among medical scientists that complex cultural problem with many smoking can be fully explored. cigarette smoking is the greatest cause interacting personal and social forces. The therm should be: the student has of preventable illness and premature However, the gross figures suggest the ultimate responsibility to decide death in the United States."'" This strongly that the school curriculum has whether or not to smoke; therefore, the year, for example, over 122,000 people failed to prevent children and teenagers student must given the perhnent will develop lung cancer in the United from beginning to smoke. For example, facts in an objective setting. The goal is States; at least 80% of these cases are although the percentage of adults who to provide the student with an oppor- due to cigarette smoking." Addi- smoke has gradually declined since tunity to make a decision based on facts tionally, thousands more will develop 1964, the percentage of children and and personal values. Attendant to this cancers of the throat, oral cavity. pan- teenagers who smoke has increased. approach is the accompanying need for creas, esophagus and urinary bl. ,Ider The rate of increase among teenage girls the student to accept responsibility for because they smoke."." Heart dis- is particularly alarming.' All told, today his or her decision. In an effort to de- eases, our nation's leading cause of six million children and teenagers velop an awareness of the full responsi- death, will take the lives of smokers at smoke.4 Past research and experience bility nivolved in such a decision, in- least twice as frequently as non- clearly show that 1) the majority of !Aructional time should be given to ex- smokers.'4 Chronic obstructive !ung these youngsters will continue to smoke plore a number of social issues such as disease, one of our nation's fastest- regularly for life; and, 2) they will be accuracy in advertising, special insur- growing chronic diseases. is largely less well and their livi -)rter because ance rates for smokers, and non- caused by cigarette smoking.'5 In short, of their smoking habit.5.' smokers' rights. after 30,000 scientific studies over three Finally, since the decision to smoke In the past many working education decades itis apparent that not one or not to sm,e is made very early in eftorts have been restricted to a narrow, measure in preventive medicine could

63 may be the least harmful; however, from a health vantage point, any smoking is hazardous to one's health. Cigarette smaing can be harmful to abb._ others, and especially to fetuses. In addition to the well-known irritation factor, which at least 60% of all people experience, there are real health threats from exposure to second-hand smoke.35-'" , dillow116 The most alarming threat is topersons goo use who are already chronically ill with dis- 4 eases like coronary artery disease, ISO 11 4 bronchitis, and chronic obstructive pulmonary disease." For example, people with existing heart disease will f develop angina pectoris (chest pain) upon exertion sooner when breathing air polluted with tobacco smoke." Further, animal studies have shown significantly more malignant tumors a in on g th ose an i m a Is brea th ing second-hand smoke on a daily basis.'" Finally, children exposed regularly to cigarette smoke have twice the respiratory disease rate of other children .4" Al- do more to improve health and to pre- lult after only a few months of regular though the smoker is affected most by vent premature death than the control smoking.28 smoking, the non-smoker who breathes of cigarette smoking.'" air polluted with cigarette smoke doe,, Cigarette smoking is deletvrious to vow here is no such thing as safe smolons. experience untoward physiological ef- health now. The association of cigarette Occasionally reports on smoking fects.4 These unhealthy and immediate smoking to the aforementioned dis- suggest that "moderate or "light" effects include elevated blood pressure, eases is well established and widely smoking of low tar and nicotine cigaret- increased heart rate, and abnormalcar- recognized. However, less well known tes may be safe. This implication arises hoxyhemaglohi n levels (carbon is that cigarette smoking is harmful to from the well-established fact that monoxide inthe blood).42 Recent the smoker's health immediately. he smoking's impact on health is a dose studies confirm that even healthy adults adverse effects of smoking begin with response phenomenon.= The number develop marked small-airways dysfunc- the first cigarette and get progressively of cigarettes smoked, the frequency of tionfrombreathing secondhand worse as smoking continues.'' Im- puffing, and the depth of the inhale all smoke.41 media te negative physiological re- relate to increased risks."' The mostfearsomeimpactot sponses to the smoker include in- The inference, however, that there second-hand smoke may be on the tetus creased heart rate, elevated blood may be a safe or threshold level below of the pregnant smoker. Unless the pressure, constriction ot blood vessels which no harm occurs is unsubstan- mother stops smoking before the fourth and trachial irritation.'"" Whileper- tiated and invalid.'"2 As already month of pregnancy, some untoward manent, irreve .sible damage to the pointed out, adverse effects begin early effect can be expected in the baby.' lungs does not occur immediMely, and grow progressively worse over Since carbon monoxide crosses the pla- hyperplasia (overgrowth of cells and time." Further, although low tar and cental bearier, the unborn fetus can be overproduction of mucous) begins nicotine cigarettes are assumed to be expected to develop carboxyhemoglo- within weeks of regular cigarette smok- less hazardous, no evidence exists binlevels comparable to the ing.2".21 Ciliary action is damaged and which would indicate that they are safe. mother's:1c." Since itis known that trachial-mucosal velocity (TMV) isre- On the contrary, certain harmful sub- carbon monoxide displaces oxygenin duced while one smokes.22-=' This, in Aances, such as carbon monoxide, are the blood, it is obvious that the fetus is part, explains why smokers are more in greater concentration in the low tar put at a distinct disadvantage during prone to infectious diseases 01 the res- and low nicotine brands." Scien- the most important period of its growth piratory tract.24 tifically,itis very difficult to make and development. For example, the In recent years, s.ui..est laveI shown blanket statements about the relative human fetus' brain is growing at the basic pulmonary dysfunction in teen- risks of different brands because of in- rate of one to two milligrams per min- agers who have smoked for only a few dividual differences in smoking tech- ute at the time of delivery.4" Thus, any years.25 Although some of the hara(ul nique. For example, some smokers who oxygen deprivation is most critical. In effects of smoking are reversibl.- if a switch to a low tar and nicotine brand addition to having more miscarriages person quits in time (e.g. smokers' lung may draw harder or inhale deeper and and stillbinhs, smoking mothers have cancer mortality rates return to non- smoke more cigarettes; thus, the rela- babies who weigh less at birth, also smoker rates 10 to 15 years after smok- tive dosage of nicotiry: and other sub- their babies are more apt to die during ing ceases),2" lung and respiratory tract stances may be about the same as be- the tirst year after birth, and, their tissue damage begins with the onset of fore. babies have more respiratory disease smoking and becomes worse the longer In conclusion, ifa person must during childhood and adolescence.4"-4" one smokes.2' Some scar tissue will re- smoke, a low tar and nicotine cigarette One of the most discouraging findings 64 7 7 educationally has been the discovery condescending attitude toward reasons socio-political issues which should be that children whose mothers smoked advanced in favor of smoking. Since dealt with in the secondary curriculom. during pregnancy do poorer on one's values relate intimately to one's What should be our federal pohcy to- achievement tests in math and reading rationale for behavior, it is inappropri- ward tobacco? Currently the federal at ages 7 and ate to label reasons as right or wrong. government is inconsistent and con- The merits and demerits of various rea- tradictory in its pohcy toward tobacco. Regular cigarette smoking usually r- sons should be explored in an atmos- Simultaneously, two cabinet-level departments pursue policies which have sults in a serlousth7,01thMt"1/probh'm. phere of respect with an emphasis on Like any drug of abuse, tobacco has the value clarification. antithetical objectives. The Department potential of causing serious depen- However, any comprehensive of Agriculture (USDA) continues to dency. Unlike users of other drugs of analysis of the pros and cons associated support and promote tobacco produc- abuse, however, research indicates that with smoking leads to one very critical tion. In 1977, for example, the U.S. De- tobacco users will usually become de- conclusion; thatis, the advantages of partment of Agriculture spent approxi- pendent for life-- they will be less well not smoking far outweigh the advan- mately 65 million dollars on the various and their lives shorter because of their tages of smoking. aspects of adrninistering the price- smoking.'l For example, it is estimated support program for tobacco." Further, that lbout 10-15"0 of the people alive the nM ion's lawmakers included to- today who ever used heroin are still de- Issues for Class Discussion bacco in Public Law 480, the "Food for pendent on it. However, 66",, of those Since the dedsion to smoke or not to Peace" program.'" Under this program still alive who ever smoked cigarettes smoke is an individual one, much of the millions of dollars in tobacco have been are currently still dependent on cigaret- educational strategy should focus on sent to developing countnes around the tes and smoke them daily." personalizing lessons. As stated, there world. While research to elucidate the mech- should be adequate coverage of the var- On the other hand, the U.S. Depart- anisms of dependency continues, itis ious values and motivations involved in ment of Health and Human Services safe to say that cigarette smoking can choosing a course of action. (DHHS) continues to battle cigarette and usually does result in strong de However, to stop at the personal level smoking in many ways. In 1964 the first pendency. The psychological factors as- would be remiss in light of the health and landmark Surgeon General's Report sociated with habit formation and de- care dilemma facing society today. In an on SmokIng was published. Since then a sire to smoke seem to be paramount; effort to explore the responsibility of number of efforts have been instituted but, at least for some smokers, the de- the individual in society, a careful at the national level to combat smoking velopment of a physical dependence to examination of social pohcies regarding through school and public health edu- nicotine may also occur." These stark cigarette smoking is important and rel- cation.In1978, DHEW Secretary facts should be included in educational evant. Three examples follow of critical Califano established the Office on units so that those deciding to smoke are aware, in advance, of the likelihood ot future dependency. Itis known from national polls that at least 8 in 10 smok- -11111. ers would like to quit if there were an easy way. Such informahon is particularly critical in view of the recent trend in children experimenting with tobacco at earher ages. A 1%7 Britkh survey of teenagers indicated that among those doP who smoked more' than one cigarette,

80"o ultimately became regular smok- 1 ers." The //du/int/Nes ot not sntokin.g tin out- ieelgh the ildcantage, of :onolon,g. Chil- dren and teenagers who choose to smoke do so for certain reasons. Al- though tht",e reasons may not be clearly elucidated and evaluated, and just as importantly, they may not be understood by the smoker, we must acknowl- edge that all behavior, healthy as well as unhealthy, is caused h is a logical assumption that many smokers find their habit enjoyable and somehow, reinforcing. For some youngsters, vo" smoking may provide a way of emulat- ing adults; for others a way of rebelling; and for still others, simply a satisfaction of curiosity.6' kducators shouldex- plore with their students these and other possible reasons for smokmg. In so doing, educators should avoid a 65 BEST COPY MAKE 7S Smoking and Health, and money con- do not smoke. In spite of this fact, many Summary tinues to be spent on anti-smoking pro- who are bothered by cigarette smoke grams.6" Americans consume 615 billion feel as though they should not express cigarettes annually.'4 Although the per their discomfort, since it is the smoker's capita consumption for adults has Who should pay the smoker's health right to smoke. care bill? The cost of medical care in dropped over the past fifteen years, the America continues to rise even faster However, no one is proposing to take amount of cigarettes being smoked by than the inflation rate. This year, away the smoker's right to smoke. On children and teenagers has increased. Americans will spend over 245 billion the contrary, all major groups active in The percent of teenage girls smoking dollars on personal health serviceS, the smoking and health controversy has nearly doubled during the last dec- more than any other nation in the maintain that a person has the right to ade." Because of this trend toward decide whether or not to smoke. How- more smoking among the young, and because of smoking's effect on human health and life, educators must redou-

" 1 ble their efforts. In spite of the diseases 1101111.11" exacted on humans as a result of smoking, cigarette smoking, as such, is not a medical problem; but rather, the real problem lies in educating youngsters 111111111.MPIIIII prior to the age at which the critical decision to smoke or not to smoke is made. Through careful planning and professional discretion the school-health team can address this challenge in ways that are meaningful and relevant to students. No longer do we need to threaten the child with dread diseases in the dis- tant future; but rather, instructional strategies can be designed to respect the student's right to choose. However, in choosing, it is imperative that the stu- world.61 With the trend toward some ever, a distinction needs to be made be- dent grasp the profundity of the ded- form of prepaid, social-health insurance tween a right and a freedom. That is, sion. Through a comprehensive and plan for all, greater emphasis needs to although one has a right to choose to balanced instructional effort the student be placed on the prevention of disease. smoke or not to smoke, one does not can better understand the personal as For example, it is estimated that 350,000 have the freedom to engage in the prac- well as social ramifications of cigarette people will die this year from diseases tice at will. smoking. With an emphasis on the role caused by cigarette smoking."' Prior to Since the beginning of our country, of values and motivations in decision their death many incurred large medical making the student can begin to ap- certain limitations have been placed on predate the words of Frost: bills resulting from expensive treatment personal rights. Generally, these limita- and lengthy stays in hospitals. Current tions are determined by two factors: the "Two roads diverged in a u'ood. and I estimates are that each year at least health and safety of the public; and the Itook the one less traveled bu. seven billion dollars are spent on the rights that might be abridged by the And that has made all the difference..." direct medical costs of treating diseases unrestricted practice of the first right. caused by cigarette smoking. If one The adoption of speed limits is an adds the lost productivity, the total cost 'American Cancer Society, Inc. A national example of protecting public safety. A dilemma:cigareit!f mokins oi the health of jumps to a staggering 20 billion dollars great jurist once wrote, -My right to Americans - report of the. National Commission annually." Presently, the direct health swing my fist ends whenmy fist on Smoking and Public Policy to Mc Board of costs are borne primarily by private in- reaches the end of your nose." Consis- Directors. 1978, 4. surance companies. Eventually, they tent with these principles and prece- =U.S. DHEW. limoking and health, report may all be paid through national health dents, one's right to smoke shouldnot of the Surgeon General, Washington, DC: insurance. Regardless of the system, be total and unrestricted. Foryears, for USPHS. 1979, ii. private or governmental, the consumer safety purposes, smoking has been 3U.S. DHEW. The smoking digest, Nationel paysall the consumers. Should non- properly disallowed in combustible Cancer Institute, 1977, 13. smokers pay as much hi premiums or areas, and, smoking in bed is against 4Horn, D. How much real progress have wemade in the Eight against smokMg?Bull taxes as the smoker? the law. Am Lung Assoc. 1979, o3, n-9. What are the rights of smokers and 5Russell, M. A. H. Smoking problems: an non-smokers? The spirit of thisage is overview, in Research on smoking behavior, rights: rights for the handicapped, We now know that ambient cigarette National institute on Drug Abuse Resedich rights for Blacks, rights for the aged and smoke can be hazardous to thenon- Monograph 17, M. E. JaMk, J. W. Cullen, rights for children. In all of the above smoker's health, especially to children E. R. Gritz, T. M. Vogt, and L. J. West, examples, one common denominator and persons with chronic illnesses. (eds.), (U.S. Department of Health, Educa- exists. Each one of the above represents Since society should promote the public tion and Welfare. Publication No. (ADM) a minority group. In the case of non- 78-581). Rockville, MD.: National Institute health, a new look at rights for smokers on Drug Abuse, 1977, 13-33. smokers' rights, we are talking about and non-smokers is justified andap- the majority. Most children and adults S. DHEW: The health consequences of propriate. smoking, report of the SUrgeoti Getieral,Office 66 79 on Smoking and Health, 1978. smoking, 1978, ch. 6. fetus, and newborn infant. Am 1 Obstet 'American School Health Association. In- 26U.S. DHEW, The Smoking Digest, p. 28. Gym'col, 1977, 29, 69- 103. troducing tobacco educatum in the elementary "Royal College of Physicians of London: school K-4, Kent, OH American School Snioking or health - the third report from the 47Dobbing, J.All fleshis grass, Kaiser Health Association, 1978, 2. Royal College of Physicians of London, Trent, Aluminum News: The World Food CrisisMan, 8W-10. Snwking and its effects on health, England: Pitman Medical Publishing Co. Mind, Soul, 1%8, 2b, p. 13. report of a WHO Expert Committee, Geneva, LTD, 1977, 76-81. "Butler, N. I.., et al. Cigarette smoking in Switzerland; World Health Organization, 'lay: op. cit. pregnancy: its influence on birth weight and 1975, 29-33. 29U.S. DHEW. Report of the Surgeon Gen- prenatal mortality, Br Med I,1972, 2, 127- 9Fletcher, C. M., & Horn, D. Smoking and eral on smoking and health ,1964 through 1978. 30. health, WHO Chronicle, 1970, 24, 345-370. "Diehl, Tobacco and your health, p. 202. "Meyer, M. B., & Tonascia, J. A. Matemal '"U.S. DHEW. The health consequences of 1160., 201-206. smoking, pregnancy complications and pre- smoking, p. 2. 3 'Royal College of Physicians of London. natal mortality, Am I Obstet Gynecol, 1977, "American Cancer Society, Inc.: Cancer Smoking or health, pp. 121-122. 128, 494 -502. facts and figure's 1981, New York, NY: Ameri- 33Worick and Schaller. Alcohol, tobacco and "Butler, N. R., & Goldstein, H. Smoking can Cancer Society, Inc., 1979, 9, 14. drugs. in pregnancy and subsequent child devel- p. 19. 14U.S. DHEW, The health consequences of opment, Br Med I, 1973, 4, 573-575. "U.S. DHEW: The health consequence's of smoking, 1978, ch. 11. 5 'U.S. DHEW: The health consequences of smoking, ch. 5. "Speer, F. Tobacco and the nonsmoker, smoking, 1978. Preface, p. 5, ch. 1, 2, 3, 4, 6. '4Steinfeld, J. 1. Presentation at Opening Arch Eninron Health, 1968, lb, 443-446. "Blair, G. Why Dick can't stop smoking Plenary Session of the 3rd World Conference 36Burns, D. M. Consequences of smoking the politics behind our national addiction, on Smoking and Health, in Proceedings of the the involuntary smoker, in Proceedings of Mother Ames, January 1979, 31-42. .3rd World Conference on Smoking and Health, the .3rd World Conference on Smoking and Ro y a I College of Physicians of London; II. J. Steinfeld, W. Griffiths, K. Ball, & R. M. Health, II, 5158. Smoking or health, pp. 43-44. Taylor, (eds.), (U.S. Department of Health. 'Tate, C. F. The effects of tobacco smoke A4Olshavsky, R. W. No more butts - a psy- Education and Welfare. Publication No. NIH on the non-smoking cardiopulmonary pub chologist's approach to quitting cigarettes, 77-1414). Washington, D.C.U.S. Govern- lic, in Proceedings of the 3rd World Conference Bloomington, IN.: Indiana University Press, ment Printing Office, 1976, 21. on Smoking and Health. II, 329-335. 1977, 3. "U.S. DHEW. The health consequence's of 38Aronow, W. S. Carbon monoxide and "R oyal College of Physicians of London. smoking, 1975, (Publication No. CDC 76- cardiovascular disease, in Proceedings of the Smoking or health, p. 89. 8704). Washington, D.C.: U.S. Government 3rd Wo-ld Conference on Smoking and Health, "U.S. DHEW: Teenage smoking-national Printing Office, 1975, 61. I.E. L. Wynder, D. Hoffmann, and G B. patterns of cigarette smoking, ages 12 through "'Fletcher, C. M., & Horn, D. Smoking Gori, (eds.). (U.S. Department of Health. 18, in 1972 and 1974. (l'ublication No. NIH and health. Education and Welfare Publication No. NIH 76-931, Public Health Service) 1976. "Worick, W. W., and Schaller, W. E. Al- 76-1221). Washington, D.C.: U.S. Govern- "Seffrin, J. R. Risks, rewards and values, cohol, tobacco. and drugs. Englewood Cliffs, ment Printing Office, 1976, 321-328. Health Values, SeptemberOctob.!r 1977, 1, NJ: Prentice-Hall, Inc., 1977, 77-109. 39U.5. DHEW: The health consequences of 197- 199. smoking, a report of the' Surgeon General: 1972, " Eck holm, Cutting tobacco's toll, p. 19. 19Dichl, H. S. Tobacco and your health. the (Publication No. HSM 72-7516). p. 21. sinokingcontroversy, New York, NY Washington, D.C.: U.S. Government Print- "Califano Jr., J. A. A new commitment to McGraw-Hill, Inc., 1969, 47- 51. ing Office, 1972, 121-135. wellness, Bull Am Lung Assoc., November =lay,S. J.,Associate Professor of "Colley, J. R. T., et al. Influence of pas- 1978, 64, 5-.10. Medicine, Indiana University School of sive smoking and parental phlegm on "Health Insurance Institute, Sourcebook of Medicine, Pulmonary Section, intervie. pneumonia and bronchitis in early child- health insurance data, 1979-1980, Washing- February 27, 1979. hood. Lancet, 1974, II, 1031- 1034. ton, DC: Health Insurance Institute, 1979, 'Essentials of life and health. New York, 4 DHEW: The health consequences of 47. NY: Random House (CRM Books), 1977, smoking, 1975, 87- 106. 62Cancer facts and figures, 1981. 86-87. 42White, J.R. & Frobe, H.F. Small-airways p. 2. 22American Lung Association. Chronic dysfunction in non-smokers chronically ex- p. 1. smoking lowers rate at which the lungs clear posed to tobacco smoke. New England Journal "Hill, H. Situational analysis: women and mucus, Bull Am Lung Assoc., July-August, of Medicine, 1980_302, 720-723. smoking, in Proceedings of ..3rd World Con- 1977, 15. 'Turns, D. M. Consequences of snu.lk mg. ference on Smoking and 1 'h,11, pp. 291- "Newhouse, M. T. Effect of cigarette "Goldstein, H Smoking in pregnancy: 297. smoking on muco-iliary clearance, in Pw. the statistical controversy and its resolution, "Frost, R. Complete poems of Robert Frost, ceedulgs of the .3rd World Conference' on Smok- in Proceedings of the .3rd World Conference on New York, NY:Holt,Rinehart, and ing and Health. II. op. cit., pp. 131- 137. moking and Health. 11, 201-210. Winston, 1967, 131. 24Diehl, Tobacco and your health, 87-95. 45Longo, L. D. The biological effects of 25U.S. DHEW, The health consequences ot ca rbon monoxide on the pregnant Worrhm,

71,!ST CUY Eir.:1:7,."

SO 67 36 TEACHING IDEAS

Addictive Behaviors A Humanistic- We used this approach to teach drug mine the percentages. To inc rease your education in the sixth grade, but it is eas- knowledge you may use the suggested Individualized ily adaptable to a number of health educa- program of learning experiences recom- tion topics. In our class of about 30, the mended in the Input and Practu e col- Approach to children had been exposed to quality Drug Education health education from grades 1 through 5. The text used throughout the district Results Inputs Practices was the Scott, foresman series. The More than 80% four-week unit covered illegal drugs. The #1, 7, 8 #1, 7 60 to 80% #1, 3. 7 #1, 5, 6 JERRY L. GRE !NI is an assistant professor legal ones (alcohol, t affeine, nico(ine) 40 to 60% #1, 3, 5,7 #2, 3, 4,6 and PHIHIP C. HUNTSINGER is an as- were studied in other units. LPSS than 405. #1, 2, 4,5, 6,7 #2, 3, 4,5, 6 sociate professor at health, physical edu- cationmd recreation at the LIniversitv of Self-Diagnosis Xansas, Lawrence, 1sansas 660./5. Directions: Read the questions and mentally answer them. If you believe you know the correct anFvver put a check in Progra.n of Learning Experiences Many tea( hers individualize instruc- the "yes- column. It you are not sure 01 Directions: The learner should follow fion to sOille eXterlt ssith()1.11 realizing it by the answer or do not know, chec k the any or all suggestions in this program. All giving spec al ulstrut tions to c edam stu- "no- c olumn. If you need to, check the of the experiences are designed to im- dents, by allowing Variety in student roles at C uracy of your answers by comparing prove ability to motivate students for in- in 0 lass, or by allowing work on ierent with other students or with the teacher's dividualized instruction. skills at ditterent times. this int!dual Proposed lea rn i ng objec live :The attention may he at the mpense Ithe learner will be able to develop a basic other 51U dent 5 be( Just' the teat her's plan understanding of drugs and drug usage. dOeS not allow tor spe, LII pa( mg and involvement. 1 he problem Isto) mate an lnput environment whit h will let the individual 1. Read Chapter 6, Health and Growth: progress thfinigh the learning program I3ook 6 (Scott, Foresman series, 1974). withhigh degree oi selt-diret tion and 2. Discuss why our culture is called a "pill involvement without impeding other culture." students. .3. Read a programmed learning unit on theprimary obi et IlVe ot the dri.gs and drug use. humanistic-individualized approac h is to 4. Discuss what role age should play in get the students involved in the learning drug use. process by doing and thinking with all 5. View the -Inside-Out" film series and their capabilities. It is up to the teac her to dkcuss. help students find the most produc tive 6.Discuss the swpe of the lot al drug way to the student-tea( her agreed upon notes. It a question was answered in«ir- scene. goals. This kind of approach should help rec dr, hange your answer to the appro- 7. Listen to a speaker troni a «mmt unity priate students learn the pro«.55 sell- organization that spec ialIzes in sonic' as- education in addition to the sublet t mat- pect of drugs. Can you- YUS NO ter. 8. Plan an input of your own, The following steps should be adhered 1 explain what the term "nart 061" toforimplementing thisteat hing means? Practice strategy: 2. define the term "halluc inogenic?" . Write a report on drugs. Self-diagnosis: The teac her should de- 1. explain what the term "depressant- 2. Collect and post newspaper and maga- velop this part ot the instruc tional unit so means? zine stories on drugs. 4, identity the meaning aSsmiated with that it is conducive to the student's mode a 3. Plan a role playing NO cm, showing how of learning. See the diagnosis exert ises. stimulant drug? the t harat ter Charlie Brown would de- 4. desc rihe a volatile substance? Prescribed a( in:ales: The leac her must so todav's drug users. determine the kind and quantity ot input c lassify the tollowing drug,: ltir), tran- 4. Develop a bulletin board showing and practice that students ()nip lete quilizer, heroinwrosol sprays,"pep dangerous household substant es. before they c an Meet the desued oblec 5. Make at roswvord pulzle using only 7. dest rib(' how glue sniffing allec ts the slang drug terms. Program ot learning c\perienc es: 1 his is body? 6. Draw something that would exhibit the total program ot ores( fibed experi- 13. desc ribe the cliff eren«, between the symptoms of the influence of drugs. physical effects of stimulants and depres- ences that the (eat her develops tor the 7. Develop a study guide on a t asWite tor students. It lin hides : Input these expe- sants? the maim drug C Iassiti ahons. rienct.2 allow the students to turther de- 9. explain what effect a nart otit would velop their competencies in areas shown ha", on tbr, body? Evaluation to be weak by self-diagnosis. Output- W. define drug abuse? l'erforrname ObjecOsesI he lea rner these experiences will altostudents to I I. list ten reasons why peopleuse will: drugs? demonstrate the skills al knowledge I. Define the t lassification (it drugs. developed in weak areas af, 12. identify «munon household sub- strengthen- 2. Understand the different ef fects of the ing by input experiences. stances that are ciangerous to the body? various drugs. Evaluation: The students and the 13. list ten slang terms assot rated with 3. Understand the ditteren«, between drugs? teacher can determine if the learning ob- the use arid abuse of drugs. jective has been attained as a result of the 4. Know what common household sub- input and output experiences by analyz- Prescribed Activities stances are dangerous to the body. ing specific performance objectives de- Diret lions: Determine the number of 5. Know the slang terms most often as- veloped for the unit. c het ks in the "yes" column. Now deter- so( iated with drugs and drug use. 68 37 TEACHING IDEAS

Addictive Behaviors

iambi

r4P0PF

fore driving several hundred miles. 20. Use of a sedative/tranquilizer to Mg Use 4. Drinking an alcoholic beverage relax before having to make a alone after an argument. speech before a large group. Mations 5. Drinking an alcoholic beverage at a 21. Utilizing marijuana at a dorm party. football game. 22. Using marijuana after work to relax 6. Using a narcotic drug in a hospital at home. BRUCE A. UHRICH is a former instructor for relief of pain following an opera- 23. Refusing when handed a ''joint" by in the HealthEducation Divisionat the Uni- tion. your best friend. versity of North Carolina at Greensboro. He 24. Utilizing marijuana on a daily basis. 7. Use of a narcotic drug by the head 25. Using marijuana before an in- is currently a graduate student in the De- ofa householdin a lower partment of Health Education at Temple soc'oeconornic area. tramural softball game. University, Philadelphia, Pennsylvania S. Use of a narcotic drug by a physi- 26. Starting each day with a cup of caf- 19122. cian. feine, before anything else. Under what conditions should the Q.Use of a narcotic drug by students 27. Taking a "hit" of some stolen ni- use of a drug be regarded as acceptable in an upper class high school. trous oxide behavior in our society? To deal with 10 Use ot a narcotic drug as a cougn 28. Sniffing glue at a party. this question I have developed, over the suppressant. 29. Taking aspirin every time vou feel any pain. past two years, a series of statements 1 Smoking tobacco in a high school which ,hallenge student values an,: 30. Reiving a patnlolling drug from a restroom. paramedic for injuries at the scene stimulate classroom discussion I give. 12. Smoking tobacco after dinner. students a handout iNith the foliowing 13. Smoking tobacco when meeting of the accident. statements and these directions: "Read new people at a reception. Because the choices are limited to the each statement carefully, then respond 14. Smoking tobacco while riding in a extremes of acceptable or unacceptable, by rating each as an acceptable or unac- car pool. most students are highly motivated to ceptable situation in which to use drugs. IS. Smoking tobacco in class. verbally ,luo:ity their feelings. This situ- Be prepared to share each of your an . 16. Using a sedative/tranquilizer to ation allows the instrudor to act as a swers with the class, and to explainlyhy commit suicide. true facilitator. For each ;tatement, all you answered as you did." 17. lke of a sed ativelra nquilizer to students indicate by snow of hands Situation relax a neurotic personality. which respcine *.hey chose. Several 18...!se1 of a sedativeitranquilizer to en- students with acceptable and unacc.-pt- 1. Drinking an alcoholic beverage at a courage sleep because of a loud able rating are then asked to explain party. roommate. their i:hoice and supportive feelings. 2. Drinking an alcoholic beverage after 19.Use of a sedativegranquilizer pre- The result is class discussion, exposing work to relax at home. scribed hy a physician and theo ail class members to a variety of opin- 3. Drinking an alcoholic beverage be- drinking heavily. ions. 69 2 TEACHING IDEAS ".111.. Addictive Behaviors Chemically Dependent But Only for One Week

does this have to do with rehabili- KAT! ft F I N HSCI IFRis a health Surprisingly enough, Hazelden is tea( her at the Orono Middle Sc hoot, tating chemically dependent peo- not harboring a group of skid row long lake. Atinne,o1,1She is now ple? During my "live in" experience alcoholics. Thereisnot astereo- I it; her se, ond war of teaching and was able to grasp the impact of typefor achemically dependent participat(1; m the program de that simple verse and its meaning person. All of them are everyday scribed here la,: summer to the entire program, and despite real people---many of the women the fact that I am not chemically are housewives and mothers. There dependent, my experience wac real- were young girls, quite a few older Haze/den (Center Citv. Minne- istic in every other sense. women, and two nuns there at that mtal. locatNl .10 miles northeast of Eight of us, four women and four time. The number of older women the Twin Cities. is a treatment cen- men, came to Hazelden as patient- surprised me, butitwas pointed ter for chemically dependent peo observers.Our backgroundsin- out that today is as good a day as plcThis was the setting for an cluded public school teachers, hihh any to start living a better life. in-service education program for 80 ¶;chool counselors, and psychiatric Th2 day isrigidly scheduled for educatorsthispastSlimmer. The clinic:personnel. Eachof us was patients; this is to in their treat- programincooperation with the assigned a differentunitas our Minnesota Departnwnt of Educa- ment, for at someoint they must home for the week, which wodld again start meeting these kinds of tion, was funded by a grant from be the essence of our experience. responsibilities. Allthree meals the Family Foundation Eight No two of us would have the sanw must be attended; each patient has edit( alms per week welt, provided situation, and yet we all would have a work responsibility such as with a"Ii\e in" exper;ence, par- grappled with some intense feeling.. ri:ipating inthe full rehab.':tation vacuuming, cleaning the unit kitch- at the end of our stay. en, etc.; morning, afternoon, and Program mth Patientsandstaff Hazelden is in a picturesque set- The purposes Of the program were evening lectures must be attended; ting. The long driveway has a way anddaily group therapy sessions to dev,gop a "gut le, al" feeling and of quieting one's mind with a gen- attitude toward people with a de- must be participatedin. The rest tle peacefulness that all works for of the day is spent reading assigned pendency problem, to hecome more .,,r)odhere. A patient'sfirstcon- materials, meeting with staff, play- aware of the causes of chemical tact with thz2 inside is the detoxifi- dependency problems, and to being solitaire, sitting around the table cationunit. Minimum stay in this drinking coffee and smoking ciga- come aware that patients intreat- area is at least one day, and most rettes.(The cigarette consumption ment share the same basic needs patients are eagerto move toa with all men. increases during a patient's stay at unit as there islittle to do here. Hazelden. This could be expected "God grant me the serenity to since they are attempting to alle- accept the things I cannot change, All of the treatment takes place in viate one problem at atime. The the courage to change the things I theunits,whichare essentially ever-present smoke, however, can ,An. and the wisdom to know the structuredina home-like atmos- be quiteoverwhelmingtonon- difference." These words have taken phere. There arethreeunitsfc:r smokers.) No recreational pursuits on a much greater significance for men and two for women. The only are provided for patients. I found me now after having spent a week time allof the units are together this confining for my usuMly inde- at f.ta7eIden. Theare words which isat meals and lectures, and then pendent nature, butthe patient's can he found in every room the. , nofraterni7ing is allowed.The purpose for being there is not for either inscribed on a wall ue reason behind the no fraternization having a fun time. or being verhaliied in group ses- policyisto prevent patients from The entire program is based on sions. They ale one part of the re- building up support groups which the Alcoholics Anonymous twelve habilitation program for the chemi- will set back their own rehabilita- steps. These steps ba)ically require cally dependent person But what tion. Our educator group, though, a person to surrender control of his certainlyappreciatedthespecial life to a higher power (belief in Cod ' chemically dependent here afternoon sessions we had together. per seis not a requirement), to to a person who is dependent either on It was the first timeI had found confess to oneself all one's fluits alcohol or drugs. Alcoholis ,:lso Con. myself in an environment where I and virtues, and to then confess sidered a drug. and itis cons dered in was the minority. And yet as the this to another person. When a pa- be the. number one drug prob,ern in the week progressed we discovered we tient reaches the fifth step in the (Ountty were more alike than different. program he is then free to return

70 83 to the outside world. The staff de- Each patient is treateo according involved inthe "helping" profes- termines when a patient is ready to to his own personal needs. An es- sions deal with people every day proceed to the next step, and this sentia! part of recovery islearning who are leading themselves to the can be anxiety-producing for some to communicate feelings. Informal brink where they only have onc patients who feel they are further group therapy sessions aidinthis other out, and that may be chemi- along than the staff thinks. task. In these sessions, patients are cals. Each of us must t. P respon- sibilityfor sharing ou. own feel- Upon arrivalat Haze !den,pa- forced through questioning by the ings and accepting thesefeelings tients do not know how long they group to open up about themselves and get their true feelings out. 'The asreal.Inturn.thcprocessof will be staying there. The normal group can become quite hard on a self-accepti. rice cLn then go forth periodoftimeisapproximately person, and itis natural for people to others. This nen will become three to Thur weeks, although some to avoid making responses that get the process we should use in pre- patients may go into the extended at their feelings. venting chemical dependency. care unit and remain up to a year. That unknowing fear can he a great Patients do not nave a magic stressfactorinthe rehabilitation. formula prescribed foithern when Most of them want to make their they leave so that they will not go Our concern becomes that of the confinement as shortas possible, back to chemicals. But if treatment "feeling"lifeof people.LeviN. but occasionally one will find a pa- has been effective they have much Larson, Education Director, North tient who has found Haze !den a more thanmagic, forthey have Dakota State Department of Health, secure place away from reality and gained a self-understanding which says the real hope of drug abuse would prefer to stay there. Few pa- can lead toafuller, happier life. prevention lies in meeting the emo- tientsfullyrealizethepersonal The stresses and difficulties of daily tional needs of peoplethe need to depths to which their treatment will living are always present, and this is be loved, to be heard, to be under- take them. Within them are the where their belief in a higher power stood, the need to share feelings, anxieties,frustrations, worries and must be strong. the need to have meaningful com- resentments which carried them to The Haze !den experienceisex- munication with other people. Re- the chemical escape they so desper- tremely worthwhile ina personal sponding to these needs is how we ately needed. Many of these people and professional sense. Allof us get people off drugs. In doing thk for the first time in their lives are -.hould be given the opportunity to sooner liesthe hope of keeping having to face feelings they have look within ourselves. All who are them from "getting on" drugs. hidden for years.

71 39 TEACHING IDEAS

Addictive Behaviors Learning by Teaching

trv,m)st *uw.,iv$t kt 0.%1110,/iv IN)wr le-Aci/)hr \I) Apr; eAriA \\14 ki k 41(efr-lv"- IIINgiri....if, 4 4,4e1k- liort; '1/47111*N:*q `it-6(17-k / Nv!A 46, 411'-'*--e.:,..

ELAINE HALS is a teacher of health The committees had complete lati- anc1 were nonjudgmental. No value and pi,ysicaleducationat South tude in handling their subject, know- Shore High School in Brooklyn, New judgments were made, but the in- ing that they had two days for their formation necessary for the students York. She is a new member of the presentation.In cme class for ex- SHR Editorial Board. to make their own value judgments ample "the why" committee spent arid their own decisions was avail- one day on adults and drugs, and able. This information was given to Drug education, an area of the one day on young..people and drugs. them by a source that theywere healthcurriculumvitaltohigh In the other clzessthe committee willing to listen to--their classmates. school students, is an area that easily dealtwithdrugsinadvertising, It was a worthwhile experience turns young people off. They are sports, the school environment, and for the class, and for me. The stu- tired of being preached to, moral- the home. In both classes thecom- dents in my classes felt free to ex- ized to, and lectured at. My dilem- mittee members asked questions of press their opinions as well as their ma was how to get the necessary the class id involved them as part knowledge. They had a chance to information across, without losing of the pres ?motion. When it became step into the teacher's rolefor a the attention and interest ofmy necessary I was able to add informa- short while ano to see the class from health classes. I tion, tried conventional ask questions,or guide the adifferent point of view. The stu- lessons, contract teaching, and o(her committee and the class. The students received not only the needed methods,but somehowstilllost dents made up and ran off their own information of the drug unit but ex- them. stelcils, some brought in music of perience in working in a group and Last term I decided to let the stu- today that concerns itself with drugs, seeing their project through to com- dents teach the unit to each other. and one group even made up a role pletion. The unit was moremean- I broke each of my classes into three playingsituation(and usedclass ingful than ifI had taught it. members to act it out). committees and selected three of Afterevaluation,thestudents the most verbal members in each The role playing situation was as found some flaws: (a) people came class to act as chairmen of thecom- follows: (a) parents waiting up for unprepared to give their reports and mittees. The committees were se- teenager to come home from party (b) people read long technical re- lected by me so that there would be young person comes home ports not meaningful to the class. an equal number of verbal people stoned; (b) reverse situation: teen- In general, they favored this meth- in each group. age boy or girl waiting for parents od. As for me, Ireally got to hear The three committees were: to come home from a party--par- aboutandunderstandthedrug 1. Why drugs? ents come home drunk. "problem" from a young people's 2. The facts. This situation, and the discussicn point of view. 3.Treatments available,includ- that followed, helped the students Thisis an approach that I will ing overdoses and emergency look at life for a moment from their use again. first aid. parent,' point of view, and to help In each class the committees had themunderstand themselvesin one day in class and two days in the terms of their tolerance for or.hers. libraryto organize theirprojects. The studenls listened to each other 72 85 40 TEACHNG IDEAS

Aging

Aging: A Need -aff: for Sensitivity 4-'

KENNETH A. BRIGGSis an assistant professor of lwalth education at the State Uni- veisity of New York, College at Cortland, Cortland, New York 13045. With our culture's shift from revering the old t.) worshipping youth and the breakdown of the extended family into separate nuclear units which usually exclude the elderly, a whole generation of young people are uneducated and insensitive to the eldedy and their needs. Comprehensive school health education, which seeks to improve the quality of life through informed choices, is a good place to educate school age children about aging.It not only makes students more aware and sensitive to menu or a newspaper, or look up the then go to the cafeteria and buy a carton the needs of the elderly; it also educates phone number of a pharmacy that will of milk. Upon returning, have the stu- them for their own aging. deliver prescriptions to old people (if dent share some of his feelings during Following are some suggestions to there is one). Have students record and the experience as an older person with help create an awareness and caring for share their reactions. sensory deprivation. Be sure to exercise the elderly and their problems. These necessary safety precautions when stu- exercises help show students what it is Hearing Loss(reported by 22 out of 100 dents perform such simulations. like to old in a culture that treats elderly) senior Lici lens the way we do. Place a cotton ball in the student's exterior ear canal. For a more pronounced Songs and the Elderly effect, have them also wear headphones Sensory Deprivation A lot of popular songs have been writ- Simulation Exercises or earmuffs. Have students listen to the TV or radio at a low level, or try to carry ten recently that do a good job of devel- on a conversation with someone who oping a caring sensitivity and awareness The following simulation exercises try of the elderly in listeners Following are to bring to the young and he a sen- has no hearing loss and must shout at :hem to be heard. Again, have students some examples of such songs and their sitivity to what it must be like to beId artists. and suffering from common sensory in- share their feelings. sults reported by the elderly. "Old Man"Neil Young Loss of Touch "OldFriends""VoicesofOld Arthritis(reported by 33 out of RV el- Cover the students' fingers with rub- People" Si111011 and Ga rfunkel derly) ber cement and after it dries, have them "When I'm Sixty-Four""Eleanor Using cellophane tape, tape students' try to thread a needle. Rigby"The Beatles fingers together in various combina- "Two Lonely Old People" Wings tions, e.g., tape thumb and index finger Loss of Smell "Hello Old Friend" Eric Clapton together and the 4th and 5th fingers to- Have studentstaste various foods "Lonely People" America gether. Wrap elastic bandages around while pinching their nostrils shut. "Good Company" Queen the knees to simulate stiff knees. Have "Hello in There"Bette Midler students perform simple tasks and then Midtiphcity (polymorbidity) "I Never Thought I'd Live to be 100" share their experitmces of what it might Certainly malc, elderly people suffer "Travelin'EternityRoad" --Moody be like to be old and have arthritis. from many ac,ing insults. They may Blues have a hearing loss, arthritis, and a vis- "Let Time Go Lightly" '.1arry Chapin Visual Handicaps(reported by 15 out of ual handicar . To help students under- "Father and Son" "But I Mighi Die 1(10 elderly) stand multiplidty and what it might be Tonight"--Cat Stevens Take sunglasses or laboratory protec- like,have several students perform A nice touch to makc aging education tive glasses and smear vaseline on them tasks with various combinations of the: come alive in the classroom is to add until you get your desired visual loss. above simulations. For example, one slides of old people to the music. It can Have students wear the glasses and per- student can simulate finger arthritis, be quite powerful in creating sensitivity form everyday things such as reading a visual loss, and loss of touch and smell to aging. 73 F E Activities for Application 4. .ixty-five is a good age at which to Take two pictures of, for example, a and Discussion retire. street corner or the entrance steps to a 5. Old people live happier lives away bus. One picture of your chosen scene Have students share some of their from the young, competitive world. should be in focus and the other should fears about growing old. 6. Old people should be kept active. purposely be out of focus. This will Have students draw pictures of them- 7. Old people suffer a sense of loss when their children leave home. dramatically demonstrate the problems selves showing what they will be like 8. Our society encourages old people encountered by those elderly who have when they are 100 years old. What to be productive and useful. a serious vision loss and the insensitiv- losses do they show? 9. Old people should stay in their ity we have to these people by having Have students think of or photograph own homes, if possible. such things as "Do Not Walk" signs that things in a grocery store that demon- 10. Old people should le discouiaged are too small to read. ;trate our insensitivity to the aged such fromdependentrelationshipswith We cannot overlook the most obvious as, unit pricing numbers and prices that agency personnel. and valuable resource of all the el- are too small to read, bulk packaging, 11. Most older people are ready to rest and don't want to be involved in "doing derly themselves. Bring the elderly to no carry out service. things " the students or take the students to the Have someone in class carry on a 12. Old people cannot learn as well as elderly. Allow them to ask questions of conversation with another person in young people because of deterioration of each other, spend time together, and class who has simulated speech prob- the brain associated with aging. most important of all, try to understand lems that follow a stroke by placing a each other. ping pong ball in his/her mouth. Because of the nature of our modern Use the following opinionnaireto society and quite often the insensitivity generate discussion about the elderly. it carries with it for the elderly, health Indicate to the right of each statement education about and for aging that tries whether vou agree or disagree. to reintroduce the elderly to those who 1. Old people are better off living with may be out of touch and insensitive to other Old people. tliii is imperative. Such educationcan 2. Old people need rehabilitation. be valuable for the aged as well for all 3. Rehabilitationis done bestina those who may better understand the nursing home. exigencies of the years to come.

74 41 TEACHING IDEAS

Aging Picnic in the Park Humanizing an Aging Unit in a Personal Health Class MICHAEL J. GAETA is a doctoral candidate The second class was devoted to a cur- The fourth class period consisted of and graduate teaching a sistant in the De- sory examination of the more common aging simulation games. With the help partment 4 Health Education, Oregon State and current biological theories of aging. and expertise of a gerontology professor, 'niversity, Corvallis, Oregon 97330. The primary objective was to familiarize the students were divided into groups of the students with the present theory of five. Shoe boxes filled with parapher- the etiology of senescence. An excellent nalia to simulate impairments brought cornt rehensive review of the biological on by the aging process were passed out .2ories of aging is found in the Handbook to each group. Arthritir., visual, hearing, of the Biology of Aging. It provides an ex- aphasic, and stroke impairments were '-Audents in my Personal Health class cellent framework.3 simulated as part of the exercise. Each ht. d a ricnic in the park with 54 elderly In the third class sessionudents had "impaired individual" was given a task res'.ients from Heart of the Valley Re- the opportunity to discuss aging with a to do alone. This was followed up by a 69-year-old senior activist. Several days t nent Center and Nursfitg Home group task. These simulations enabled t' ..p!ex in Corvallis, Oregor as the before the class students were instructed the students to more realistically under- 1,itination of a unit on ar'ng. In plan- to write down any questions they had stand t;.e impairments and restrictions romg the aging unit I decided to design a about any aspect of aging. The guest that many aged people live with ^ach program that would provide the stu- speaker was given the questions a few day. For an excellent review of aging dents with an accurate knowledge base days ahead of her scheduled talk so that simulation games see Health Education of the biological, psychological, and so- she could more accurately ascertain the September/October 1977.4 ciological aspects of aging; and even needs and concerns of the students, In clAss five a gerontological counselor more important, provide them with ex- Sitting in a large circle with the class, addressed the area of psychosocial needs periences that would sensitize them to the speaker answered questions and re- of the elderly. The counselor em- the realities of aging. At: of this was to be lated her philosophy of life so eloquently phasized that we are all creatures of terminated in a picnic, a celebration of that the entire class was caught up in her needto be fed, kept warm and dry, to life bringing the young together Mth the bubbling enthusiasm for life. She shared grow and develop at our own pace, to be old. her feelings on everything from sexuality held, caressed, recognized, loved and "Ageism" is prejudice and disc;imina- to death. After a standing ovation, the stimulated. While most people recognize tion leveled by one age group against students without coercion lined up and the importance of practicing and sub- another.' It is just as volatile and in; ust as one by one proceeded to hug and kiss scribing to these tenets in the early years other forms of bigotry such as racism and her as they left the class. R was obvious of human development, many of us sexism. It is founded upon ignorance, that those students went away with a forget t :tat these needs must be met from myth, stereotypes, and fear. It results in more positive and beautiful perspective cradle to grave if we are to reach alienation, despair, der ?.'vation, power- on aging. lessness, and even hL ,Llity. The only I.4111MMEIL- way to combat this prejudice is to meet it 4,.--_ head on with accurate information and experiences that will demonstrate to cam. 413. ,,z-.4-_ 111111Pan. people of all ages how cruel it is to think - 1". .0 of our elders as inhuman. A total of six class periods were devoted to the aging unit. We started the first class with Palmore's "Facts on Ag- ing" quiz,2 which covers basic facts and misconceptions about aging. The quiz ewe takes approximately 10 minutes to ad- for minister, but stimulates much discussion about basic physical, mental, and social facts and most frequent misconceptions about aging. The quiz con- 4. tains factual information documented by ¶ empirical data. This tool is an excellent -c resource that provides the students with vi a relevant vehicle for more clearly under- 14.0 standing the multidimensional topic of Mow -111bp aging. 75 8 On Friday, June 2 1978, the ; Gazette-Times of Corvallis, Oregon ran this picture story Gazette-Times Photos about the class By Torn Warren described by Gaeta in this article. The photographs on this Laurence Garner, left. talks with student Math Rabichaud. page were taken by Tom Warren. Lunch in the park _ fro The 10 stir:lents in Michael Game's Personal Health class at Oregon State had a special final examinationa box lunch in Chintimini Park with 40 resi . dents of Head of the Valley Center. Jeanette Stoner. Rosemary Wick, Barbara Quinn and Cindy Miller enter- tained by singing to the senior citizens oarrPo Jeannette, who is a freshman preveterinarian student from Hood River, said students brought their own lunches and exchanged them with a senior. "Ft was the neatest final I've ever taken," she said. "I used to be afraid of growing old, but I learned from the seniors that they have a lot of fun, have hobb4s and really get around the community." She said she's also learned how they cope with arthritis, hearing and seeing problems.

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Danita Ruzic, chats with Cora Warner, holdln-, cup. at the picnic in Chintimird Park Danita has been spending each morning at Heart of the Valley Center and produced 11111.111...- a term paper on her experiences.

Youngsters and oldsters soak up the sunshine.

Kimberly Koehler, lett, helps Marian Taylor 'Oh her picnic lunch

76 BEST COPY Ala.Z.E 9 optimum growth and chelopment. The day of the picnic was beautiful. Time seemed to fly by and before we This last session put the finishing The sky was blue, the sun was shining knew it the time had come to leave the touches on preparing the students for and the temperature was pleasant. I ar- park. On the way back to the Center the picnic with the elderly. rived at the Center at 11:30 and found traffic was blocked up both ways on Working in conjunction with the ac- patients lined up in the lobby eagerly Harrison Boulevard, as students and tivities director from Heart of the Valley waiting to depart. The police arrived residents moved ina procession that Retirement Center and Nursing Home shortly thereafter and were given in- stretched from the park to the Center. the groundwork was laid fc,r the picnic. structions as to when we would depart Residents and staff from the Center The picnic called for the exchange of and what route we would traverse to were in the windows waving to our box lunches with the elderly. The stu- reach the park. Within a matter of min- group as we arrived. dents were asked to prepare a lunch utes students started to arrive and we The reactions from students and el- complete with treats not usually found began hooking them up with residents ders alike was unequivocally positive. in an institution. Arrangements were from the Center. As I looked out of the No sooner did we get back to the Center made through the administrator for the main doors, the group of elders and than one elderly woman asked when Center cafeteria to pre-ide box lunches students reminded me of a beautiful the n xt picnic was to be scheduled. for the students plus lehionade and cof- parade. A meeting of the young and the Without any question, it was obvious fee tor the entire group. old. People with canes, some in wheel- that many of the fears, myths, and The activities director took care of chairs, all being escouted by students. stereotypes of aging were bashed down publicizing the event at the Center. Human beings that had been separated that day. With a little bit of imagina- Signs w placed in the elevator and by walls, not walls of wood or stone, 'ion, coordination, planning, and coop- on the bulletin boards notifying the but walls of ignorance and fear, were eration, a picnic in the park on a sunny residents of the picnic. A list of poten- sharing love, food, talk, and compan- day in May gave a group of personal tial participants from the nursing sec- ionship. As I moved about the group health students the opportunity to learn tion was compiled and these patients taking pictures, I was amazed at the rate first hand that aging is not all negative were contacted and asked if they would and quality of interaction that was hap- and that old people are no different like to attend the event. pening all around me. from young people. The park chosen for the picnic wac Students with musical talents played one block away from the Center so no harmonica, guitar and sang to entertain bus transportation was necessary. the group. Song sheets of old time fa- However, since our group would have vorites printeu in large block type were to cross a busy str9et to get to the park, distributed and the whole group joined 'Butler, Robert N. "Ageism: Another the Corvallis police were contacted and in the merriment by singing songs, Form ofBigotry." Gerontologist,1969, Vol. 9: they agreed to provide traffic direction clapping hands, tapping feet, and 243-46. and assistance. laughing. 2Palmore, Erdman. "Factsor, AgingA After sharing lunch in the warm sun, Short Quiz."Gerontologist,197', Vol. 17, No The local newspaper was contacted gifts were handed out to the elderly by 4.: pp. 315-20. and told of the picnic in the park. It was the students. With the extra gifts stu- 3Finch, Caleb E. and Leonard Hayflide thought that the publicity would be dents suggested that we have a contest (eds.) Handbook of the Rio;ogy ofAging, Van good for both the Heart of the Valley and hand out gifts in descending order Nostrand Reinhold Co., New York, 1977. Center and the health education de- 4Briggs, Kenneth. "Aging: A Need for from oldest to youngest. A 94-year-old Sensitivity."tieatt'i Educatim..Sept./Oct. partment. grandmother won first prize. 1977, pp. 37-38.

f)U 77 42 TEACHNG IDEAS

Consumer Health 2. Divide the class into two teams. Following is a list of 45 anagrams with Have each group elect a captain who is the appropriate answers. responsible tor recording the solution 1. Heston Sahsgole Anesthesiologist for each anagram and serves as their 2. Les G. Trail Allergist spokesman. Allow 30 minutes for each 3. Lenore Vut Volunteer team to work. Validate the answers be- 4. Sandie Sure Nurse's Aide tween the two teams at the end of the 5. Togol I. Scadir Cardiologist time limit. The team with the most cor- 6. Hope Toast Osteopath rect an

Consumer Health

some direction in our consumer health Consumer Wellness, program. Out or this we instituted a consumer health program entitled WISE ONO School's MAN. APProach W ise I independent otivate S afe/ef fective Aware ION W. HISGENis a health instructor in Iivilluate otable wankee Public Schools, 210 Main Street, Pewaukee, Wisconsin 53072 and an Each of the letters represented a com- instructor of consumer health for the Uni- petency we wanted our students to versity of Wiseonsvi, Milwaukee. . have by the time they left our health program. 1. The student will be able to ...rake wise Every year Iinstruct my consumer and careful decisiorc about the consumer health units at the seventh and ninth products and services he/she uses (consumer grade levels I am made acutely aware of health protection). people's trusting nature. In this "credit 8. Sales have increased each year for the 2. The student will be able to make deci- card culture" where we exist, instant last three years. sionsindependentof outside influences (e.g. pleasures are a signature away. There is 9. Famous people have endorsed the advertising, pseudo-science, etc.). product (the Osmonds, the Jackson Five). 3. The student will be able to choose no better example of this approach to products and services that are bothsafeand consumer decisions than in the world of 10. A local newspaper is coming to take advertising pictures of students holding the effective. health products and services. We product. blindly use hit or miss tactics in every- 11.If the students bring the money next thing from wiping out those unsightly time we meet, I'll give them a special offer of blemishes with steam to strengthening two bottles for the price of one. our rectus abdominus muscle with electric belts. Over the past five years around 91% The condition of wellness is a combi- of the students have agreed to bring the nation of many interacting forces, in- cost of the product the next day while in cluding the individuals' environment, fact 70% actually did. When Itell the their reaction to it, associations, psy- students that a cruel hoax was played chological background, Nicl ability to upon them the following responses can accept attitudinal change. Today's be heard: "I'll never trust you again." j; F health consumer is more likely to face "We thought you were above that." these forces after his/her health has "Well, you certainly made me look been threatened in some way. Con- foolish." "I was just playing along with sumer wellness is not an easily acquired your little same." status but must be learned. The alarmingly high number of gulli- My initial seventh grade consumer ble consume.-s pointed out the need for health activity is to sell each student a bottle of Dr. Lernke's Stomachic Drops 1111111111111111111111°"111"41101W 4. The student will be able to using a stereotypical medicine man ap- ,04. evaluatenew proach. The following is an example of fr and existing health products and services the pitch I use to convince the class the (the work of government agencies, insurance product works. programs, alternative medical practices, etc.). 1.Itell students about a college assign- 5. The students will be able toniotivate ment to recreate a medicine from an old others in their present or future family to medical text. make wise consumer health decisions (well- 2.I chose Dr. Lemke's drops because of thought out family medicine chests and first its advertised ability to cure both acne prob- aid kits). lems and split endb (7th grade concerns). 6. The student will beawareof pitfalls fac- 3. The mysterious ingredient is cap- ing the consumer of health products and sicum that must be inported from Africa services (quackety, superstitions, fads, and and grown hydroponically. falla cies). 4.I finished making the product in two 7. The students will be able to makenota- months and successfully field tested it on my ble savings in their consumer health budget friends and myself. and notable improvement in their overall 5. Iunsuccessfully asked for support wellness. from the AMA and Bristol Meyers. M E S 6.I decided to market th2 product Our school's consumer health pro- through magazines after receiving a patent 00 5Pii gram is based on these competencies. A on the product. copy of our consumer health curriculum 7.I bought a factory to grow capsicum and methods guide can be obtained by and produce Dr. Lemke's drops. maim: wriing the author.

79 44 TEACHING IDEAS

Consumer Health

pose suc h operations, students paint and groups ot students. Types of health prod- A Healthy label empty coffeeans with "American ucts good for study include: prescription Cancer Center. "National Sc hoot tor drugs, over-the-counter drugs, perisha- Consumer I Newt( S'. or some other phony health ble foods, cosmetics, or food sold in a Health Class agency name. Working in pairs, the stu- health food store. dents take money and write down After groups are formed, students phn pledges. After c ounting the money, it is to visit a variety of stores such as a chain returned to donors with an explanation. food store, small pharmacy, and disc ount This activity should be widely public ized stoye. Pri.:.es may vary depending on loca- so that they can learn without being un- tion of the store, so encourage students TOM MO-ARLAND is a consumer educa- ne«.ssarily embarrassed. More people to visit suburban, rural, and urban areas, tion specialist at the family Life Education will know they should check before giv- itpossible. Items to he price-chec ked Center, Toledo Public Si hoo/s, Toledo, ing. should be standardized by brand, size, Ohio 43604. ANN RLIDRAIJI f is educative weight, count, or whatever, so results will services specialist for tVGT1 -TV, Channel be «wiparable and a« u rate. 30, in Toledo. Groups can make c harts to depict their Health Insurance results, analysis 01 data, and conclusions. Presentations to the whole c lass should Our experience has shown that the he made. most succ essful way to teac h consumer Health insurance is a crucial issue health is to throw out traditional c lasses about which few con sunwrs have a work- and have students learn by doing, using ing knowledge. One way to identify and Health Practitioner Interviews the community as a classroom. Most of probe health insurance issues is by values the learning experiences we desc ribe are clarification tec hniques. Voting an pertinent questions. How oriented toward high sc hool or collcge The teacher can assign job clasifica- level but adaptations c an be made to sUit many of you have health insurance? How various sc hoof aged or «mini unity many are covered under a family policy? tions or let students select the one they groups. How many are covered under a group are most interested in,t J go out and policy? How many have Blue Cross-Blue interview someone in that area. Several Shield? How many can list the exclusions possible candidates are listed under in their policy? "guest speaker" later in the article. forced choice questions. These help Make sure students are aware of how to Advertising students decide which alternative they contact people, set up in terviews, a nd ask pret er: private medicine or socialized pertinent, interesting questions. Role medu me; unnecessary luxury or neces- playing in the classroom before the inter- Thorough understanding of how ads er- sity? Students can vote hy moving to view will give confidence to carry out the Using works Is necessary for the con- either side of the room, then find some- project successfully. sumer health student. Scum, suggested one there to disc uss.t he reasons for their Follow up activities inc;ude: oral re- at tivities are: dec ision. The teacher can design ques- ports, role play, group comparisons of Ad substantiation campaign. Slifvev tions to bring out important points to be categories, mock debates with students local media tor advertisements ot health disc ussed. playing the role of the person inter- and beauty produc Is. Printed ads c an be Values continuums. Use to emcm rage viewed, and so 001. brought to c lass; radio and TV ads c an be partic 'nation m discussion ot Ulrrent is- taped tor disc ussion. Many ad agem io sues related to health insurance. Health and TV and radio stations throw away costs are: too highjust right----too low. General their tapes and layouts and are hal,py to Medicine should be: socializedtotally see someone get sonw use I rom them. private. Health insurance is: a wasteall Claims made in the ads aro sc rutinized right cruc ial. I usually block out the Guest speakers. A wealth of informa- and some are selec ted tor analysis. `tu. c enter et the continuum to discourage tion can be provided to students by out- dents write ompany president,- and ask students who ond it too easy to be indii- side experts. This is especially helpful if tor tactual substantiation ot the adver- terent. tield trips are not within the budget. tisement. lliis is examined to see it the Rank order I)List motor exclusions Tea( hers can call on a wide selection of laim justified. lhe information gath- tound in insuran«, pohc ws. Rank in order «mimunity people inc luding: ered c an he shared with c lassmates and of danger to «msomers. 12) list ways to Health practitionersdoctors, pharma- c an be made public . learn about health insurance and rank in o ists, paramedic s, nurses, public health Counter-xis Sinc e adwrtising is obvi- order ot preference. leo( hers c an use ()Moak, nutritionists. ously biased. «msumers deserve to hoar Ilus list in planning c lasses. Ist types Governmental or voluntary agencies-- the other side of the stor. pre ot health insuranc e coverage, and rank in Better Business Bureau, Consumer Pro- pareounter-ads SIR h as. "aspirin Is all order ot importance to the consumer or le( bon Agency, Post Ottic e. local health the same, it may 0 ause internal bleed- in order ot expense, suc h as: basic hospi- departments, civic groups. ing." A visit to an ad agem y or asking an tal. major medical, dental rider, materiuty ducators --university health staff, con- advertising man in as guest instrut tor c an benefits. Students can share their sumer specialists. other teac hersf rum heft) students prepare their ads. Students ahonalvs tor rankings in groups of three. the 5( hool. should then try to get Inc al media to use Businessinsurance agents,f ood pack- their counter-ads as public st.rvic e spots ers, advertising agencies, credit bureaus, fraudulent chanties. Most ol the Price Comparison Research health bond store owners, «)smetolo- fraudulent groups a..c. «mtered around gists, lawyers, rowan h in disease prevention and c tire, 1 hese researc h results c an s'ied mu( h ft a speaker s time is limited, tape the and they have bilked «msumers out ot light on luture buying prac ti«,s. A «,dain presentation for the rest of the classes. millions of dollars. In this projec tto ex- type ot prodmt is selected tor study by Invite several guest speakers at onc e to

80 9 3 form a panel or have a debate on a given information covering the entire worse, it at least Om e a year; I am adequately cov- topi( .Preparing the speakers and stu- ( an he used as tl posttest. ered by medical insuram e; I have a good dents ahead ot time and following up Some sample questions are: ( recto "4.1. Unfinished sentencesI makes this more effec tive. 1. Content-based items (true or falso- sp v.1 :ley loutishly on ; Pretest. Thk is a good way to assess the 1 oothpastes are necessary for good den- ,op around for group's knowledge, mis«m«Ttions. tal health; the best relict 01 arthritis pain speriment with some (it the a( tivities ba( kground, values, and behavior. It ( an is p rest ription drugs; gargles or mouth- des( nhed here; adapt and appls them to he used to learn what the students want washes are not ettettive treatment ior our own teac hing situation. Remember, to know or as a springboard tor disc us- sore throats.2. Attitude and behavior- an involved ( lass is a 'healthy""lass. sion.II the lest includes «mtent-hased based itemsI see a do( ton and a dentist

9 4 81 45 TEACHING IDEAS

Consumer Health The Teenage Consumer

LEE ANN LARSON is a 7th and 8th grade health teacher at cases do not even have to be so dramatic. This leads to the Dexter McCarty Middle School, Gresham, Oregon. an investigation of quackery and a realization that they are one of the prime target groups because of their susceptibility. Mail-crder quackery traps them with its glamour and seeming privacy of the postal system. They get involved with researching training, signs, and results of quackery. Students can become pretty outraged about what The marketplace iswide open to today's teenage con- quacks are "getting away with." At this point, students sumer. As the target of constant bombardment by adver- investigate some of the organizations working in some tisers, the teenager with access to money is in the posi- way to protect the consumer from fraud. They study the tion of making decisions with very little information. Food and Drug Administration, Federal Trade Commis- Health products, in particular, appeal to the teenager sion, U.S. Postal Service, American Medical Association, with their promises to beautify. Although information Consumer's Union, and 1.:etter Business Bureau. for the student in this vital area hard to find, I teach a unit with seventh and eighth graders to develop aware- Throughout the discussions, students are reminded that ness of consumer health educati Dn. these organizations are handicapped by their de- If the con- To understand any new body of knowledge familiarity pendence on consumer complaints to act. with the terms that relate to that area is necessary. The sumer is too ashamed, too af raid, or too lazy to report an students' first task is to find definitions of appropriate incident or complaint, other unsuspecting consumers words. We use health books rather than dictionaries to will be subjected to the same treatment by a fraudulant give students specific subject definitions rather than person or company. Even if students have some information on quacks and general definitions which they may have trouble apply- the groups which protect the consumer, they are still left ing to topical situations. This list of words introduces the with the problem of what to look for in good medical unit: services. Investigation continues with some of the bait and switch media guidelines to follow in selecting a physician followed by code-dating system nostrum a review of specialists (pediatrician, general prac- comparison shopping patent medicine titioner, internist, surgeon, psychiatrist, etc.). Students consumer product need to look for the physician best able to handle their cosmetic proprietary compound needs at various stages in life. An increasingly important dentifrice quack aspect of medical service is that provided by hospitals. fraud trademark Students try to find out what kinds of hospitals exist and indirect lic what questions should be answered before choosing a hospital. The students next investigate some far ts about their role as consumers. What is the history of health prod- The next project gets students involved in investigating a product. With school funds, I ucts and services? What about the "medicine man" of purchased three the old west and his cure-all drugs? How are his claims brands of several products from a discount store, adding another price to the label from a regular grocery store or different from or the same as advertising that we might drug store. The products used were aspirin, toothpaste, hear or see today? Students investigate how advertising affects the consumer and just how much advertising is shampoo, deodorant, vitamin tablets, ready-to-eat directed at their age group and why. They take a look at cereal, arid acne preparations. Knowing seventh and how Americans spend their health dollar, and of total eighth grade students,I emptied all of the containers income how many of their dollars are spent for health before using them in the ( lassroom. The class arranged products and services. itself in groups to provide an equal number to work on Middle-school students are still SN u re with the each product. To make it somewhat fair, each group thought that if they get sick or hurt their parents or some drew a number to indicate its turn at choosing a product. other adult will make sure they are taken care of proper- Once the preliminaries were settled, each group rely. 'This unit's lessons present them with situations and ceived a form on which to write the information to pre- factual histories in which they must make sonie deci- sent to the class. The questions include: sions of their own. What if their doctor tells them that they have a disease which cannot be cured, but they read about a doctor who can cure the disease? What if they are told they have cancer of the leg and it must he 1. What is the history of the product? (Where did it amputated, but someone knows of a doctor who has a come from? \Vho found it and how? How long has it cure for cancer? The possibilities are endless and the been around?) 82 5 KitfseteMINNIMP

2. What are the ingredients as they are listed on the 8. What do advertisements for this product look or label of the product? sound like? (Students can cut ads from magazines to 3. What are tne uses for the product as listed on the show or report Ones they have heard on the radioor label? from friends, or seen en television.) 4. Can this product cause any harm? (Not only the particular brands they are investigating, but any other The reports to the class c:In produce more questionsano brand of the same product. In most cases this informa- further research plus a wealth of basic information. tion is not on the label so they will have to do further One of the common concerns to come from this in- reading.) vestigation is the inadequate information found on the 5.Is any brand of this product better than others? labeling standards and new ones currently under consideration. Included in the unit are not only the products Where did yp(t. find that information? (Students havea tendency to rely on advertising, written or word-of- investigated, but any product which may in someway mouth, to make this decision. Encourage them to use relate to health and safety, such as baby cribs and toys. resource materials to see if they can find reliable infor- Thic, is also an excellent time to get into nutrition label- mation.) ing. A fun exercise is for students to design a label fora 6. What is the price comparison for the product? product, including all of the information they think is (Comparing the same brand at two different stores, dif- important for the consumer. ferent brands at the same store, and different sizes of the Another way to get students thinking about health same brand. I purchased the products, as much as pos- products and selections is to have them collect adver- sible in the same size, but students sometimes take it tisements abc ut many different brands of some product. upon themselves to check on other sizes. 7. What is the latest information about this product ? (I After students decide which brand of thewoduct is best, using only the advertisements, each collected all the informationI could--magazine and will tell how newspaper articlesabout a product and let the stu- confident he feels in his decision. The studentswill also dents decide what is significant enough to report to the indicate other information they would liketG ha..e rest of the class.) make an even better choice.

83 46 TEACHING IDEAS

Consumer Health Crisis Hot Line Experience

ALOYSIUS I. IANGL is health education havior or any "abnormal" behavior is the 2. Devise a reference list of persons, instructor and subject area coordinator at psychiatrist's or psycholohist's province groups, or agencies that deal with Ards ley Middle School, Ards ley, New alone. Suicide prevention is not exclu- suicide or attempted suicide. York 10502. sively a medical or psychiatric problem. 3. Identify clues in the individual's be- Health educators can operate within cer- havior that suggest a need for consul- tain limits in teaching and counseling. tation with a professional specialist or Moreover, they can help shoulder their a need for other forms of immediate mental health responsibility by present- help. ing the essential facts concerning crisis 4. Identify and suggest various _onstruc- behavior in a meaningful way to their stu- tive alternatives and psychological first dents. aid advice. The following is an example of an instructional strategy that has been used in a middie school mental health unit dealing with crisis prevention and intervention.It may encourage other health instructional Materials educators toward more effective affective 1. Battery operated walkie-talkie; 50 ft. teaching and the rewarding experience of extension. humanistic health education. 2. Record player with microphone and speaker jacks; speaker with 50 ft. ex- Behavioral Objectives for Students tension jack cord; microphone jack 1. Cite particular situations which have cord. the potential for critical or self-de- 3. Thirty or more dittos of Crisis Hot Line structive behavior. Evaluation Sheet.

CRISIS HOT LINE EVALUATION SHEET The emergence and impact of two relatively new mental health concerns, death Instructions and suicide education, can be viewed as Place the name of the student who is the crisis hot line operator in the numbered box outgrowths of the education system at- atop each column. While listening carefully to the conversation, check off, in the tempting to ensure healthy personality vertical column under each operator's name, the psychological first aid advice he development. Nevel.theless, mental suggests. health areas within the health education NAME OF OPERATOR curriculum are often neglected or poorly presentI. Why? Perhaps the curriculum PSYCHOLOGICAL 1. 2. 3. 4. 5. is largt_r fact-oriented with little accom- First Aid modation for the bulk of affective content involved in mental health. The wealth of Listens attentively emotions and attitudes combined with Takes complaints seriously inexperience and/or fear of affective teaching may make some health educa- Evaluates seriousness tors apprehens. de about such vital health of intention areas. With statistics climbing, suicide is now Examines intensity of the third leading cause of death among emotional disturbance young people between the ages of 15 and Assesses resources available 19, and it ranks first or second on college campuses. The area of suicide and its pre- Does something tangible vention should be of vital concern to the health educator. Suicidology, the scien- Affirmative, yet supportive tific study of suicide, investigates the Asks directly about suicidal many complex causes leading individuals thoughts and intent to self-destructive behavior. Research has shown that cuicides are not spontaneous. Not misled by passing There are dues that foreshadow this be- second thoughts havior to which both educator and student alike can become sensitized. Armed Suggests personal or with this awareness and sensitivity, pre- professional assistance ventive and rein forcing steps can be Thus eviluation sheet has been formulated from the article. -Ecological Aspec ts of Self.Destruction: Some legal, taken to help the individual. It is errone- Legislative and Behavioral Implicat ons,- by Calvin Frederic k m Health and Human Values by Allure ,efcoat (John ous to assume that handling suicidal be- Wiley & Sons. Inc.. New York, 19.7) pp. 172-80. 84 9 7 Instructional Activity speaker. Only the selected crisis hot line by class members through their evalua- Instruct each student in the class to operator will be able to respond with tions arid any additional comments by the write out a critical situation which would questions, advice, or "psycholog;cal first teacher. Two different students are warrant a call to a local crisis hot line aid" via the walkie talkie, while the other selected and the activity is repeated. At center. Next, distribute a Crisis Hot Line class members listen and evaluate the the end of the period, the assignment for Evaluation Sheet to each student. Select operator's performance on their sheets. the next class is given: (1) to list all the one student who wishes to be the crisis Five to seven minutes of dialogue is usu- persons, groups or agencies mentioned, hot line caller and another student to be ally sufficient. dealing with suicide or attempted suicide the crisis hot line operator. The hot line (2) to list any verbal or behavioral clues caller will be stationed outside the class- that indicated or implied any self- room speaking into the microphone, thus Follow-Up Activity destructive behavior on the part of the relating the incident tu the entire class After the hot line dialogue, the per- crisis hot line caller. within the room via the extension formances of both students are discussed

85 47 TEACHING IDEAS

Consumer Health Health Help Phone Numbers NATIONALHOTLINE;

Compiled by RICHARD C. HOHN is an associate pro- Richard Miller, George Mason University fessor in the College of Health and Physi- cal Education, UniversityofSouth Mary Hundley, AAHE Program Assistant Carolina, Columbia,South Carolina 29208. Alcohol Hotline 800-ALCOHOL American Academy of Allergy 800-822-ASMA "I'm pregnant!" What a way to start a Amercan College of Obstetricians and Gynocologists 800-INTENDS conversation. The young lady sitting American Council on Transplantation across from me was young, pretty and 800-ACTGIVE just about the age of my own daughter. Association of Heart Patients 800-241-6993 I knew her from my health class but was Auto Safety Hotline totally unprepared for such a statement 800-424-9393 from her. I looked more closely. Her Bulimic and Anorexia Self-Help 800-762-3334 eyes were red and a little wild looking, Consumer Information Hotline something like a cornered animal. She 800-772-9100 wasn't kidding! She had come to me for Drug Abuse Prevention Hotline 800-638-2045 help. Why me? I'm just a health teacher. Hazardous Waste Hotline Is it possible that this story could be 800-424-9346 your story? Are you a teacher, parent, National Asthma Center Lung Line 800-222-LUNG counselor or just a friend to individuals National AIDS Hotline with problems? 800-342-AIDS The story above is tictional but the National Cocaine Hotline 803-COCAINE situation is not. With that in mind I set National Child Abuse Hotline out to identify sources which could pro- 800-422-4453 vide information for health related prob- National Down Syndrome Society Hotline 800-221-4602 lems. The sourcesharttobe immediately availal-'e, free, and accessible National Gay and Lesbian Crisis Line--AIDS 800-221-7044 to anyone, anywhere. National Hearing Aid Help line 800-521-2610 After listening to many persons in the National Pregnancy Hotline 800-238-4269 helping professions bemoan the lack of immediately available, free information, National Runaway Switchboard 800-f 21-4000 a search was undertaken to identify as many toll free health related telephone National STD (Sexually Transmitted Diseases) Hotline800-982-5883 numbers as possible. Outlying health Office of Cancer Communications 800-4-CANCER professionals should especially benefit Organ Donor Hotline 800-24-DONOR from this information. It is fine tc be ina major metropolitan area or neara ldrge Right-To-Know Hotline 800-535-0202 university, but it is another matter al- Shrink Link Hotline together ko be in the middle of nowhere 800-336-6333 and need immediate up-to-date infor- Toughlove 800-333-1069 mation. When there is a problem, in- Toxic Substances Control Act Hotline formation is needed immediately, not 800-424-1404 days or weeks later. U.S. Public Health Service AIDS Hotline 800-221-7044 The information in this articlecan be VD National Hotline utilized by students, faculty, parents, 800-227-8922 and others free of charge. It wouldseem Other only reasonable that these numbers be posted in conspicuous places in the school and given to faculty and parents for their use. If you havea question or concerncall! Being aware of these numbers ar.dre- cording new oncs in the spaces marked "other" will be helpful. Periodicals and Updated March 1992 newspapers will have new numbers as they become available. 86 48 TEACHING IDEAS

.11.1111M.

Consumer Health Students Can HaveaSay

JOAN L. BERGY, formerly a consumer specialist in the Federal Register, including the effective with the U.S. Food and Drug Administration in date for the regulation. Seattle, Washington, became on September 4, A new requirement now makes it mandatory 1973 the director of the Seattle Area Office of the that every "final order" is to include a summary U.S. ConsumerProductSafetyCommission. of the types of comments received and whether BARNEY HANTUNEN is the regional public infor- the "final order" includes, rejects, or modifies mation officer, Public Health Service, Department comments received. In any case the "final order" of Health, Education, and Welfare, Region X, must include the information on which the deci- Seattle. sion was based. The process of rule-making begins after Con- A student voice in government rule-making? A gress passes a law and the President signs it into consume, voice in government rule-making? Im- law. Then, itis the responsibility of the federal possible, you say? agency charged with carrying out the law to pre- Not rea::. if you look into a little known pub- pare appropriate regulations to implement the licationtheFederalRegister.Studentscon- iaw. Preparation of regulations is a complex and sumerscan have an impact on, for example, the time-consuming task. However, once that job is selection of the route for the proposed Pacific done, the regulations are printed irl the Federal Crest National Trail, the labeling of cosmetics, and Register. a whole host of planned federal actions which This is the critical point. Usually 60 daysare affect all aspects of our daily lives,if they learn allowed for comment. This is the time when the about this publication and are willing to take student--the consumer--will have the opportu- action. nity for reacting to Ind commenting on the pro- The Federal Register is a legal document pub- posed set of regulations.Itisalso possible to lished Monday through Friday by the Office of change current regulations by the rule-making the Federal Register, National rchives and Rec- process. An individual or any group may petition ords Service, GSA, Washington, D.C. 20402. a federal agency to propose a change in regula- The Federal Register provides a uniform system tions. for making available to the general public regu- The systemfallsshort, however, when con- lations and legal notices issued by the Executive sumers do not participate. More often than not Branch of the federal government. Also included the number of comments received in response to arePresidentialproclamations andExecutive Federal Register proposals is very limited. Orders as well as various federal documents re- In March 1973, as an example, FDA published quired to be published by Act of Congress. in the Federal Regi.ster a proposed change in regulations that would require cosmetic ingredients The format used to present regulations in the to be listed in descending order of predominance Federal Register includes: on labels attached to each cosinetic product. The ...A preamble which reviews the background of p.oposal specified details about the label design, the proposal language to be used, size of print, as wellas fra- ...A statement of the proposal grances,coloring,andflavoring usedinthe product. As of May 1973, thesources of com- ...Information onthe procedure for submitting ments were as follows: comments Where comments should be forwarded ...The deadline date for receipt of comments Cosmetic industry and associations--19 ...Professional organizations-1 Following the expiration date the federal agency considers all comments and takes action. Theac- Universities-3 tion may be in the form of a "final order" printed ...Other federal agencies-1 1 (4 87 ...Organizations-5 rule-making? How can they gain a perception of ...Individual consurners--267 the process which will stand them in good stead A second example is the proposal to require as they move from academic community into the a warning statement on the labeling of aerosol community at large? containers, which wa. published in the Federal A prerequisite, of course, is availability of the Register during March 1973. One of the several Federal Register in the classroom or the school proposed warning statements was: "Warning: library. A committee of students might review the Do not inhale directly; deliberate inhalation of Federal Register for a period of time in order to contents can cause death." As of May 1973, the select a proposal for class consideration. following summarizes comments received: Once the proposal is selected, the committee ...Aerosol industry and associations-21 might develop information and perhaps a demon- ... Organizations-2 stration project to illustrate to the class what the present regulations are and what changes are con- Universities---5 templated in the proposal. In addition, the stu- ... Consumers-1 dents might analyze proposed changes in the It should be pointed out that the Federal Reg regulations and their effect upon industry, the ister is not the easiest document for the student consumers, and others concerned with the sub- or the consumer to locate. It is available from the ject under consideration. Superintendent of Documents, Government Print- Upon reaching a consensus and having recon- ing Office, Washington, D.C. 20202 at a cost of ciled various points of view, the comments could $3zi0.00 per year;single copiec cost $1.50 each. be submitted to the agency, as indicated in the Molibraries stock the publication. It is also gen- Federal Register, which has responsibility for pre- eraly available through libraries maintained by paring the "final order." fedel.al agencies in the Regional Office cities of The stu dents would then need to develop a Boston, New York, Philadelphia, Atlanta, Chicago, follow-up plan to assure continuity in their efforts Dallas, Kansas City, Denver, San Francisco, and to observe the final outcome of the process. Seattle. When the "final order" does opear in the Federal From time to time proposals published in the Register the wdents will be in the unique posi- Federal Register are included as news items in tion of comparing their own experience and accu- local daily newspapers. However, more often than mulated materials to the final outcome. not very little information .s included to guide the Most important of all, they would have seen, student or consumer in submitting timelycom- and sharedin,the rule-makinl; process. They ments to the appropriate place. would, hopefully, have developed a heightened So how can students become involved? How conc:Tt nf their .igi-ts and responsibilities in the can they gain access to the "system" of federal American rule-making process.

88 1 01 49 TEACHING IDEAS

Death and Dying A Unit for Independent Study in Death Education

JOAN D. McMAHON isahealtheducation teacher at Thomas Johnson Junior High School rently teaching a course on death education to in Lanham, Maryland. over 300 students a semester. In an article in the Journal of the American College Health Associa- The subject of death and dying is most often tion, Leviton outlined his topics and speakers for rojected by the conscious mind of the American the course. Some of the same general topics are eople. Our society is one aimed at the preserva- included in this unit. It consists of behavioral ob- t'on and enhancement of life; denying death and jectives, questions to be answered, activities to be reducing its harshness have helped to cushion the performed, and assessment tasks. American people's fear of their eventual end. In coming to grips with the dy.ng process and UNIT IN DEATH EDUCATION death, a person may have a better understanding of his own feelings and those of others who are Prerequisites: Any combination of the following: practicum in counseling; work in crisis intervention centers actually experiencing dying and death. Death, for or on hot lines; course utilizing techniques; course in most people who are touched by it,presents a the psychology of adjustment. crisis state out of whkh coping with a new lifestyle becomes extraordinarily difficult. Too many Course Content: people die suddenly and leave their families to- Subunit A: The Taboo of Death tally unprepared to rearrange their living patterns. Subunit B: Definitions of DeathBiological, Social, Learning how to cope with a crisis, then, would and Psychological Subunit C: lite Crises of Man appear to aid an individual in his adjustment to Subunit D:Views on Death and Dying such a change as death brings. Subunit E: Understanding the Dying Patient or Rela- A unit for independent study in death educative tion has been prepared; thisis an educational Subunit F: The Funeral,Burial, and Bereavement: method that allows progress at anindividual Psychological Implications Subunit G: Understanding Suicide and Self-desttuc- learning rate.Itis the primary objective of the tive Behaviors unit to help people come to grips with their own feelings and attitudes toward death and the dying Directions: Perform in the following order: process so that life will be more rewarding and 1.Read the behavioral objective enjoyable and death will become less feared.1 2.Read the required readings 3.Answet the questions listed The unit was compiledfor advanced high 4.Perform the activities school or college students or thosprofessionals 5.Perform the assessment tasks interested in improving their kno: ledge of the dying process and death. It was originally devel- 1 Leviton, Daniel, "A Course on Death Education and Sui- oped from suggested course outlines by Daniel cide Prevention: Implications for Health Education," Journal of the American College Health Association, April 1971, Leviton of the University of Maryland, who is cur- pp. 217-20. 89 1 02 Before beginning the course: Answer the following 8.To what extent do you believe in a life after death? questionnaire and save your responses. a. Strongly believe in it. b. Tend to believe in it. QUESTIONNAIRE I c. Uncertain. d. Tend to doubt it. 1. When you were a child, how was death talked about in e. Convinced it does not exist. your family? a. Openly. 9.Regardless of your belief about life after death, what is b. With some sense of discomfort. your wish about it? c. Only when necessary and then with an attempt to a.I strongly wish there were a life after death. exclude the children. b.I am indifferent. d. As though it were a taboo subject. c.Idefinitely prefer that there not be alifeafter e. Neser recall any discussion. death. 2.To what extent do you believe that psychological fac- 10.Ifit were entirely up to you, how would you like to tors can influence (or even cc use) death? have your body disposed of after you have died? a.I firmly believe that they c6rl. a. Burial. b.I tend to believe that they cali. b. Cremation. c.I am undecided or don't know. c. Donation to medical school. d.I doubt that they can. d.I am indifferent.

3. What is your belief about the causes of most deaths? 11. How much of a role ha5 religion played in the develop- a. Most deaths result directly from the conscious ef- ment of your attitude toward death? forts by the persons who die. a. A very significant role. b. Most deaths have strong components of conscious b. A rather significant role. or unconscious participation by the persons who c. Somewhat influeitial, but not a major role. die. d. A relatively minor role. c. Most deaths just happen; they are caused by events e. No role at all. over which individuals have no control. d. Other. 12. Which of the following most influenced your present 4. Who died in your first personal involvement with death? attitudes toward death? a. Grandparerts or great-grandparents. a. Death of someone close. b. Parents. b. Specific readings. c. Brother or sister. c. Religious upbringing. d. Other family member. d. Introspection and meditation. e. Friend or acquaintance. e. Ritual (e.g., funerals). f. Stranger. f. TV, radio, or motion pictures. g. Public figure. g. Longevity of my family. h. Animal. h. My health or physical condition. i. Other. 5. To the best of your memory, at what age were y JU first aware of death? 13 Which of the following has influencedyour present at- a. Under three. titudes toward your own death the most? b. Three to five a. Pollution of the environment. c. Five to ten. b. Domestic violence. d. Ten or elder. c. Television. d. Wars. 6. How religious ck ye, consider yourself to be? e. The possibility of nuclear war. a. Very religious. f. Poverty. b. Somewhat religious. g. Existential philosophy. c. Slightly religious. h. Changes in health conditions and mortality statis- d. Not at all religious. tics. e. Antireligious. i. Other.

7.Which of the following best describes your childhood 14.To what extent has the possibility of massive human conceptions of death? destruction by nuclear war influenced your present atti- a. Heaven-and-hell concept. tudes toward death or life? b. After-life. a. Enormously. c. Death as sleep. b. To a fairly large extent. d Cessation of all physical and mental activity. c. Moderately. e. Mysterious and unknowable. d. Somewhat. f. Other than ihe above. e. Very little. g. No conception. f. Not at all. h. Can't remember. 15.Have your attitudes toward death ever been affected by narcotic or hallucinogenic drugs? a. Yes. These questions are taken from the ''Death Question- b. I have taken drugs but my attitudes toward death naire" by Edwin S. Schneidman in Psychology Today maga- have never been affected by them. zine, @Communications/Research/Machines, Inc. c.I have never taken drugs.

90 103 16, What does death mean to you? e. Death after a great achievement. a. The end; the final process of life. f. Suicide. b. The beginning of a life after death; a transition; a g. Homicidal victim, new beginning. h. There is no "appropriate" kind of death, c. A joining of the spirit with a universal cosmic con- Other, sciousness. d. A kind of endless sleep; rest and peace. 24,For whom or what might you be willing to sacrifice e. Termination of thislife but with survival of the your life? spirit, a. For a loved une. f.Don't know. b. For an idea or a moral principle. c.In combat ora grave emergency where a B.Other, life could be saved, 17. What aspect of your own death is the most distasteful d. Not for any reason, to you? a.I could no longer have any experiences. 25. What is your primary reason for the answer to question 24? b. I am afraid of what might happen to my body after death, a. To spare my spouse loneliness. c.I am uncertain as to what might happen to me if b. To avoid loneliness for myself. there is a life after death, c. To spare my spouse grief. d.I could no longer provide for my dependents. d. To avoid grief for myself. e.It would cause grief to my relatives and friends. e. Because the surviving spowe could cope better f.All my plans and projects would come to an end. with grief or loneliness, g. The process of dying might be painful. f. To live as long as possible. h. Other, g. None of the above. 18. How often do you think about your own death? h. Other, a. Very frequently (at least once a day). 26,Has there been a time in your life when you wanted b. Frequently. to die? c, Occasionall,. a, Yes, mainly because of great physical pain. d. Rarely (no more than once a year). b. Yes, mainly because of great emotional upset. e. Very rarely or never. c. Yes, mainly to escape an intolerable social or in- 19. When you think of your own death (or when circum- terpersonal situation. stances make you realize your own mortality), how do d. Yes, mainly because of great embarrassment. you feel? e. Yes, for a reaon other than above. f. No. a. Fearful, b. Discouraged. 27. Suppose that you were to commit suicide, what reason c. Depressed. would most motivate you to do it? d. Purposeless. a. To get even or hurt someone. e. Resolved, in relation to life, b. Fear of insanity. f.Pleasure, in being alive, c. Physical illness or pain. g. Other. d. Failure or disgrace. 20.In your opinion, at what age are people most afraid of e. Loneliness or abandonment. death? f. Death or loss of a loved one. a, Up to 12 years. g. Family strife. b, Thirteen to 19 years, h. Atomic war. c. Twenty to 29 years, i. Other. d. Thirty to 39 years, 28. Suppose you were to commit suicide, what method e. Forty to 49 years, would you be most likely to use? f.Fifty to 59 years. a. Barbiturates. g. Sixty to 69 years. b. Gunshot. h. Seventy years and over. C. Hanging. 21,If you could choose, when would you die? d. Drowning. a.Iri vcurn. e. Jumping. b. in the middle prime of life. f. Cutting Or stabbing. c. Just after the prime of life. g. Carbon monoxide. d. In old age. h. Other. 22. When do you believe that, in fact, you will die? a. In youth. b. In the middle prime of life. c. Just after the prime of life. d. In old age.

23.If you had a choice, what kind of death would you prefer? Subunit A: The Taboo of Death a, Tragic, violent death. Behavioral Objective: The student will be able to b. Sudden, but not violent death. freely discuss and come to terms with his own feeling c. Quiet, dignified death, concerning death, d. Death in the line of duty.

104 91 Answer the following questions: Assessment Tasks: 1.Why do language barriers exist on the subject of 1.Correlate five patientsinKubler-Ross's book to death and dying? Bowlby's model as to the stages of adjustment they 2.How do you perceive death? went through during a crisis. 3.What euphemisms can you think of to describe 2.Read one of the following and write a two page death and dying? explanation of how a character goes through any 4.Do all persons have a negative attitude toward of the stages mentioned by Fink: dying? Death Be Not Proud, John Gunther A biography of Eleanor Roosevelt, any author Activities: Interview a person about his feeling toward death. Subunit D: Views of Death and Dying Assessment Tasks: 1. Behavioral Objective: Upon examining the required Either talk with sz'meone about your ideas on death readings on the views of death and dying, the student or tape record your ideas and replay them. will be abie to briefly explain how death and dying 2. Save the responses that you made to the Schneid- are perceived from the viewpoint of children, adoles- man questionnaire. cents and young adults, the middle aged, the elderly, and the terminally ill. Subunit B: Definitions of Death: Biological, Social, and Psychological Answer the following questions: Behavioral Objective: The student will be able to dif- 1. What are the developmental stagas in childhood ferentiate tictween the biological, social, and psycho- that lead to a mature concept of death? logical definitions of death. 2. Name three adjustment mechanisms that affect the elderly's attitudes toward death. An.swer the following questions: 3.Name four factors which influence the terminally 1. What is the biological definition of death? ill's adaptation or adjustment to their impending 2.What constitutes social death? death. 3.What constitutes psychological death? 4. Do college students perceive death as threatening? 4. How do these definitions interrelate? Support or refute. Activities 5. How do you feel the middle aged population feels about dying in their prime? Upon reading all required readings for this subunit, make a chart depicting the interaction and separation Activities: of each definition of death. 1.Create a hypothetical situation concerninga child's reaction to the loss of a pet. Assessment Tasks: 2.Predict how you would react ifa person in your 1.Define biological, social, and psychological death family was diagnosed as terminally ill. How doyou as described by the various authors listed in the think they would want you to react? required readings. 3.Identify your feelings ifyou were suddenly faced Cite three case histories (can be hypothetical) that with the realization thatyou had a terminal illness. depict each type of death. Assessment Task: Plan a chart illustrating the variousage groups, varia- Subunit C: The Crises of Man bles affecting their death attitudes, the behaviorthat Behavioral Objective: Upon identificationof the dif- should or should not manifest itselfon experiencing ferent stages of adjustment toa crisis, the student will a situation involving death, and the views held by each apply these stages to death and dying. age group on the subject of death and dying. Answer the following questions: Subunit E: Understanding the Dying Patientor Relative 1. What are Fink's stages to the adjustmentof a crisis? Behavioral Objective: Upon learning of the impending 2. What are Bow lby's stagesto the adjustment of a death of an individual, the student will besupportive crisis? and perceptive of their feelings and needs. The student 3. What are Kubler-Ross's stages of adjustmentto a will also be able to develop strategies for helping the crisis? dying patient or relotive tocope with death, dying, 4. Do the terminally ill adjust to death and dyingac- and bereavement. cording to the stages above? Answer the following questions: Activities: 1. What emotional and psychological needs shoulda relative have fulfilled in order tocope with the im- 1.Write a story about a terminally ill person who pending death of a relative? must cope with his own immediate death in terms 2. What emotional and psychological needs should of Bowlby's model (2 pages). the patient have fulfilled in order tocope with his 2.Examine a crisis in your life and determine which own impending death? model or combination of models approximates 3.Explain the reactions and emotions of those who your crisis state. confront dying daily, e.g., police officers, the mili-

92 105 tary, morticians, clergymen, physicians, nurses, etc. 4.Plan afinancialstatementthat would include 4. How would you feelin the presence of a dyil mortgage, insurance policies, children's education, person? and funeral expenses. 5.Should a patient be permitted to return home to Assessment Task: die? Why or why not? Prepare a detailed and operable plan to be used in the 6. Whose responsibdity isittotella person he is going to die? event of your death. Include who should be notified of the death, expenses, settlement of the estate, dis- Activities: posal of personal possessions, etc. What is the ration- 1. Interview any two of the following concerning their ale for your plans and did you account for the needs reactions and emotions in observing death and the of the family who would be left? dying process: police officer, mortician, war veteran, physician, nurse. Subunit G: Understanding Suicide and 2.Identify those factors which cause relatives to de- Self-destructive Behaviors sert a dying patient. Do these apply to yourself? Behavioral Objective: The student will be able to de- Assessment Task: vise a reference list of persons, groups, or agencies that deal with suicide. He will also be able to identify Eric is a 14 year old Negro with sickle cell anemia. His family has kept from him all mention of the disease, clues in the individual's behavior that suggest a need its symptoms, and its fatal outcome. He has been sleep- for consultation with a professional specialist or a need ing a great deal lately and his general condition has for other forms of immediate help. been weakening. His teacherhas been discussing Answer the following questions: biology and disease causing organisms with him. He 1. Why do children commit suicide? has been asking questions as to whether he has a 2. Why do college students commit suicide? disease. Eric has noticed that he has little energy and 3. What are clues that a person may want to kill him- thinks he may have a serious disease but his family has not told him anything. You can perceive that he self in the near future? 4. What is crisis intervention and how can it be used may ask you what disease he has and what it will do in suicide prevention programs? to him. S. What can you do as a professional or nonprofes- What needs and feeling do you suppose Erichas? Develop a strategy to cope with Eric's dying with him sional to help an individual cope with his problem? and his family on your visits. 6. When should you recognize the necessity for professional psychological therapy for the individual? Subunit F: The Funeral, Burial, and Bereavement: What persons or agencies are available for such Psychological Implications referrals? Behavioral Objective: This studentwill be able to 7.Does a person have the right to take his own life? evaluate the American grief process and foimulate con- Activities: structive plans for his or a relative's death. 1.Visit a suicide prevention center or a crisis inter- Answer the following questions: vention center that deals with suicide intervention. 1. Who should make the arrangements for the funeral? 2.Contact the Center for Studies of Suicide Preven- Who should be responsible for the final decisions tion, National Institute of Mental Health, Rock- on place of burial, method of body disposal (cre- ville, Maryland 20852. mation, burial, etc.)? 3.Interview two specialists on campus or in the com- 2. What constitutes a normal bereavement reaction? munity who would be in contact with suicide prob- What constitutes an abnormal one? lems:healtheducator;clergy;sociologist;psy- 3.What arethereligiousimplicationsforburial? chologist; counselor; or health service personnel. What are the psychological implications for burial? Assessment Tasks: 4.What grief reactions can be expected upon learning of the death of a child, a teenager or college 1. Make a list for your immediate reference of per- student, a middle aged individual, or an elderly sons, groups, or agencies that you could contact if person? you face a suicide case. 5.What happens to the family or perscns who con- 2. Identify those clues to suicide behavior that continue to live after a close friend or relative has stitute immediate help, psychiatric help, or other died? professional services. 3. Retake the Schneidman questionnaire and compare Activities: Choose two your responses from your first attempt 1.Consult a funeral director and/or visit his "lab." 2. Decide what your role would be in the death or REQUIRED READINGS dying process of mother or father; brother or sister; Readings from outside published sources are an husband or wife; young child; close friend; ac- important part of the unit. Students should be en- quaintance; and pet. 3.Write your will and go over the legal implications couraged to make use of computerized on-line data- with a lawyer. bases to locate appropriate materials.

C 93 50 TEACHING IDEAS

Death and Dying

Puts Little Life and make theproperchoiceof Once you have your topicsplanned, philosophies to complement the indi- find the teaching activitiesto comple- vidual's behavioral needs. ment your lesson. Hereare just a few. in tour both Philosophy 1 is death fear. In this phi- 1. Visit a cemetery losophy people have such a fear of death 2. Visit a funeral home that they change certain patterns in their 3. Invite guest speakers (coroners, life to accommodate this fear. By doing doctors, lawyers) CHARLES R. O'BRIENis a graduate stu- this they minimize the risk of death and 4. Make poems dent in the Department of Health and Physi- also many of life's pleasures. 5. Make up tombstones and epitaphs cal Education at Bowling Green State Uni- Philosophy 2 is'death acceptance. In 6. Write an obituary versity, Bowling Green, Ohio 43403. this philosophy individuals understand 7. Write out wills and accept the reality of death. Through 8. Make up a life inventory acceptance of death within themselves, 9. Role play they lead their lives in whateverway 10. Interview students they wish, and accept the final outcome 11. Look up laws on death (state and of these actions. taxes) During the past years in health in- The second personal questionone 12. Crossword puzzles struction, there has been a major drive should ask is: Do you fear death? If the To help with the classroom activities. by educators to include the topic of death answer to this question is yes, take teaching techniques like small group dis- and dying in the ruiriculum of their in- another look at this fear, determine if cussions, debates, and problem-solving stitutions. One of the many reasons for you fear death or if you fear dying. These seem to be enhanced by the use of re- this impulse is because of the changes in are two terms which sometimes are used cordings. Below is a list of records which society. With these changes, death has synonymously, but are they really? pertain to death education and help been taken out of the family structure Death means the end of life whereas dying stimulate student participation. and been replaced by "outsiders." is the process of death. Thereare many 1. "Ohio"-Neil Young Years ago death was a significantas- ways of dying such as through disease, 2. "Life in the Bloodstream"-The pect in the foundation of the family. An aging, and accidents. With an individual Guess Who individual was born, lived, and died at there is only one death. This deathmay 3. "Unborn Child"-Seals and Crofts the same location. Death at this timewas come in two speeds; slow as in disease, 4. "Imagine"-John Lennon an experience which was cherished by old age, and pollution; fastas in acci- 5. "Talisman"-The Guess Who the family, friends, and individual reli- dents, suicide, war, and domestic vio- 6. "Fiddle in the Sky"-Seals and gious beliefs. At the present time how- lence. Crofts ever, people tend to hide their children Once you have gone through this 7. "Changes IV"-Cat Stevens from the reality of death andpay others self-realization process, you should be 8. "Follow Me"-Seals and Crofts to take the burden off their hands. Re- able to see one of the basicreasons for 9. "Better off Dead"-Elton John cently this factor has presentednumer- teaching about death-the students' 10. "Heaven Only Moved Once Yes- ous mental problems for a number of wellbeing. Death education could bean terday"-The Guess Who Americans. Some of these problems important aspect of every individual's In today's society we find it morbidto have resulted in child runaways, suicide, life. Death as we know itnow is some- discuss and think of our own death. By breakdown of religious beliefs, and have thing which happens toeveryone, but is not discussing death, we place it in the forced changes in individual life pat- something we havo little controlover. closet hoping it will not become a reality terns. Because of these and other rea- Individually we may be able to put off we will have to face. A unit on death sons, the public and the education pro- death through exercise, diets, and good would make possible a needed discus- fession think it is necessary for the topic health practices, but death itself remains sion to help eliminate the problems dis- of death to be included withal the educa- the same. cussed earlier.It would also help stu- tional structure. dents understand the full meaning ot life

Since death education is beginning to and bring out the necessity of . der be included in many school systems, it Now that you are aware of your views standing death. has created problems suchas: what con- on death you can start examining topics tent areas should be included in a death which will be included in the death unit. unit and how are the contentareas to be The following topics can be included. taught? Some major personal questions 1. Religious beliefs should be examined beforeyou attempt 2. Rituals to construct your unit on death. The first 3. Stages of dying question should be: do you knowyour 4. Types of funerals philosophy on death? 5. Insurance Research indicates that thereare two 6. Attitudes toward death and dying basic philosophies dealing with death. In 7. Heaven-hell concept both of these philosophies the primary 8. Death philosophies concern is awareness. The reason for this 9. Euthanasia (direct-indirect) is that by being aware of death the indi- 10. Types of dying (physical-mental- vidual may be abie to see the full life cycle social)

94 107 51 TEACHNG IDEAS

Death and Dying DEATH EDUCATION: An Integral Part of School Attitudennformatkm Inventory Health Education I. owhat extent do you believe in a life after death?= Male Female. Darrel Laiis health coordinator for (he AStrongly believe in it. TurkeyValley Community S..hools, B.Tend to believe in it. Iackson Inaction. town, and a member of C.Uncertain. Iowa's task force for comprehew;IN' SO1001 D.Tend to doubt it. lwalth education. E.Convinced it does not exist. 2. To what extent do you belive in reincarnation? School health education is a continu- Male Female ous process which enables the student A. Strongly believe in it. to assume individual responsibility for B. Tend to believe in it. developing and maintaining personal C. Uncertain. behaviors which promote total well- D. Tend to doubt it. ness.' If this goal is to ever be achieved, L. Convinced it cannot occur. death education needs to be integrated into the school's health curriculum. 3. How often do you think about your own death? Six years ago a death occurred in mY Mole Female family and this was my first close con- A. Very frequently (at least once a &:),). tact with death. I felt totally inadequate B.Frequently. and concluded that many of my ,stu- C. Occasionally. dents probably fit into this same model. D. Rarely (no more than once a year). To counter this inadequacy, I integrated E.Very rarely or never. a death education unit into our mental health strand for the secondary level. 4. What does death mean to you? Before 1 could develop a proper unit Male Female that would adequately serve the major- A.The end; the final process of life. ity of my students, it was necessary to B.'Flw beginning of a life after death; a transition, a new beginning. conduct a ten-questionattitude C.A joining of .he spirit with a universal cosmic consciousness. information inventory. From this in- D.A kind of endless sleep; rest and peace. ventory, I was better able to understand E.Termination of this life but with survival of the spirit. my students' feelings about death. F.Don't know. The inventory is self-explanatory and 5. What aspect of your own death is the most distasteful to you? gave me a fairly good perspective on Male Female the approachI should take with my A.I could no longer have any experiences. students towards death education. The B.I am afraid of what might happen to my body after death. following is a copy of the unit in death C.I am uncertain as to what might happen to me if there is a life after death. education that Ifeel has adequately D. It would cause grief to my relatives and friends. served my students. E.All my plans and projects would come to an end. F. The process of dying might be painlul.

Death Education UnitOutline Day 1 ----Introduction to death education. Survey on death. Drawing: Visual Impression of Death. Day 2 Vocabulary of death. Funeral customs around the world. Day 3 ----Protestant-Catholic View of death. .Innister & priest guest lecturers) Other religious views of death. Day 4 collage on life and death. ins 95 Day 5 Filmstrip,Living withDying,3 6. When you think of your own death (or whencircumstances make you realize your own mortality), how ci ) you feeP on how America lives with death. Male Female A. Fearful. Day 6 Five stages of death, grief and B. Discouraged. bereavement. C. Depressed. Day 7 ----Film: "WhatMan Shall Live D. Purposeless. and Yet See Death4,Part I. E. Resolved in relation to life. Day 8 --Film:What Man Shall Live and F.Pleasure in being alive. Yet See Death4,Part 11. 7.If you had a choice, what kind of death wouldyou prefer? Drawingstudents'own Male Female tombstoneand writing A. Tragic, violent death. epita phs. B. Sudden but not violent death. Day 9 Pictorial reporton epitaphs C. Quiet, dignified death. taken from cemeteries. D. Death in a line of duty. Death-related music. E. Death after a great achievement. F.Suicide. Day 10Group reports on death G. Homicidal victim. 1) Life insurance H. There is no "appropriate" kind of death. 2) Military view on death 3) Medical examiner 8. What are your thoughts about leavinga will? 4) People who have been Male Female brought back to life. A.I have already made one. Day 11Fantasy exercise on death.5 B.I have not made a will, but intend to doso some day. C.I am uncertain or undecided. Day 12Field trip to funeral home. D. I probably will not make one. Day 13Positive-negative euthanasia. E.I definitely won't leave a will. Day 14Explaining death to children. 9. To what extent do you belive in life insuranceto benefit your survivors? Death has been a fascinating subject Male Female that people have always questioned. A. Strongly believe in it; have insurance. Through a thorough unit on death edu- B. Tend to believe in it; haveor plan to get insurance. cation, many questions and thoughts C. Undecided. about death may be answered. Itis D. Tend not to believe in it. hoped this approach would better edu- E.Definitely do not believe in it. cate our youth and eventually ovr soci- 10. What are your thoughts about funerals? ety. We all should have a better understanding of death, for weALLwill face Male Female A. Feel they are very important for the bereaved. it some day. B. Tend to feel they are valuable. C.I am uncertain or undecided. D. Definitely do not believe in them.

1. Definition of Comprehensive School Health Education, Iowa'sTask Force on Com- prehensive School Health Education. 2.Perspectives on Death Student Activity Book,David W. Berg, George G. Daugherty, 1972., p. 2-4, Arlington Press, 201 Eighth Ave. S., Nashville, Tenn. 37207. 3. Sunburst Communications, Pleas- antville, N.Y. 10570. 4. Area Educational Agency, Film's, Inc., 1972. 5. Psychology of Death & Dying,John C. Morgan, Richard L. Morgan, Westinghouse Learning Press, Sunnyville, CA. 96 109 52 TEACHING IDEAS

Death and Dying A Teaching Strategy onTragedy students where their ideals and values needed to be researched and clarified further. CONNIE 10 DOBBELAERE is a graduate Four of the 40 questions that were assistant at Bowling Green State Univer- clarified at some length in the classroom sity, Department of Phu lth and Physical are discussed here. They exemplify the Education, Bowling Green, Ohio 43402. type of discussion that was carried on as a result of the questionnaire. The first question seemed to influence "Mary's life seemed to be at a perfect the way in which the students answered point! She was 16 years old, pretty, in- the rest of the questionnaire: to what ex- telligent, enthusiastic, a varsity cheer- tent do you believe in a life after death? leader, and had just been elected a. strongly believe in it; b. tend to be- homecoming queen for her high school. lieve in it;c. uncertain; d. tend to She had a happy home life, with two doubt it; e. convinced it does not exist. brothers, four sisters, two parents, and Some students were confused about a dog named Brownie. Mary loved life their feelings on the subject and there- and had everything to live for. On a fore seemed to have a great deal of clear night in March, she was driving trouble completing the test. However, home from work, just getting ready to others answering the question either make the left hand turn off of Highway completely affirmatively or completely 617 into her driveway when from arises. We teach death in order to better negatively had little trouble with the nowhere a semi-truck started to pass live and understand the total process of test. By discussing the question in her on the left. Mary died on March 23, life! greater detail it appeared thai most of 1976." the students felt more at peace with A similar tragedy may happen at any A Tragedy Strategy their own feelings towards the subject time in your community or school system. The question is, how do we pre- Once the need for a unit on death and felt more open about their convic- education has been establislwd, the next tions because they found out that they pare our students to handle the death of were not the only ones who had trouble problem a teacher faces is just exactly a friend or loved one properly? Is there with the subject. how to introduce the unit into the class- ever a proper way to handle this situa- A second question prompting interest tion?" Death 40 to 50 years ago was ac- room. One teaching strategy, which tried to clarify situations in which one cepted as a natural culmination of life. proved to be very functional in past would give up one's own life: For whom However, today Americans try to cover health instruction and upon which this it up and pretend that when death does article is bised, used a questionnaire en- or what might you be willing to sacrifice occur they will be able to accept it. This titled "You and Death," by Edwin your life? a. a loved one; b. an idea or idea has not proven to be valid in recent Shneidman.' It contains approximately moral principle; c.in combat or a grave years. There appears to be an inescapa- 72 questions which were condensed to emergency where a life could be saved; ble need to furnish our youth with a 40 for class purposes. In essence, it en- d. not for any reason. more comprehensive view of what tails answering the questions in an at- Most of the students had a great deal death really means, how they can cope tempt to identify and clarify students' of difficulty imagining sacrificing their with a death when it occurs, and why it feelings and conceptions on death. The hves for anyone or anything. Most of is important for them to carry on and questionnaire proved to be a thought the members enjoyed their present live a more fulfilled life. provoking and discussion stimulating lives. However, they all agreed that A death education unit taught in a technique to introduce the death unit. they would probably change their health class needs to be implemented For a more complete and interesting minds if they were confronted with a for the benefit of each student. If death discussion of the questionnaire, the real life situation involving one of these is accepted as a natural part of life, an students were instructed to mark a star choices. inevitable event in all existence, then we by the most thought provoking ques- will be able to stress the importance of tions; an "S" by those which most sur- living life to the utmost for today! The prised them; a "1" beside the questions Another thought provoking question main objective, it seems evident, is for about which they would really like to had to do with the actual date of one's the death unit to emphasize the need to talk with someone; and an "MI" in front death: ifit were possible, would you develop in each individual a crisp zest of those questions they would like more want to know the exact date on which for every undertaking, day-to-day, that information on as they went through you are going to die? one can. Life is rich in varied opportuni- the test. These marks pinpointed the The catalyst of this discussion was ties and the mission is to find and per- areas of most interest for the ensuing supplied by one student's statement ceive each and every advantage that discussion. They also symbolized to the that "if I were told that I was going to 1114 97 live to be at least 40 years old, I would live the strategy proved to be for each partic- --others believe in God and put their trust in life to its fullest and try to experience all ipant. me of the answers from the His promise for eternal life. students 1ollow. Many treasure livingnot as solely based that life affords and not wait for old age to on survival ethics, but on a fulfilling do the things I've always dreamed of do- . I learned that... basis .. "I want all from life that is good ing." Others responded that they would life, though often taken for granted is and beautiful." definitely not like to know when they temporary, and protection of same, even were to die because it was a fearful subject promotion of same is of number one prior- I want h. remember that. . . for them and they would rather not think ity. --today may be my lastI need to keep a about it. Still another response was shared "death education" can be an interesting smile on my face and a rainbow in my with the class by a student stating that it topic if tadght with the objective of living heart! really doesn't matter to him whether or life better for now. no matter what else I learn through my not he knew because his religious faith I am able to stand firmly convicted to the educational career I am sure to remember belief in life after deathnot fearing death today! was so strong and he was so satisfied with whatever I do with my lifethe only im- his present life that anytime death came he as we know it here on earth. I am satisfied with my life and deathcon- portant thing is to die with Jesus control- would be ready. cept. ing my heart. Conclusions made from this question death is not the end! helped students to answer and discuss a life has order, peace, love and total appre- fourth question: What effect has this ques- I want to.. . ciation of nature." tionnaire had on you? a. it has made me find out more information about the stages Death education can be a mind- of life when one's attitudes toward death somewhat anxious or upset; b. it has change. expanding unit if taught with the objec- made me think about my death; c.it has live what life is afforded me to its fullest, tive of getting the students to learn to reminded me how fragile and precious life but regretfully must adjust to constraints accept and understand death and to is; d. no effect at all; e. other effects (some of which may be unnecessarily self- think of it as an inevitable end to life, as (specify). imposed). we know it here on earth. When they Most of the students responded to the live my life to the fullest and when death can accept this phenomenon, they can question by either marking "b" or "e." comes, I hope to accept it gracefully and it develop a more meaningful opinion The questionnaire did make them think accept me the same way. about the necessity to live life to the ut- about their own death but it also made live daily with the attitude that today is my most and to instill in themselves a zeal only opportunity to tell others why I don't them deliberate about their feelings on fear death. for a more fulfilled life. suicide. It also brought suppressed feel- It is vitally important that One learns ings out into the open and helped them to that one does not have to wait for be more content with their ideas on death I hope that I. . . tragedy before confronting the funda- and dying. can live life productively, yet joyously mental and ineluctable questions related As we discussed the whole topic of and never stray from the sense ofperspec- to death and dying with which one may death once more in the summary, they tive that enables me to "always smell the be confronted. The requirement here is flowers .." felt also ,hat they could have responded can develop sharper opinions on some of for one to be willing to participate and "c" as well. The discussion of death did the questions I was unsure of. learn to understand and accept death as remind them of the pricelessness of a if I discover I am scheduled to die soon, I a natural part of all life. fulfilled life and forced them to reevalu- can lead exciting tinal days and not spend ate their personal lives at the present my last days pouting and cursing my des- 'Edwin Shneidman, Center for Advanced time. tiny. Study in the Behavioral Sciences, in consul- live to be a ripe old age!! tation with Edwin Parker and C. R. Funk- Strategy Evaluation houser of Stanford University, "You and Death," Psychology Today. Communications As a final evaluation of this experi- I was surprised to see that. . . Research Machines, Inc.; Del Mar, CA, Au- ence, the students filled out a sheet of --some people didn't want to give their lives gust 1970, pp. 67-72. open-ended statements. These evalua- for others. tions proved even more valuable than when confronted with the possibility that even I might consider suicide,Ireally the discussion. It helped ztudents to be could not think of the way in which I more understanding of each other's would take my life. personal feelings and views on death I don't have very many strong convictions and the pricelessness of a fulfilled life. about my attitude toward death. The students were given no directions some refuse to seek the full life. on the proper way to complete the statements and thus were forced to an- I was glad to see that. . swer them with their own unique per- my religious faith is strong enough to answer most of these questions with ease. ceptions of the total experience. In shar- I was consistent in my thoughts on death. ing some of their answers it is my hope I did have to think as a result of this ques- that each reader will see how successful tionnaire about my feelings on death.

98 h 1 1 53 TEACHNG IDEAS

Enc ironmental Health Health or Hazard? A Post-China "1-4114. - - - , Syndrome Game '4Xisitakn""S`Ammit4t;Ve,

Moon S. Chen, Ir. is an assistant professor of health education at Ohio State University, sa. 215 Pomerene Hall, 1760 Nkl Avenue. Col- umbus, Ohio 43210. How important isitto teach about ionizing radiation or noise protection or industrial safety? For most students, these three topics seem remote and removed from the classroom. However, the movie,The China Syndrome,made the Three Mile Island incident and the hazards of radiation hauntingly realistic. I Students and teachers in the Harrison- burg area were undoubtedly affected and students elsewhere certainly felt , curiosity and a need to know more facts. What better place to bring together the Jt. topics of radiation and health hazards of the working environment than in an environmental health course or in a unit on 1- environmental health? And how better '14* to make learning more fun than with a game? player has fifteen seconds to respond by Fun and success with such a game, ing teams. Each team should prepare it- showing the card with the correct health called "Health or Hazard?", are attrib- self independently. Based on the cogni- protection measure against that hazard. uted to proper orientation and to student tive information given in class, ch If the correct health protection measure involvement and discovery. Orientation team should prepare an array of "oft-m- is not on one of the defensive player's to the game consists of a cognitive intro- sive" hazards and an arsenal of "defen- cards, the defensive player has the same duction to the basic forms of radiation sive" health protection measures. Es1ch fifteen second time limit to write the (e.g., ionizingalpha, beta, gamma hazard and each health protection mea- proper health protectiol: on a separate rays, and non-ionizingmicrowaves) sure should be written on a separate index card. No coaching from teammates and how to use time, distance, and index card large enough so that it can be is allowed. shielding for protection. A cognitive in- read across a classroom. A score results when either side wins a troduction to health hazards of the work- The spirit of competition between the "round." Decisions regarding which ing environment should cover the det- two sides fosters a spirit of cooperation side wins will be made by the student rimental effects on humans of noise, on each side. Team members naturally judge for that particular round. The stu- dust, gases, and toxic liquids. Protection help each other in learning the associ- dent judge must decide whether the de- measures would include environmental ations between hazards and the proper fensive player's response is correct and manipulation, medical surveillance, health protection. made within the fifteen-second limit. management decisions, and personal Competition begins after about fifteen (The time should be kept by another protection. Students should be taught to minutes of preparation. Each side alter- judge.) If the defensive player displays adapt such principles to specific hazards nately chooses a player from the oppo- the correct response within the time (that is where much of the learning oc- site team to "challenge." Each challenge limit, the defensive side scores a point. If curs). is considered a "round." Each team al- not, the offensive side wins a point. The Following cognitive input, the teacher ternately assumes an offensive and de- first team to win a predetermined should divide the class into three equal- fensive position. number of points wins. sized and intellectually-matched During the round the offensive player For greater variety and excitement, groups. One group will be student re- chooses a hazard with which to "attack" more than one hazard can be introduced ferees with respoosibility for awarding the defensive player. The hazard is hid- at one time, forcing the defensive players points and making decisions regarding den from view until the offensive and to respond more quickly. This game can disagreenwnts between sides. Their defensive players face each other in the be played at the pace of the students. It is preparation will consist of correctly front of the classroom. The defensive fun, exciting, and a harmless way to matching hazards with proper health player brings his arsenal of methods. On learn health protection measures against protection methods. a signal from the judge, the offensive radiation and hazards of the working The two other groups will be compet- player flashes his hazard. The defensive environment. 99 1 ?BEST COPY UWE 54 =1. TEACHING IDEAS Environmental Health to provide the students with the oppor- nuclear power plant in your neighbor- Nuclear Power tunity to try on various viewpoints re- hood. Each of you may select one of the , garding nuclear power in a simulated following roles but there must be at least Debate real life situation. FirstI provided the one person for every role. For the pur- students with readings from a range of pose of the exercise attempt to assume perspectives; then I presented the pros the arguments of the role assigned as Bruce G. Morton is an assistant professor of and cons of each of the relevant issues in you perceive they would be. Each person health education, at Temple University, as unbiased a manner as possible. A on the panel will have a maximum of five Philadelphia, PA 19122. general discussion ensued. Emphasis minutes for an initial statement after throughout was placed on determining which there will be time for rebuttal and The nation is entering its second dec- the credibility of the information and on open discussion. ade of crisis over energy resources and the subsequent identification by stu- energy consumption. Gasoline has more dents of the issues, facts and feelings than doubled in price in the past two salient to their attitudes and values to- Participants years. The rising price of home heating ward nuclear power. I found a plethora SaliSally Slick is the electric company's oil threatens the health and welfare of of biases-4 materials written for the lay spokesperson. She:he is an outstanding poor people who are unable to pay their public trom the local electric company proponent of nuclear power whose spe- bills. Congress is considering a proposal and from one of the local anti-nuclear cial talent is putting the levels of risk to relax environmental standards for groups active in my community. I aug- posed by nuclear power into perspective strip mining and air pollution emissions mented this with academically credible. with other risks from automobiles, coal from coal-burning power plants. Ram- sources. (A list of references is available mining, natural disasters, cigarette pant inflation, partly caused by sky- on written request). smoking, etc. rocketing energy costs, threatens public The procedures for the debate that I BertiBertha Booster is the Chamber of health as government slashes social pro- have found to be most valuable are as Corn merce public relations person. Al- grams to balance the budget. follows: though this character may be either for or Concurrently, the long term commit- 1. During the class session prior to the against nuclear power, she/he is inde- ment of the nation to the nuclear path- scheduled debate, present or discuss the fatigable in boostering local business. way to energy independence is being re- issues with reference to the articles ConradCoirnie Cmicerned is a local resi- considered. The major accident at Three which the students should already have dent who is the parent of two children Mile Island, together with the less pub- read. Next, break the students into who go to school in the vicinity of the licized but nonetheless serious incidents groups as per the directions below. proposed power plant. at Browns Ferry, Chalk River, Rocky 2. At the beginning of the second Alan'Alice Academic is the local univer- Flats, and Idaho Falls, have thrown a class, just before the debate, give each sity scientist who is concerned with the pallor over the once rosy future of nuclear group 10-15 minutes to compare notes balanced presentation of the facts. power. At this writing only one state in and ideas, and select one person to serve She/he will often bring out the other side the country (Tennessee) is now willing to on the panel. of the argument so that everybody will accept radioactive wastes for storage and 3. Solicit a volunteer or assign some- be apprised of all the facts. She'he likes disposal. Among the general public, one to be moderator. Charge this person to put things in the perspective of risks concerns about radiation, the potential with the responsibility for limiting the and benefits. for sabotage and the contribution of nu- time for each presentation and facilitat- EdiEdna Ecolop, is a local environmen- clear power technology to nuclear arms ing the democratic opportunity for tal ae tivist who is deeply concerned development, have grown dramatically everyone who wants to speak at least about the ecology of the river on which in recent years. Among those who define once. the plant is proposed to be built as well as themselves as environmentalists, oppo- 4. Ask those not on the panel to as- a number of other environmental prob- sition to nuclear fission power is virtually sume the roles of concerned citizens who lems. unanimous. have the right, and who will be given the Be consci,mtious about limiting the But there are two sides to each of these opportunity, to ask questions or make time tor each panel member to present questions. Proponents point to the im- statements. and rebut. The purpose of the exercise is pressive safety record of nuclear plants. 5. Plan 30-40 minutcs for the debate to get a range of viewpoints out in the They argue that without nuclear power, including questions and comments from open, not to resolve the issues or to concerned citizens not on the panel. electricity would be much more expen- judge the presenters. The 10-15 minutes sive than it is now and the air would be 6. After the debate, open up the class in groups before the debate assures that more polluted from coal-fired power to general discussion and give people the each panelist will have a few good points plants. They contend that there are bene- opportunity through discussion and vot- to make, and is itself a good exercise in fits and risks to every energy alternative ing to identify the issues, concerns and information sharing. However, you may and nuclear benefits far outweigh the feelings most important to them, and to want to provide the moderator with a risks. clantv and affirm their personal values few leading questions just to get the dis- In a course I teach on health and the with respect to nuclear power. cussion going should it come to a environment I attempted to broach the standstill. Usually, the reverse occurs problem of presenting the conflicting in- Directions to Role Players ::is hard to limit the debate. The role formation which clouds the nuclear playing seems to providemany students questior by organizing a debate in You are a participant in a discussion with a comfortable vehicle ',II- interac- which the students assumed the roles of among local residents and interested tion, and the instructor with a method various interested persons as described persons concerning the preposa I by the for examining a controversial health con- below. The purpose of the exercise was electric company's directors to build a cern. 100 1 1 3 55 TEACHNG IDEAS

Environmental Health

my throat! Looking at the mutilated tie Health and Safety and thinking about the close call, I suddenly realized what a perfect visual aid Waft from me this would make in teaching about hazard potential of various items of Trash Can clothing. I saved the tie and it became the first of many items in my "trash can I. CLAY WILLIAMS is an associate profes- collection." sor of lwalth education at Bowling Green A plastic cup brings to mind a per- State University, Bowling Green, Ohio sonal Lxample of how an accidental 43402. JUDITH K. SCHEER is assistant "I'd like to donate this to your trash poisoning might occur.I wanted to collection," said one of my students as professor of health education at the Uni- make a smoking machine out of a liquid versity of Toledo, Toledo, Ohio 4.3606. he handed me an old extension cord. detergent bottle so I went into our The cord was peeling and cracked and kitchen, grabbed the soap bottle, and dried out with wires exposed. He had poured its contents into a plastic cup, used this under the carpet for several placed the plastic cup on the window years. Instead of just telling students sill and began making the smoking ma- not to run extension co:ds under rugs, chine. this cord can show how friction will About a week later, Tom was making break down the insulation. When stu- lemonade for the twins and found only dents were asked to suggest ways that one clean glass in the cupboard. Look- the cord might have become so abused, ing around, he spied the plastic cup on they told of pets which had chewed the window sill and filledit with through extension cords and about lemonade for Robby. Robby took a big times when heavy duty appliances were drink and started to cough and choke used on light duty extension cords caus- tearfully. His mother came running in e ing the cord to deteriorate. One of the and said, "What's the matter? Is your values of utilizing items from the trash lemonade too sour?" She took the glass can is that they act as discussion from him and sampled it herself to see stimulators providing students with As educators, we constantly dream of what was wrong, and she's been blow- opportunities to share personal experi- ing bubbles ever since! This is an excel- ways to obtain effective visual aids to ences. help us develop concepts; however, the lent example of how poisonings occur One such experience involved a difficulty of getting school monies ap- in the home! We are fortunate that the handmade sweater which our twins de- propriated for visual aids to enhance glass didn't contain drain cleaner, au- cided to use as a replacement for their tomatic dishwasher detergent, or other classroom presentations too often con- lampshade when redecorating their fronts us. I am going to share a secret of room. The light bulb entrusted with how to cope with, even enjoy, two prob- charred wool and the tiny sweater with lems of our everyday existence a hole the size of a grapefruit tell the teaching on a shoestring budget and rest of the story. Luckily, it was a wool taking out the trash! The trash can of- sweater! Had it been made with syn- fers unlimited potential for collecting an thetic yarn, it could have caused a fire abundance of effective teaching aids. instead of smoldering as it did. With My recent practice of accumulating dis- the sweater and light bulb or other carded items provides a wealth of in- wearing apparel the concept of flamma- valuable materials for the classroom bility in clothing could be explored. that we can use effectively to develop The topic of home fires is rich with important health and safety concepts. bizarre stories. This past summer, I In my collection is a necktie which is heard a lot of commotion in the kitchen, ripped and tattered. It makes me think so I came running in from the back yard back to early spring, several years ago. I toxic substances which would have and saw flames shooting out from be- was itching to get my boat in the water caused extensive tissue damage. By this hind the refrigerator. The coils on the so, on returning home from church, I example, we can learn quite a lesson back of the refrigerator had come into announced that anyone who wanted to a'sea proper storage. contact with the plug; over a period of go to the lake should be ready to leave Other trash that can be used to teach time, vibrations had caused the coils to in five minutes. My wife objected say- about poisons is abundant. A paint can cut through the insulation. The melted ing that I had promised to build some with a "lead-free" label is an appropri- plug is a good reminder that we should kitchen shelves for her and that I was ate visual aid when teaching about lead regularly check oui electrical not leaving the house until the job was poisoning. A rusty, swollen or dented appliances. done. Needless to say, I was in no mood food can might be the focus of ques- In my trash collectionI have a dish to build kitchen shelves! Rushing like a tions designed to stimulate 'an aware- towel that touched the lower heating madman, I started to cut a board with ness of food poisoning. element in the oven. A section of it the circular saw and the next thing I Once your trash collection becomes burned away when it was being used as knew, my tie was tangled in the saw well known, others will bring you items a pot holder and the unsuspecting cook blade which was rapidly approaching and stories to add. had a fire. i 1 101 As a child, you probably enjoyed she u.s for jobs around the house. through the garage window onto the playing with tape measures. Jeff was no When the twins were three, they dis- hood of my car. Are you saving your exception. While watching TV, he was covered those bags in Grandmother's plastic bags, broken screwdrivers and reeling out a tape measure and watch- kitchen. They were just the right size to hammers as aids in developing concepts ing it spring back. As he reeled it out, get over their heads. I happened to walk relating to hand tools and home safety? the end dropped between a chair and in just as Robyn pulled one down over Ar nually, hundreds of youngsters the far wall; Jeff flew out of his chair, her eyes and nose. Had she been more are tatally injured as a result of home eyes like saucers and hair standing on successful, she would have been in firearm accidents. Many of these acci- end. The metal tape had :ome into con- dents occur because youngsters don't tact with the prong cata lamp plug understand the danger of firearms. It is which was not all the way into the re- not uncommon for children to consider ceptacle. The other endhitthe .22 caliber guns as toys because of the aluminum frame around the sliding small size of the cartridge. In an attempt glass patio door. At the contact points, to make students appreciate the de- the tape melted and charred. Jeff's tape structive capabilities of a small bore clearly illustrates how seemingly harm- gun, A I showed them a soft drink can less activities can be dangerous if the which was shot with a .22 hollow point. right conditions exist. great danger of suffocation. A larger The average person can do little to plastic bag in my collection was on a prevent the unexpected; however, a rrib mattress at a hotel which could safety conscious individual can take have tragic consequences if tired par- measures to guard against common ents don't take time to check for such hazards. When purchasing electrical hazards. Many other household helpers can be hazards. We all know that power to ls should be handled with great respect, but often there istendency to abuse or be careless with "everyday" tools. You probably have a screwdriver with a blade that chipped because the cool was used as a chisel, a crowbar, or something else for which it wasn't designed. When there is finally an opportunity to tighten a screw, there's not enough blade. As you apply pressure, trying to appliances how careful are you to look turn the screw there is danger of perfor the Underwriters Laboratory (U.L.) label? When I found a battery charger at an unbelievably low price I looked on the display card and found the U.L. label. It wasn't until sometime later that I realized the U.L. approval applied only to the cord and plugnot the battery, charger.I low often we have been This mutilated metal creates a lasting led into a false sense of security by not impression when used to illustrate the reading the fine print! damage a .22 caliber bullet could inflict Items like the extension cord, swea- on a human body. Gunshot wounds can ter, refrigerator plug, tape measure, and also be explored with x-rays obtained U.L. labels are discarded daily. Alert from a radiologist. My x-rav of a skull your friends and students to save these sonal injury as pressure causes the bro- that has been penetrated by BB clearly types of items for you. It has been our ken blade to slip from the screw head. illustrates the importance of safe gun experience that students are much more Another example is my 98e bargain handling. willing to listen, share, and remember hammer which was designed for light These items are examples of numer- examples of home hazards than they are use uch as driving tacks or small nails ous objects that can be recycled from to memorize lecture notes of do's and When the kids decided to build a fort in the trash to the classroom. As educators don'ts. the back yard, they used my hammer to know, the more we can do to allow stu- Hundreds of suffocations occur in drive spikes. Half the spikes went in &tits to identify with our subject matter homes each year. Students become di- crooked so they tried to pull them out. the more we can enhance the learning rectly involved when Iintroduce the All ot a sudden the claw bvoke, and there process. By using common items of subject of suffocation by placing a was a tiving missile that might have put sunk as a local point for discussing real plastic bag over my head. I demonstrate out an eye. These would-be-architects life situations, teachers can help stu- when plastic bags are and are not also damaged my hammer so that the dents develop important concepts con- dangerous. A plastic bag, tied in knots, head would no longer fit. To avoid upset- cerning their own health and safety. will illustrate the p;oper method for is ting me, they left it on the workbench -Fight school budgets and rising infla- disposal. just as they had found it, saying wrong. tion might be just the motivating fac- My mother-in-law receives shirts A week later, asl was working on a proj- tors to encourage rummaging through from the cleaners in plastic bags which ect the hammer head flew off and sailed the trash tor classroom stimulators.

102 115 56 TEACHING IDEAS

Environmental Health Ecology Games documents, historical events, and his- of the class: to develop a game related torical persons in a game setting with to their area of interest. This game must the rules and regulations for the game contain rules and regulations, include RONALD W. HYATT is assistant profes- based on the possibilities found within choices and chances, iod involve a de- sor, Department of Physical Education, that game. Rules and regulations are cision-making process. Some of the University of North Carolina, Chapel based on the many combinations which rules may be preplanned, or they may Hill, North Carolina 27.519. have or could occur in the interplay of be developed on the spot. The model of people, places, and events. Learning monopoly may be used where dice are opportunities for the student are many, rolled or number cards may be de- Ecology is currently a "hot" topic in varied, and allied in theme. Creative veloped .'s a means for the students to health education courses in colleges situations are different for each student travel around the board, encounter the and high schools. The topic is relevant, and each group. In brief, the game simu- different situations, and experience the subject matter is current, abundant lation method produces an excellent learning opportunities. Chance cards resource material is available, the mass learning situation. Granted, this ap- are placed at appropriate areas, and media are active on the topic, public proach is rather a simple one, but it can students have to decide on a course of and private agencies are concerned, be modified for use on the college and action. (For example: A student draws a and the students are involved in chang- Ligh school levels and, perhaps, the junior high school level merely by mak- ;ng local classroom adaptations. Itis noted that several commercial games are marketed in the area of ecology. SMOG, Litterbug, and Cleanup are good examples of these. Pollution, a commerical product using game simulation,is suitable for use with junior high school students through adults. The learning experiences described here are different from the commercial games in several respects. Some of these differences are as follows: 1. The students provide the input and knowledge necessary to develop their own game. 2. The game conditions are current. 3. The game situation can be scaled to local problems. 4. The creative aspect is present. 5. Small group work is educational and fun. ing attitudes and legal approaches to- 6. Decisions must be made by the ward ecological matters. Still, the com- players which are relevant to their petent health education teacher, with needs of the moment. card and has the choice of additional all of this support, seeks fresh ideas waste controls in the company in which in teaching ecology. Your department he owns stock, or he has an increased editor has experimented with a learning dividend of two dollars. What will approach in ecology which is current, he/she take?) Who wins the game and innovative, educationally sound, eco- Materials Needed how winners are declared are parts of nomical, appropriate to several school the game which the group must estab- levels and allows for student creativity. Few materials are needed, and they lish in their rules and regulations. This method is the game simulation are inexpensive. Six or eight pieces of technique, which allows students to cardboard, scissors,felt tip pens or create their own ecology games with crayons, glue, and scrap paper are suffi- ecology problems and solutions pre- cient. (Recycling is practicing what you sented in the games. teach!) The rationale for using this instructional technique is,to some extent, Class Organization based on the games theory which was Group leaders are appointed, and six Starter Ideas developed in the 1960s at Johns H6p- to eight students are grouped in the In case your students need kick off kins University and other institutions. areas of population, water, air, noise, ideas, here is an approach one class The games simulation theory, which and others as class size warrants. An used. has been used extensively insocial extensive bibliography is handed out NOISE POLLUTION: Aplayer studies, political science, and consumer several classes prior to this experience. starts out with normal hearing. He education, uses reproduced materials, Students are oriented as to the purpose moves and lands on a square of rock

103 music (3 decibels hearing loss), construction (-5 decibels), or sonic the dice or cards, is insufficient in boom (-I- nervousness to your physi- real life. Cooperative planning must problems, so as not to produce ad- cal conditi1). Chance cards might take place if we are to win the ecol- ditional problems of ecology, is im- be safetyJgislation, adding carpets ogy game of life. portant. and drapes in house, etc. 2. There isatotal involvement 5. There should be a greater con- The teacher can use starter ideas needed of legal methods, legislative cern and knowledge about ecology to get the groups rolling, but nor- processes, citizenship practices and with its problems and promises. mally a good introductionto the concepts, industrial concerns, reli- problem is sufficient. gious beliefs and practices, and gen- The kind of game simulation and uine concern about people and our game development outlined briefly Desired Outcomes environment. here has worked for this teacher on the college level. The students like The following teaching points are 3. An understanding of the inter- it, and its use creates an effective among those that should be made relationships of ecology systems and learningsituation.Otherhealth forcefully and vividly while ecology subsystems is a prerequisite to effec- games are being used. teachers on different levels in other tive action. locales might well use this approach 1. The "random chance approach" 4. Careful selection in the me-ns to help their students learn more to ecology matters, as expressed by of correcting the different ecology about ecology.

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Environmental Health Guidelines foraRecycling Project

George H. Brooks is assistant to more of the volume of municipal main parking lot traffic pattern, the dean of the University of solid waste is made up of paper yet permitting smooth in-and- Northern Colorado Graduate and paper products, andthat out traffic flow along both sides School and chairmanofthe about half of that volume con- of the trailer. Arrangements were Greeley Committee on Environ- sists of newspapers and maga- made with the local police de- ment, zines. They contacted a paper partment for traffic control and salvagecompanyin Denver, with the city street department Healtheducatorsandtheir which assuredthe committee for portable barricades to chan- students may become involved that they would purchase the nel traffic flow along both sides in local environmental action by paper they collected. of the trailer. helping to establish a community A subcommittee was ap- The second Saturday of the newspaperrecyclingprogram. pointed to finda building to month was selected and publi- One such programhas been serve as a untral collection cen- cized as collectionday.The successfully operated since July ter.In a irg, unfruitful search Committee on Environment 1971 by the Greeley (Colorado) they founL building owners re- loaded the trailer that first Sat- Committee on Environment. The luctanttopermitstorageof urday,while a subcommittee committee, appointed by the city newspapers because of the po- sought volunteer groups to fur- council in 1969, originally con- tential fire hazard, or desiring nish labor for loading in subse- sisted of about a dozen mem- to secure a long-term tenant. quent months. The firstday's bersbusinessmen, housewives, Theyinvestigatedthepossi- collection yielded 27 tons. See- teachers, and faculty members. bility of securing a railroad car ing what the collection could Other members have been on a convenientsiding,but amount to, the committee de- added, including a staff member learned that a car couldn't be cided to share the monetary re- of the local newspapera recent spared. A localtruckingfirm, turn from the sale of paper with journalism graduate, keenly inlearning of the project, offered the groups which offered to help terested in thecommittee's to spot a semi-trailer in a local --one-third tothe committee, work, whose added publicity ef- shopping center parking lot on one-third to the morning volun- fortshave greatly helped the collectionday,thenhaulthe teer group, and one-third to the success of the project. trailer to the paper salvage com- afternoon group. The news The committee decided to un- pany in Denver. Permission was media carried the story of the dertake a newspaper recycling gotten to use the parking lot area committee's plans for continu- project after learning that 50% or far enough away fromthe ing the paper collection on the

dr4 41111hrile." 105 BEST COPYMAPLE second Saturday of each month. terials must be notified in ad- Volunteer groups, wantingto vance of the start of your proj- earn money fortheir projects, ect. were soon put on a waiting list Haveadequatetransportation as groups were assigned collec- available. Greeley's first Satur- tion days several months in ad- day collection filled a 40-foot vance. vantypesemi-trailer.Every A telephone answering service Saturdaysince,twotrailers agreed to receive calls from aged have been needed; in March persons and others unable to 1972 a third truck was partially bring their papers to the collec- filled. tion center. Trucks and station wagons, furnished by members Advisecityofficialsandthe of the groups working atthe policedepartmentofyour

collection center, collected pa- project. A=Ma. I. pers from callers. Most people Publicize each collection day, IA who wantedpick-upservice taking into account the differ- 4 \ made their calls ahead of the entdeadlinesofdaily and 'OW 10 a.m. deadline on collection weekly newspapers and radio day. There was little cause for andtelevisionstations,An- concern over abuse of the serv- nounce and adhere to open- S. ice. ing and closing hours; remind The Committee on Environ- people not to leave materials ment hopes that Greeley wili atany othertime.Include soon combine its trash collection phone numbers of key com- withrecycling on acity-wide mittee members and answer- basis. However, though the tech- ing service, if any. Give clear nology is available for such an instructions on how materials undertaking, the market for re- are to be tied, bundled, or cycled materials needs to be ex- boxed. panded. Even paper collection alone is not yet feasible on a liability insurance is a must. city-wide basis; the paper sal- Have adequate workers on hand vage company says it would be a minimum of 10 or 12 unable to handle all of Greeley's during all collection hours. At paper along withallthe other times even that may not be paper delivered to its docks. enough, though at other times Greeley's Commiuee on En- it may be too many. Workers vironment can boast of a great may need gloves for handling dealoffirst-handexperience paper bundles. Lifting bundles with what has become a widely by the heavy cord soon wears accepted but not always prac- blisters on tender hands. ticed dictum: man .riust live with his environment, not despoilit. Someone should be responsible People will cooperate,if prop- for receiving the checks by erlyinformedandmotivated mail from the companypur- with sound, well-pla.Ined proj- chasing the papers or other ects. materials. A home addressor Here are some suggestions for Post Office box may be used. those who want to starttheir The same person should be own recycling project. authorized to write chi( cks to the volunteer groups who fur- A market for the materials to he nishlabor for your project, II" recycled is a must. The com- and should keep records of pany accepting secondary ma- names and mailing addresses.

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Family Life Easy Ways of Getting into Trouble When Teaching SexEducation

trators, and will certainly draw the fire image. Using anatomical drawings is GLEN G. GILBERT is associate professor of the anti-sex education group. certainly a legitimate exercise, but have of health education, Portland State thi- them duplicated for your students. versity, School of Health and Physical 2. Keeping your principal or administrator in the dark.it is imperative that 6. Using questionable language. Slang Education, P.O. Box 751, Portland, Ore- your principals and administrators be terminology is often all students know gon 97207. apprised of what is happening in your of reproductive anatomy and physiol- classroom. If you really wish to get into ogy. Students should not bere- During my career as a health educator trouble with administrators put them primanded for using such terminology have observed or have had related to through a couple of late night phone unless they use it on purpose to create a me numerous stories of problems calls from irate parents concerning sex disturbance, but they should be tact- teachers have encountered while teach- education material or projects which fully taught the correct terminology. ing sex education. Without exception they know nothing about. It is highly Teachers who feel they must use such these teachers have been well meaning likely you will also be blessed with a terms generally to "get on their level" and have had the best interest of their call from that administrator. Keeping may soon be on their level equally un- students at heart. Poor judgment on the appropriate administrator up to employed. their part, however, has often resulted date, for some, will mean just a state- 7. Not previewing films or materials. in placing their sex education programs ment that you are now studying sex There should be a district committee to in jeopardy; many supporters of sex education. For others it will mean de- approve films, and you are courting education have become nonsupporters tailed lesson plans from which you are disaster if you use films not on the ap- because of incidents involving poor not to deviate. proved list. It is always wise to preview judgment. It is the hope of this article 3. Giving "secret" lessons. Another films, but in sex education it is essen- that such error can be minimized by surefire way to get into trouble is to tial. I will never forget an acquaintance calling them to the attention of present have secret lessons with your students. of mine who was not teaching health and future teachers of sex education. Just make a statement such as "Today's education by choice, and consequently The list offered here is by no means lesson is just between you and me-- it used a large number of films. He or- complete as teachers are constantly is our little secret" and you can be cer- dered the district approved-for-high- finding new ways to get into trouble. tain many parents will hear of it. You school film, "The Story of Eric" (an ex- Here are a few easy ways of getting into have no business teaching material that cellent film on Lamaze childbirth), for trouble teaching sex education. you cannot defend. his class. As the film progressed he was 1. Teaching sex education with in- 4. Violating district or school policy. not prepared for the scene of actual adequate background. Sex education is This is clearly a violation of your re- childbirth. He jumped in front of the one of the few areas where teachers are sponsibility as a teacher. Curriculum projector, and his class witnessed a :tually held accountable for what they guides are set up to give you paramet- childbirth in vivid color on his white teach. Teachers of almost any other sub- ers to work in, and in a general sense shirt! He had not previewed his film ject area can have some poor days of reflect the wishes of the community. and was not trained or willing to dis- teaching and as long as they maintain You should stay within those paramet- cuss childbirth. order itis unlikely they will ever be ers no matter what "you know is good" 8. Not being prepared for opposition. chastised fortheir teaching.Let for your students. If you don't agree Most programs that are properly estab- teachers of sex education make an error with the curriculum you should cer- lished suffer little opposition, as the and you can bet they will hear of it. It tainly work to change it, and a great vast majority of Americans support sex isn't that they shouldn't be held ac- many curricula need improvement. education, but numerous programs countable, because they certainly Until you get it changed, however, you have been attacked. All teachers should should, but that such accountability is are legitimately bound by contract to re- be able to verbalize the need for sex rare in education and a major challenge flect the existing curriculum. education when called upon and should for sex educators. There are few non- 5. Using poorly constructed home made anticipate such encounters. Do not re- dedicated teachers teaching sex educa- materials. Parents especially do not find spond with hostility or contempt. Par- tion for long, as it is a great deal of hard a poorly constructed penis model or free ents will have honest questions and work. It requires a thorough backhand drawings of genitalia amusing. they deserve sincere well-documented groundinthesubject matter Remember that you are dealing with answers. university courses, seminars, and/or a their children. Giving a homework as- 9. Teaching by the joke. Several in- great deal of solid reading. Making con- signment of freehand drawings of the structors have gotten into trouble by tent errors in this subject will quickly male and female genitalia may seem in- telling or allowing students to tell "off result in lack of credibility with stu- nocuous, but many a parent has noted color" jokes in the classroom. Teachers dents, parents, colleagues, adminis- that their daughter drew an erect penis telling inappropriate jokes can give the ape, wondered where she got her model sex education classroom art improper "lb f-1 107 atmosphere for such an important sub- ticular lifestyle has no business preach- ject. One local high school teacher got ing it in the classroom. We are all 16.Leaving nonapproved reading mat- into trouble by leaving his classroom biased. Recognize that bias and be care- ter out for public view. It isof course ap- for a long distance phone call. In his ful not to try to convert your students. propriate for you as a teacher to read absence a student leaderwas left in 13.Using inappropriate guest speakers. anything you wish, but remember that charge, who allowed jokes to be told. It The selection of guest speakers must be the district has approved materials for was an all male class and the jokes soon done with great care. Inviting right-touse with students. Do not leave nonap- got off color and deeper in raw sexual life groups to class with brutal pictures proved matter out where a student expressiveness. One male not accus- can be a traumatic experience for stu- might pick it up or where an outsider tomed to hearing women discussed in dents. Certainly the anti-abortion might view it. There is an excellent such terms left the room in tears. groups should have the right to express paperback on birth control and STDs 10.Setting unrealistic goals.Many their point of view, but you as a teacher (sexually transmitted diseases) entitled programs have been set up with goals have the right and the responsibility to Intercourse Without Getting Screwed and objectives to eliminate VD, di- screen howitisdone. Inviting which is a valuable resource. Many par- vorce, etc. Such programs are doomed homosexuals to a junior high or high ents, however, may not find the title to failure. A good example of this is school class is another example of an amusing if they happen to walk by and when a program sets out to lower the easy way to get into trouble. Certainly view it on your derik. VD rate. When a good sex education they should have the right to express Please ask yourself if you are un- program is established, the VD rate their opinion, but the problem thus necessarily endangering your sex edu- often goes up! The reason for this in- created might jeopardizea totalpro- cation program. Sex education is far too crease is that people recognize signs gram. important to be eliminated or watered and symptoms and go in for treatment. down because of mistakes in judgment. At a later date the rate may go down. 14.Citing personal sexual eperience. Remember, sex education is one of the 11.Forcing teachers to teach sex educa- It seems hard to believe that teachers few areas of education where teachers tion.Mandating that all teachers should need to be reminded that this is not are truly held accountable for their teach sex education is ludicrous. Forc- okay, but it still occurs. Do not let stu- teaching. Making errors in teaching his- ing teachers to teach in any area they dents push you into revealing your per- tory, English, or any other subject sel- don't wish to teach is unwise. Suchac- sonal life. It simply has no place in the dom results in chastisement, but make tion frequently leads to poor quality classroom. an error in teaching sex education and education, and in sex education that 15. Using nonapproved questionnaires you may be looking for a new line of can lead to disaster. Many teachers will of students sexual experiences or at- work. never be comfortable teaching sex edu- titudes.It may seem to you that finding Readers are advised to review the cation. Such unwilling or embarassed out what is actually going on with your NEA publicationSuggestions for Defense teachers can easily be turned toan students is a good place to start your Against Extremist Attack: Sex Education anti-sex education position by such program, but your principal or ad- in the Public Schools,by the Commis- forced compliance. ministrator is likely to think differently. sion on Professional Rights and Re- 12.Letting personal bias overly influ- Remember that such questionnaires sponsibilities, Washington, D. C. ence teaching.Everyone knows what may be construed as a reflection of the Readers might also wish to consult with normal sexual behavior is-- itis the performance of the school or district as local universitiel, the American Associ- waytheybehave. This erroneous belief a whole. Be certain to clear all such ation of Sex Educators, Counselors and of major consequence is often carried questionnaires beforehand. They may Therapists (AASECT) and the Sex In- into the classroom and can be devastat- provide useful information, but be care- formation and Education Council of the ing. The advocate of open marriage, ful they don't cost you your job or hurt U.S. (SIECUS) for appropriate courses marriage at all costs, or any other par- the reputation of your school. in sex education in their locale.

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1-amily Life Three Teaching Strategies A soap opera,asilent walk, andapuzzle help present the faas about sexuality ina way that is comfortable for both teacher and students

FLORENCE I. SNARSKI and CECEI IA A LYNCH How can I involve my students in this learning? are healtheducatorsteaching s cation How am I most comfortable dealing with this? courses at Scotch Plains-Fanwood High School, Do I have limitations in this area? Scotch Plains, New Jersey. Once these questions have beer ,:onsidered, the instructor can institute techniques that will deal with the three areas mentioned: physical- psychological-societal.

Prior to using any teaching method, the instructor must carefully examine the philosophy of his/ her course as well as the role of the teacher in the classroom. Our basic philosophy is thatsex edu- YOUR OWN SOAP OPERA cation is the study of me-you-us. Sexuality cannot Purpose: In sex education there is a need to explore be separated as a discrete, identifiable part ofus. ,ocietal expectations versus individual values. It permeates every aspect of our behavior. There- Objectives fore, as sex education teachers, our role is to help our students learn more about themselves and To explore varied life style! others. In our classroom, we consider threegen- To become aware of society's expectations for be- eral areas of self: physical-psychological-societal. havior. We do agree there is more to the totalperson 10 explore alternate modes of responses to life situa- than these aspects; however, time and situation tions. limit content offerings. To stimulateeative thinking. As health educators, we have a part in the To illustrate the dynamics of day-to-day living experi- growth of our students in an area that is extreme- ences as they influence our choice of behavior. ly interesting to them and most humans. It could Procedure: Divide class into groups of four, providing be so easy to slip into the same techniques for for male/female input in each group, if possible. all our classes. Therefore, we strive touse differ- Each group is instructed to create a couple, giving ent techniques to meet the needs of each student biographical structure to the couple, suchas age, edu- and the different personalities of each class. Effec- cation, jobs, familial relationships, status of couple's tive teaching strategies can be as important in sex rela`ionship, socioeconomic position, how did they education as solid factual information. enter each other's life, etc. In determining teaching strategies,we feel there After the groups are given about 20 minutes the are basic questions to ask yourself: fictitious couples are presented to the class witha discussion of each couple as they relate to variabilities What do my students want to learn? that may influence their relationship, the future of the What do I want my students to learn atthis relationship, the permanency, and what kinds of needs time? this relationship meets for each partner.

1 cl 109 AWARENESS WALK Purpose: A relevant task of the sex education teacher is to provide for exploration of differing values among the students. An underlying factor in developing these attitudes stems from previous learning experiences. tip Though we share some commonalities, we behave individually. Objectives e." To illustrate individual, divergent perceptions in reaction to identical environments. i41 To stimulate an understanding of One's own learning processes. To provide insight into one's own responses or lack of responses. To provide communication channels relevant todif- --`41-211 ferent attitudes about sexual behavior. Materials Paper/pencils Ditto slips reading: "We are on a classroom experiment. We are not allowed to talk to you. Please Ohjectives: check with my teacher (Name) for further informa- To display knowledge of terms and definitions of re- tion. We are timed so please do not delay us. Thank productive systems----male and female. you." To provide student participation in general review. Procedure: Divide class into groups of four. Instruct To determine areas requiring further clarification. students they are to be nonverbal until further notice. Each group is to take a walk in and around school Materials: environs deciding nonverbally where they are to go L a rge box and planning to return to the classroom in 10 minutes. LIFE puzzle One member of the group will take a ditto explana- To prepare WI. puzzle. tion should 'anyone confront them in the halls. They 1. Cut four letters-1 I f Iout ot large pie«s of con- areinstructedto opentheirsensestoeverything struction paper 124 x 36) _For coding purposes and ease of around them on the walk. !vision lion, a different mlor is used (or each. Start the groups a minute or two apart so thatOne 2. 1)ivide eat h largo letter into segownts, sith each seg- group moves out of sight before anotherbegins. ment containing 115o piec('s 55 )11( ii 11,1%1' hUVII ( into inter- Upon returning to the classroom, each student (still im king irregular pieces. -Ihr numbei oi total segments of nonverbal) is asked to write down all the things they all letters is determined hy usual class we so ia(h student became aware of on their walk. led'si one tw/lle part Also to he considered art' total When all groups have finished writing, allow five number ot terms anti definitions tom les ww. On one hall of the segment Ow anatomical termis minutes for each group to share perceptions among written and on its interim king hall is placed the definition. the group and then form a large circle to discuss the 4. Make a master layout designating \shot terms are on differences in perceptions and translate the responses the appropriate large letter tor instructor's reterence. to variances in behavior. 5 Place all puzzle park into one large box Conclusions: You will find yourself ref rring to this Procedure: Students select puzzle parts containing a exercise many times in subsequent classes loexplain term or definition pertaining to the reproductive s 's- differences in behavior. This exercise provides a subtle tems. Eac h student must find partner with correspond- learning experienre which requires teacher skillfor ing term or definition. Partners present term/definition translation into application. to the class and then place their portion on the floor to put puiile together, eventually spelling outthe large word LIFE. Note- l)epending upon class si/e and 'Lime schedule, LIFE PUZZLE thisc tivity may require more than one (lass period to complete. Purpose: A crucial building block for open communi- cationinsex educationisthe establishment of a Com lo,ion: At the end of the lesson, the students "working vocabulary." An innovative review of anat- have defined their terms. But this can also be used to omy and physiology of the male and female reproduc- illustrate the balance of Me, thatall the,e terms to- tive systems is through the LIFE puzzle. gether "spell" life c reating as well as sustaining.

110 60 TEACHING IDEAS

Family Life student, the senior high student, and ceived in class and their own feelings The I the parent. about the different methods. There are Don't Clown, several contraceptive choices or alterna- of Burst MisconceptionsGrades 7-9 tives, and there are many different phys- This activity is effective as a cultnina- ical, mental/emotional and social conse- Education lion to a basic introduction of birth con- qtwnces that will ultimately affect an in- trol methods, functions, and knowledge dividual's decision. After individual dispelling misconceptions. in front of selection,.groups of four or five students the class is a large, colored drawing of a can share their contraceptive choices clown. From his hands, strings project and justify their selection with others in to different colored balloons. Above his the group. The teacher and class can head is the caption: Don't Clown, Burst then identify similarities and differences Misconceptions! Inside each inflated of contraceptive preference basedupon balloon is a misconception about con- the physical, emotional, and social fac- traception; underneath each balloon on tors influencing or prohibiting one's construction paper the same size as the contraceptive choice. balloon is the reason why the statement in the balloon is a misconception. Dear WorldParents The activity is started when the teacher asks students of different teams This activity is to help facilitate com- to correctly spell words related to con- munication between parents and their traception. Examples are diaphragm, sons and daughters. Parents individ.,- endometrium, intrauterine, lactation, ally and'or collectively decide how they gynecology, ovulation, etc. If the stu- would answer the following letter: WARREN L. McNAB is an assistant profes- Dear World: sor of health education at the University of dent spells the term correctly his team receives two points. If the student mis- I'm a parent with two beautiful teenage Houston, 3807 Cullen Blvd., Houston, children. Torn is sixteen and Christine is Texas 77004. spells the word he must come to the fifteen, and both are dating regularly. clown drawing, burst a balloon, and ex- While I certainly respect and trust them, I plain why the statement in the balloon want to talk to them about the "facts of Eleven million teenagers inthe is false. A correct answer is worth two life," contraception, and responsible be- United States today are sexually active;' points.If the student cannot explain havior.I know I am much too late, but 20% use contraceptives on a regular why the statement is a misconception, they seemed to grow up so fast! How can basis 2 The unfortunate result of this he opens the construction paper balloon I go about talking to them and what behavior is .indicated by one million and reads the correct answer to the should I say? unwanted pregnancies, higher fetal and class. An example of a misconception is: Signed Tongue Tied Parent maternal death risk, increased number A woman cannot become pregnant Following the parents' individual re- of female school dropouts with a greater while lactating. The answer disproving sponses they can collectively talk of the risk of unemployment, forced mar- this misconception is: 20% of nursing problem, what their response would be, riages, and a higher suicide rate among women who do not use a birth control and how they would go about talking to expectant teenage mothers, These method become pregnant, and ovula- a son or daughter. From this involve- statements certainly indicate the need tion precedes menstruation. Reaching a ment parents can share ideas and dis- for contraceptive education as a primary certain point total can be the end of the cuss other ways to open family com- means of prevention. game. munication channels about human sex- Contraceptive education is not only uality. providing information and services to Projected Future During our lives we are continually prevent teenage pregnancy. It is also Grades 10-12 making important decisions based upon education for young men and women what we as individuals feel is best for who later in life may want a family and Individually students are given the our own sexuality. Learning activities will need to select a method of birth con- following hypothetical situation: If you involving the cognitive and affective trol that will allow them to plan for a and your husband/wife have decided domains which help students make de- wanted pregnancy. In addition, con- not to have children for a while, or have cisions based on their own perception traceptive education teaches those who decided upon a nonparent lifestyle, of a given situation, reinforces indi- do not want children to select a method what contraceptive method would you vidual responsibility which is para- which will allow them the nonparent use to prevent pregnancy? Justify your mount to contraceptive education and life style they wish to live. It is impera- choice based upon the physical, preventive health. tive that we, as educators of sexuality, mental'emotional, and social implica- reinforce our cognitive objectives and tions of the contrac"ptive on your principles through relevant learning ac- health. For this exercise list the follow- Bibliography tivities which will enhance the total sex- ing he,dings in separate columns: prob- uality and decision making skills of to- lem; alternatives; consequences; deci- Guttmacher Institute,11 Minim! Teenaga.., Planned l'arenthoodFederationof day's young people. With these con- sion. America, New York, 1976. cepts in mind the following learning ac- The problem is selecting a contracep- Byrne, Donn. "A Pregnant Pause in the Sex- tivities are structured for three different tive. Individually the students fill in the ual Revolution," II:yt-holoxy Today11:2 target groups--the junior high school categories based upon knowledge re- (July, 1977) pp. 67- 78.

1 !) 111 61 TEACHING IDEAS

Family Life

, s IA 1-

44,4

PregnancyA Gaming Technique

EDWARD T. TURNER is professor should be included on the topic. 3. When a player lands on a space and the coordinatorof graduate 3. Select appropriate format for the he/she must read aloud the mes- studies, Health, Physical Education physical layout of the game. sage written on that space. Dis- and Recreation; and teacher of hu- 4. Place the needed information in cussion among group members man sexuality,AppalachianState theappropriateplacesonyour ensues. Thi., is an important part University, Boone, North Carolina board. of the learning concept of the 28608. 5. Construct your boards with col- game. ored tag board or poster board and Gaming techniques are becoming cover them with clear contact paper 4.If a player lands on Conception more and more a part of our educa- in order to increase their longevity. or Doctor Draw he/she selects tional classroom teaching methods. 6. Select equipment including mark- the top card, reads it aloud, and With the greater use of games nu- ers, dice, spinner, and decide on makes the move. The group dis- merous companies have been man- the number of players. cusses it. ufacturing simulations and games 7. Select rules and interpretations 5. Eachplayerfollowsthe same foruseintheclassroom. These play the game a number of times, procedure. games are very good but they have revke your rules as needed. two drawbacks: they are expensive; 8. Mimeograph enough copies of 6. Thefirstpersontoreachthe and they may not meet the specific the game and rules so that each newborn happy face is the win- needs of a given teacher's class sit- member of the class has an indi- ner. The exact number must be uation. Games and simulations can vidual copy. rolled on the die inorder to reach be easilythought out and con- 9. Revise rules and procedures and Baby Happy Face. If another numberis structed by any interested teacher adjust game as necessary. rolledthe in order to meet his/her own indi- player must wait until the next vidual classroom needs. Pregnancy Pregnancy GameThe Layout (See turn to complete the game. is one such game which was de- sample drawing and cards) signed for use in a senior graduate The Doctor Draw and Concep- 7. Other players continue untilall college class on human sexuality. tion cards are cut out of heavy have reached the end withthe The game has been quite success- paper, and stacked on the board total group, including thoseal- ready finished, still responding ful inthatit has greatly enhanced face down. On the back of each in the discussion. learning through competition ina card is printed Doctor or Concep- tion. fun sense. The largest problem in Thisisjust one type of board constructing any game of this type game that a teacher canconstruct Pregnancy Rules is getting your thoughts together on at a minimumcost.Any other just what you wish the game to Players-2 to 5 players per board. health topic orany other area can encompass. The following construc- Coed group preferred. lend itself toa similar game. The tion steps are helpful hints for put- Equipment board, markers and time and effort in formalizingthe ting together a board game, such one die. idea is well worth thepositive learn- as Pregnancy. 1. Decide who is to go first. ing which ensues. 1. Select your topic or area. 2. Each playerrollsthe die and 2. Collectideaswhich youfeel moves his/her marker, beginning 112 on Start Fin. 1 9 ri in\

End of 2nd month CONCEPTION CARDS End of 1st month Embryo is 1" Emergency Embryo is 1/4" long. Large h-iad, Room EMERGENCYGo To long, heart nervous syst m Rest. Emergency ROOM and miss beating 65/B/pm, functioning, Doctor's Abdomen begins to enlarge two turns eye, ears, & nose embryo start to Office during the third monthbuy begin to form, & move this point loose fitting clothesTake an (Doctors office) on embryo known as fetus EXTRA TURN.

CONCEPTION CARD DOCTOR DRAW

Morning sicknessnausea End of 3rd lunar !nth-- 4th weekFood passing Fetus is 3" long, teeth during the morning hours from from mother tn embryo 6th to 14th weeks. MISS ONE forming under gums, fingers and toes, bare thin nails TURN. and sex is distinguishable.

2nd week-2 membianes form around embryoan inner and outer. Fluid End of 4th lunar mth More frequent urination. Uterus between them is amniotic Fetus is 61/4" long, body is pushing against bladderMISS fluidstructure is known covered with downy hair, as bag of waters. skeleton is hardened, and ONE TURN in order to buy extra mother may feel fetus toilet tissue. movement.

DOCTOR DRAW

CONCEPTION CARD GO BACK 4 SPACES Implantation of zygote in uterus wall--6th to 9th day End of 5th lunar mth Fetus is 91/2" long, more PREGNANCY movement, heartbeat car' DOCTOR DRAW CARDS be heard with stethosco,

Egg not implanted in uterus Float Trip in uterus for properlygo back to nearest several days End of (Ah lunar mth-- conception. Fetus is 12" long, large head, skin is very wrinkled, eyelids open and close

Rapid Cell Division and End of 7th lunar mth-- Zygote Becomes similar to Fetus is 14" long, thin and MiscarriageNatural abortion s .iall hollow ball scrawny, reddish skin, if up until 6th month of pregnancy born po)r chance of go to emergency roommiss survival one turn then go to Start Fin. End of 8th lunar mai Three day trip down the Fetus is 16" long, hair on tube head more abundant, thin and wrinkled, if born there is a good chance of survival Cesarean birth--incision in wall Newly fertilized cell is of abdornen in order to deliver called zygote DOCTOR'S OFFICE babystay still and miss three turns. End of 9th lunar !nth-- Fetus is 18" long, fat develops underskin giving Da tors Offke Labor Stage 3-- phimper look, if born immediately after excellent chance of survival delivery for 10 min. Artificially induced labor vigorously ends oxytocintake two extra turns. with passing of 10 lunar mth--Fetus is 20" Doctor Draw placenta (afterbirth) long, fullterm 5'h to 11 lbs. average wt.

One Sperm of 2-400 Breathing begins within one minute, feet giasps and baby 1 21; 113 62 TEACHNG IDEAS

Family Life

"When does life begin?" Students re-.suclion techniques cover points 5 Contraception- spond independently until all who want through 10. Induced labor with saline Abortion Lifeline to respond, do. An "L" for life is placed solution could cover points 10 through on the continuum for each voluntary re- 12. sponse. After the cognitive portion of the Glenn E: Richardson is in the department of Once the students have privately or technique is finished, then the valuing health and physical edtaa lion at Tem s openly contemplated where life begins, questions begin. Questions such as the A&M University, College Station, Texas a cognitive discussion of contraception following can be used: 77843. and abortion methods can ensue. For 1. Which, if any, of the contraceptive each method of contraception dis- methods is acceptable to you intellectu- When using values clarification tech- cussed, put a mark on the continuum ally? Spiritually? Emotionally? Socially? niques, health educators often tend to above the life line. The decision of For what reasons? overlook valuable teaching opportuni- where to place the contraceptive 2. Which, if any, of the abortion ties within the structure of the value method depends on the action of the methods is acceptable to you intellectu- clarifying experience. The valuing expe- contraceptive method. ally? Spiritually? Emotionally? Sodally? rience helps keep students' attention For example, the condom, foams, jel- For what reasons? while incorporating facts in an interest- lies, and diaphragm could be placed at a The final question in the technique is ing manner. A technique that deals with point between 7 and 3 because they one that will reinforce personal values the sensitive issues of abortion and con- prevent the sperm from reaching the or promote the examination of personal traception and yet integrates both teach- egg. The IUD would be placed between values in a way that personal affective ing and valuing is what Icall the 4 and 5 because the IUD prevents im- and cognitive value dissonance will be contraception-abortion life line. The planta ion of the fertilized egg. Vasec- avoided or clarified. The question is: Is technique can be adapted to a 20-minute tomies would be placed between 1 and 2 the mark where you believe life begins period or continued for several hours of since the sperm is never deposited. This on the right or left of your personally discussion depending on age group, ob- allows for an interesting discussion of accepted contraceptive or abortive jectives of the unit, and fadlitator skills. the contraceptive techniques and can be methods? If the life mark is on the right explained in conjunction with the use of of the acceptable contraceptive and contraceptive kits. abortive techniques, then the preven- Method Following the discussion of con- tive action of the methods occurs before On the chalk board or on a large piece traceptive techniques, abortion tech- life begins and no dissonance related to of paper, the instructor first draws a niques can be discussed and the periods terminating life should be experienced. life-line with some key points labeled. of most appropriate use be placed on But if the life mark is on the left of .he A values question is then asked, the lifeline. For example, D & C and methods, then in the perception of the individual, the method takes action Contraception-Abortion Lifeline after life has begun and potentially could be the source of mental and emotional guilt feelings if the methods are used. The final question can lead to a dis- cro cussion of how to find peace of mind when using contraceptive methods, that Ft- Induced Suction Abortion is, using appropriate methods (if any) '2 E D&C which conform to one's own values. If students are unsure when life begins, as L many are, then the technique will prob- L L L L ably stimulate some pondering. It can also lead to a discussion of the ease of I I I I I 1 I I 1 modifying behaviors (use or non-use of 4 5 6 7 8 9 10 11 12 13 14 15 1 2 3 contraceptive methods) versus the facility of changing values.. Other questions can be developed to relate the lifeline to other values, e.g., questions regarding spontaneous abortion and life, therapeutic abortion ond values, and decisions to abort, keep the child, or give it up for adoption. The abortion-contraception lifeline, a confluent education technique, places a traditional discussion of contraception and abortion methods within a valuing framework. The technique has been used many times in university classes and has provided a stimulating, clarify- L - Life begins ing, and valuable experience for teacher and students. 1 14 127 TEACHNG IDEAS

Family Life Teaching Students About Their Future RoleasParents

JAN YOUNG is a health issues instructor in the Mankato sexuality and transactional analysis," and for the first Public Schools, Mankato, Minnesota 56001. session not one student stopped by. They were attracted to the more obviously intriguing rooms labeled "vag- abond;ng Europe," "why you shouldn't get married," Isn't it interesting, when we think of all of the time and and "medical aspects of abortion." Before the second effort that is spent in curriculum development and cur- session began, I put a new sign on the door that read: ricular changes, to realize that we have frequently made "How to win an argument with your parents!" For that a complete circle to find ourselves back where we and the remaining sessions,Ihad a full house, with started? This appears to be more and more evident in the enthusiastic students. I covered the same material that I trend to go back to the "open school," to nongraded had intended to cover, but took a different approach. classrooms, and to teachers working with students of We discussed many of the concepts from the book by different grades and certainly different interests and Thomas Gordon, Parent Effectiveness Training, and talents. Thomas Harris's book, I'm OKYou're OK. By putting In our attempts to concentrate on technical and scien- myself in their place and approaching parent-teen con- tific advances in knowledge, and our efforts to ensure flicts from their view, the motivation was thereand the the proper sequential development of certain basic learning outcomes were evidenced by their comments knowledge and skills, is it possible that sometimes we and participation in role playing. overlook that which is the most obvious? Are we so concerned about what we think the student should Many basic concepts included in a health class also relate to basic content areas in parenting. know that we tend to overlook what they so desperately 1. Growth and Development: A parent who understands need for their future mental and social happiness? growth and development will be better prepared to adjust to In my 11th grade health classes, whenever I pose the changes in offspring. question or design an activity relating to future goals, at 1 Attitudes and Habits: A parent who is knowledgeable about least three-quarters of every class indicates that some the influence of the home in fostering healthy versus un- day in their future they plan on being a parent. We give healthy attitudes will be more apt to convey positive health them instruction in many other areas and subjects, but attitudes and habits. educators neglect to spend much time on the subject of 3. Communicative Skills: A parent who is aware of common "how to be a better parent." communication blocks and adept at using positive com- It is the "in thing" for many students in high school municating skills will have a better chance of fostering and maintaining good family communication. today to talk about how their parents "just don't under- 4. Decision Making Skills: Parents who allow their children to stand" and are really not "hip" or "in tune" with what is make some choices will probably have teenagers d adults going on. We who work with students every day see who will be more responsible in making decisions that affect much evidence of parent-teen conflicts. their health and welfare. Talk about "learning opportunities"! Let's start taking 5. Coping with Crisis: Parents who understand that children advantage of these "teachable moments" in our health learn how to cope with crisis situations will be more likely to classes! For a perfect starter, the next time you hear any set a better example for the children in how they as a parent of your students make a negative remark about their meet a crisis in their family. parents, you can come back with the statement, "Well, I 6. Parents' concern for their own development of maximum quality of physical, social, and mental health will hopefully suppose they have had little or no training in how to be a develop a similar concern in their offspring. parent and so perhaps it would be nice to allow them to make a few mistakes." This, or some similar statement, can get you off the ground into some very interesting These concepts are included in many health educa- "parent training" concepts. tion programs, but those concerned with coMmunica- Another interest getter is to write in large letters tive skills and decision-making skills are oftenover- across the blackboardTODAY'S LESSON: HOW TO looked. Therefore the remaining part of this article will WIN AN ARGUMENT WITH YOUR PARENTS. Ican deal with methods to use these skills in teaching about guarantee you their undivided attention! parenting in a classroom. The three main skills in parent effectiveness training Recently, I was among the guest speakers at a confer- that I find myself using over and over again inmy health ence on "interpersonal relationships" at a local high classes are: school. A variety of topics were offered simuitaneously 1. Active Listening: this is the ability to understand what the throughout the day and students chose the five they person is "feeling" as well as saying. were most interested in. My assigned topic was "human 2. Use of "/ Messages": An "I message" consists of three parts: 115 128 (1) how you feel, (2) the situation or problem, and (3) the In role playing involving common conflicts, suggest effect or reason. 3. Who Owns the Problem: Sometimes a conflict resolves itself role playing using typical responses in contrast tore- when we decide whether it is really our problem or some- sponses using active listening and "I messages" or prob- thing we are making our problem. If the problem is owned lem ownership. by both parties involved, often a compromise is necessary. SITUATION I: Jim and Father have Some examples of the three techniques and how they frequent arguments overuse of the car. Jim feels he should be ableto use the car for his dates might be used by a parent, a teacher, or a teenager are and his father feels that he shouldget a job and buy his own car given below: because he thinks Jim doesnot take good care of the car. SITUATION: A parent is totally frustrated by her daughter's leaves it in a mess anduses too much gas. disregard for house hours or policies established for school SITUATION 11: Mary, an 11th grader,has a continual hassle at nights, weekends, etc. home over her messyroom. It has created a lot of friction Positive Parent Responses: among the entire family and many heatedarguments between 1. "You really seemed upset when I questioned you after you Mary and her mother. Whoowns this problem---Mary or her came home late." (active listening response) mother? 2. "I feel bad that you came in so late since I thought we had made an agreement on weekday hours." (I message.) SITUATION 111: Jackie has a constant battle every time she dates 3. They both own the problem. It is definitely a problem for the Jerome. She likes him and feels her parents are unfair and mother, because of her concern for daughter's ability to prejudiced because he has long hair and works in a service keep up in school. It is a problem for the daughter so long as station. Jackie's parents want her to go to college and feel that she is a member of the family living in the same household. her steady dating with Jerome will squelch this as Jerome is By using either active listening or an "I message" or both, the planning on taking a one-year mechanics course at a vocational parent is taking some of the pressure off and may avoid a more school. serious confrontation than using typical parent responses, Health teachers can gain an understanding of how to which immediately put the person on the defensive, such as: use the main methods which are explained in Gordon's "What is the matter with you anyway?" "When I was your age, if I came in that late I would have been campused for a month." book on parent effectiveness training (PET). There are "How do you ever expect to amount to anything? You will never other general communication strategies which can and be able to keep a job if you can't obey some orders." should be used, such as paraphrasing and receptive listening. Courses are offered in communications and human relations. The PET classes which are offered in Classroom Strategies many cities by certified instructors are an excellent way 1 .Role play family-teenage conflicts in groups or to better understand the principles involved. Practice partners. helps and is really necessary to use the skills effectively 2. Practice using "I messages" in response to cer- and naturally in the classroom. tain situations with a partner. A common complaint of teenagers today revolves 3. Conduct small group discussions about com- around conflicts with their parents. PET offers what is mon teenage-parent conflicts and how to considered to be a no-lose method of solving conflicts. handle them using active listening, "I mes- If you introduce these concepts to your high school sages" and transactional analysis positions. students, they start to look at their own personal conflicts with their parents and by putting themselves in their parents' place they often gain much insight into how complicated the job of being a parent can be. They could, as a result of some parent training, become more responsible parents in the future.

116 64 TEACHING IDEAS

Family Life Ask the Students Themselves

A. GORDON BENNE11 is supervisor furnishedbytheStateBoard of Doyouthinkhealtheducation of health, physical education, and Health and the State Board of Edu- should be put into our course of recreation in the flyria City Schools, cation. Examples of the stark and study? If so, when? Elyria, Ohio 44035. dismayingstatisticsfurnishedfol- low: When did you first become interested and adventurous in sex? Do you think venereal disease edu- 1 The U.S.isinvolved in the worst In spite of a new liberation, in- epidemic of venereal disease in his- cation should be included ina cluding children, we are stillVic- tory. course in health education? torian in talking with our youngsters VD is second only to the common All the students responding felt aboutintimatepersonalhygiene cold in the communicable disease field. that health should be taught K-12; matters. Yet, they watch us act free- 3. InElyria alone the reported cases the majority favored aformalized ly and without restraint; we drink jumped from 20 to 60 in one year. health education program beginning to excess, smoke too much, take too 4.In LorainCounty, Ohiothe sometime betweenthefifthand many tranquillizers, eat too much twelfthmostaffectedinOhio-- ninth grade. None suggested begin- of the wrong things, exercise too there was an increase of over 25%. ning such a program as late as the little and let our children get hung- 5.In the state of Ohio, reported cases eleventh or twelfth grade. As one up on drugs. Adults are still overly increased over 20%. student remarked during the dis- concerned about "hush-hush" and 6.Cleveland, Ohio had 73,880 new cases and is ranked 8th in the na- cussion, "If we don't know it by "hidden" subjects, and when any- tion in venereal disease increase. then,it will be too late!" The stu- one mentions sex education in the 7.Ohio had 218,356 cases of gonor- dents wanted health education to public schools, everyone panics. rhea reported. cover such topics as personal hy- 8 Inthe U.S.there were over five giene, grooming, VD, disease pre- Despite the antiquated fears of million new cases of venereal dis- vention, and dating. parents and the general public ahout ease in one year. theconcept,ElyriaHighSr hool Itisestimated by leading health In the area of VD education, our students overwhelmingly confirmed authoritiesthat only 1 outof 8 students feltfree to acknowkAge that they want and need sucha pro- Cases of venereal diseaseisever their need and lack of information. gram in their city schools. reported. Adults are afraid to talk to their chil- Students do not talk to their par- dren about intimate physical sub- ents about the problem of venereal Afterbeingexposedtothose jects,but many refusetoallow disease, for instance, but theyare statistics, the Elyria High School stu- knowledgeable professionals to do very much aware of it. Venereal dis- dents participated in a county-wide so. What kind of climate isitthat heall at easeisa small part of thetotal VD Awareness Week. They made will for permissiveness health education program, yet the posters,spenthoursmanning a home and intheschool, but be statisticsinthis area of thetotal boothforthe Lorain City Health almost obsessively opposed to giv- subject show us the weakness of our Departmentatthe Midway Mall, ing young people necessary facts to programs in the public schools, and distributedliteraturecontrib- protect them fromtheresults of uted by the State Boards of Health this much touted premissiveness? Elyria High School, Elyria, Ohio and Education. Withthekindofpositivere- has an enrollment of 2,734 students, In an effort to determine, the atti- sponse of high school students dem- tenth through twelfth grades. In No- tude of students to health educa- onstratedin the brief survey con- vember, 1,767 students went to the iton in general, and to the inclusion duc ted at our high school,itap- gym to see the film "Quarter Mil- of such topics as venereal disease pears imperative that mmm Unities lion Teenagers," participated in dis- in health education, we asked about begin to listen to young people arid cussion, and were given names and 85'!1, of the student body to respond help them get the health education addresseswheretheycould be anonymously to questions such as pmgram theyfeelthey want arid tested for VD by a health depart- the following: need. ment official. The next day, about three fourths of thestudent hody were given some form of education on venereal disease..1-hefacts presented were

13U 117 65 TEACHING IDEAS

Family Life

Students then shared their ideas with the class. Each question or implication offered by the students was written on the board for the entire class to see. (An overhead projector could be used.) Our list contained 26 items including questions or implications such as the following. Gives new hope to couples who have been childless due to tubal problems. May help in the discovery of new contraceptive methods. If the child is not "normal,- who is responsible? Could reveal new information on the first hours and days of life. One more step toward manipulation of life processes. Could increase the population. Women with tubal ligations who changed their minds and wanted to have a child may be able to become pregnant. Opens door to surrogate mothers. If several fertilized eggs die with IVF, is this abortion? May help scientists find ways to prevent sonie genetic diseases.

When all questions or implications were on the board, students wrote out creased, thus placing additional decision making demands on individuals. the three they thought carried that most Test Tube Through health education experi- importance in the debate over this form ences, students can be aided in coming of reproduction. Then, they placed the Considerations to grips with moral issues which may number 3 next to the most important arise as a result of scientific advances in question or implication, a 2 by the second most important, and a 1 next to the human reproduction. The following activity was designed to help college stu- third most important. The papers were collected and the scores were tallied. dents identify a wide range of possible implications of WI'. The same format The most commonly identified concerns were the question of responsibil- could be used to elicit consideration of other issues with far-reaching pos- ity should the child be deformed, the new hope given to couples who could sibilities. not conceive, the ft DEBORAll A. DUNN is (issislant profes- After a review of the actual procedure r of manipulation sor and health specialist In the Department involved in IVF, the students were of life processes, and the possibility of asked to recall the reactions of various the procedure leading to new con- of Physical Education for Women, traceptive methods. tvashiuNton Stale 1.Inivelsily, , individuals and groups to the an- The followup to the exercise con- tVashin:Oorr9016.1. nouncement of the first successful IVF. How did prominent scientists and sisted of a discussion of why the ques- theologians react? Flow was it handled tions and implications that were most by the press? What did } Jur family, often raised by the students were friends, or acquaintances have to say worthy of such careful thought and con- The July 25, 1978 birth of Louise about it? How did you react to the sideration. Brown, the first so-called test-tube news? baby, intensified an international de- Keeping these reactions to IVF in bate over the ethical, legal, and societal mind, the students were asked to si- implications of in vitro fertilization lently list some of the questions that (IVF) as a means of human reproduc- had been raised and some of the impli- tion. With talk of cloning, surrogate cations that had been identified. What motherhood, and parthenogenesis, it's legal questions have surfaced? How possible that in the years to come, soci- might it affect the family? What could it ety's reproductive options may be in- mean to science?

118 131 TEACHT\IG IDEAS

Family Life Selected Impacts of Contraception on Man and/or Society

PATRICK KIDD TOW is a graduate assistant in the Department of Health Education at Southern Illinois University, Carbondale, Illinois 62901.

This teaching strategy was designed primarily for college health survey classes, however, it could also be applied to students in the senior high school setting. This activity could follow .111 after a unit on population growth, human sexuality, or birth control education.It involves dividing a cbss into separate groups to brainstorm a list of all possible impacts from the usage of contraceptive methods. The topic can be examined in view of the impact upon the individual or society as a whole. Fif- teen minutes are usually allotted for this portion. After this step has been accomplished, their next announced objective would be assigning symbols to each de-

rived impact. These symbols (=, , or r t / ?)would representrespectively, . 4i e '.. . whether they felt the concerned impact 4'fr -e_ ' desirable, undesirable, or questiona- lkyalue judgments must be made as a - group. There will be some items that are - obviously controversial, therefore, it Symbol Designations would be advisable for the classroom + = positive or desirable teacher to circulate and help facilitate = negative or undesirable the discussions when necessary. This ? = questionable portion of the activity usually involves about 15 minutes. Emotional Impacts Environmental Impacts 1. eases fear of pregnancy out r)f a lov- 1. human race may become extinct (?) ing relationship (+) 2. 2. 3. Bringing the groups back together as 3. a class, the teacher calls upon a member from each group to share the findings Physical Impacts Economic Impacts on the emotional impacts of contracep- 1. contraceptive devices may cause 1. parents are afforded more time and tive usage. On the second round, a different member in each group presents cancer () money to plan family ( +) the environmental outcomes. This pro- 2. 2. cess continues until all six areas of con- 3. cern are brought out for classroom dis- social Impacts Religious Impacts cussion and everyone has an opportu- 1. inlaws frown upon childless couple 1. considered a violation of religious be- nity to present their group consensus. () liefs by ministers () This final part should take approxi- 2. 2. mately 20 minutes. 3, 3. 112 119 67 TEACHNG IDEAS

First Aid and Safety A Working Model for Simulation Techniques

GLEN C. GILBERT is instructor of health education, Uni- formance of tirst aid procedures by the instructor or the versity of North Carolina at Greensboro, Greensboro, stLIdent. North Carolina 27412. Much of the material for this article 2. They can serve as an instructor-student interaction is from the ongoing research .by the author for his doc- strategy by presenting the situation and jointly (instruc- toral dissertation at Ohio State University. tor and class) analyzing the proper course of action and reasoning. Instructors of emergency care are faced with the chal- 3. They can be a group activity with several people lenge of educating personnel to deal with complex situa- working out a course of action and then undertaking it, tions that require prompt and efficient treatment. The This might be better in more complicated situations. instructor, largely because of time limitations, is often el. They can function as an independent student activ- forced to rely on "one shot" coverage of the individual ity by setting up an area where students come in and skills involved. Commonly such coverage is followed by perform skills in varied situations. a paper and pencil test in an attempt to evaluate the You may wish to devise your own simulation situa- students ability to apply specific skills. tions or ask your students to make them up for you, in This article presents an alternative method of teaching which case each student should designone situation and evaluating those skills dealt with in emergency complete with symptoms and procedures. A file of such health care classes. It promotes confidence in the stu- student situations can be collected and made available dents' ability to employ the newly acquired skills in real to students for review. life situations, presenting a variety of situations thatre- quire the application of a multiplicity of first aid skills. The Simulation Model: Scenario The use of simulated emergency care situations is not The student sel:Kted to perform as a first aider selects a new idea, but this article F esents several new varia- a card, reads the number, and leaves the room.' While tions on simulation design and provides a working he is out of the room the situation numbered is setup. model for those persons unfamiliar with simulation Other students are employed as victims with symptom techniques. tags, medical alert tags, or whatever is appropriate for Simulated situations can be an asset to any emergency the situation, placed on their person. These tagsare put care program for the following reasons: at the site of the simulated injury or symptom. The mate- 1. They provide examples of real life emergency care rials which are available to the first aider are placed in the situations. area designated as the situation area. 2. They provide practical applk-ations of skillsuw- The student re-enters the room upon notification and ered in the classroom. reads the card out loud to the class (he is allowedto keep 3. They provide practice in the analysis and evaluation it during the situation). He then examines the situation, of emergency situations without possible injury result- makes a judgment based upon thesymptom tags, and ing from judgment errors. other information provided, and then performs the 4. They prc, ide an alternate teaching strategy for the proper first aid procedures. The instructor rates the stu- instructor. dent's performance using a predesigned form. 5. They provide a possible evaluation technique for The more realistic a situation, the better itis as a instructors. learning device. There are simulation kits available that 6. They provide students with practice in performing include sintulated injuries and simulated bleeding skills under stress and thereby should increase self- whicn can be used, but they requirea much larger confidence. amount ot time and the cost is often hiOt. The major Simulations can become an integral part of an emergency care instructional program from the onset. They can be used in a variety ot ways, some ot which are 'Selection of situation cards should be accomplished by outlined below: shuffling and the taking of the top card each time orsome other method at the discretion of the instructor. However, it is advised that a random device be employed so that students will 1. They can be used as a direct communication not feel their situation was predetermined at the will of the strategy by presenting the situation and the correct per- instruc tor. 120 advantage of the system described here is that it is relatively fast and inexpensive while providing a good deal of realism. You may wish to add certain realistic touches such as turning out the lights to simulate night time, adding SAMPLE EVALUATION FORM more props, or even having victims chew cookies and TRANSFER-BREATHING-BLEEDING simulate vomiting. The extent to which you carry this is Circle the appropriate number and total at the bottom. Values limited only by your imagination. should be assigned according to the importance of each skill.

YES YES NO Critique Wen Done Adequate Following the completion of situations itis recom- 1. Was the victim examined quick- mended that a critique be held, explaining the proper ly tor all possible injuries? 3-2 1 0 procedures and clearing up any questions. This can be 2. Was the victim quickly removed done after each situation, at the close of each session, or from imminent danger by an at the end of all the situations depending on the instruc- appropriate method? 6-5-4 3-2-1 0 tcr's time schedule and wishes. Copies of the rating Notelack of speed would be form may be distributed and used by fellow students a deduction here. dtrring the performance, for comparison and to rein- 3. Was victim given proper mouth- force learning. They can also be collected by the instruc- to-mouth artificial respiration tor to aid him in his rating. until victim revives? 5-4 3-2-1 0 Another technique is to employ overhead projections A. Clear Obstructions (1) (showing correct procedures) during the situation, but B. Proper head tilt (2) in such a manner that the participating first aider cannot C. Timing (1) see them. Flashing the projection immediately after D. Dealing with difficul- completion of a situation is a technique which also saves ties (1) class time that normally would be taken reviewing each Notein some cases mouth-to- different situation at a later time. nose, mouth-to-stoma or a In the majority of situations several alternate first aid manual method may be procedures are possible and appropriate. The design of required. evaluation forms should take this into consideratibn. 4. Was victim given proper care Evaluation should be based only on the results of the for mild bleeding? 3-2 1 0 first aid and not the appearance of any special bandage A. Direct pressure and the instructor had in mind. The intention is to help save elevation (1) lives, not win a neatness contest. However, effective 13. Proper bandage (2) bandages are most often neatly applied. 5. Was victim given verbal encouragement? 2 1 0 'Notejust saying you will be OK (sn't very good verbal Preparation for the Instructor enc ouragenlent.

The instructor should develop and review the situa- 1). Was victim treated for shock? 2 1 0 tions to be sure he understands the correct procedures 'Noteremember shock and has all the proper materials necessary. Tags and treatnlent varies. other materials should be kept in separate envelopes 7. Was proper additional. and numbered for easy access. Masking tape can serve professional aid called for? 2 1 0 to hold tags in pla«. Assistants should be recruited and trained to ensure that the situations will be set Add 2 up rapidly. Deductions The instructor should review all instructions with par- Total ticipants and should present a sample situation. Possible 25

Comments: --Additions can be used to I he makeup of each class determines the situations. equalize situations so they First aid for housewives should emphasize more house- all have the same point hold accidents and first aid for firemen should em- values. phasize burns, smoke inhalation, and so on. Deductions include improper order such ac Careful selection of victims is necessary. Some situa- treating a fracture before hte tions require little acting ability (e.g. an unconscious threatening bleeding. victim), but others require a great deal of showmanship to be effective (e.g., drug freakout). Try to involve everyone at least once as a victim or bystander. You may wish to employ "professional" victims to ensure that the simulations will be well done. 13,4 121 SAMPLE SITUATION 2. You may use only material provided in the testing area. 3. You may not use any notes or cards other than those provided. Situation: 4. For assistance you may use only those people provided Your brother is playing in the garage when you hear and you musr give explicit directions for any aid they an explosion. There is smoke in the air and the roof administer. No undirected assistance or information is to appears in danger of collapsing. be given by other students or victims. Where: 5. Time will be an important factor in life threatening situa- Your home. tions. A reasonable time will be allowed for less severe Miscellaneous Information: injuries, but do not waste time. (After having used a situa- No one else is home. tion several times an instructor will have an idea of how long it should take to complete and may wish to set a time limit.) Above is the card that is given to the first aider. The information below is not seen by the first aider. It gives the directions for the conduct of the simulation. Position of victim: SIMULATION TAGS Face down. Special Instructions for Victim: Simulation tags which have symptoms written on them are Remain unconscious until signaled by instructor. constructed for each situation and attached !oviclims by mask- Special Instructions for bystanders: ing tape. They are coded hy ulorre( :deeding, blue for No bystanders present. breathing difficulties and gree. I yellow for miscel- Supplied Materials: laneous symptoms. 1. Home materials box (a box containing those first aid Their size is appropriate for the symptom. This means that supplies generally found in the home. symptoms that would be obvious such as severe bleeding, have Tags: a large tag and clear fluid from the ear, are relatively small. No 1. No air going in or out (1) chest attempt is made to hide tags any more than in real situations. 2. Blue skin (1) face The objective is not to trick anyone, but rather toensure a 3. Mild bleeding (1) right forearm thorough examination. Burns are listed by degrees for easy identification of proper PARTICIPANTS INSTRUCTIONS first aid treatment. Bleeding tags are marked mild, moderate, or severe. 1. You must treat this like a reallife situation. Nothing will be In appropriate situations medical alert tags arid cards plus assumedyou must do all that you would in a real life medications are supplied to further aid the first aider in diag- situation. To receive credit for any procedure it must be nosis. Medications are given in several cases to ensure under- accomplished completely. The only exception to this is standing of the Red Cross position on providing or giving medi- procedures that cannot be done in the classroom suchas cation. Names on medications and cards should be uni-sex making a phone call. (i.e., Pat) so that male or female vk tims fit into all situations.

122 1 68 TEACHING IDEAS

First Aid and Safety chain will not be activated and symboli- the trigger. There are conditions when Breaking the cally tlyi accident will not have oc- all the elements leading to an accident curred. are present but nothing triggers it. Accident Chain The first upright represents environ- There must be a trigger for an accident mental factors such as: crowding, doors, to occur, but if the othel tactors are drinking fountain, floors, lighting, no changed or eliminated the trigger will handrails or weather. The second repre- not be activated. sents human factors such as: active In analyzing the accidents ask your game, fatigue, horseplay, lack of train- students questions such as: What were ing or experience, running, violation of the environmental factors? How could rules. Next comes the agent which in- the condi cions been changed to prevent cludes: animal or insect, electricity, fire, the accident? What was the agent? What gases, liquids, recreational equipment, was the trigger? How could the situa- pencil, student, or vehicle. The trigger is tion been changed to avoid activating the actual incident which results in the the tngger? acddent. The slipping of the car tires on All accidents can be analyzed with the the pavement, the bat flying out of the accident chain model. Why not add it to student's hands, the toe of the person's your instructional devices. Figures 1 foot catching on the stairstep, the rug and 2 show the accident chain before slipping on the floor, are all examples of and after being activated.

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ACCIDENT CHAIN Richard 7'. Mackey is in tlie Departnwnt of Health and Physical Education at Miann University, Oxford, Ohio 45056. Figure 1.

"Accidents don't just happen, they are caused." It's a simple straightforward statement, but how tough it is to convince people of its validity. An "acddent chain" is an effective instructional device for helping individuals analyze the causes of many types of accidents.It can be used in school health instruction or in an industrial set. ting. Here's how it works. The "accident chain" consists of a 2 x4 length of wood with six, 2 x2 inch pieces resting on one-half inch dowels cut lengthwise. The dowels are glued to the 2 x 4s. Grooves are cut in the 2 x 2s so they rest on the dowels. The six upright pieces contain chain words and are placed six inches apart so that when any one is removed the chain action will be 0 0 interrupted when the pieces are top- pled. The removal of one word repre- ACCIDENT CHAIN sents the removal of one factor which Figure 2.Agent is removed or changedaccident is prevented. leads to an accident. Thus the acddent

1 31; 123 69 TEACHING IDEAS

First Aid and Safety dependently on a procedure usually Class Management CPR INN does not work. Most students need more structured instruction. A large class can be successfully man- 3. Lack of ManikinsMany schools aged. First concentrate on procedure; MARK KITTLESON is an instructor in the manikins are not needed. Once the pro- Health Education Departmentat and universities cannot afford mani- cedure is in student memory, learning Youngstown State University, Youngstown, kins. For those who can, few have the proper compression depth and ventild- Ohio 44503. He is currently certifiedas an proper number to ef:ectively ;each CPR tion will come fairly quickly with prac- instructor-trainer in CPR by the Ameritwn (a 6-1 ratio is recommended by the tice on a manikin. heart Association. American Heart Association). The following procedure works best 4. AreasofCertification The for me. Other instructors must adapt it Cardiopulmonary resuscitation (CPR) American Heart Association requires to their needs. has been making a lot of headlines that students master four areas before Line students up in the hallway in lately. Several states have now man- they are certifiedobstructed airway, groups of threes. The victims lie on the dated CPR instruction to all high school infant resuscitation, single and two per- floor or on several blankets with their students before they are allowed to son rescue. It seems almost impossible heads in the same direction. One stu- graduate. Many people are turning to for one instructor to teach all thoseareas dent is the observer and stands at the the health educator to provide this CPR to a large group of students, but it can head of the victim. Because of the large training. Through the help of the be done. All it takes is a little imagina- number of students it is difficult for the American Heart Association many tion, a little "army regimentation," and instructor to observe every student. The health educators are receiving this train- a strong voice. observer can spot any major mistakes. ing to teach such courses. Unfortu- 5. Limitations of ManikinsAl- The third student is the rescuer. All res- nately, most schools cannot provide the though the recording manikinsare cuers should kneel on the same side of necessary equipment to effectively teach well constructed, they do lack the the victim to prevent confusion when a CPR course. This article discusses human touch in several areas. It is im- giving instructions; when you say right problems the CPR instructor will en- portant that students work on the fol- hand you mean everybody's right hand. counter and possible solutions to them. lowing areas on a real human. Start with the shake and shout and (1) The nostrils on the doll need to be then opening the airway. Go through tough to stand the wear and tear, which the entire procedure until you feel the makes them more difficult to pinch than a students have mastered the skill. Make human nose. sure students switch around to experi- Problems (2) The doll's neck is more rigid dm a ence all three roles. human's, so students need to practice open- There are several major areas that There are several problems that ing the airway on a real human. By doing so need repeated work. health educators face when teaching they find the head tilts nrich easier. CPRin (3) Palpating the pulse is one of the most 1. Moving from chest to mouth and back almosteverylearning important techniques. CPR done on a person to the chest in five seconds. This teaches the situationhigh school, community col- with a beating heart could result in serious student Na move quickly to the mouth and lege, university, community. damage. The instructor must emphasize the get back to the chest to find proper hand po- 1. Size of Classlt iscommon to importance of taking at least 10 seconds to sition. You can drill students"Find hand have a great number of students en- find the pulse. Students should practice tak- position, go t.mouth and ventilate; find rolled in first aid or CPR classes, which ing a pulse on a live person to know what landmark and hand position, go to mouth makes learning difficult. Many institu- that pulse feels like, where to find it, and and ventilate, etc." Give the students five tions, such as the University of Maine at how hard to press. seconds to ventilate before instructing them Farmington, limit class size. A large (4) Finding the xiphold on the manikins is to find the landmarks. Drilling for only two group Ihr.its individual help and many not as effective. Everybody has a different minutes can give them the feel for movh.,3 placement for the xiphoid, thus it is impor- quickly. students may feel neglected. Other tant that the students have the opportunity 2. Counting properly for efficient output. universities, such as Mankato State to find xiphoids on several other humans. Have the student put hands in position on University, have access to paramedic This is an area of concern because if the the chest and without compression, count at students who are also instructors. This xiphoid is pressed on, it will break off and the right rate, then move to the head and does alleviate the problem somewhat. cause internal bkeding. ventilate, and go back to the chest. Students 2. TimeInvariably, a few students (5) When you are working on a human, can count together or individually. Use a cannot achieve the certification because you need to be gentle. When working with a stop watch to see if the students are counting the manikins must be returned at a cer- manikin, this ,3ent1eness seems to diminish at the proper rate. after a few hours. The shake and shoutpro- 3. Switching with a second rescuer. The tain date. If you are in a high school or cedure, which is the first step in CPR, can be major problem in the two person rescue is college that does not own its own mani- misinterpreted as a "slugfest" with the vic- the switch. Locate one rescuer at the head kins, you muFt reserve them from in- tim. Rescuers get a feeling of how hard to and the second at the chest. The instructor stitutions (e.g. American Heart Associa- shake if they work on a real human. Students should do the counting and tell the rescuers tion, Red Cross, hospitals, ambulance learn to gently open the airway when work- when to switch. You can see any mixups, crews) and it might take several weeks ing with a real subject. It is possible when which there will be the first few times. Keep before they are available. working with a manikin to throw the airway this procedure going until you feel the stu- Much time is wasted during the actual open abruptly, which could be hazardous to dents have mastered this procedure. class period. Only two people can work the victim. 4. Finding the xiphoid. A simple drilling technique is to have the students find the on a manikin at a time, thus several stu- landmark (xiphoid), then take their hands off dents must sit around and lit. Telling the chest. Keep drilling the students by giv- students to work with one onother in- ing only two seconds to find the landmark and then having them drop their hands. 124 137 These drills allow the instructor to Alternatives to Manikins large balloon to the opening. With a teach the students the basic procedure knife, make a small slice in the middle of before they even have a chance to get on the bottle and insert the opening of a the manikin. This will reduce needless If you have a large class and lack small balloon in it. Make a larger hole enough manikins, ou can still give stu- (to stimulate a mouth) below the small work on the manikins and reduce idle dents a simulated compression and ven- time; every person is involved. The ob- balloon. What you have basically is a server notes whether or not the rescuer tilation activity. Collect liquid soap bot- head and lung. Blowing into the mouth is doing the procedure properly, and tles and rinse them out. Fill the bottles will inflate both balloons; however, in the victim can inform the rescuer if the about three-quarters full with water and CPR you pinch the nostrils, and thus in reseal the caps". Students should use this simulation you pinch the smaller hand position is incorrect. Doing this proper hand position on the bottle and procedure for two hours will drill the balloon. This gives a pretty good idea of compress. This gives a pretty good idea how much effort is needed to ventilate a proper procedure into the students. of compression. Be prepared for occa- Students can concentrate on perfecting real human. Naturally, these two simu- the proper compression depth and ven- sional leaks. lations cannot match a manikin or a tilation rate when they get on the mani- For ventilation simulation, collect old human, but they are simple, cheap kin, instead of wasting time learning the fabric softener or similar bottles and techniques to teach the general princi- riocedure on the manikins. rinse them out thoroughly. Attach a ples of CPR.

135 1125 70 TEACHNG IDEAS

Mental Health On The Level A New TV Series for and about Teenagers

Gus T. Da lis is a consultant in health education and teaching strategies in the office of the Los Angeles County Superintendent of Schools.

The concluding scene is the high school yearbook office. Alice's boyfriend, Jerry enters . . . Alice, I should have known you'd be here.

Back at the scene of the crime . . . Lis- ten, do you know what's going on? 'Course I know, did you think I didn't see Gail before I left the table? So go and deal with her, will ya? Leave me alone, ferry! But you started the whole blasted war! It's none of your business. Why don't you just get out of here! Hey, look who's getting mad. Go shout like that at Gail! Don't you tell me what to do! And get something straight, I don't like to fight with people, I can't stand up to anybody and I'm tired of you rubbing my face into it all of the time! Alice is startled by the sudden opening of the &or. It's Gail . . . hi Alice. Gail! What do you want?

I wanted to talk to you . . . canI come in?

Come on . . . let me in.

Alright. . . come onin . . . we have a lot to talk about. The door closes, the screen goes black and the credits appear. The end? Not really. It is really a beginning. By using a group setting and surrounding it with relevant discussion questhns and activities, teachers can use dramatizations such as this one about conflict to get at some of the gut-level issues affecting teenagers. On The Level Series The above scene is from a program in On The Level, a classroom video series for fourteen-to-seventeen year olds that is being broadcast during the school day by many PBS stations. This series consists of twelve 15-minute programs, each of which dramatizes a problem in the lives of this age group. Program topics in- The problem here is tbat Sam doesn't want to be a baker, even though he's taken clude: Developing self-concept, accept- overthe ing feelings, facing conflict, thinking, family bakery for his ailing father. The scene is from On l.w Level,a new classroom video series for teenagers that focuses on personal and social growth.

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Tyrone, a would-he jazz artist, searches for his identity in "Who Am I?" a program about self-concept that is part ofOn the Level. changing family relationships, alone vs. Accompanying the video series is a Series Development lonely, friendship, coping with stress, Leader's/Teacher's Guide. Included in career aspirations, peer group member- this guide for each of the 12 video TheOn The Levelseries was produced ship, prejudice, and love. dramatizations is a program summary, by the Agency for Instructional Televi- Through program viewing along with background information about the pro- sion (AIT), a nonprofit American- pre- and post-viewing discussion and gram topic, student outcomes, before- Canadian agency, in conjunction with a activity, students are provided the op- and-a fter-viewing-the-programques- consortium of 32 state and provincial portunity to explore the series top:cc. It tions and activities, and reproducible ac- education agencies. Additional funding intended that this exploration will tivity sheets. Each OnThe Levelvideo support came from the Corporation for certain personal and social groe program has been adapted in an audio Public Bfoadcasting, Exxon Corporation, comes for students. These outcome . format. Unlike the video programs General Mills, the George Gund Foun- clude increased: which are open-ended, each audio pro- dation and Union Carbide. gram gives several alternate endings. Awareness of the interaction of emo- Creative use of this audio component The series is designed to promote the tional and physical health; should help adolescents discover that personaland social growthof Skill in identifying and analyzing the there are a variety of different ways to youngsters fourteen-to-seventeen years interplay between feelings and out- deal with a given issue. A student activ- old. The series developers e 'Me per- ward behavior; ity book is aiao available. It serves as a sonal and social growth as aprocess that personal guide to help teenagers explore fosters possession of skills, information, and Understanding of causes of emotional the life issues dealt with inOn The Level. attributes needed to shape life events and stress and ability to cope construc- The guide includes sdf quizzes, readings make constructive and maturing responses in tively with such stress; on the topics, and activities to encourage those events. In this context, life events are thinking, writing and doing. Students changes in physical make-up, intellectual de- Understanding of their relations with can use the guide for independent study velopment, personal feelings, or changes in peers, non-parental adults, parents, or for an accompaniment to theOn The relations with others or with the physical and younger children. Levelvideo or audio series. environment .1 144 127 Planning for the series began in 1977. The programs for all these AlT series of recriminations from classmates or the Using a prospectus published in 1978, are particularly helpful in facilitating af- teacher. A1T staff and consortium representatives fective !earnings. That is, when properly To establish such an environment it is sharply defined the series goals in 1979. used they are useful in helping students helpful for the teacher to set discussion The project design team developed, in explore their own beliefs, opinions, and ground rules.= For example, "In our dis- the fall of that year, twelve program top- likes and dislikes. cussion today let's have one person ics, each considered relevant to the per- speak at a time. Remember it's OK to sonal and social growth of high school Effective Use of the Series disagree but don't be disagreeable when age youngsters. you do so. Also, no put downs." As the In order to validate the program topics Essentially, proper use of theOn The discussion unfolds the teacher's role is to and student outcomes, secondary school Levelseries involves (1) selection of ap- main'ain the ground rules and to refrain teachers and other professionals likely to propriate questions and activities to pre- from judging students' ideas directly or use the series were interviewed in cede and follow the program, and (2) the indirectly. groups and asked to complete a take- establishment of psychological freedom It was through such a teacher- home questionnaire. They found the in the classroom or group setting. established classroom environment after topics in personal and social growth to be The Leader's/Teacher's Guide con- viewing the program on conflict that one familiar and important. There was a gen- tains a pool of questions and activities student reported that she did not feel eral feeling that many of these topics are useful in "squeezing health education af- alone. The student communicated relief now included in a variety of curriculum fective juice" out of the series. For examin not being "weird" because through areas, that the intensity and manner in ple, in using the program "Face to Face," discussion she discovered she was not which they are covered varies, and that which centers around the conflict be- the only one afraid of dealing with con- some topics are distinctly more difficult tween Alice and Gail, one of the teachers flict. Somehow there seems to be a sense to teach than others. In addition, the participating in evaluation of that proof security in knowing that one's peers teachers thought that the series would be gram selected the following from the have similar anxieties, fears, and joys. an important tool for engaging teachers Guide: This sense of security can come to and students in discussions of these rel- Before the Program thousands of high school students if ap- evant issues. propriate affective teaching materials as From here the series was put into Get a group agreement on the definition of conflict. Discuss some of the well as teaching behaviors are carefully production. Extensive evuation was utilized. conducted with 4,000 teenagers and factors that help to determine the se- verity of conflict. Perhaps the power of theOn The Level their teachers during production. The -Qries became most apparent when stu- programs provided the catalyst for In small groups, make a list of the posi- dents responded with disappointment teenagers to discuss issues of importance tive things that can result from conflict. The negative things. and frustration at the lack of "r :al" pro- to them. Teenagers reacted sometimes gram endings. After viewing the pro- strongly, sometimes timidly, but almost After the Program grams students often responded with always with the acknowledgement that Ask students to respond to the follow- What happened to the rest of it? When is the they were concerned about the issues ing questions: What were the conflicts rest of it going to be on TV? I want to see what and appreciated the opportunity to talk in Alice's life? Did any of these con- happens. about them. flicts have an effect on Alice's physical Yetit was this frustration which On the basis of student as well as and emotional health? If so, how? seemed to be a viable starting point for teacher reactions many changes were Have each person write an ending to the exploration of ideas and opinions made in the treatment and scripts. Revi- the program's story line. (What hap- relative to growth and development. sions included: character and plot altera- pened when Gail and Alice con- And that is what this series is all tions to make the characters and situa- fronted each other?) Discuss the dif- aboutproviding a catalyst for the ex- tions more realistic and relevant to ferent endings. ploration of life issues relevant to high teenagers; and dialogue changes to en- Complete the reproducible activity school students. hance the program's message and make "How Do You Handle Conflict?" lo- the programs more comprehensible. cated in the back of the guidebook (this is an instrument useful in deter- . _ . Vehicle for Affective Education mining ways people handle conflict). 'Agency for InstructionalTelevision. Edu- Invite students to discuss the follow- cation for personal and social growth of secondary Through experience A1T has found ing question: How do you feel about school st udoits.Bloomington, Indiana: Agency that video programming, when properly facing conflict? for Instructional Television, 1978. shaped, can be useful in enhancing the The most critical element in the suc- 'Agency for Instructional Television.Re- affective curriculum in schoc Isettings. cessful use ofOn The Levelis the teacher. search Report 70Secondary health project: con- Such series asRipplesandInsidelOutfor That is, what the teacher does and does cepts review.Bloomington, Indiana: Agency the elementary school level andSelf In- not do as he or sheinteractswith teen- for Instructional Television, 1980. rorporatedfor the junior high level repre- 31Dalis, Gus T. and Strasser, Ben. B.Teach- agers will determine the degree of suc- ing strategies for values awareness and decision sent efforts to assist teachers in dealing cess or failure in using the series. In addi- making in heahh education.Thorofare, New Jer- with affective issues in the area of per- tion to utilizing relevant questions and sey: Charles B. Slack, Inc., 1977. sonal growth and development. With activities, the teacher needs to create a the completion of theOn The Levelseries classroom environment that ,:llows free, Anyone wishing further information about MT has achieved a K-12 affective educa- open and responsible discussion. Such a local availability of "On the Level" 'nay con- tion program in the area of health educa- psychologicallyfreeenvironment tact: AIT, Box A, Bloomington, Indiana tion. should allow diversity without the fear 47402, (812) 339-2203. 128 141 71 TEACHING IDEAS

Mental Health

Perceptions of Me possessing a positive self-concept students to explore other childrens' might be exiwcted to walk tall (up- perceptionsofthemselves. It is right) whilc one with anegative hoped that surprises about certain might walk slumped r . self-concept responseswillhelpchildrenbe over to physically indicate "lowli- more accepting of others and better ,---, ,...4 ness-; or one with a positive sense understand themselves.If the class ------.??-- 4mr, of sexual self-esteem might be out- trusts the teacher sufficiently, the going and pleasant, whereas one readingofthe responses by the with a negative feeling about one- teacher might also aid the teacher self sexually might behave in a shy, to better plan instruction which per- withdrawn manner. tains to the needs of the students, Based upon the importance of \ perceptions of oneself, and, in addi- Discussion Questions tion, how others perceive one (since Using questionsto stimulate 7 theywillbehave towardothers group discussionsisnot arecent based upontheirperceptionsof educational innovation,butthe, & lik them)activities should be devel- types of questions suggestedfor oped and «mducted with students use here differ from thoseemployed to help them to: elsewhere. 1. More realistically perceive 1.What is the one thing that *irV4aAts themselves and others. scares you the most? 2.Explore the relationshipbe- 2. When are you most hurt? 0%.. il tween their perceptions and 3. What is the very first thing how they act. that you remember? is thing Make whateveradjustments 4 What the saddest IERRO1 S. GRUN131 RG Ls coordi- they deem necessary to be- that has e er happened to natorof health education, State Uni- come what they want to be. you? 5.What is the hest thing that vers;tyofNew Yorkat Buffalo, Buf- Presentedinthis articleare falo, New York 14214. lie selves as examples of such learning ac- has eer happened to you? contributing editor forthisSHR tivities. 6.What do you dislike most paittnent, which 1,, designed to be of ahout school? particular tiwfulnesto the class- Sentence Completions 7 What don't you like about room tea( her at all levels. Unfinished sentences whichre- yourself? quire the student to react by com- 8. What do you like most about pleting them, allow for self-inquiry yourself? of a kind to which people are not 9.What would you rather have: wealth, intelligence, or physi- Though realizing the degree of a« ustigned. I xamples of such questions indicate the breadth of possi- cal attractiveness? immodesty of which 1 c an be ac- bilities and range of topics which 10. Who is the most intluential cused, let me risk stating thatthe can he explored With 1111,.. person in your life? most interesting topic to rue is me. 11. What do you wish? Further, the most interesting topic tional strategy. 1. I often 12. How can you he happy? to you is probably you. 1hat's noth- 13. What do you love to do the ing startling. We all are interested 2.I seldom most? in ourselves. Realizing this phenom- 3. liii bored when 14. What was the strongest feel- enon, educators re«mumend -4. I love to that ing you had last week (anger, !earnings m school be related to the )ther children , 6. I will joy, grief, etc.. and what liteexperiences of the learner.It then seems to follow that with the must caused that feeling? 15. What is something you can learner himself the topi«)t study, 8. I am very

1 tell us now that you wouldn't the efficiency and effectiveness ot 9.I wish could the learning process would he maxi- 10. My friends are hae felt comfortable telling, mized. 1 I. My parents . us before? lhe question of the applopliate- 12.I wish Each group should he reminded ness of oneself as a topictor study 13. I feel that there are no right or wrong an- within a school setting, however. re- 14. I'm happy when swers to such questions md, there- mains. Since one behaves on how 15. My body fore, they should expect each per- one perc elves ieality lather than up- Whereas the completion of these sontoresponddifferently.The on reality itself, one's perceptions of sentences requires the student to group members' role should be to oneself will determine many health think ahcnit himself, processing the askquestions oftherespondent related behaviors. F or example, one responsesinsmallgroups allows \Om h will help the group to better

129 142 understand the response, rather than 19) Whowillalwaysbe 5. When do you hurt people? to attempt to get the group to agree physicallyattractive? 4. What turns you on the most? on what would be the "hest" an- 201 A'ho would make the 5. Do youhaveanyhealth swer. As a result of this exercise, it best friend? problems? What are they? is anticipated that each student will 6.What are your leastattrac- have a more accurate picture of tive features? both himself and his classmates than 7.Do you believe in God? Or- prior to the exercise. ganired religion? To the left of each number, stu- Question Sociogram 8.Areyourpa rents happily dentsdre to requoed placethe married? Why? Why not? An activity which can be used to name of one student in their group aid students to see themseh es as (3. low do you feel when you or class. Only one name can be love? others see them is the Question So- written on the blank line and each 10. What makes you swear? ciogram. Unlike a regular sociogram blank line mmt have a name on it. 11. What do \Mt which asks children to lkt a num- After the responses have been made think about ber of people they would liketo homosexuals? 0,1(11( hild( an ask eac h other c hild attend a movie with, etc., the Ques- 12. Do you like yourself? Why? %VIII( iicle riptionshe mostfits, Why not? tionSor iogramaskschildrento thereby a«pnring others' percep- place the name of the person in 13,what wa,, your greatest tionsothimself. To better know the class most lrkek to failure? Greatest suc c ess? fit the de- oneself isthe first step in improv- scriptionimplicitinth('question. ing oneself. Examples of questions whic h can be used will help to clarify this technique:

1) Who most likely is afraid of mu e? 2) Who most likely cannot resist eating a donut' \ fs Who wakes up often r with nightmar('s? i 4) Who loves cowboy movies? i 5) Who loyes romanti( / movies? 6) Who most wank a lot y of money' t

7) Who wat( hes ,1 lotof television? tA 8) Who most likely will be a scientist? b Aa 9) Who will he apoliti- OAKS cian? OP%.0 11 101 Who will make the best mother or father?

1 Ii Whowillnever get married? 1)) Whowillnever 11,.(' 14. \Nho would citibeif you drugs? Intimacy Questions «iuld be anyone elsethat 11) Who ismost likelyto you wanted? cheat on an exam? On«, trust has been developed in '14) Who will Ix, the most a class or group of children, questions of a more intimate nature can thoughtful lover? these questions deselop greater 1S) Who will he a talking be explored. Best discussed inpairs bemeen two pople ssho toprovide a closerelationship, liberal who won't do ore honest and trusting to begin anything? some of the following questions can be employed hy a teacher will- withmd likewisecaiide elop 1(') Who willinsiston a greater distance between two peo- small wedding' ing to take risks to provide meaningful educational experiences: ple who feel threatened by such -17) Who would be the best openness. Itis important, therefore, teacher? I.What doyou feel most to employ this activity only with a 18) Who is apt to do anon- ashamed of in your past? groupthathas matured and can ymous favcusfor peo- 2.What have you deliberately take advantage ot such an opportu- ple? lied about? Why? nity to mature further.

130 .13 72 TEACHING IDEAS

Mental Health

Background information: In many 3. Phone calls to students' homes may Enhancing Positive classes students never have an oppor- uncover information special to students Self-Concept tunity to get acquainted with their while promoting health education to classmates. All of us share a need for the parents. Through Creativity in meaningful interpersonal relationships. 4. When data is collected and written However, many times creating a class- up, duplicate and distribute to all stu- the Classroom room environment conducive to posi- dents in the class. tive interaction is awkward and dif- 5. Pic:ures may accompany written Bathara Beier is on the academic staff in tlw ficult for teachers. This activity could be information for a pemonal touch. health ediwation department at thy Univer- a good starting point for teachers who 6. Designate one shiclent per week to sihi of Wisconsin, La Crosse, 54601. seek to facilitate growth in students' po- be recognized as "Who's Who Student tential for interpersonal relationships. of the Week." I am convinced that one of the major Objective: The student will have the 7. Present bulletin board materials to challenges to teachers and other group opportunity to recognize meaningful honored student at end of the week. leadersisthe creation of aself- information about themselves which Activity #3: Who Am I? enhancing learning environment. Some can be shared with classmates. special people seem to do this quite Procedure: Grade level: 3rd grade naturally out of their own authentic 1. Distribute paper bags, one to each Materials needed: 3x5 notecards, pen- being and their commitment to others. student. cils. Most of however, benefit from sug- 2. Instruct students to select from the gestions or training in allowing our cre- fabric, pictures, and decorations. Background information: Every person ative potentials to enhance a positive, 3. Illustrate on the outside of the bag needs recognition. Itis expressed co- humanistic environment in the class- how they think other people see them. gently by the lad who says, "Mother, room. 4. On the inside of the bag, have stu- let's play darts. I'll throw the darts and A workshop, "Creative Teaching dents illustratehow they see you say 'Wonderful.'"3 Methods in Health," offered by the themselveshowthey really are. To enhance student selfconcept using University of WisconsinLa Crosse Di- 5. Upon completion, the bags may be students' own thoughts and ideas. To vision of University Outreach, allowed shared with the entire class, with a give the student recognition from the creative process to surface in me. As small group or with a partner. teacher and classmates. a young health director I was quite concerned with dispensing cognitive mate- Follow-up questions: Procedure: rial to my students, but I have begun to 1. How did you feel when sharing 1. Have students write out biograph- understand that young people need your creation? ical information. Include such things as more than subject matter. Ilike to 2. What are some of the ways you are talents, family happenings, hobbies, think, now, that I teach the students, different from the way others see you? favorite places, activities, etc. not just the subject. 3. How accurately do you think you 2. Collect the cards. Creative methods for teaching health preceive yourself? 3. On occasion, read the cards at the education can be written, published in 4. Do you feel good about the way beginning or end of class. books, and distributed nationwide, but others perceive you, about the way you 4. Include a teacher description also. these ideas are only tools. Their use de- perceive yourself? As health educators, promoting posi- pends on you. Your use of ideas to fos- Activity #2: tVho's Who of the Week tive selfconcept in the classroom can be ter positive selfconcept will depend Grade level: 5th grade challenging but quite rewarding. By upon your own selfesteem. As John Materials needed: background informa- creatively letting loost, involving the Vasconcellos states, students, giving students' recognition, "Only if you are truly into your own being, tion on students in class, construction paper, paste. and by allowing the student tofeelin possess and value yourself, feel comfortable the classroom setting, a teacher can cre- with and good about yourself, believe in and Background information: An emerging atively enhance positive selfconcepts. live your right to be yourself-will youtruly task in education today is to define self- As a kindergarten student putit, enhance selfesteem in those young human esteem and to discover the process by "When you ask me how I feel, I'm the beings whose selfesteem, whose lives, are which it is nurtured. The ultimate in only one who can tell you! And I like touched by you."' selfesteern is found in the full posses- that!"4 Research literature is filled with re- sion of one's total being - the intellect ports indicating that cognitive learning and the emotions and (especially) the 'Vasconcellos, J., Chairman of the Joint increases when selfconcept increases.' bodyin other words, in the self. Legislative Committee on Educational Goals Following is a series of creative teach- and Evaluation, Member of the California ing methods compiled to foster a posi- Objective: To enhance student selfcon- Legislature. tive selfconcept in students of health cept using personal data and positive 2Purkey, W. W.Self-concept and school education. reinforcement of accomplishments. achievement.Englewood Cliffs, New Jersey: Prentice-Hall, Inc., 1970. Activity#1: Sharing Bags Procedu res: L Compile a "Who's Who Bulletin 'Baughman, M. D.Educator's handbook of Grade level: 10th grade stories, quotes, andhumor. Board." 4Canfield, J., & Wells, H. C.100 ways to Materials needed: any size paper bag 2.Data can be gathered about enhance self-concept in the classroom.En- for each student, pictures, fabric, de- achievements, hobbies, pets, future glewood Cliffs, New Jersey: Prentice-Hall, corative findings, scissors, paste goals, family members, etc. Inc., 1976, p. 207.

131 141 73 TEACHING IDEAS

Menial Health Ideas froma

Class in Inter- 1' personal Relations

, 4

CAROLL KAISER teacheshealth education atMinnetonkaSenior High School, Excelsior, Minnesota. Her interpersonal relations c/asses, composed of sophomores, juniors, and seniors, are the most popular of the ten healthclasses offered for credit.

Interpersonal relations stresses the importance of self-image and self- acceptance in the development of personality. Without a secure self- image and a healthy self-acceptance, kr' a person cannot risk the emotional investment necessarytorelateto another individual. With a secure are to consider themselves as robots. self-image and healthy self-accept- Another device Iuse for teaching Before they are allowed to enter self-awareness and self-acceptance ance, a person can risk the neces- human society, they must take a test sary emotional investment, and he iswhat I callthe -Protoplasmic to determine whether the 'three Blobs." These are o series of draw- gradually acquires arepertoire of lows" which are built into their ro- successfulbehavior.Buildingthis ingsorblobsfaintlyresemNing bot being are functioning properly. humans, which elicit student inter- repertoire of successful behavior is The laws are a functional part of the a process of becoming and indi- pretations of what the blobs are circuitry and I further emphasize feeling. Since itis relatively easy to viduation. Thus, a cyclical evolve- that all circuits ore logical and can- ment takes place: self-image and cataloggesturesthatpeople use not be altered in ,my way without to intensify statements, I feltthat self-acceptance determine the qual- serious damage. and that as robots ity of interpersonalbehavior;the I could use protoplasmk blobs to they cannot violate the three laws illustratethe subtlety of gestures, quality of the interpersonal behavior either through action or through determines the growth of person- the idea being thatif a student inoction. The laws are rigid, almost could perceive the-gestures in thk ality;thegrowthofpersonality mec hanical: experiment, Ile might more reodily determines self-image and self-ac- robot ma\ not infurc d human or perceive them in hk everyday liv- ceptance. through inqu him ollow humon ing. Interpreting these characters is Some of the techniques I use in come to horm. similarina senseto the process the interpersonalrelationsclasses .1 robot nitp.tobt.% people go through to interpret the attempt to improve self-image and d hl111101) (.1(CW %%hew h Rorschach Ink Blot Test. This par- self-acceptance in order to develop order might conflict Mth law. ticular exercise k weci in conjunc- a repertoire of successful interper- tion with a unit on body language. sonal behavior. One device k what 3 A robot impi Prole( tik own( \ I The exercise con.kts of 26 blob I call "Laws of the Robot." In this ence lf,ng a urh prow( hon (1,1- not( (mill( 1with the IasiU ,ccirnd illustrations on d paper. At the bot- experiment I tryto show students IdW tomofthepagearelisted26 that the human condition is coped comments. The students match each with,understandablyand even Before the exercise isover the comment with the blob character it justifiably, on anonrational, even students become bogged down and best expresses. For example. a stu- emotional,basis, and thatthisis almost disfunctiondl in solving the dent may interpret two characters not bad. In the Laws of the Robot, hypothetical situations. Totheir as "quarreling,"and he would I pose hypothetical situations which great frustration, logic is not enough supply a comment moq appropriate students must try to solve using a for a solution because nonlogical for that depiction which might be, purely computerized type of logic. ramifications of the problem must "please forgive me just one more My direction to students is that they be taken into account. time." Students can work individu- 132 BEST COPY AMIABLE 145 ally or ina group where students mental forceisa most cogent ex- aware for the firsi time of the inten- compare their different interpreta- perience. The strength of this project sity and the miracle of human com- tions. Incidentally, this exercise can liesin the fact that the completed munication, One is forced to look lead to some interesting and effec- assignment ranges from the most at and study the person who is do- tive role playing. simple illustration to the most coming the communicating. One sees plex and intricate ones, involving, all the nuances and connotations of The ''Fnvironmental Box" idea is insome cases. mirrors,electric what issaid and felt. One of the used toward the end of the unit on lights, and small models to create high spots in this unit is a lecture self-awareness as a final projec t.It illusory effects. given insign language by a deaf is especially effective and reward- lecturer.Theintensityandcon- ing for those students who are not Since communication is an inte- centration observedatthispoint adeptverbally. The studentsare gral part of interpersonal relations, isworth a whole year of teach- asked to portray or depict in visible Ihave used as an additional tech- ing. I might add that teach- form a conceptorfeelingthey nique a short unit on the sign lan- ing this skill is not difficult or time- possess. They are to -remove" this guage of the deaf. Often,inthe consuming, and the hand alphabet feeling from environmental compe- verbal language we use in every- can be learned in 15 or 20 minutes. tition hy "placing" it in a shoe box, day conversation, parallel conversa- Since there are hand gestures that fix the cover on the box-md then tions are conducted in w hich one make up entire words rather than cut a hole in one end for the ob- person is not really listening to the spelling out each letter in the word, server. Peering into the box and ob- other. Ultimately, after much paral- I also introduce five or ten hand serving these visual manifestations lelconversation,theartofreal gestures every day until each stu- of a student's inner life in complete listeningislost. Teaching students dent develops quite an extensive isolation from an outside environ- basicsignlanguage makes them vocabulary

1 4 f; 133 74 TEACHING IDEAS

Mental Health Role Playingas aTool in Mental Health Education

Lynn Teper is assistant professor of health educa- individual which resultindifferentresponses. tion at Long Island University, Brooklyn Center, This understanding can be gained by having sev- Brooklyn, New York. She was formerlyan in- eral students view and report on a given situation. structor at Kingsborough Community Co /lege in The result will usually yield a variety of opinions Brooklyn. as to what took place, as when witnesses are asked to report on an accident or crime. This will Teachers of health education must transmit to reveal to some degree the lack of reliability be- students the concept that physical and mental tween observers due to a predisposition to select health are interrelated. Each is an aspect of the different aspects of the situation for notation. In total indivki ial; each is dependenton the other addition, it will help students to see that their way for optimalfunctioning.Formerly the mental of seeing and interpreting situationsis not the component ofhealth was overshadowed by only way. health educators !n their attempt to educate the student about bodily functions, but gradually, mental health has gained importance and isnow a significant aspect of many health education cur- Step 2The Warm Up riculums. Through units in mental health, itis This step involves setting up the situation for hoped that students will learn to meet withsome the sociodrama to take place. Topics for enact- adequacy their personal, interpersonal, and social ment can include conflict with the family, peer conflicts and thus will function more completely group relationships, attitudes involved with topics as young adults. included in sex education or the use of narcotics. One of the toolsavailaL forpromoting The instructor states the situation somewhat ab- healthy behavioral patterns is known as "socio- stractly. Roles are described and volunteers are drama." Sociodrama is a spontaneous, impromptu selected or chosen. For example: A girl is troubled expression dramatizing intergroup relations and by the fact that she is given little freedom from collective ideologies. The students who playa her parents. At this point someone is chosen for role in a sociodrama do not recite froma script. the role of the girl, another for the role of the A situation is presented to the class and without mother; father and possibly a sister or brother can prior preparation students are chosen or volun- enter the scene. teer to act out the particular situation. Man is a role player, in a sense, every day of his Step 3The Enactment life. An adolescent girl, for example,can be a At this point, without any additional prepara- daughter, a friend, a student, a member ofa club, tion the role players act out what they believe etc. Each individual is characterized by a certain would happen when the family was together. range of roles which dominates his or her behavior. The role player in a sociodrama is aware that he is acting out a role, even though he may be Step 4Helping the audience observe intelligently unaware that the role, as he enactsit,reveals many of the conflictsthat confront him and Much of the value of sociodrama depends on others. the discussion with the class following the spon- The process of sociodrama unfolds as follows: taneous dramatization. Some of the questions could be: Step 1Sensitizing the group 1. Do you feel that the enactment was realistic? it is important for the participants to recognize 2. As future parents, what do you believe the that people perceive and interpret situations and role of the parent should be? stimuli differently. As a result of their particular 3. How do you think parents and their children interpretation, attitudes are developed by each can come to better understand one another? 134 147 In other situations as well as this one the prime concern one way to implement this approach since it allows should be to discuss causes of behavior and appropri- students to explore some appropriate ways of dealing ate ways of behaving and to encourage self-appraisal. with others as well as with themselves. It is a process whereby one can look at familiar conflicts seen through the eyes of others. Subsequently, recognition Step 5Replaying the situation that one is not alone in some of his confrontations may result in lessening anxiety. A three way process is it is helpful for students to see how the situation estab!ished. looks from different angles by switching roles. The daughter may become the parent or volunteers may 1. The teacher relates with the students through in- replace those who have already participated. This will terest and involvement. bring additional insights into the situation. 2. The students relate with one another by participating, observing, and commenting on the sociodrama. Step 6The Evaluation 3. The students relate to the teacher by referring to In the evaluation it is important to emphasize that tht teacher for guidance and structure. with positive flexible attitudes individual growth takes place. Students need to discover for themselves that Moralizing by the teacher is curbed and condemna- anxiety, fears, and immobility are not inherent in an tion and judgment by an adult figure are eliminated. object, event, or person, but are within themselves. Involvement is a key to understanding for students. The individual needs a positive attitude toward Whether the student is a role player or part of the change. To say "I'll try" means motivation for growth discussion group that evaluates the sociodrama, in- is present. volvement is a significant outcome. Conflicts often will If real learning is to take place, problems studied in be left unresolved, but hopefully the students will have school should deal with crucial situations in the lives witnessed or have been a part of acting out and discus- of the student no matter what the subject area may be. sing a variety of ways for promoting healthy interac- The use of sociodrama in health education classes is tions involving the individual in his environment.

14S 135 75 TEACHING IDEAS AMI1 Mental Health

THE MIRROR GAME' Follow up (I",-20 minutes of another class or home assignment)

I With Your class go over the list ROSA SULLIVAN is a health educa- 4.They then compare what they and mark each word as either tion teac her at Herbert Hoover Jun- marked about themselves and positise or negative (example: ior High,La( kawanna, New York each other. This should reveal if sou marked always or some- 14218. a number of differences between timesforsensitivethenit is their self-impressions and how p)sitive;if you marked seldom they are perceived by others. or never for sensitive then itis This may take as long as 15-20 negative). minutes. 2 A sheet «mtaining the follow- Itis so extremely important for 5.During thelast S minutesin ing questions Is then passed out individualstoheableto look (lass and continued ,P a home and the teacher requests the stu- back on themselves in order to be assignment, students should dent to he as truthful as pos- evaluative of their personality traits. write on the back of their pa- sihle in responding sin«, no one Many times people cannot detect pers three things they learned will see their answers without their negative faults or, in contrast, about themselves that they did their expressed permission. tend only to find negative traits. A not know before. They should What image did you project to mentally healthy individual should also explain what thesethree your partner? be able to search on both sides and things mean to them. progresstoworkingout"bad" Whal ,ire ,,onle of the traits you traits. The following activity is one feel you possess but others do way to work toward this. not feel you possess? Why do your perceptions differ Objectives from others' perceptions? 1. To have a better understanthng of who you are as you ,-ee your- Do you have a strong self-image? (Do you like yourself or if you self. weren'tyou, would youlike 2. To have a better underwnding of how others see you. you?) 3. To rewgniie andunderstand you have more negative or that others always do not see positive traits? Why? you as you See yourself. Iveryone has traits they do not 4.To appreciate the fact that You Thmk about Iwo of your have negative points and evalu- negative ones and explain how ate how to change them if you vemcan goabout hanging wkh them. 5.To evaluate how others see you and decide if thatis your true I Adapted from Go lo Health (New image. York: Dell l'ubliOling Cu.,nc., 1972), p. (18. The Game Duplicate alist of 20-30 pep,on- ality traits suitable to the students' age group. (The grou) I used the game with was 14 years of age and TRAITS PAR1N[R enrolledatajunior high school.)

Set them up in columns with morn ii; for graduatedratings ofself and E E z VI partner. (See example.) Cs C, >- ,.. -.:. Procedure cE 31 I. !lave each student pie k 1 partner 1 Stm,atni. with whom they are familiar. 2 Arrogant 2. After passing out the hst, stress that they are not to taik while .1.Silly they are evaluating themselves 4 I rusting -f or their partner. 5. 1vmier 3. The groups have 10-15 minutes to make their judgments. 1s,, ()Jared

136 76 TEACHNG IDEAS

Mental Health

Step 2: Learning to Cope 2. Which of the following behavioral re- Now to Cope with Stress Constructively sponses did you use to cope with the stress? I'lace an x next to how you responded. with Stress in Students are given a stress sheet to Fight Freeze Flight relate classroom theory to actual con- Compromise the Classroom frontations with stressful situations. The Briefly describe the consequences of students are asked to take the following your response:itdid did stress sheet home and fillit out after not alleviate the stressful situa- CHARLESC.DAVIS is coordinator for undergoing stress. tion. health /physical education instructional pro- 3. Check any defense mechanisms that grams, State University College at Oswego, Stress Sheet you used to deviate from the stressor. Oswego, New York 13126. This sheet is designed to stimulate in- avoidance regression terest in and an understanding of how deny reality you react to and cope with stress. It is fixa tion Learning alternativefor handling also hoped that completion of this sheet repression sublimation stressful situations and then giving stu- will cause you to do some reflective projection dents an experience in handling stress thinking on how to handle the "wear other (specify) and developing coping ability some- and terr of life" or stress. rationalization thing often left out of the classroom. As 1. Identify: A stressful situation; the 4. Draw a line to indicate how you ex- educators we often find it difficult to stressor(s), internal and/or external pended energy as you pi ogressed place students in situations where they primary stimulus causing the stress. through the Adaptation Syndrome. can learn practically how to handle various stressors. Much of what we say is abstract or theoretical until the student is forced to confront stress. The following Alarm Reaction I Stage of Resistance stress sheet is designed as a practical way Prestress EnergyOutput State of Exhaustion for students to identify stress and then analyze how they cope with various stressful situations. A deeper discussion of stress and the learning of alternative Time situations to various life problems can be better understood. The stress sheet is adaptable for many age groups and grade levels. Mit IR..

Step 1: Content The students are tatiOt the intricate details of life and stress in their class. The following aspects are reviewed. 1. The stress conceptwhat is stress? discussion of Hans Selye's theory of stress. 2. Stress as it affects our livesstress is not inherently good or evil, it is dependent on the consequences of our reactions to stressors. 3. Coping with stressGeneral Adap- tation Syndrome (GAS), the physiological response to stress; flight/flee response or coping behavior (general alternatives). 4. Learning ways to cope with stress-- protecting the ego ideal under stressful situations; defense mechanisms; Maslow's hierarchy of human needs. ThLy t 5. Adapting to stress--suggestions for learning to cope with stress in a constructive mannPr; positive and negative consequences of deviations. 137 151i ZEST COPY AMMILE 5. Sources of help. Did talking with 2. Understand the meaning of the terms period, then analyze how they cope anyone help you cope with or adapt stress, stressors, stressful situations. with and adapt to stress. to the stressor? 3. Analyze the individual use of defense no yes mechanisms in stressful situations 2. Break students into small discussion specify whom used to minimize conscious anxiety. groups, give each group the job of 6. What deviations did you use to 4. Understand that humans are affected depicting: what is stress? or what is equalize the effect of the stress on the by and respond to stressors as total mental health? or what is the relation- body? (for example sports, reading, organisms. ship between stress and mental etc., please specify). Briefly describe 5. Understand the general categories of health? how your deviations relieved the behavioral responses to stress: flight, Give each group about 20 minutes to stress. fight or compromise. come up with their pictorial descrip- 7. Did any psychologically induced pain 6. Understand the consequences of tions. No words can be used in any of the cause a physical reaction? conversion reactions such as psycho- three assignments. When the allotted no _____ yes logically induced pain manifesting time has ended, the instructor holds up specify e g ,prolonged ten- physical reactions when stressors are the finished product from one group and sion leads to upset stomach. not successfully adapted to or de- the class responds to what they see de- viated from. picted. The same is done for the other Step 3: Behavioral Outcomes 7. Investigate how individual coping groups. The instructor phrases the ques- behaviors (sports, dancing, etc.) suc- tions in a way which will extract the rela- After taking home a predetermined cessfully allow an individual to al- tionship between stress and mental number of stress sheets the students leviate stressors. health. should have some stress-relieving skills, The outcome of the stress sheets exer- such as the following. cise encompasses the interrelationship of the theory of stre.-,s and how it relates Step 4: Classroom Adaptability to mental health by personalizing stress 1. Analyze some of the stressors com- through the stress sheets and visually mon to the experiences of students, 1. Students can be asked to do several depicting the wide interpretations of such as competition or failure. stress sheets over an extended what stress is.

138 1 5 1 TEACHING IDEAS

Mentri Health required health course (or any other ap- Am I Worthwhile Task propriate segment, e.g., urban problems, crime, values and goals) to include dis- Have eac h student talk about self for two minutes saying only good things. cussion topics and activ.ties such as the Do this activity in groups. Have the following. group members help the individual speaking whenever necessary. The Topics purpose of this activity is to help each 1. Prejudic e--its (auses and relationship student see that he or she is worth- to violence while. 2. Respect for the views of others 6. Values Auction from Auction Caine by 3. Respect for the property of others Ric hard Cohen in hii graduate murse, 4. Peer pressure; gang involvement "Health Education in the Se«-mdary 5. Values formation(c larifi ation); Sc hook," at Brooklyn College. priorities Give eac h student an imaginary $1,- 6. Constructive methods of problem solv- 000 to bid with, give them a values ing and dealing with stress list, and hold an auction. If several 7. Setting realistic goals for the I uture students are willing to hid the entire 8. The impact of violence on out so( iety 51,000, have each give his or her rea- Fear of involvement son for wanting the item and then Fear of going out alone allow the class to vote. After the auc- Tendency to overreact tion evaluate student priorities. Crimes committed in wIt-deten se People arming themselves Items To Be Auctioned Ac ceptance of violent deaths as 1. Invitations to all the most exciting parties statistics iany plac e with anyone in the whole world) 9. Need for feelings of self-esteem every single night. Being recognized by others as 2. To possess perfect health and a sirig. flex. ible, beautiful, graceful body. worthwhile 3. A lifetime without "hassling." No one w ill tell 10. Constructively compensating tor you what to uo or how or when to do it. weaknesses 4. A dady "storm" of new ideas: original 11. Handling emotions-learning to poems, songs, books, movies running through think before acting your head; visions of paintings to paint, pots to mold. buildings to design and build. 12. Working towards a healthier society 5. To be the richest person in the world. How? 6. The opportunity to direct the workings of the Role of the individual whole world .. to control individuals, busi- Coping 13. Value of life-own and otheis nesses, monies, whole nations. Everyone is important to someone 7. No "hang-ups" whatsoever; to possess With self-knowledge. Activities 8. A chance to spend a year with the greatest 1. Role playing religious figure of your faith-past, present. fu- Violence Mock court case ture. Student caught cheating 9. To live forever without growing old. Racial or ethnic role reversals 10. The opportunity to stick up for and protect the person or thing to which you feel the 2. Values activity greatest allegiance (like sticking with a friend Have students rate the following as through a crisis or fighting for your country, acceptable or unacceptable for etc.). themselves. Discuss reasons for each 11. To have the perfect romance/or the perfec t student's choice. love relationship (s) with the person (s) of your a. breaking laws they don't believe in choice. b. law enforcement agencies 12. To have a computer-bank of facts and in- c. smoking marijuana formation in your head; to be able to answer ELAINE HALS teaches at the South Shore any questions and solve any problems which d. our government present themselves to you. High School in Brooklyn, New York 11236, e. cheating 13. To have the strength always to do what you f. demonstrations against the estab- believe to be right. To be a person of integrity. What can we as health educators do to lishment 14. To have the skills, know-how, and tone to reverse or at least slow down the chain of g. compare students' values with really help others and serve humanity. violence with which our students live? those of their parents 15. To have a real sense of what is fair and just; Our objectives should be: (1) to have stu- h. capital punishment to deal with others as honestly and fairly as dents consider all life as positive, (2) to i. plea bargaining possible. 16. To be at pea«, with yourself and know the guide students in establishing construc- 3. Search for Values (PfaunvStandard, purpose of life. tive goals for the future, (3) to help stu- (in( innati, Ohio 1974). Read sec tion on 17. To become a professional athlete of your dents explore their values and priorities, Time, Lesson 3: "Examining Personal c hoice. (4) to help students explore the impact of Goals" Health educator% will not be able to violence on our society-ind (5) to assist 4. Simoo, Sidney 13., Howe, L. W., Kir- eliminate violence, but we can en«)urage students in finding nonviolent methods henbaum, Howard, Values Clarifua our students to examine theauses arid of handling potentially explosive situa- Hon: A Handbook of Practical Strategies end results of violence. We can show tions. tor leachers and Students (Hart Pub. Co., them more constructive outlets for their These are difficult objectives to reach. New York, 1974). Play the Bomb Shelter anger arid their frustrations-is well as How do we achieve tnem? One way is to Game (prejudice) and the I ransplant how to set and reac h positive goals for the plan for the mental health segment of the Game. future.

152 139 78 TEACHING IDEAS alma Mental Health

Personality Spokes 2. Recognize faults in their per- the top and one at the bot- sonalities. tom of a piece of paper (see 3.Delve into themselves and be example). Next he is to draw ROSA SULLIVAN is a health educa- abletoestablishshort and spokes as if these circles were tion teacher at Herbert Hoover Jun- long-term goals. wheels. One topcirclehas ior High School, Lackawanna, New 4.Evaluate what faults and as- 10 spokes and is labeled per- York 14218. sets will help them to achieve sonality assets. The other top or fail to reach their goals. circlehas5spokes andis labeledfaults.Thebottom 5. Communicate with others Man has qualities about himself wheel has 5 spokes andis whattheyfindoutabout that are of great value to him in labeled ambitions. reference to future ambitions. He themselves. Procedure 3.Each student istofillin the also has faults and because of these spokes accordingly, examine he sometimes isincapable of ac- 1.Have each student pick a part- whatthey wrote andthen complishing goals. Itis a necessary ner. draw lines from the assets to objective of 'ife to be able to recog- 2. Each student is to draw three the ambitions these assets will nize both faults and positive attri- half dollar size circles: two at help satisfy. Then the student butes which can hinder or enhance ASSE T S f AUL 1 man in his quest of the future. is to draw lines from the faults to the ambitionsthat these At what age should a person be- faults will prevent from satis- gin to examine his own personality fying. to establishprioritiesinlife and plans to achieve in these areas? The 4.The students should then ex- answer isitis never too soon to changeandexamine each initiate at home or in the classroom, other's papers. .-.ctivitiesto stimulatethinkingin Each student next explains to these areas.Personality Spokesis p;--tner why these assets and one activity to achieve this end. fau ,s will help or hinder his Objedives ambitions. They also should talkabouthowimportant For swdents these ambitions are to them, Recognize assets in their per- and why they are so impor- sonalities. tant.

1 r: 140 A ILI I) BEST COPY AVAILABLE 79 TEACHING IDEAS

Mental Health with the class as a whole. It can help to stomach, genetalia, thighs, legs, feet, About Yourself create an atmosphere for fostering open toes. communication and self-knowledge lead- You are now surrounded in a warm ing to better mental health. bath of colors and feel good. I will count These instructions should be related to backward from 10 to 1. While I am count- the class by the instructor: ing, start opening your eyes. At the count We are now going to do some get ac- of 1 you will be wide awake and feel good. quainted exercises. We first will do a re- I now want you to turn to the person laxation exercise to tune in to ourselves. next to you and discuss what you experi- Then we will do several exercises to get to enced. know others in the class. This may be a new experience for some of you, how- Getting Acquainted' ever, most people find it fun. If for some reason you find you do not wish to con- 1. Go up to someone you do not know tinue, you can stop at any time. However, but think you might have something in I'm surf you will find it enjoyable. common with and would like to know better. One person talks for two minutes Relaxation (10 minutes) while the other just listens. Then reverse the role. Now, the two of you find 1.First put your head on your desk and another pair you do not know. Introduce get comfortable in your chair or lie down your partner to the other pair. on the floor and get comfortable. 2. Go up to someone you think you 2. Close your eyes, relax, and become have nothing in common with. Sit back to aware of the sounds in the room. back and talk. loin another pair and dis- 3. Next, I want you to pay attention to cuss things you learned about communi- your breathing. Feel the air go in and out. cation by sitting back to back. 4. Now I want you to take a deep 3. Go up to another person you do not breath, feel the air going in your lips, know. Look each other in the eyes. Do down into your lungs; feel air go out. not talk. Follow each other's hands (Repeat this two times.) around as if you were looking in a mirror. a 5. You should feel relaxed; in fact, it is Join another pair and discuss what you probably the first time you have relaxed learned about yourself and the other per- today. son by doing this. 6. Now become aware of your feet, feel them against the floor, in your shoes. Debriefing Now tighten your feet as long as you can. Now relax. 1. Get back into a big circle. What did 7. Become aware of your calf, (con. you experience with the fantasy trip? tinue with thighs, whole leg, shoulder 2. How does it feel to go up to a and buttocks, chest, fist, neck, face, stranger and talk ? whole body). 3. How much did you find you had in RUTH C. ENGS is assistant professor, Be- 8. You will feel relaxed; become aware common with the person you thought partment of Health and Safety Education, of parts of your body, touching the chair you had nothing in common with ? Indiana University, Bloomington, Indiana (floor). 4. What problems did you have in 47401. 9. Now relax. And take a deep breath. communicating back to back ? 5. What did you learn about nonverbal Body Trip2.The Magic Golden communication or about your own com- Ball (10 minutes) munication skills from sitting back to back ? A "mentally healthy" person is often To be used after people are in a relaxed 6. Who led in the hand mirroring? characterized as having an accurate per- state. Why? What did you learn about yourself ception of reality, able to maintain close Imagine that you see a warm golden in this exercise, about the other person? interpersonal relationships, able to ball in front of you. communicate openly and honestly with As you watch it,it slowly begins to others, arid aware of personal goals, val- shrink becoming smaller and smaller. ues, abilities, and behavior.' Because of When it is the size of a dime it moves the variety of environmental stresses and toward you. our individual backgrounds, we all have It gets closer and closer and finally at- different problems of living. The extent to taches to your forehead. which we learn to successfully cope with Then it turns into a magic warm golden - these stresses often determines how paint. 'Maslow, Abraham H., Toward A Psy- mentally healthy we are. It flows over your forehead, nose. chology of Being, 2nd edition, Van One of the primary objectives of men- Smell it, taste it. Nostrand-Reinholt Co., Toronto, 1968. tal health education in the classroom is to As it flows it feels warm and glowing. 'Adopted from Dick Price's "Gestalt help the student become aware of him- When it reaches your neck the magical Workshop," Esalen Institute, Big Sur, Cal- self, his communication techniques, and paint takes on different colors and still ifornia. his behavior as an aid in learning to cope flr,ws over your body-----shoulders, upper 'Pfeiffer, I., and /ones, I., A Handbook successfully with life. The following warm arms, lower arms,fingers,chest, of Structured Experiences for Human Re- up can help the student become ac- lations Training, Vol. I-IV, University As- quainted with himself, with others, and sociates, Iowa City, Iowa.

1 5 4 141 80 TEACHING IDEAS

Mental Health

Following introductory class periods devotedtopersonalitydevelopment and enhancement of mental health, the instructor should enter c!ass with a test or quiz which has been prepared from materials the students were supposed to have lead and additional questions which are not from the assigned read- Below is an example of a test of this type.

HES 100 Personal Health Quiz]. Emotional Health

1. List Erikson's Eight States of Person- ality Development. (8 points) 2. Indefining and describingthe psychotic personality disorders, the text speaks of organic and functional causes. Describe each. (4 points) 3. Give three examples of character dis- r-"" orders. (3 points) 4. According to the text, what is anxiety? (5 points) Keeping veryserious,announce: "You will be having a test now, please remove all materials from your desks." they can use to alleviate these emotional You will notice abrupt changes in facial A Lesson on Stress crises in constructive, appropriate ways. expression, body movements etc., rang- This is the case in the following class- ing from panic to anger which can pro- room technique: vide a basis for a discussion of bodily JANET H. SH1RREFFS is in Depart- manifestations of anxiety. ment of Physiology and Health Science, Ball Goal: (1) Learn what stress is State University, Mutwie, Indiana 47306. (2) Learn what anxiety and/or anger Pass out tests. Allow the students feels like as the result of encountering about three minutes to look over the test A generally acceptededucational a stressful experience and announce: "Write your feelings at principle is that students learn best in an (3) Learn how stress can best be han- this moment on the bottom of the test environment in which certain moderate dledinpositive andconstructive paper." A number of reactions actual to high expectations are made clear to ways to resolve problems and reduce students have reported during this ac- students but is only minimally or mod- feelings of being "overwhelmed" by tivity are: complete confusion; helpless; erately stressful. Excessive stress may appropriate individual action. I would like to throw my chair at you for be so incapacitating that no effort on the springing this on me; anger; complete part of the individual can alleviate it. It Level: This classroom experience has nothingness; a burst of adrenalin shot is impossible for learning to take place been used effectively at the college through my system; disgust and frustra- in an overly stressful environment in level during a unit on mental health. tion; my heart fell, anxiety, shocked, which the adaptive potential of students The learning experience would also confused; feeling of total lack of control; is exceeded. Of course, individuals dif- be applicable at the senior and junior insecure;I am feeling completely lost fer in both perceptions of stress and in high school level with some modifi- and kind of scared. their ability to cope with stress and conflict in their daily lives and these dif- cation. ferences are important considerations Method: (1) Students should be fairly for the educator in discussing stress and comfortable with teacher and vice- Announce' inmudiately after you have emotional health. versa. asked the students to record their feel- Although health educators cannot (2) Class environment shouldbe ings on the bottom of the test page: teach mental health per se, it is possible humanistic and typically low-stress "This is not a real test, but an experience to provide classroom experiences deal- prior to the experience. to get each of you to realize right now ing with mental health and the solution (3) Teacher should have made evalu- what stressful situations can make you of every day problems which can help ation requirements of the class very feel like inside. (You will hear sighs of students tune-in to real life situations, specific, including an announcement relief, laughter, and comments such as feelthe emotions they evoke, and that no unannounced quizzes would "I didn't think you'd do anything like analyze achons and behaviors which be given during the semester. this to us, whew!") 142 155 STRESS MODEL Discussion: General questions which relate to this experience include: What is Stress stress? What situations are stressful to Anxiety Frustration Anger Emotional Responses you? How can stress resulting in anger or anxiety be handled constructively Endocrine functioning as a consequence of and destructively? What do you do parasympathetic system's reactions to stress with anger when you feel it? What are some constructive outlets for anger Stress and anxiety? What do you think are Adrenalin Non-adrenalin Physiological Response the dangers of repressed anger and anxiety? Increase in blood pressure, heart rate, sweating, dilation of pupils, etc. Lecture: The model presented on the next page can serve as a framework for Flight Fight Internalization Behavioral Adaptation a lecture on stress, including its emo- with no release tional, physiological, and behavioral parameters. Health-generating reso- Individual differences in alleviating stress lution of stress should be emphasized. Potentially constructive Potentially destructive Health educators cannot eliminate the many stresses their students will en- Deal with anxiety and anger as they Let anger and anxiety build up by not counter in their daily lives. They can, occur in small pieces. recognizing internal feelings and/or by however, help students to examine the not acting on them. types of situations which evoke individual stress reactions and can discuss Be assertive, honest, and real when Be aggressive and outwardly hostile or alternative ways of coping with stress, so situations involving people create submissive when situations involving that young people will be able to incor- feelings of anxiety or anger. people create feelings of anxiety or porate health-generating behaviors into anger. stress-provoking situations in their lifestyles. Select and use appropriate physical Attempt to hold in and repress feelings outlets for venting anger and anxiety of anger and anxiety and try to forget the (running, cycling, playing tennis, or situations that caused them. playing piano).

Appropriate use of defense inappropriate overuse of defense mechanisms. mechanisms.

143 81 TEACHING IDEAS

Mental Health aloftNM Health SVategy agE ' PATRICK KIDD TOW is an assistant professor in the Department of Health and Physical Education at Old Dominion Uni- versity, Norfolk, Virginia 23508. This teaching strategy is appropriate for secondary school or college level health classes. I have used it at the end of a mental health or drug education unit, but it might also be applicable to any health unit which uses value clarification. Each participant begins with a set sum of moneylet us say $25,000, and is entrusted to keep a running tally of how much they have spent and what was bought. Members of the class bid on certain aspirations, loves, or wishes in an auction. The items for auction could pertain to physical, emotional, social, or even spiritual health. The instructor plays the part of an auctioneer. Only he or she should know what items are up for auction and should try to keep the bids as high as possible. Fervor and interest will grow as the soaring bids become more competitive. The auctioneer should deal with each item one at a time by anat nouncing and writing it on the board. After the final bid is accepted, the selling price is written next to the item. The objective of this strategy is to evoke introspection on what values the individual cherishes. At the same time, students can see which behaviors and 10. Travel back or forward in time and 24. Be granted more handsomeness or values are held in high esteem by their change history beauty peers. The impulsive and eccentric na- It Be considered a fantastic lover 25. Reincarnation into anything or anyone 12. Be the most loved and popular politician desired ture of some participants may also be- in the country come apparent. After completing the 13. Never have a sick day in your life Additionalobjectivesmaybe exercise, there will soon be an influx of 14. Possess unrivaled intelligence or genius achieved by modifying this auctioning comments and questions from the re- 15. Eat as much as you want and never get strategy. Following are some sugges- sults. fat tions. The following items have been auc- 16. Be the author of the world's best-selling Reduce or increase the number of items tioned off in a mental health class. book 17. Be considered a successful financial to suit a specific health topic being 1. Guarantee to die a peaceful and painless wizard covered. death when the time comes 18. Be exceptionally skilled in any sports one Distribute a list of items for auction so 2. Ability to prevent World War III desires they may be arranged according to 3. Ten extra years added on to your life 19. Phenomenal love for animals individual preferences. 4. Never have to work and still be paid 20. Never have an enemy in the world, be Allow small groups to submit public 5. Ability to save the life of one person loved by all bids as a consensus. 6. Phenomenal love for children 21. Die with a clean conscience, no debts, Permit borrowing or lending of money 7. Ability to play any musical instrument and no sins left behind desired 22. Guarantee to never become addicted to among participants to see how many 8. Be boss and sole owner of a company any drugs overextend themselves. 9. Own the only solar-powered sports car 23. Climb the highest mountain and survive

144 82 TEACHING IDEAS

Mental Health People Labeling CATEGORIES OF PEOPLE Stmtegy Labels parent teacher neighbor TV star stranger Total

Alcoholic PATRICK K. TOW and HAL WINGARD are assistant professors in the Department of Mentally Health and Physical Education at Old Disturbed Dominion University, Norfolk,Virginia 23508. Homosexual Drug Addict Many people are in the habit of label- Divorcee ing or stereotyping other members of society. Some of these "tagged victims" Total may be acquaintances of those doing the labeling. While peer group coercion has been able to provide the necessary motivation for constructive changes in our fears governing our lives. It will become three. However, he may seldom feel tol- lives, it can also be destructive in nature. obvious in discussions among high erant enough to associate with a homo- The insidious manner in which labels school or college students that some con- sexual stranger and assigns a score of and stories can spread help blow the pic- cerns are groundless and based upon two. ture far out of proportion. Perhaps sheer ignorance. However, there will be A sum of totals from each row and someday we may come tc realize such some thoughts expressed which were column reflect that label or category of practices tend to do more harm than based on feelings derived from personal people deserving the most and least de- good. experiences which might not necessarily gree of tolerance. For example, the high- An innocent person defamed by a be refuted. Therefore, it becomes abso- est row total found associated with di- circulating, malicious slander may feel lutely essential for teachers and students vorcee would suggest that student is the intense social and emotional im- alike to pay heed to what is being said. more tolerant of divorcees than any of pacts. Public denial of such labels may be the other given labels. By the same to- interpreted as frantic attempts to conceal ken, the highest column total, which is guilt. There is always that tragic alterna- The teaching instrument to be used is associated with stranger, may indicate tive of the stigmatized acting in accor- shown as a table. The rows represent five that student is more tolerant of their im- dance with the label bestowed upon types of labels apt to be used as brands proprieties than the other category of him. On the other hand, there is also the for certain undesirables. The columns people. The lowest row or column totals possibility that a label accurately depicts represent five categories of people that may indicate that label or category of a person's past or present. Nevertheless, are hypothetically given the labels. Stu- people least tolerated by the student. such unscrupulous denotations ex- dents are directed to correlate each label Other variables besides what is given pressed out of spite or ignorance tend to with every category of people and assign in the table can be used in substitution. diminish the faith and trust one has in a score to indicate the degree of tolerabil- Any of the following can be added to one's fcnow man. ity they have toward these individuals. people categories: brother/sister, politi- S'agmati?.ation is only one part of the The range of scores is: 4will always be cian, cousin, boy/girlfriend, or minister. he other is one which many of able to tolerate; 3will frequently be able Any of the following labels can be used, us to on a number of occasions. to tolerate; 2will sometimes be able to too: transsexual, shoplifter, murderer, :faces when listening ears tolerate; 1will seldom be able to toler- marijuana smoker, hit-run driver, sui- ievt and treat a person ac- ate; 0will never be able to tolerate. cide attempter, child abuser, or bisexual. that real or unreal stigma. Examples of the process involved Of course, there are also other possible tices may appear to be a should be provided for the students. For alternatives that can be conjured up by -ffo. t to prevent an individual example, astudent examines the the teacher. fins the mainstream of Amen- hypotb.,,fic.11 situation that one of his In the ensuing discussions, students y Perhaps some people be- pardnts is an alcoholic. He may find that should begin to realize people with such -,ver actions are associated .:t absolutely intolerable and assigns a labels used in this strategy need more I label warrant public desc ore of zero. On the other hand, he may empa thy than sympathy from other noL, ad infinitum. The resulting be quite willing most of the time to accept people. Most anyone can provide pity, social a..o emotional damages could be the fact that his favorite TV star turned but understanding is a step beyond what avoidedf we we, e sensitized to the out to be an alcoholic. If this is the case, the stigmatized may expect. It is fortu- ramifications of our persistent "pigeon- the student would assign a score of nate that changing times and people in holing" behavior. three. In another example, a student today's world beckon us to relent and This teaching strategy is intended to may be willing to tolerate his homosex- modify our opinions about others now draw out various prejudices, biases, and ual teacher most of the time and scores a deemed out of place in our society.

1 5 145 83 TEACHING IDEAS

Nutrition Creative Food guidelh,es Any information that is not a, eilable, such as net weight, may tfo.NET'A..: e es Syr: ted or made up. Labels: Consumer '.WHOLE BEAN:)4 Health Eduestise *,,..UNcoATED TABLE/PM a;or,..; =

1. Make a food label and in doing so will be familiar with the various components of food labeling. 2. Make judgments on the quality of var- 3. Announce that there will be prizes HYSON ious food labels. (first prize and runner-up) awarded 3. Experience, discuss, and categorize to the most original label, the most the decision-making processes of popular label, the most attractive many consumers. label.

Procedure Day Two MOON S. CHEN, JR. is visiting assistant professor, Department of Health, Physical Day One 1.Have all those with the same fruits Education, and Recreation, Box 4070, Texas 1. Introduce the topic of food labeling place their labels in one area of the Tech University, Lubbock, Texas 79409. with emphasis on reasons for labeling classroom. The objective is to place labels in such a way that they will "sell" themselves. Have students put a price on their items. Any unit or course in consumer health 2.Once labels are in place, distribute should include a section on what to ex- three pieces of paper to each student 111,1011NONIOIN for ballots. pect on food labels. Described in the fol- MACKEREL'S. 3.Instruct students to write their lowing outline is one way to facilitate qqqq student learning in food labels. choices for the best label on their ballots. Students may distribute their voting on these ballots in any fashion Teacher Preparation they wishall three ballots for their 1. Read the handout, "A Consumer's choice of best label, two ballots for Guide to Food Labels," by Margaret one choice and one ballot for another, Morrison from the Tune 1977 FDA or one ballot for three different Consumer. choices. 2. Prepare enough copies of the hand- food, FDA requirements for food out for distribution to each student. labels, explanations of the various 3. Write the names of approximately components of the nutrition informa- five to seven fresh fruits on strips of tion label. paper so that there are enough for 2. Introduce the idea of a contest to be each class member and each fruit is conducted the next class day on food more or less equally represented. labels. Each class member draws from a paper bag a choice of a fresh fruit. These

Nutrition

Sensible listing 4. Compile magazine and newspaper advertisements on diets, diet aids, and slimming devices. Evaluate the reliability of these advertisements analyzing the use of objective facts, pseudoscientific words such as "cellulite" and "diuretic," or claims to do something for nothing such as, "lose ugly fat while you eat the foods you love." 1. Investigate commercial health spas and community recreationalfacilities. Compare cost, services offered, equipment available, and reputation. Investi- gate commercial dit'' qics comparing 'Siiadhbai;Lmi.7b. type and length of "treatment," prom- 11P' ises made, food plan, consideration for a.. 4.1 changing food habits, and success rate.

5. Write to adolescent summer weight camps and adult "fat farms" for brochures. Figuring length of stay and desired weight to be lost, determine how much each pound of weight loss would cost.

MARILYN MUDGETT is associated with 2. Make a study of doctors who spe- the Health Education Department, Group cialize in weight control. Examine pro- Health Cooperative. DOROTHY CULIAT is fessional qualifications, length of treat- presently evaluating the weight control pro- ment, types of treatments (pre-packaged gram of Group Health Cooperative, 200 15th foods, pills, shots, hypnosis, etc.), suc- Avenue East, Seattle, Washington 98112. cess rate, and possible health dangers.

6. Make a survey of family and friends to determine if they ever dieted, types of diets, aids, products and/or facilities Dieting is an obsession for many used, success rate, and cost. Americans. Money readily spent on fad Two excellent resources for consumer diets, exercise devices, over-the-counter education and weight control are Thin weight loss aids; miracle foods, and na- From Within by Jack Osman and A Diet for tional self-help organizations all add up Living by Jean Mayer. to a billion dollar weight reduction industry. Physical activity has been taken out of the realm of the natural and is under the domain of big business-- health spas, athletic clubs. The search to be thin can be confusing and costly to the consumer. Students need accurate, unbiased information to make decisions about weight control and 3. Visit the local drugstore and make a learn how to protect their pocketbooks at list of the over-the-counter reducing aids the same time. The following assign- available or visit a library or bookstore ments are methods of educating the po- and note the number and titles of books tential consumer. on dieting.

147 1 6(4) PART II Foreword

Health Teaching IdeasSecondary was first published in 1983. The publication has been very popular and has experienced a consistent demand from those interested in improving the delivery of health education. Since 1983, the Journal of Health Education has cortGnued to print teaching strategies under the heading of "Teaching Ideas." Prac- tically all of these are included in the revised edition of this publication. In addition, other teaching strategies have been included that will eventually be printed in the Journal.

Although the title states "secondary," teaching strategies have been included here that would be applicable for middle school through the college level. Users of this volume have the flexibility of adapting the teaching strategies to the grade level that is most appropriate for them.

The Association for the Advancement of Health Education believes that Part II will add to the value of the earlier materials and make this expanded volume an excellent reference for all those seeking workable ideas in teaching and delivering health education programs.

As editor, I wish to thank the authors for sharing their creativity and successes with the profession. Without their willingness to make this professional contribution, the new edition could not have become a reality.

Within the covers of this book are a multitude of ideas to make health education relevant and exciting for the student -- and enjoyable and rewarding for the teacher.I invite the reader to explore the innovative and successful experiences presented here.

Loren B. Bensley, Jr., Editor Professor of Health Education Central Michigan University Mount Pleasant, Michigan Focuson Process

1G3 TEACHING IDEAS 85

The Writing Process in Health Class Vicki Steinberg and Teresa M. Fry

In Exeter Township's Health HI class, births. Obviously, some students do not the start of labor, getting to the hospital a health quarter course required for live with, or even know, their birth on time, or the labor processthe phys- graduation, teacher Terry Fry involves mothers. These students have a sheet of ical and psychological aspects of birth- students in the learning process using ten options from which to choose, such ing. Students don't feel a need for a various writing techniques. Previously, as to interview three different people or grade; they enjoy themselves and reveal Mrs. Fry used teacher generated lec- express their own views concerning sex knowledge at the same time. tures, quizzes, tests, and a few learning education in the schools. This interview As Mrs. Fry continues to use the centers to give students a basic under- gives the student an insight into the writing process, she finds more uses for standing of human sexuality. For four times of his birth and brings parents it. A recent addition to her course is a years, Mrs. Fry used traditional meth- and teenagers together. One boy dis- chronological description of the steps of ods, but she was bored with the fin- covered he had been born on the day the menstrual cycle. After the lecture, ished assignments,particularlysince that Bobby Kennedy was shot and was studrInts write their understanding in she teaches four similar classes in one named after Kennedy, while many kids paragraphs to clarify any mistaken con- quarter; therefore, a test meant 120 stu- found their dads had been in Viet Nam cepts in timing and to solve problems dents turned in dull true/false or match- at the time of their births and had not before the same question appears on a ing answers. Also, Mrs. Fry was con- even known their babysex. This as- test. cerned that students were not really signment makes students talk to their Previously, each HealthIIIclass involved in their own learning process. parents pleasantly and brings them wrote research papers on various topics Although many of the tests remain closer for a moment or two because it from rape to child abuse to in vitro the same, through the writing process gives students insight into their person- fertilization, but the papers were repeti- there is more interaction between stu- al history. tive and copied word for word from the dents and between the students and the source material. This problem ended teacher. At first, Mrs. Fry tried a simple For afullweek, about half way when Mrs. Fry presented the class with assignment. She began hy telling the through the course when class members the a list of different ways to tackle writing class about her birds and the bees' talk are comfortable with each other, the researched material. Instead of sim- with her mom and her misconceptions Flour Baby Project begins. Here each student must make a baby from a five ply copying the material, students could about sex. Class members then wrote in pound sack of flour and carry him/her write a diary of a child abuser, a Phil class their recollections of a similar talk Donahue interview with a surrogate with their parents. Those students who everywhere for seven days. During the week, in order to achieve more than an mother, a dialogue between a lawyer did not recall a talk or were sure they average grade, studen:s may do two and a rape victim, or anything similar. had never been involved in such a dis- mecerent interviews about the Flour These options made the teacher's and cussion wrote what they will tell their Baby Project, one to obtain the parental the students' jobs more enjoyable and children. Since some of the information therefore a better learning experience. is quite revealing, students who do not view of the project and any suggestions for improvement and one interviewing Even those students wlio wrote a tradi- share but do turn in the rough draft and a parent other than the student's own tional research paper had to add a per- each class member receives credit for concerning being a parent. Other topics sonal final paragraph to humanize the the assignment. Using this simple writ- text. ing, Mrs. Fry breaks the ice, showing include checking the finances associated that everyone has the same thoughts with having a baby and writing about The most recent writing started in and experiences. Students who have the information. class but was finished outside class. written in order to learn about them- As a culminating exercise, students First, the class brainstormed reasons, selves realize how nervous both they complete sentences such as "I learned pro and con, for a teenager having a and their parents were. that..," "I now know that..," and "I sexual relationship. A recorder kept This early success encouraged Mrs. hated that . . . At the end of the ques- track of the ideas and the class received tions, students may give opinions about a copy the following day. Working indi- Fry to give extra credit to students who the project and how they would change interview their mothers about their own vidually, class members drafted a dis- the project. After papers are turned in, cussion of four ideas from the list. Mrs. the class orally reviews the ideas. Fry had magazine articles available to Vicki Steinberg is a teachcr in the English As classwork, students split up into help back up responses. For extra cred- Department of Exeter Township School Dis- groups of three or four to write dia- it,students could have their parents trict in Reading, PA 19606. Teresa M. Fry logues about the birthing process. After read and sign the paragraphs, again is a teacher in the Physical Education!Health rough drafts are completed, ,tudents opening discussion at home through Department of Exeter Townshi.p School Dis- read their dialogues aloud to the class. writing. trict. Typical encounters mdude scenes about Because of the added written assign- 153 ments, students learn more about them- can adapt future work to problem spots. Because the English faculty at Exeter selves, other people, and their families. Through end of the quarter evaluations, has been encouraging all teachers to use Tests and quizzes do not allow the close she can also discover what needs to be writing in their classes and providing feelings among class members or stu- taught di(ferently, faster or slower, or in ideas to make it possible in each unique dents teaching themselves to see their more detail. Fortunately, none of the situation, the health curriculum has be- feelings. extra writing is a large burden in time come an exciting and enjoyable educa- The teacher also learns more about because students have found their tional experience for both students and what members of the class know and voices and are interesting as well as teachers. knowledgeable.

154

1 G 5 TEACHING IDEAS 86

Logo-Mania: Creative Health Art

Frank Caisbeek

The logo or trademark is a power- group. Usually the logo is field-tested to ful communication tool in the hands of a see if it accurately reflects the image that creative health teacher. It is useful for the organization has of itself. It must getting students to examine the "human- also mold this image in a positive way. izing" messages that health agencies Images can be misinterpreted,amplified, develop and project for themselves. or ignored. Artistic symbols are used to craft a A healthy image will exhibit or likeness or identity for the organization's elicit some, if not all, of the following mission and philosophy. These images characteristics or responses: 1) strong are planned and developed with intent emotional response, 2) appearance of and purpose. Each is significantly dif- power, 3) sense of experience, confi- ferent and is a projection of the unique dence, and tradition, and 4) sl ow process qualities that an institution or agency resulting from consistent repetition wishes to convey about itself (Napoles, 1988). The idea of a logo or trademark is very old. Marks have been found on Discovering a Logo's Image early Chinese porcelain, on pottery jars Five current health logos are pro- from ancient Greece and Rome, and on vided on the following page to use for goods from India dating back to about Hermes, the speedy messenger of the reproduction as an overhead transpar- 1300 BC (Morgan, 1986). gods in Greek mythology. The wand ency. They represent professional, vol- was a gift from Apollo and had the untary, and official (tax-supported) Set the Stage power to unite all beings divided by health organizations and agencies. Some Students can be motivated to be- hate. Hermes discovered the unifying may be well known and easily recogniz- come involved in logo-mania by calling power of the wand when he threw it able. Others may be unfamiliar to your their attention to a logo that many have between two fighting snakes who class. An identification key is given at seen, but few may understand. The promptly wound themselves around it in the end of this article. caduceus, with its two snakes entw ined friendly association. The wand also pos- Project these logos on a screen and in opposite directions around a wand sessed magical powers over dreams, have students examine each one indi- made of olive wood and gold, always waking, sleep, and even death. vidually. Ask probing questions that arouses their curiosity. Point out the fact Later, a single snake wrapped focus on the following: that both snakes are "eyeballing" each around the staff came to be a symbol for other and that they are surmounted by Aesculapi us, thc god of medicine. Today 1. What objects do you recognize in two wings. Students generally recog- it s the symbol of the medical profession. each logo? nize that the wings are symbol ic of speed; 2. What symbolic meaning does each they are sometimes affixed to a track Health Logos Today object have? shoe and given as an award to the school's Health agencies are very sensitive 3. To which agency/organization does track star. These wings belonged to to the public 's perception of their image. this logo belong? Their logos take form as a symbol, set 4. What do you know about the mis- apart by unique design, with distinctive sion of the agency? Frank Calsbeek is in the Health Edu- coloring, lettering, or any combination 5. What impression do you have about cation Divisionof Sout' westTexas State of these. The purpose is to give a pow- the identity and image of each agency; University, San Marcos, TX 78666. erful identity to the health agency or organization?

1 G t; 155 pr.* 4,4". a.

Creative Logo Design Encourage students to creatively Key to Logos Have students form six design translate the image and identity of each teams of three to five students. Ask each school service group (or others, if they A. World Health Organization team to creatively design a logo that apply) into the logo design. It may be B. Association for the Advancement of projects an image and identity for one of necessary to inquire from each service Health Education the following school-based gniups: group how it views itself and its mission. C. American School Health Team 1. A local SADD chapter Suggest that each logo should utilize Association Team 2. Your cafeteria program popular colors that would make it attrac- D. American Public Health Team 3. The nurses' health center tive for a T-shirt or coat emblem. Association Team 4. Crossing guard program After all teams have completed their E. March of Dimes - Birth Defects Team 5. Custodial/janitorial service design task, culminate the activity by Foundation Team 6. Smoking cessation group having each group share its creation for teens with the other design teams. Prominently Art materials such as paper, rulers, display all six logo designs and invite compasses, color markers, and other school service group members to view items should be supplied. Students may the logos and verify if their mission and be apprehensive at first, claiming *hey identity were accurately projected. Morgan, H. (1986)SymbolsofAmerica. New York: Viking Penguin, Inc., p. 7. have little or no art ability. F.L. isure Logo-mania is fun. It encourages them that the thsign concept is :ntral students to participate in a conteinporary Napoles, V. (1988). Corporate identity de- and that perfection could be carried out art form while creating an awareness sign. New York: Van Nostrand Reinhold later by an art professional. What is and apprec iation for different health ser- Company, Inc., p. 11-26. needed is the basic idea. vice groups at their school. TEACHING IDEAS 87

Overcoming Xenophobia: Learning To Accept Differences Judith A. Baker

Health educators are often called enjoying the opportunity to improve of the client groups listed previously upon to interact with special popula- quality of lifein later years with on a brief questionnaire. Reactions to tion groups. Some of the special pop- physical activity. working closely with clients possess- ulations health educators serve are Strategies exist to help health ed- ing each of the listed characteristics the medically indigent, the homeless, ucators overcome negative and pro- are ranked by each student following the elderly, the obese, gays, the dis- fessionally destructive attitudes the question: "Would you feel un- abled, racial minorities, and alcohol- toward clients. As part of a commu- comfortable or ill-at-ease when work- ics. Unfortunately, most health edu- nity health education class at a mid- ing with any of these clientsr Many cators and their clients have been western university, students were en- prejudice attitude questionnaires or raised in a society which tends to couraged to overcome xenophobia in instruments have been developed view people with these characteris- themselves and others. To prepare which also can be used to measure tics in a negative and stereotypical for teaching the unit on special pop- xenophobic reactions (Wingard, 1981; manner (Snyder, 1986). When these ulations, the instructor first exam- Smith, 1973). The first session en- societal views are internalized, xeno- ined her own xenophobic reactions ables the instructor to identify one or phobia limits the ability of health and participated in each of the learn- two special population groups for educators to provide quality service ing strategies. The only materials which most of the students in the to all clients. Xenophobia is a term necessary were a brief xenophobic class express the greatest xenopho- used here to identify the fear of assessment questionnaire, a list of 10 bic reaction. strangers or anyone viewed as differ- successful people from the special In the second session, the instruc- ent from the norm. population of choice, a list of books tor helps students to identify all the The disasterous impact of xeno- and movies about the special popu- myths commonly heard about the phobia on the practice of health ed- lation, and a written description of special population group of choice. ucation is apparent in the case ci student assignments. Three class ses- Students are asked to collect factual internalized ageism of elderly clients. sions were allotted for the learning knowledge about the characteristic Obstacles to early detection of breast unit. Each of the strategies presented or the group of people from materials cancer among elderly women listed can be adapted for use in a variety of provided in class. Misunderstand- by Frank-Stromborg (1986) are myths health education classes including ings and myths are corrected in class about older people, viewing pain as those dealing with human sexuality, by the students. an inevitable part of aging, and at- aging, alcohol abuse, and weight man- Next, students are asked to contributing symptoms to aging rather agement. sider how society oppresses people than illness. Internalized ageism and In the first class session,self- with the characteristic. What labels its associated fatalism may lead to awareness is addressed. The first and are commonly used to describe peo- diminished perceptions about the se- last names of all students enrolled in ple with the characteristic? How does rious consequences of developing dis- the class are written on name tags. the label serve to perpetuate stereo- eases which might otherwise be pre- Students are asked to sele n one name typing and oppression? Are the con- vented. And, elderly adults who have tag other than their own and place the notations of the labels helpful to internalized ageist beliefs that older name tag on someone in the room to strengthening the self-esteem of peo- people are clumsy, ineffectual, fear- whom they believe the name be- ple with the characteristic? ful, dependent, and slow (Shaie & longs. Additionally, students are asked Repeated and positive personal ex- Shaie, 1977) prevent themselves from to give a fabricated introduction based posure with people who possess the solely on appearances to the class characteristic may help to alleviate about the people they selected. Fol- xenophobic reactions. Outside class- lowing the introductions, class dis- room assignments include the sug- Judith A. Baker is an assistant pro- cussion is generated about the ste- gestion that students get to know fessor in the Department of Health reotypes used during the name tag these people socially or at least out- Education, Texas Woman's Univer- activity. Next, students are asked to side a professional setting. Students sity, Denton, TX 76204. recognize how they feel about each could attend a self-help group com- 157 1Pq prised of these people. Students are what life would be like if 90 percent clients. Clients themselves can ben- provided with a list of movies and of the U.S. population were gay or if efit from experiencing these strate- books depicting the special popula- the student woke up tomorrow weigh- gies to help overcome their internal- tion in a positive manner. Students ing 50 extra pounds. In the third ized xenophobia. Quality health compete by trying to identify the session, dialogues based on the es- education requires that health educa- greatest number of famous and suc- says are created and acted out by tors engage in the professional and cessful people from the special pop- students in class. In addition, stu- personal development necessary to ulation. dents report on their experiences in overcoming xenophobia. Other ways to reduce xenophobia completing the outside classroom asin addition to increased self-aware- signments. Frank-Stromborg. M. (1986). The role of the ness, knowledge, and personal expo- The use of these strategies in a nurse in early detection of cancer: Popu- sure are simulations, role plays, and community health education class aid- lations sixty-six years of age and older. role reversal. A simulation is con- Oncology Nursing Forum, 13(3), 66-74. ed students in comprehension of a Schaie, L. W., & Schaie, J. P. (1977). Clinical ducted by having students verbally complex issue. Students were able to assessment and aging. In J. E. Birren and express their immediate reaction to generate their own examples of ways K. W. Schaie (eds.), Handbook of the each of the following situations: ( I) xenophobia acts as a barrier to the psychology of aging. New York: Van you had to listen to an obese speaker practice of community health educa- Nostrand Reinhold. in class talk about Overeaters Anon- Smith, K. (1973). The homophobic scale. In G. tion. Weinberg, Society and the healthy homo- ymous, (2) the specialist to whom Once students work through all the sexual. New York: Anchor. you have been referred for a medical strategies for reducing their xenopho- Snyder, M. (1986). Self-fulfilling stereotypes. problem is obese, (3) your best friend bia, they will be better able to work In D. Goleman and D. Heller (eds.), The from childhood who came to visit is pleasures of psychology. New York: New with a greater variety of clients. Even American Library. obese, (4) you discover that you are if they cannot identify xenophobia in Wingard,J. (1981). Measures ofattitudes toward obese. themselves, they have responsibili- the elderly. Experimental Aging Re- Examples of role plays and role ties as health educators to recognize search, 6, 229-313, reversals are essay assignments about the problems encountered by their

1 58 TEACHING IDEAS 88

Factors Important in Teaching Confroversial Issues Ansa Ojanlatva

A few years ago one of my assigned questions commonly asked by high (2) values clarification, courses was a required methods course school students about sexuality), and (3) positive climate, for those intending to teach health edu- 2. take five minutes to write down: (4) openness to any relevant cation at the secondary school level. (a) how they would answer the questions. Most of the students in these courses question (subject matter); (c) planning evaluative proce- were physical education majors and as (b) how they would teach about it dures. often is the case, they were studying (method of teaching); The eva iation revealed that in most health education as their second teach- (c) what qualifications a teacher cases the activity accomplished what it ing field. Unfortunately, in these cir- should possess to present the was meant to accomplish. Twelve stu- cumstances, students often expect materials in an effective man- dents participated in this class experi- health education to be an easy field of ner. ence, and each turned in an evaluation. study, and therefore, by the time of their The students worked on the topics Following is a synopsis of their reactions senior year, many still are ;ma ware of the without discussing them with each to the questions on the evaluation sheet. knowledge,skills, and sensitivity other. Time did not allow for all topics to 1. Did you find out anything about yourself needed to teach controversial health is- be discussed, but after the five-minute as a teacher? sues. period several questions were selected to Four students indicated it was hard to Additionally, Merki' found evidence be answered: talk about sex; three of them suggested in 1976 that there is a plethora of instruc- 1. What is a wet dream? careful preparation was essential for the tion about physical fitness; but life-re- 2. Do women have wet dreams? outcome; and five felt comfortable in lated topics such as human sexuality, 3. What is masturbation? talking about sex with the class, who mental health, and consumer issues, 4. What is a normal penis size? posed as high school students. The:e frequently requested by students, are 5. Can the sperm supply be used up? was indication of not having the needed often lacking completely in the cur- 6. What is homosexuality? information to teach the subject, and of riculum. This has prompted my search The material* presented during this having found out what to teach and what for activities which might increase stu- session included: not to teach. dent awareness of the qualifications to 1. The instructor's role. 2. Did you learn anything about the re- teach controversial issues. (a) knowledge required, quirements of the subject matter? I developed the following teaching/ (b) sensitivity needed for discuss- The answers ranged from "no" (two learning activity with the above stated ing the topic or issue, e.g.: students) to "different things" (one stu- objective in mind. Specifically, the activ- (1) sensing other people, dent). Some of the particular require- ity concentrated on drawing out infor- (2) feeling comfortable with ments were: mation about the following: one's own sexuality. (a) getting your points across. 1. the instructor: his/her characteris- 2. Subject matter. (b) using teaching aids effectively. tics and professional background; (a) facts, c) preparing up-to-date material. 2. the subject matter: the cognitive (b) continuity. (..1) needing more preparation than substance and the continuity of it in rela- 3. Methods of teaching. previously expected. tion to other subjects; (a) planning a program including (e) needing so much factual informa- 3. the method of teaching: the plan- elements such as: tion, knowledge of attitudes and ning of instructional activity, the instruc- (1) support from needed com- behaviors, plus ability to talk and tional methods, and the possible evalua- munity groups and from listen. tive procedures. parents, ( f) needing information from related Before this session students engaged (2) personal involvement from subjects such as psychology, in values clarification activities and they students, anatomy, etc. were aware that they would not be (3) ddequate time for learning, 3. Did you learn anything about the factors forced to participate. However, as future feedback, and evaluation, needed to plan a controversial teaching unit? teachers of health education, they were (4) meetings with students and The variety of responses makes a encouraged to participate in the activity. their parents. summary somewhat difficult. Some of In this class no one refused. (b) using methods of instruction the responses cautioned: The students were told to: elaborating on: not to ask students to reveal per- 1. pick a topic "from the hat" (all were (1) positive vs. negative ap- sonal information they may not proaches, wish to reveal; Ansa Ojanlatva is in the department of to think more about how the subject _ Health Science and Human Ecology, School 'The students used the following book as a matter may affect the student; of Natural Sciences, California State College, resource: Read, Donald A., and Greene,Wal- to prepare for extreme feedback. San Bernadino, CA 92407. Her article was ter H. Creative teaching in health.New York: (The responses seemed to refer to accepted for publication in June 1980. MacMillanPublishing Co. Inc., 1975. 159 BEST COPY MAE 1 7 (4 possible need for counselingafter two students said they felt inadequate in study of controversial issuese.g., terms of factual knowledge. a student's bursting into tears dur- 5. Any other comments? ing discussion of death arid dying The answers to this last question indi- issues.) cated overall feelings: Further, the answers revealed that the objection to an activity involving students realized the importance of the homosexuality. following: "The class today was great. . . I the need for a comfortable attitude thought it was one of the most un- in the teacher to make students feel usual classes I have been to." comfortable. interesting exercise (two students). the necessity of an organized pic- "I think teaching on sexuality ture of the various factors in sex should fall within the limits of the education and the particular steps to approved curriculum if you want to consider. keep your job as a secondary school the need bor a lot of planning before teacher." a teaching unit can be implemented This activity was meant to make stu- the consideration of class makeup: dents aware of the information, skills, social background, experience. and sensitivity needed to teach contro- the need of the other related sub- verbial subjects. The topics were chosen jects in planning a unit (anatomy, based upon issues discussed in class, psychology, sociology, humansex- which happened to be on sexuality. In uality related topics). the same manner, one might raise ques- 4. How did you feel when you had to teach tions about use and abuse of drugs, or the topic? any other subject for which there is no Two students indicated they feltner- one solution. vous because they did not know how the class was going to react. Five students 'Merki, Donald. Personal communication, indicated the opposite: they felt comfort- January 1980. able in talking about the issue raised. 'Read, Donald , and Greene, Walter H. Three students indicated embarrass- Creative teach;is, Oh. New York: MacMil- ment or hesitance in the beginning. And lan publish' , Inc., 1975.

160 I 7 1 TEACHING IDEAS 89

Teaching About Authoring Systems: Instructional Design Tools for Health Education Paul D. Sarvela and Marilyn J. Karaffa

Microcomputers have become in- tems currently available for health Implementation and Time Frame creasingly important as educational educators, Apple SuperP1LOT. (Su- The lessons and activities are im- tools in the health education program perPILOT is an authoring package plemented in the following sequence: (Petosa & Gillespie, 1984). Adoption which enables instructors to develop (1) Introduce CAI hr). of microcomputer technology has oc- CA1 in an efficient and effective man- (2) Review Instructional Systems curred not only for hardware sys- ner. Features include a comprehen- Design (1SD) model of curric- tems, but also for software systems. sive tutorial, an excellent set of doc- ulum devdopment (1 hr). Even though there has been an in- umentation materials, and four (3) Discuss special curriculum decrease in the quantity and variety of editors: lesson text, graphics, sound velopment issues related to CA1 software for health education, one of effects, and character set.) This tech- (1 hr). the biggest problems facing health nique was designed for students en- (4) Introduce basic SuperP1LOT educators who try to use computer- rolled in a basic microcomputer ap- commands (1 hr). assisted instruction (CA1) is the short- plications course at Southern Illinois (5) Demonstrate previously devel- age of high quality educational soft- University at Carbondale. With mi- oped student or instructor- ware (McDermott & Belcastro. 1983; nor adaptions, this approach would generated programs (1 hr). Sarvda, Ritzel, Karaffa, & Naseri, be excellent for in-service work- (6) Student review of SuperPI- 1989). Therefore, health educators shops and training programs for health LOT tutorial (3 hrs). sometimes find it desirabk to devel- educators wedng in a variety of (7) Student design and develop- op CA1 to meet a specific need. Since settings (Le., schools, hospitals, comment of CAI materials (8 hrs). many health educators do not have munity agencies, and worksites). computer programming skills at the (8) Pilot testing and revision of Preparation CA1 materials (3 hrs). level neces,iary to create high quality (9) Student demonstration of their software, riuthoring systems can serve In private industry, computer soft- projects to class (1 hr). as an ex zellent alternative. Author- ware design and development is usu- In our classes, 20 hours have been ing syst.ems are software packages ally dictated by a set of specifica- allotted to the process of teaching thatP.re designed to create CA1 tions. We have. found this strategy to how to use the SuperP1LOT author- through a process of mediation be- be an effective way to teach design ing package. tween the author and a high-level and development of health education computer programming language CA1 as well. Figure 1 shows an ex- Necessary Materials (Whiteside & Whiteside, 1987/1988). ample of a specification that we have The following materials are needed The purpose of this paper is to prepared for use in our CA1 classes. present and describe the metheds of to implement this teaching tech- For e project, the instructor nique: one Apple 2e computer with a teaching technique which aims to should organize students into groups. two disk drives and monitor per group; introduce and develop proficiency in It has been our experience that groups applying one of the authoring sys- one SuperP1LOT authoring system of three or four students usually are per group; one blank disk per group; best. Next, documentation and pro- checklists for pilot testine the CA1 Paul D. Sarvela is an associate programs created by students (or instruc- materials (i.e., Horne & Gold, 1983); fessor in the Department of Health tors) in previous sessions should be student background readings on CA1 Education, College of Education, made available to the students. These and 1SD (i.e., Bork, 1984; Sarvela & Southern Illinois University at Car- materials are extremely helpful to Noonan, 1988; Damarin & White, bondale,Carbondale,IL62901. students as they study the best ways 1986); and resources on tne health Marilyn J. Karaffa is an assistant to design and develop their authoring education topic for the CAI selected professorintheDepartment of packages. by the group (students gather these Health and en.. ical Education, Col- materials). lege of Arts and Sciences, Young- stownStateUniversity, Young- st61, OH 44555. 161 172 Integration with Other Topics grams that have been designed and Horne, D. A. & Gold, R. S. (1983). Guidelines developed by our students. For the for developing health education soft ware. This project is part of a course Health Education, 14(6), 85-86. taught at SIUC entitled "Computer past two years, we have demonstrat- McDermott, R. J. & Belcastro, P. A. (1983). Applications in Health Education." ed several of our student projects and The microcomputer bandwagon is here While the focus of this project is on teaching techniques at computer ses- but watch your step! Health Education, skills relative to the development of sions at annual meetings of AA- 14(6), 76-79. PHERD. For example, in 1988, we Petosa, R. & Gillespie, T. (1984). Microcom- computer software, students also in- puters in health education: Characteris- tegrate and apply current informa- conducted a workshop on how to tics of quality instructional software. Jour- tion from a variety of health educa- develop and teach a course on com- nal of School Health, 54(10), 394-396. tion content areas (nutrition, drugs, puter applications in health educa- Sarvela, P. D. & Noonan, J. V. (1988). Test- stress) through the selection of their tion. At the 1989 meeting, we dem- ing and computer-based instruction: Psy- onstrated several programs developed chometric considerations. Educational topic for the CAI and subsequent Technology, 28(5), 17-20. development of the program. Fur- by our students. CAI program topics Sarvela, P. D., Ritzel, D. 0., Karaffa, M. J. & thermore, this project could be inte- included: exercise, functions of the Naseri, M. K. (1989). Applications soft- grated with a health education cur- heart, caffeine, cocaine, alcohol, and ware packages in the school health pro- dietary fiber. gram. Health Education, 20(2), 43-49. riculum and instruction class, when Whiteside, M. F. & Whiteside, J. A. (1987/ the class is studying various instruc- 1988). Microcomputer authoring systems: tional delivery systems. Valuable tools for health educators. Health Education, 18(6), 4-6. Bork, A. (1984). Computers in education today Previous Results and some possible futures. Phi Delta Kap- We have used this method of teach- pa, 66(4), 239-248. ing for the past three years. It has Damarin, S. K. & White, C. M. (1986). Ex- proven to be an effective approach, amining a model for courseware develop.) ment. Journal of Computers in Mathe- as demonstrated by the innovative, matics and Science Teaching, 6(1), 38- high quality health education pro- 43.

,) 1,11 Pik*. Objective: The objective of this assignment is to demonstrate the ability to use the SuperPILOT authoring package. This assignment is a group effort. Each group will submit one set of project deliverables. Points: The assignment will be worth 35 points. Task Description: Each group will submit a CAI tutorial lesson and relevant documentation designed and developed by the group. The topic of the tutorial shall bea health issue (e.g., teenage pregnancy, cocaine, or aerobic exercise) of the group's choice. Deliverables: The CAI tutorial will he comprised of the following deliverables: 1) tutorial documentation -objectives of wtorial -target audience -equipment requirements - design strategy -operator directions - listing of tutorial program - pilot test results 2) tutorial introduction and objectives - description of how to use system -interactive with the learner - use of the following commands: ST: A: SM: STY: *TN:

SW: - content valid - about a 7-10 minute program -include a test section with response analysis closing message for further health information on topic 3) disk of tutorial

162 TEACHING IDEAS 90

TIC-TAC-TOE Mary Lawler

Want to get your students interested, One copy of eachquestion is Players continue taking turns until involved, and excited? Need something needed for each two students in the the game is won or a draw is declared. different to motivate evetyone from the class. I used several different methods Players then draw a new tic-tac-toe grid brightest to the least gifted in your for preparing the necessary questions. and continue playing until all questions classes? Strike it rich with something as They can be typed on colored paper, have been answered correctly and taken simple as tic-tac-toe. coded for the degree of difficulty. An- out of play.Progress throughout the In tic-tac-toe students pair up and other way is to type all questions on game varies with ability of the students. administer their own game by being white paper and code them for difficulty Students in my health classes (grades 9 master/mistress of ceremonies, judge, by marking the end of the sheets with the and 10) play the entire packet in 30 to 45 and contestant at the sam Mime. Students appropriate color. One copy of each minutes. love to compete and cannot be passive question is then placed in an envelope; Students benefit by working at a while playing this game. It's based on the envelope is sealed and slit at one end self-paced, directed activity at a difficulty the timeless game everyone knows how to expose the color coded end of the level of their own choosing. They are to play, so attention can be placed on questions (questions can thus be selected involved on task with reading, answer- learning or reviewing the material at without being read). Another method is ing, judging answers, and planning hand. to print the questions on cardstock, of strategy. The teacher's role should be First, I wrote questions and an- three different colors; these are more only as final judge for accuracy and swers on our current unit.Questions durable but take more time to prepare. fairness. were then judged as easy, mediu or The class is divided into partners to The game is easily adaptable to any difficult. Difficult questions shou.:ot begin the game. Once a player selects a subject material and grade level. It has be true/false, in order to eliminate difficulty level, their opponent reads the been a fun, exciting activity that left my guesswork. The number of questions appropriate level question from the students involved, interested, and excited can be adjusted to your material or time cardstock stack or envelope. The first over health class. restraihts.Table 1lists a sample of player answers and if correct, places questions used in our substance abuse their symbol, X or 0, in the tic-tac-toe edition. grid.Xs or Os earned with correct Questions andAnswers I began with 25 easy and medium responses to easy questions can only be questions and 6 difficult questions. placed in the four corners, medium for the Fewer difficult questions are needed questions in the mid-box, and difficult Substance Abuse Unit because they earn fewer squares within questions in the center of the grid, as the tic-tac-toe grid. The questions are shown in Figure 1 (see next page). Easy Questions typed with the acceptable answers fol- Missed question3 are returned to the lowing. For example: Chewing tobacco stack or envelope and remain in play 1.Name a drug in the narcotic cat- causes a white patch in the mouth called until answered correctly. It is possible egory.(heroin, codeine, methadone, .(leukoplakia) the question may recycle to be asked of morphine, opium) the player who previously played it. 2. What are the narcotics used for in However, it is entirely by chance and medicine? (stop pain, stop a cough, stop students are rewarded for remembering. diarrhea) Mary Lawler is a teacher at Only the difficulty of the question is in 3. What is the natural source for nar- Greenfield-Central High School, the control of a player, not the actual cotics? (opium, poppy plant) Greenfield, IN 46140. question selected.

174 163 4. Where is all cocaine grown? (South cohol use: relaxation or loss of balance? 9. in tobacco makes it America) (relaxation) addictive. (nicotine) 5. Free-basing is a method of using 25. Name the organization which 10. in tobacco causes which drug? (cocaine) works with teen-agers who live with an cancer. (tar) 6. Is caffeine a stitnulant? (yes) alcoholic. (alateen) 11. What groupisthe only 7.Canyou overdose on caffeine? American group to increase its tobacco (yes, but it takes a lot) Medium Questions use? (teenage girls) 8. What effect does a barbiturate have 12. Which gets into your system on a person? (can calm or put you to 1.What is the disease in which fat faster:a smoked cigarette or chewing sleep) replace.s normal cells due to the damage tobacco? (smoke) 9.Do anti-depressants make people done by alcohol? (cirrhosis) 13. Which has more tar, ammonia, high? (no) 2.What is the best way to quit carbon monoxide, and hydrogen cya- 10. What group of drugs make a smoking? (cold turkey) nide: mainstream or sidestream smoke? person see things which aren't really 3. What narcotic is often found in (sidestream smoke) there? (hal lucinogens) cough medicine and pain relievers? (co- 14. Proof is equal to--- times thc 11. ------is anything deine) percent of alcohol. (two) which causes a change in your body 4.Name a medical use for amphet- 15. is when an physically, mentally, or emotionally. amines. (narcolepsy or hyperactivity) alcoholic cannot remember. (black-out (drug) 5. What is the most commonly used or alcohol amnesia) 12. Stopping drug use aml getting drug in America? (alcohol) 16. oz. of beer has an sick because the addiction isn't fed is 6. Approximately - % of all fatal equal amount of alcohol as ----oz. of called .(withdrawal) auto accidents involve alcohol. (50) wine. (12:5) 13. dependence 7. Which drug is the most addictive in 17. Five ounces of has as involves both tolerance and withdrawal. the world? (cocaine) much alcohol as a shot of--. (wine: (physical) 8. What is the term for needing in- hard liquor) 14. dependence creasing doses of a drug to get the same 18. 1 1/2 oz. of whiskey has------means you think you need the drug. effect? (tolerance) oz. of ethanol. (1/2) (psychological) 15. Name one cancer besides lung II1" cancer caused by tobacco use. (oral, kidney, throat) 16. In 1972 cigarette ads were banned on .(TV and radio) 17. is a disease caused by smoking and is both incurable and progressive. (emphysema) 18. Name three things you cannot do while smoking, (answers will vary but may include swim, kiss, live) 19. What type of alcohol is found in alcoholic beverages? (ethyl) 20. What is the only organ in the body which can break down alcohol? (liver) 21. If someone had four mixed drinks, how long would it takc to break down all of the alcohol in their body? (four hours) 22. Which produces a stronger beverage: fermentation or distillation? (distillation) 23. What usually happens when the BAC level reaches 10%? (death) 24. Which happens first with al- Figure 1. 164 TEACHING IDEAS 91

19. What is the active ingredi^nt in marijuana? (THC or delta-9 tetrahydro- cannabinol) 20.One marijuana joint has the same ability to cause cancer as of cigarettes. (one) Picture Charades: 21. Name the hallucinogen which causes violent hallucinations and was once used as an anesthetic for animals. (PCP) 22. Most names for prescription depressants end in . ( al) 23. When legal penalties have been decreased for drug use or possession it has been . (decriminalized) 24. are abused to build muscles and may lead to cancer and other health problems. (steroids) 25.Glue, butyl nitrate, and gasoline belong to the group of drugs known as

.(inhalants) Difficult Questions A Health Teaching Device 1. Chewing tobacco causes a pre- Richard T. Mackey cancerous white patch in the mouth called

.(leukoplakia) 2. Lung cancer is % fatal. (95%) Looking for a classroom activity that you become an observer. The leader has 3. The lit end of a cigarette reaches your health students will find exciting a list of four or five terms, phrases, or what temperature? (90) -1200 degrees and fun-filled? Try picture charades. It's perhaps definitions pertaining to the enjoyable, promotes learning effec- health topics the class has been study- tively, and is particularly good in helping ing. At the start of the game, a captain 4. What would be the effect of 60 students clarify vocabulary words you from each team goes to the leader and milligrams of nicotine taken all at once? include in your health instruction. gets the secret word. The captain hurries (death) The rules for pictures charades are to his or her team and draws a picture of 5. What's the difference bk tween a quite simple. They are really the same as the term. The captains may, in addtion to problem drinker and an alcoholic? (al- for regular charades, but instead of act- drawing the picture, sketch a dashed line ing out the words, participants must indicating the number of words or sylla- coholic is addicted, problem drinker's draw a picture of the word, phrase, etc. bles in the phrase or word. They may drinking leads to problems but they may Here are thz., rules: Divide the class into answer only yes or no to questions from not be addicted) teams of four to six members. All teams teammates. The team member who dis- 6. is a drug used for aver- can compete against each other at the covers the correct.m becomes the new sion therapy in treating alcoholism.same time, or you can arrange other captain, rushes tc e leader to verify the forms of competition. The important correctness of the term, and then gets a (antabuse) thing is to keep all teams actively partici- new one. The first team to identify all the pating. terms is, of course, the winner. You, the teacher, can act as tlw leader, You can supply the health vocabulary or you can appoint a student leader and words or terms or invite your students to develop a list. A list pertaining to dental health, for example, could include the following: fluoridation, soft bristles, unwaxed floss, bicuspid, brush and floss once in every 24 hours, toothpaste, junk food, and gingivitis. If you students enjoy a challenge and you want to add some zest to your health _ class, picture charades are for you. After Richard T. Mackey is in the Department of you see them play the game, you'll prob- Health, Physical Education and Recreation at ably find a way tbecome a participant Miami University, Oxford, Ohio. yourself. The author did! 165 TEACHING IDEAS 92

Drawing Interpretations of Health Vicki L. Cleaver

HOIDE MOTIVATION SPIRITUA LIFE PEERGROUPS SOCIAL -FRIENDS WORK SCHOOL

EMOTIONAL OEPFIE HAPPY SAO ANGRY

pEER PSYCHOLOGICALDoivoi0 pRESSUR` PHYSICAL 7.10evs NORM" "vo ExERCIsE

REST proper hygiene

AFFECTION, SELF ESTEEM, 01). SECURITY 9 O. Teachers often strive to effectively use 061 PSYCHOLOGICAL a variety of teaching methods, especial- ototA,,,sot NEEDS vbot. at 1410 ly with large classes. A technique which 011 gond. the author has used periodically and ,. oo which has proven successful is to have p4 I °so the students draw their interpretations 0 00 oe of health rather than assigning an essay. 0, 0 0 o el oO 0 43 0 0 Directions for the Assignment °G0:ye° a Divide the class into groups of four to five students. If possible, the teacher should provide the drawing paper or poster board needed in each group. The students should be advised ahead of time to bring colored pens, pencils, or markers to class. Each group should discuss what health means, then dray., a picture representing their interpretation. Give each group approximately 45 MISS PHYSICALLY minutes to discuss and complete the FIT drawing. Have each group hang their picture in the room. If time allows, have Vicki L. Cleaver is assistant professor in the a representative from each group ex- Health, Physical Education, and Recreation plain the group's drawing. Department, 119 Huston Huffman Center, University of Oklahoma, Norman, OK On this page are samples of creations 73019. by former students. 166 177 TEACHING IDEAS 93

Using Team Games to Teach Health

Mark A. Croson Roseknn Benson

Correct health information is an im- VERBAL student has the opportunity to respond to portant part of a growing student's life. questions at all three levels of difficulty. However, the hea:th educator must be `.'.13LLEYBALL Points can be scored only by the offen- able to get the student's attention in sive team. order to clarify what is fact or myth, Cbissmum_shunizatian healthy or unhealthy. A lasting impres- Orgaze classroom chairs into three Penalties sion that will involve students in a rows per team, facing each other. Penalties are assessed by the referee stimulating learning experience in the for answering out of turn, or any inap- classrom will aid retention of material. Quail= propriate classroom behavior. For de- Learning by doing will result in greater The questions should be organized fensive team penalties, a poi nt is awarded retention because learners who are re- into three levels of difficulty. Level one, to the offensive team. For offensi v e team quired to be active in the learning pro- the easiest questions, go to the passers. penalties, side out is awarded to the cess must be attentive. Level two, more difficult questions, go defensive team. Purposeful activities that are based to the setters. Level three, the most dif- on a student's interests include teaching ficult questions, go to the spikers. Re- strategies involving problem solving and gardless of question difficulty, students Three hats from which to draw each active student participation, as in group must have a set time in which to respond. level of question Pre needed. games. Well-known team games such as Atypical time limit would be 15 seconds. volleyball, football, and baseball are Yariatiuns natural vehicles to interest all students in Rules The game may be focused on indi- learning. The students are organized into two viduals, small groups, or the entire team Three examples are described here. teams and a coin is flipped to determine depending on how the teacher wants to Student objectives could include but are which is the offensive team. The team direct who may respond to the questions. not limited to recalling or explaining serving the ball is the offense and the key terms, definitions, and ideas. Each team receiving the ball is the defense. FOOTBALL game is appropriate for introducing The individual in the offensive serving material with which the students are position draws and relds a level one FOLLIES already familiar, or revie v. ing for an question to the passers. If they answer exam. These games are ex !...ng activi- correctly, the server draws and reads a Questions ties that will get everyo:ie out of his/her level two question to the setters. If they The questions should be organized seat and involved in the action, answer correctly, the server draws and into three levels of difficulty. Level (me reads a level three question to the spikers. questions, the easiest, are worth 5 yards. If they answer correctly, the referee Level two questions, more difficult, are draws and reads questions in the same wortn 10 yards. Level three questions, order to the offensive team. The question the most difficult, are worth 15 yards. series continues uru it one team misses. Regardless of question difficulty, stu- Mark A.Croson and RoseAnn Benson If the defense misses, a point is awarded dents must have a set time in which to are in the Department of Health. Spot t to the offense. lf the offense misses, a respond. A typical time limit would be and Leisure Studies at George Mason side out Is awarded to the defense and 15 seconds. University, Fairfax, VA 22030-4444. team members rotate:. By rotating, each

167 Rules BASEBALL and reads one question. The individual A diagram of a football field includ- at bat has only one strike to correctly ing yard markeis is made on the chalk- BOOGALOO answer a question. If the question is board. The students are organized into incorrectly answered an out is assessed teams and choose the order m which Chosammikganizalim and the next batter is up, and so on until they are to resporki to a question. A coin The classroom should be organized three outs. If the question is correctly is flipped to determine which is the into a diamond shape with chairs for answered the team in the field has the offensive team. The offensive team stu- bases and player positions. opportunity to throw the batter out by dent whose turn it is to answer a qaes- answering a question of equal difficulty. tion, chooses the difficulty level/yard- Questiow Single and double questions are an- age. The referet, draws and reads the The questions should be organized swered by the infield (as a group). Triple question. If the questiou is answered into four levels of difficulty. Level one and home run questions are answered by correctly the yaids are awarded. The questions, the easiest, are worth a single. the outfielders (as a group). offensive team has four chances to make Level two questions, n,ore difficult, are If two base runners reach base a first down or 10 yards. If they succeed, worth a double. Level three questions, safely, the defense may attempt to answer they continue w itn four more chances. If even more difficult, are worth a triple. two additional double questions in order they fail, the defensive team is awarded Level four questions, the most difficult, to make a double play. If they miss one the ball and has four oppertunities to are worth a home run. Regardless of question, the lead runner advances one make a first down. question difficulty, students must have a base. If they miss both questions, one set time in which to respond. A typical runner scores and the other advances Malta time limit would be 15 seconds. one base. Players advE bases as forced Penalties are assessed by the referee by the hitters following them. for answering out of turn or for any Rula inappropriate classroom behavior. The The students are organized into two Penalties penalty cards are shuffled and one is teams and choose their batting order and Penalties are assessed by the umpire drawn and assessed agairvt the guilty field poEition. A roster must be submitted for answering out of turn or for other team. to the umpire. A coin is flipped to de- inappropriate classroom behavior. If an termine which team is at bat. The offen- offensive player breaks a rule, an out is Equipment and Materials sive team student whose turn it is to then assessed. If a defensive player Three football helmets are needed to answer a question chooses the difficulty breaks a rule, a walk is given to the hold the three levels of questions. A level/number of bases. The umpire draws player at bat. white penalty flag is needed for the referee to drop when a penalty is to be assessed. Penalty cards consisting of 5. 10, and 15 yard losses should be made on 5 x 8 cards. If the penalty is against the offensive team an additional card, "fumble," should be added. A paper football marked with an arrow placed on the playing field marks direction and progress toward a touchdown (7 points).

168 TEACHING IDEAS 94

The Concept of Health and TechniqueF of Conceptual Analysis

Joseph E. Balog

To take what there is, and use it, concept of health is not an empirical develop, record, and refine two lists as without waiting forever in vain fact or a directly observable and objec- common features which your students for the preconceived - to dig deep tive phenomenon. Rather, health is a use h. describing why they think some- into the actual and get something human construct that is defined in ac- one should be considered healthy or ill. out of that - this doubtless is the cordance with our cultural values, so- Note that including the examination on right way to live. cial norms, and presuppositions about illness helps students in developing its existence. Second, the profession of their views on health. -Henry James health education has traditionally Begin this exercise by handing devoted little and formal study to out a sheet of paper which asks two The ancient Greeks viewed analyzing concepts in its curriculum. questions about a list of people. The health as one of the greatest goods. In The task of defining health is dif- questions and list may look as follows: fact the cult of Hygeia claimed that ficult, hut the fact still remains, an un- health was the foremost good and "the derstanding of health is a most essential Conceptual Analysis Activity most desirable thing" (Temkin, 1977). and fundamental ingredient for being a However, other cults cautioned against health educator. Thus, health Are the following people healthy? the glorification of health. The Stoic educators should ask of themselves, Explain. philosophers did not view health as an and of their students, "What does Are the following people ill? Ex- absolute value, but they did emphasize health mean?" even if for no other plain. the idea that health was necessary for reason than simply that someone may - A person with bronchogenic car- the practice of virtue (Temkin, 1967, have an answer or provide a clearer and cinoma (lung cancer). 1977). Regardless of where the ancient more insightful way of viewing health. - A person with hypertension and Greeks and modern day health The following activity is anginal pain. educators rank the value of health, this presented to help health educators in - A student-athlete who is a top concept is still at the core of the facilitating a discussion on the concept middle distance runner. profession's role and exist 'trice in of health while providing some basic - An aerobic physical fitness in- society. As a consequence, it is ;mpera- techniques for conducting conceptual structor. Live for health educators to help their analysis. A more detailed and thorough - A person with dyschromatic students and future professionals in description, which contains additional spirochetosis (discolorization of the their understanding of what it means to examples and dialogue, can be found in skin caused by a spirochete). be healthy. Conceptual Questions in Health Educa- - A person with myopia (near- This is perhaps one of the most tion and Philosophical Inquiry or in Eta sightedness). difficult intellectual tasks which con- Sigma Gamma's monograph, Ethics - A person who is a paraplegic. fronts health educators. The reasons and the Field of Health Education for this are many and have been dis- (Balog, 1982, 1985). As the instructor, you may wish to cussed elsewhere (Balog, 1981, 1982, develop your own list. However, if you 1985). In general, though, studying the do use alternative examples, make sure concept of health remains elusive for the items on your list reflect the follow- two very important reasons. First, the Conceptual Analysis Activity ing ideas and techniques of conceptual analysis. Joseph E. Balog is with the Department The overall goal zthis activity is Hand out the list and have your of Health Science, State University of to help students n constructing their students take it home as an assignment. New York, CollegeatBrockport, own view of hewn/. More specifically, The students' task is to answer the two Brockport, NY 14420. the main objective of this exercise is to questiors by writing out a brief ex-

169 1 sti planation on why they think the people runner. The objectives are (1) to com- normality, natural body designs, or on the list are healthy or ill. When the pile a list of features which the students proper physical functioning. Thus, the students return during the next class use in describing health and (2) to com- purpose of using related cases in con- period, the instructor's main tasks are: pare and contrast this list to the above ceptual analysis is to discuss concepts (1) to facilitate a dialogue and (2) to list on illness. which are similar, connected, or re- record on the board, two lists (one for Next, use the example of the lated to the concepts of health and ill- health and one for illness) of common aerobic fitness instructor, andas above, ness. terms, phrases, and/or features which compare, contrast, and merge into one The examples of a person with students use in explain;ng whether the list of features which students offer in myopia or a person who is a paraplegic individuals on the handout are healthy talking about health. You may find stu- are good cases for beginning this or ill. Developing two lists and con- dents wanting to disagree with the dialogue. In both cases, students might trasting the ingredients !or defining items on the health list. Welcome the be quick to agree there is present an im- health and illness should help the class arguments, but also try to draw out and proper functioning, an unnatural in seeing how they view these two con- identify items whien can be placed on functioning, or an abnormal function- the list. ing, but slow tt. ::-..mclude that these individuals are unhealthy. As a result, students are led to question whether Classroom Discussion and Model Counterexamples these criteria should be on their list of Cases common feature for health or illness. Counterexamples are cases These examples also beg a discus- Begin the discussion by using a where a premise might ix true, but the sion on whether a person can be physi- model case example on illness. For conclusions are false. A person with cally abnormal, or have an improper your purpose, a model case example is dyschromatic spihxhetosis is a good physical functioning, yet at the same a person from the list who would be example to use with this technique. For time be considered healthy. Students typically seen as being ill in our society. instance, this condition is a discoloriza- will want to say, for example, "Yes a Choose the example of a person with tion of the skin caused by a spirochete. physical limitation of improper hi ochogenic carcinoma. Most people, including your students, functioning is present, but this does not Identify and list the common fea- would argue that this physical state is mean these people are unhealthy." Try tures of an illness which your students abnormal and represents an improper to pin point the criteria they use in ar- use in their explanations. For example, or unnaturat body :unctioning. guing and justifying their positions and they may offer descriptions such as an However, point out that a famous add or subtract these items to your lists. abnormal growth is present, the condi- medical sociologist, David Mechanic, tion can cause death, or this person's discovered that in a South American body is not functioning properly. tribe this condition was so common, Summary Next, select another model case "Indians who did not have (it)were such as the person with hypertension regarded as abnormal and wereeven At this point, you should have and anginal pain Once again, list com- excluded from marriage" (Mechanic, recorded on the board two lists of common descriptions which the students 1968). mon features which your students present in explaining why this person is 7 his is a good place to propose to developed in describing health and ill- ill. Compare and merge the list by ad- the class that some conditions which ness. The class, however, may still be ding or subtracting items which the stu- might seem abnormal, improper, and unsure and confused about the con- dents believe are essential criteria in considered ill by some people can also cepts they have been discussing. Thus, determining what is an illness. be judged as healthy by others. Thus, the instructor must tie together the ac- this example raises the question of tivity and offer a summary. In general, whether a person can be healthyeven if your summary should include the fol- Contrary Cases an abnormality or an improper physical lowing three points. functioning exists. Afteryou discuss First, you should note that a The next step in your analysis is this point, see if you need to addor sub- variety of views were offered, because to use a contrary case example. A contract any items on your list of health and health and illness are concepts which trary case is similar to a model case ex- illness. individuals define relative to their cul- cept the interest lies in inquiring into tural values and presuppositions about examples which people typically these two concepts. Second, point out believe are the opposite of an illness or Related Cases that ideas of health and illness usually disease. The idea is to consider cases group into three different themes or wnich people would say "Whatever an As the example of dyschromatic categories. The first theme centers on spirochetosis points out, when students illness or disease is, this case certainly the idea that health and illness areop- isn't an example of it." discuss the concepts of health and ill- posites. The absence of one establishes Choose the example of a student- nes it isn't long before they need to the presence of the other, i.e. health is athlete who is a top middle distance start examining related concepts like the absence of disease or illness. A 1 70 s 1 second theme views health and illness health are appropriate concerns of the Temkin, 0. & L. C. Temkin, eds. (1967). in regard to how well an individual health professions. Thus, the challenge Ancient medicine: Seiected papers of Ludwig adapts, adjusts, of functions daily. For facing students of health is to develop Edelstein.Baltimore: The Johns Hopkins instance, an individual whocan not answers to the perplexing conceptual University Press. carry out his or her daily tasks would be questions about health and illness and considered ill. On the other hand, an argue why one is better than another. individual who functions well in life Challenge your students not to accept would be viewed as being healthy. preconceived answers, but "...to dig Finally, a third popular way of viewing deep into the actual and get something health and illness is simply bya out of that - this doubtless is the right person's own self-assessment. In this way to live." case, all that really counts is how an individual perceived his or her own level E alog, J. E. (1981). The concept of health and of health and illness. the role of health education.Journal of School Health,Sept., 461-464. Next, review your list on I.ealth .log, J. E. (1982). The concept of health and and determine into which category the disease: A relativistic perspective.Health student's view of health falls. Then, Values: Achieving High Level We/bless,6(5), move on to constructing a definition of 7-13. health which evolves from the student's Ba log, J. E. (1982). Conceptual questions in list of health criteria. health education and philosophical inquiry.Journal of School Health,52(4), 201 Finally, bring the discussion full 204. circle. Go back to Henry James' quote Balog, J. E., J. H. Shirreffs, R. D. Gutierre-,, and note that in defining health and ill- & L. F. Ba log (1985). Ethics and the field ness, there are no absolute answers. of health education. Eta Sigma Gamma, The answers people create, however, Monograph Series,4(1), 63-110. are very real and greatly influence: (1) Mechanic, D. (1968).Medical sociology: A se- people's attitudes toward achieving lective view.New York: The Free Press. health; (2) which professions are Temkin, 0. (1977).The double face of Janus: And other essays in the history of medicine.Bal- responsible for dealing with health; and timore: The Johns Hopkins University (3) which patterns of dealing with Press.

182 171 TEACHING IDEAS 95 The Town Council Meeting: Decision Making ThroughaLarge Group Role Play James D. Brown

Health educators are often challenged could be: D.WJ. legislation, drinking to help collect and analyze data,to to develop a strategy concerning a con- age, flouridation, metal can ban, nucle- guide students through the problem tToversial issue that includes decision ar power, pollution controls, fire arms, solving process,to ensure decision making, maximum participation, and a seat belts, mandatory retirement for dv- making, to develop follow-up activities, balance between information giving and ic and school employees, and many to ensure participation and to take a others. discussion. Because theTown Council 4. Time frame and the council meeting agenda. stand on the issue, if asked, after stu- Meeting can be adapted to many group By taking class time to give the assign- dents have expressed their decisions. settings, many educators may enjoy an ment carefully, hold strategy meetings, activity that provides detailed informa- complete the council meeting and de- tion,dramatizations, heated debates, velop some appropriate follow-up activ- judgments, and fun. ities approximately threefullclass meetings can be used. The council meeting needs an agenda and time Directions schedule. A number of options can be The specific directions for this activity are: equally effective. For example, tl:e pre- 1. Role assignments.Establish tlw council senters could have each member make meeting date and assign the various a timed presentation or elect one or two roles a few days in advance to allow fo1 members to role play expert testimony. adequate preparation. The rolesin- Time should also be set aside to have clude: th? mayor (1); council members council members question the present- (6-10); presenters for the pro side of the ers and to have the concerned citizens issue (4-6); presenters for the con side respond. Once the testimony is com . 7-...... of the issue (4-6); media representatives pleted the members of the council vote (1-4); and concerned citizens (3-10). on the issue. Prior to submitting their Choose the role players carefully. Usu- news copy to the class the following ally it is best to use volunteers or indi- day, the members of the media should viduals known to enjoy being in front. interview the participants. The presenters are the key to a success- 5.Follow-up.During the following meet- ful program because their role demands ing have the members of the media effort and ingenuity. For example, they present their coverage of the proceed- may want to "plant" a few concerned ings. This could be in the form of a citizens. Since our local council meet- newspaper article or presented as a ings are televised, our role players re- radio or TV spot. Follow the media cently had a wonderful time mimicking presentation with a class discussion. the mannerisms of our civic leaders. Some of the kir-. questions for the class 2. Information gathering.The teacher can discussion might include: (1) How accu- have most of the materials available and rate were the members of the media? (2) should allow a few days for students to Who changed their position on the is- gather additional resources. This could sue during the council meeting and include interviews with civic leaders why? (3) What were the major points and the members of the council, sur- developed on the pro and con sides of veys, visiting agencies, etc. All class the issue? (4) For those who might be members should take part in the infor- interested, what activities could group mation gathering. members take part in to support their 3. Choice of topic.The most apprepriate side of the issue at the local or state topics are controversial issues C-at are levels? currently before our state and local gov- ernments. A review of your town council's agenda may find such 0,, 1. For example, our class choseAI 1-nance under consideration by (.tuncil The Teacher's Role banning smoking in buildings The teacher's role in any controversial and public transportation .i.er issues issue is to guide, motivate, clarify, and 41. help gather reliable sources. The teacher .." James D. Brown is with the Department of must remain unbiased; more specifical- dik- -""Ar-t- Health and Physical Education, 20 Both- ly, the teacher's role encompasses the 'eft well,University of A4issouri,Columbia, following servic?s: to help define the Missouri 6'7211. problems, to evaluate student progress, -411711`; 172 1S3 TEACHING IDEAS 96

The Health Reporter Pool David Wiley

Student, who are often viewed as class, with each health-related charac- into specific time frames and availabil- "receptacles" in which to deposit heal th- ter. ity of resources. For example, the activ- related information, should be more Several days prior to the press con- ity can be used as a 10-minute introduc- actively involved in the learning process. ference, the characte- and the reporters tion to a new unit or as an entire class A primary problem with mass-prr ducet. conduct research to discover facts and session on a particular topic. Also, the teacher guides and curriculum manuals other health-related issues pertaining to teacher can design questions for thc par- in health education is that they tend to the character. Reporters must formulate ticipants to research or rely on the stu- focus more on subject matter than on relevant questions such as: "What is it dents to generate their own set of ques- student participation. The field of health like to be a bacterium?"; "What good do tions and responses. Most importantly, education, however, presents many op- you do anyone?"; or "If you are sup- no special materials are needed for this portuni ties to activel-7 involve the student posed to help humans, why do you con- activity, although students should be in the !catmint process. The goals of stantly have to be controlled?" The encouraged to use appropriate props to health education differ from other sub- teacher can limit orexpand the types and represent their specific character. jects, such as mathematics, geography, numberof questions based on availability Advantages of using the Health or history, where knowledge is factual of time and resources. Reporter Pool are numerous. MI st, it and cumulative. In health education, An exchange between the reporters actively involves students in thc learn- knowledge should be combined with (R) and the character (C) might go as ing process. Health class then becomes efforts to influence positive health atti- follows: "something to do," rather than "some- tudes, effective decision-making skills, thing to attend." Students become in- and promotion of pc sitive health be- R I: "So tell me, what makes you, a volved in researching a particular sub- havior. bacterium, so important?" ject for something besides a research The Health Rcporter Pool is an C:"Well, I am very important in paper or other written report. Second, activity that can combine a variety of helping the body conduct a variety of topics that many students might con- student-centered activities into a single funciions." sider boring (e.g., nutrition, infectious lesson format. The central idea of the R2: "Would you be so kind as to disease, personal health) can be made Health Reporter Pool activity is that a elaborate on two or three of these func- exciting and fun. In addition, controver- student is ercted to role play a particular tions?" sial topics (e.g., AIDS, sexuality, sub- health-related "character." The choices C: "First of all, I assist the intestinal stance abuse) can be approached from for characters are limitless, for example, tract in the digestion of food. In addition, an impersonal perspective that could a bacterium, a carbohydrate, a drug I can help ward off certain infectious serve to reduce the inherent volatility of abuser, a positive self-esteem, a good organisms." MP' of these issues. Third, the activity decision, or the human immunodefi- R3: "PleL .e describe your relation- be used with special populations. ciency virus (HIV). Based on class size, ship with antibiotic drugs." For example, classes comprised of a a number of other students are selected C: "As you may be aware, I've ncvcr predominantly minority population can to be reporters "assigned" to cover a really enjoyed being around antibiot,..c examine health care issues from the per- press conference, in the presence of the and I'll tell you why...." spective of that particular group and even carry on the interview in a lan- The Heath Reporter Pool)ft hc gcage other than English. used with a variety of grade levels (7 -12) Fourth, the Health Reporter Pool David Wiley teaches at Southwest and diverse ability groups. In addition, can be used to integrate health with other Texas atate University, Scn Mat cos,TX this activity is structured with maximum content areas. As an example, the prob- 78666. flexibility to allow the teacher to fit it lem of AIDS can be examined from a

184 173 TEACHING IDEAS 97

sociological perspective, with the health educator and sociology teacher using the Pool to serve as an introductory activity in a coordinated effort to provide a focus on the topic. Thus the activity provides a medium to spread the health education curriculum across re- Health Education Supermarket lated content areas within a school. Fifth, students must learn beyond rote memo- Mary S. Sutherland rization and advance to higher level thinking and interaction skills. With the Health Reporter Pool, students learn to answer a range of questi ns focused on advancing discussion beyond basic facts. Finally, students have the opportunity to develop public speaking skills. This learning strategy is appropriate chased by every family member, based For many students, speaking before afor a secondary health education class- upon family health needs. Upon comple- group is a very uncomfortable experi-room or a college personal and commu- tion of the shopping trip, each family nity health course. The strategy has been unit member will share reasons for his or ence. By structuring the activity care-used successfully in selected health con- her selected purchases and how the pur- fully, the teacher can provide studentstent areas such as mental health, drug chases will help the family improve its with the opportunity to practice speak-education, family health, or diseases and level of wellness. ing in a controlled environment. Foris applicable to any health education con- Following is a sample list of available tho- e students who speak comfortablytent unit which uses value clarification items in each aisle. Only the items men- and/or decision making techniques. tioned are to be purchased: in front of a group, the Pool provides an The participants are grouped as an Aisle one items: (1) package of food, opportunity to ad lit, and have fun cre-imaginary family unit for a wellness water, air; (2) package of sleep, dreams, ating an interesting interview. shopping trip, where they can purchase and warmth; (3) mental illness candy; (4) The Health Reporter Pool idea hasitems to attain a more healthful lifestyle. shelter; (5) pill for self-love; (6) pill for the potential for use in a variety of ways.Family members might consist of a lov- parental love; (7) pill for sibling love; (8) ing father and mother, each about forty- pill for love of parents; (9) independence Teachers have the discretion to use thefive years old. The parents are typical syrup; (10) person's favorite music; (11) activity in a strictly controlled mannerhardworking individuals, both em- changing values mix; (12) behavior; (13) or to allow students to construct theirployed full-time, who want the best for happiness; (14) emotional snacks; (15) own interviewing activity. As this ac-their family and desire to k Is well as maturity. tivity is used throughout the school year,be loved. All family members are affeo. Aisle two items: (1) religious drink; (2) social drink; (3) machine for changing the more comfortable and creative stu- tionate. Children may display the following characteristics: drinking habits; (4) tape of teenage dents can become in its use. A. A single eighteen-year old son, drinking habits; (5) reality-escaping Its most important characteristic is who displays a fond for alcohol and drink; (6) excitement drink; (7) six pack of that it directly involves students in the a need to be loved. peer pressure drinks; (8) bottle of alcohol process of learning. The Health Reporter B. A sixteen-year old daughter who is and driving attitudes; (9) pint of effects of alcohol; (10) gallon of alcohol and acci- Pool provides teachers with a creative extremely popular with boys. However, her morals are suspect. dents; (11) a heavy drinker mix; (12) pill and challenging activity in which stu- Each family unit member will then to become an alcoholic; (13) pamphlets dents may develop new skills while re- visit the health su:lermarket and pur- on number of alcoholics in U.S.; (14) re- fini.ig skills that already exist. chase appropriate wellness items. The ceipt from alcoho: cost; (15) understand- shopping aisles may be divided as fol- ing; (16) helping hand. lows: Aisle three items: (1) societal pressure; Aisle oneMenti Health (2) choice of schools; (3) communication Aisle twoAlcohol package; (4) responsibility cans; (5) cul- Aisle threeFamily Healtl- tural mix; (6) bag of unity; (7) can of secu- Aisle fourVenereal Disease rity, (8) jar of affection; (9) pound of fam- Five items from each aisle may be pur ily pride; (10) sale on ethics. Aisle four items: (1) bag of truth; (2) penicillin tablets; (3) appointment for the doctors; (4) appointment to a public health clinic; (5) ja: of symptoms; (6) Mary S. Sutherland is at Florida State Uni- ounce of fear; (7) package of ignorance; versity, Department of Human Services and (8) a pill for courage to tel: parents; (9) Studies, 215 Stone Building, Tallahassee, FL change of sex practice pill; (10) slice of its 32306. going away. 174 TEACHING IDEAS 98 Health Education to the Third Power (Cubed?) Susan Cross Lipnickey

They seem to be everywhere. Grand- soforth.This manipulative puzzle wearing a seathdt; and the need for parents have them. Parents have them. works beautifully to help explain the positive ..opirg skills, to name a few. Children of all ages can bo seen with concept of school health education. One could easily assign nine health them at school, at airports, in front of There are six 'sides' to school health knowledges to each of the nine Jquares the television, and when they are sup- education: for the learner there is the on the health knowledges side of the posed to be in bed sleeping. What is this side of health knowledges, the side of 'cube.' ubiquitous object? Why, it is none other health attitudes, and the side of health Health attitudes include howone than Rubik's Cube (a trademark of Ideal behaviors and practices; the health 'pro- feels about one's own health as wellas Toy Corporation). gram' also has three sides, or facets. how one feels toward the health knowl- Rubik's Cube is a six-sided, six-col- These are the healthy school environ- edges she/he has gained and whichare ored manipulative object. Each side has ment, the health instruction which oc- reflected in one's health practices. Does nine smaller squares. The object is to get curs within the school, and the school the student have the attitude that "it each side to contain nine squares of all health services. will never happen to me" and smoke one color so that there is one side which Health knowledges, in this case, refer cigalettes because she/he enjoys it now? is all orange; one which is all green; and to what the student actually knows that Health behaviors and practices are is the skills or information she/he has what one actually does. These practices Susan Cross Lipnickey is an instructor in gathered along the way: the long term may be positively or negatively influ Miami University's HPER Department, benefits of frequent aerobic exercise; enced by the health knowledges and Oxford, Ohio. how to perform CPR; the advantages of attitudes previously noted: brushing 1 75 186 and flossing one's teeth in combination sides may each consist solely of one the dimensions of 'the learner' with the with regular dental check-ups; driving color, but the side representing atti- dimensions of 'the program.' Since nei- at a rate no greater than the speed limit; tudes, the side representing behaviors ther can exist without the other, itis or asking for an explanation from the (as affected by Tom's attitude that acci- vital for us to combine the two in one physician when one doesn't understand dents only happen to others), and the model and not look at 'the learner' as an something. Each health behavior exhib- side representing healthy school envi- entity in and of itself, or 'the program' ited by the student could be assigned a ronment are a mixture of colors. Itis as divorced from 'the learner.' Health block on the health behaviors/practices quite possible then that only three, or instruction directly affects the health side of the 'cube.' half, of the sides are composed of blocks knowledges of the learner--if some- The healthy school environment, one of all one color: health knowledges, thing is not taught, the learner will not of the three sides of the 'School Health nealth instruction and school health have the opportunity to learn it.If it is Program' portion of Rubik's Cube is services. taught effectively, hopefully the student comprised of such 'blocks'as good On the other hand, positive relation- will have that knowledge to add on to as lighting for the students; the opportuni- ships can exist between the learner and time goes on and new information is tiesfor peer interaction within the the program. The following illustrates learned, as well as to draw upon when school setting; and an adequate amount just such a relationship with the facets that particular body of knowledge proof time for physical exercise and eating, of the program affecting the learner. . vides relevant information. But the as well as intellectual stimulation and Julie is a fourth grader at Lane Elementary knowledge of the learner can be affected challenge. The health instruction side of School. She, as with most fourth graders, by the healthy school environment as the 'School Health Education' cube has was not an overly health conscious person. well: if the room is too cold or too hot blocks such as a field trip to a water Two weeks ago, during recess, she fell and the student may be unable to concen- purification plant; the viewing of health suffered a severe laceration of her lower left trate and, therefore, miss essential con- films or discussion of current events leg. The school nurse was able to stop the leg cepts; if thclassroom environment is related to health; a guest speaker from from bleeding, take the "sting" out of the one in which the student is frightened an orgarCzation such as the American wound, and reassure her that everything or intimidated by the teacher, how Heart A sociation; or the teacher deliv- would be okay. She explained to Julie, while much knowledge will she/he gain? ering a k lure on a current health topic. they were waiting for her mother to come, School health services, as demonstrated School health services, the sixth side of the importance of keeping the wound clean in the example of Julie thc fourth grad- our cube which is neither more nor less and giving it a clrnce to heal. The school er, also has the potential to influence important than the preceding five sides, nurse showed Julie how to change 'he dress- the learner's body of knowledge. Health is composed of such blocks as vision ing so she could explain it to her mother and attitudes and practices can also be influ- and scoliosis screening; the treatment of help in the process. Her wound healed beau- enced by the programrole models of health emergencies within the school tifully. health behavior, reinforcement of posi- setting; and the administration of tuber- In this example there is primary inter- tive health practices by the teacher, and culin tests for faculty and staff mem- action among five of the six facets. . . encouragement in acquiring positive bers. There are numerous other exam- Health Knowledges: Julie learned how to health behaviors not previously demon- ples which could occupy the blocks change the dressing and why it was strated by the student. which comprise each of the six sides; imporant to keep the laceration clean; In addition, the Ftudent can influence the aforementioned are only a few. Health Attitudes: we can assume she felt the three program partswhat the stu- School Health Education is more than it was important because she followed dent knows or doesn't know mav influ- the sum of these facets; it ie; the interre- the directions, resulting in the complete ence what is taught; the student's atti- lation of these dimensions. When one of healing of the wound; Health Behaviors: tude may influence the rules for safety these six facets of school health educa- Julie followed the advice of keeping it in the school; the student's practices tion is incomplete, then at least one clean and changed the dressing to aid in may influence the type of school health other dimension is affected. Just as is the healing process; School Health Serv- services required. It should also be not- the case with Rubik's Cube, there is no ices: the school nurse was there to pro- ed that the three segments within 'the way to have only one of the sides in- vide emergency treatment as was need- program' portion affect each other and complete. At no one time can just one of ed; School Health Instruction: the school the same is true for the three segments the dimensions be incomplete due to nurse not only provided information in which comprise 'the learner' segment. the high degree of interrelatedness the form of why it was essential to keep The model of Rubik's Cube also affords among them. What we as health educa- the wound clean, but she also taught us the advantage of looking at each of tors must do is to realize aild appreciate Julie the skill of changing a dressing. the co- .ponents within the learner as the fact that school health services are The only side of the cube not primarily multidimensional. For example, knowl- not only tied very closely to and are involved in this illustration was that of edge is not just One item but encom- dependent upon health Mstruction and the healthy school environment. The passes a myriad of pieces of information a healthy school environment, but they school health services and health in- and skills gathered from as many affect very closely and are dependent struction were responsible for influenc- sources. upon the health knowledges, attitudes, ing the knowledges, attitudes and be- So, Rubik's Cube, the toy so popular and actions of the learner.Itis also haviors of the learner; thus five of the among today's children of all ages, pro- important for us to understand that six sides of our cube became one-col- vides us with a unique approach to there is a reciprocal relationship with ored sides and therefore so did the looking at School Health Education as a the learner affecting the program as sixth. multidisciph lary and di% 2rse entit, much as the program affects the learner. Utilizing Rubik's Cube as a conceptu- Going back to our Rubik's Cube of al model for the School Health Educa- School Health Education, three of the tion Program allows us to incorporate 176 iS7 TEACHING IDEAS 99

Junior High School Students as Facilitators of Elementary School Health Education Carnivals

David K. Hosick and Parris R. Watts

During the early 1980s, Watts and natural learning patterns of children their school, and the community. Invol- Stinson (1981) began to advocate prior to a formal student teachingex- vement of junior high school students "health education carnivals" for perience. From the beginning, objec- in facilitative roles enabled them to bet- elementary school students. These car- tives of the health education carnival ter appreciate their own health within nivals are similar to traditional health have been the promotion of (1) per- a context of a broader based ex- education fairs which have been sonal interaction between the perience. In addition, they were able to popular for years (Daughtrey, 1976; facilitators and children, (2) meaning- develop a sense of teamwork by joining Lafferty, Guyton & Pratt, 1976; Mc- ful health education experiences for together in a common cause. Also, the Kenzie, Scheer & Williams, 1981). The the children, (3) cooperative involve- junior high school students were given most obvious similarity of the carnivals ment among the facilitators as they a great deal of responsibility for provid- and fairs is that they boat employ many plan and implement the activities, and ing a quality health education learning of the sante instructional strategies and (4) positive public relations within the opportunity for elementary school stu- materials. However, where a typical school and throughout the community. dents, and they felt much personal health fair includes screening tests, the The authors of this article simply have pride when their efforts were success- health education carnival does not.The extended those expected outcomes ful. latter actually is comprised of a wide into a new dimension by replacing the variety of health education activities, elementary education majors with incorporated into a festive, carnival- junior high school students. In using OrganizingJuniorHighSchool like setting; hence, the reason for its junior high school studentsas Students as Facilitators name. Although health professionals facilitators of an elementary school still are involved in the carnivals, health education carnival, all four of The carnival idea was presented physicians, dentists and nurses replace the previously stated objectiveswere to eighth grade students of the Phelps their usual work apparel with costumes achieved for the elementary students, County Missouri School District as a that are more appropriately related to the activity areas of which they are a part. Watts and Stinson initially luoromil.:11' developed the health educationcarnival concept to expose undergraduate elementary education majors to the

Parris R. Watts is an associate professor of health education at the University of Missouri-Columbia,Columbia, MO 65211. David K Hosick is the former eighth grade science and health teacher in the Phelps County Missouri School District. He currently is a ninth grade science and healtn instructor at Blue SpringsJunior HighSchool,Blue

Springs, MO 64015. 6-

BEST COPY MAE 188 part of their junior high school science and to participate in a physical activity the teeth. Proper brushing of the teeth and health education course. Video and then listen to determine how much included in the skit, along with other tapes of other carnivals were shown faster their hearts beat in response to dental hygiene practices. and synopses of certain journal articles exercise. Playing of a game which em- First Aid Introduction to the were distributed for review (Watts & phasized the sequence of blood flow three degrees of burns and a Stinson, 1981; Petty & Pratt, 1982; through the chambers of the heart and demonstration on how to properly treat Bays, 1986; Wolf, 1986). After students reviewed how the heart works. Dis- each. The correct way to bandage burn informally discussed the idea among tribution of pamphlets and other injuries in order to help relieve pain themselves and considered it as a resource materials on blood circulation and prevent infection stressed. Printed group, they decided to conduct the car- and the benefits of maintaining physi- resource materials dealing with burns nival. It should bc noted that the health cal fitness throughout the elementary distributed. education carnival was not the only school years and beyond. learning activity within the course. A Nutrition Introduction of the health textbook wns utilized and tradi- four basic food groups and an explana- Conducting the Carnival tional health education class sessions tion of the importance of each. Discus- were held throughout the semester. In sion of "junk foods" and provision of During the week of the health preparation for the health education actual substitute foods for the children educationcarnival,regularly carnival, the class was divided into five to eat selected from among the four scheduled daily class periods for the different groups. After the groups were basic food groups. Playing of a nutri- eighth grade science and health course organized, each was given the oppor- tion game wherein students reached on Tuesday, Wednesday, and Friday tunity to choose from among five health into a sack of groceries and placed the were used for the carnival. On each of conceptual areas included in the car- food item withdrawn into its proper those days, the 56-minute scheduled nival. Those instructional areas were basic food group. class time was used to set up, conduct (1) smoking, alcohol, and other drugs, Dental Health Presentation of the carnival, and disassemble the ac- (2) physical fitness, (3) nutrition, (4) a skit involving the elementary students tivity areas. The first ten minutes of the dental health, and (5) first aid. Figure 1 themselves where they were intro- class period were used to assemble and outlines tasks completed by students duced to dental caries and given a organize the five activity areas. Then on and by the teacher of the course during graham cracker to eat. Plaque revealed each day, a different class (second the nine weeks devoted to preparation on their teeth and cleansed away by grade on Tuesday, third grade on Wed- for and staging of the health education using carrot and celery sticks to nesday, and fourth Grade on Friday) carnival event. demonstrate how foods can help clean participated in the carnival, held in the

Overview of Activity Areas Figure 1.Student Task Aulgrunents and Teacher Checklist Weeks Student Task Assignments __._.._... Following are brief descriptions 1-2 Develop the activity/conceptual area, including the :ielection of a carnival of the five conceptual areas included in theme and send for and/or locally secure information and resource the health education carnival. materials. Smoking, Alcohol, and Other 3-5 Organize information received and materials secured for use in the carnival Drugs Employed a smoking activity areas. machine to demonstrate the effects of 6-7 Work on banners, posters, handouts, and costuming for the activity areas. cigarette smoke on the lungs along with 8 Complete all preparatory work and rehearse presentations to be made the encouragement not to smoke. Brief within each activity area during the carnival. descriptions of what happens within 9 Conduct the health education carnival for the elementary school students. _he human body when people drink al- Weeks leacher Checklist cohol or use other drugs. Playing of a - smoking, alcohol and other drugs game 1-3 Motivate the junior high school students and offer ideas which will, in turn, generate additional ones. which included basic questions about 4 Start to promote the carnival among the administration, faculty, and staff of those substances, with emphasis placed the sc:,00l and keep students on task. on advantages of not using them. Dis- 5 Secure volunteers from among school personnel to help publicize the tribution of coloring books, iron-on carnival within the elementary school and throughout the community (to and stick-on patches and information- promote parental and family involvement) and continue to keep the al pamphlets pertaining to this activity students progressing in their work. arca. 6-7 Encourage carnival facilitators (students) to finalize work on their activity Physical Fitness Display of a areas. model of the human heart and identify- 8 Preside over the rehearsal sessions; select student facilitators to visit the ing and explaining its various anatomi- elementary school classes to promote the carnival event, and make certain cal parts. Use of a stethoscope for that media coverage is arranged. students to listen to their heartbeats Coordinate the efforts of the student facilitators during the carnival. 178 school gymnasium. Students in each class were divided into five separate groups and assigned to begin at a dif- s,4,1,tifts, ferent learning center. They were then rotated through all five activity areas so that every student was exposed to each set of learning experiences. All five groups of junior high school facilitators were given seven minutes to conduct their activity area 14,1t vh, session. The seven minute time period x 'tk typically consisted of one minute to in- -0,1411/4 , troduce to the conceptual material, two

minutes of information sharing, two to , three minutes of games or other hands- ' 'Kt on activities for the children, and one s: minute to synthesize and conclude the js: r learning experience. During the weeks e ,ha )1114 of preparation for the carnival, the ta 11- junior high school student facilitators tkV where instructed to design the activity A;;riz140:i14' areas so that they would (1) be child- centered, (2) provide basic information 11.4k. at the proper grade level, and (3) *Icr, 4 promote learning and fun throughout the experience. All three goals were effectively achieved, best evidenced in the attentive behavior and enthusiastic response of the elementary school children. arnples of the lasting impact of thecar- What was possibly even more amazing After all groups had rotated nival on their lives were noted by the is that we never doubted fora moment through each station, plenty of time at junior high school science and health that they could do it. Junior high school the end of the class period remained for teacher. Members of the third grade students are "naturals" as facilitators of disassembly of activity areas and clear- class confessed they had no idea that elementary school health education ing out of the gymnasium. With milk was so good for the body and they carnivals. Give them the chance and everyone working together, there was proclaimed that they would continueto you will be glad that you did! no need for junior high school students drink more of it. Members of the to miss any additional class time out- sccond grade class organizeda "Smoke side the regularly assigned science and Busters" club and promised towear Bays, C. T. (1986). The elementary school their "Don't Smoke " emblemsto fur- healthfair: A process involving the health class period. whole school in health education.Journal ther demonstrate their commitment. of School Health,56. 292-293. The teacher observed that the second Daughtrey, G. (1976). The Norfolk public Carnival Follow-Up grade students remained trueto their schools healthfair. Health Edacation, 7(4), promise. 36-37. Additional follow-upwas also Lafferty, J., Guyton, R. & Pratt, L. E. (1976). After the health education car- The University of Arkansas health fair as nival was over, the primary author of done by teachers in each of the three professional preparation.Health Educa- this article, who also was instructo of classes involved in the health education tion,7(4), 24-25. the eighth grade health class, visited carnival. During the next few class McKenzie, J. F., Scheer, J. & Williams, I. C. elementary school classes involved in meetings, they processed the healthre- (1981). The health and safety fair: A cookbook approach.Health Education, the experience. He found students lated information and materials given 27-29. to their students. Elementary school 12(1), studying, completing the worksheets, Petty, R. & Pratt C. (1983). Student staffed and using the pamphlets and other teachers expressed sincere apprecia- health fairs for older adults.Health Edu- printed resource materials provided tion for the outstanding, active learning cation,14(2), 40-42. for them during the carnival. Elemen- opportunity made available to their Watts, P. R. & Stinson, W. J.(1981). The i--y school students clearly seemed to students during the health education health education carnival: Giving the old carnival. Teachers health fair a face-lift.Health Education, Jo more conscious of their health and were surprised that 12(6),23-25. expressed considerable interest in fol- the junior high school students could Wolf, Z. R. (1986). A health fair for school- lowing good health habits they had be so well organized, motivated, and age children presented by registered learned during the carnival. Twoex- capable of providing sucha high quality nurses. journal of School Health, 56, 192-- learning experience for their students. 193. 179 i TEACHING IDEAS 100 Thinking and Writing A Strategy for Teaching Positive Health Decision Making Paul Villas

When an undesirable or unpleasant The Activity tions that have taken place in a person's event occurs, people are often reminded life that may make him/her prone to that it did not have to happen. The advice The assignment begins by provid- make certain decisions. Poor self-es- is that if a different route were taken, the ing each student a sheet of paper divided teem or an inability to make any close unpleasant occurrence would not have into four columns as shown in Figure 1 friends in the formative years may pro- to come to fruition. A television com- with an explanation of the meaning of gram a person toward a destructive mercial explains this concept perfectly each area. lifestyle. by emphasizing a particular car's brak- ing ability. The commercial promotes Micle or Event: This is the heart of Post Event: The lesson or lessons the notion that vehicles do not have to be the assignment The students are asked learned from the event go in this col- crashed to prove they are safevehicles to select a newspaper artic le, news story, umn. The lesson could apply both to can be safe if you can stop them before or an event they are familiar with that those who survived or are the main they crash. The point is made that the had negative consequences because of players in the event as well as to those best way to survive an accident is never poor health decision making. Examples who knew or learned about it. It. is im- to have one. This commercial's theme such as suicide, vehicle accidents, teen portant to understand that there are con- becomes the strategy for this teaching pregnancy, anorexia nervosa, etc., could sequences resulting from poor health ideasomething can be done before the be used. From these articles or events, decisions. The teaching aim is to lead point of no return is reached. students creatively but realistically fig- students to resolve not to repeat the Criticism directed toward education ure out why poor health decisions are events they are reporting on and learn today claims that students cannot think made. that background information leading to critically. Another area of concern is the poor health choices can be overcome to inability of students to express them- Trigger: Under this heading, the stu- promote positive health behaviors. selves in writing. Thinking and writing dent speculates about what could have skills can both be enhanced in health happened to trigger the particular event Final Note education courses by employing a time- in the minutes, hours, or days preceding , line teaching activity, which allows it. If the event deals with a suicide or The writing assignment could be as students the opportunity to make posi- attempted suicide, the trigger could have intensive as a teacher desires. The Ls- tive health decisions at the same time. been an argument with parents or a signment could be done on the sheet of The time-line teaching activity is breakup with a boyfriend/girlfriend. If paper provided, or that sheet could be designed with three goals in mind: pro- the event was a car accident, 'he trigger used as a working paper for a more mote writing skills, enhance critical might have been driving under the influ- formal writing assignment. Hopefully, thinking, and equip and direct students ence of alcohol in combination with lack by providing opportunities for students toward healthful decision making. The of sleep. to figure out why poor health decisions main objective is to help students un- are made and to understand their con- derstand the consequences of poor health History: This column enables the sequences, they will not get themselves decisions and realize that lack of aware- student to discuss situations or condi- in the same predicament. ness makes them select poor health History Trigger Moles Post choices. Writing and thinking skills are (Days, Years) (Days, Hours, Of Event Event the tools used to achieve the main objec- Minutes) tive.

Paul Villas is with the Department of Health Science, New Mexico State Uni- versity, Las Cruces, NM 88003. Figure 1. Time-Line Teaching Form

1 80 TEACHING IDEAS 101 Nkr-sklai Personal Health Via Community Health Linda Olasov A.011M11.

ale

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Traditionally,students inpersonal for any education students. This article this project had four primary objectives: health classes at universities are asked will describe the field placement experi- (1) help alleviate the bored.xn and inac- to complete a variety of assignments. ence for four students in a personal tivity which many patients experience Among them, the most traditional of all health class who chose to work with in the hospital; (2) enhance the self- is the term paper. Usually it is a two exceptional students in a community sufficiency of patients by teaching them way communication between the stu- mental health fadlity rather than to practical skills; (3) provide an opportu- dent and teacher with few others shar- write a formal term paper. nity for interested, qualified pathmts to ing the information. However, it is pos- begin preparing for the General Educa- sible for a teacher to offer an alternative tional Development (GED) examination to the formal term paper, to offer an In the Beginning while hcspitalized, which coltki contin- opportunity to the student to interact in ue iollowing discharge, and, (4) edu- a community health facility through a The basis for this program was estab- cate, through direct experience with a sharing of information, different per- lished two years ago by a health educa- community mental health fariliiy, peo- spectives, and skills. tor at Northern Kentucky University ple whose chosen profession will make This new partnership between stu- who asked a clinical psychologist from them influential in the community re- dents in a health education class and a Rol lman Psychiatric Institute in Cincin- gardii g attitudeF toward mentA illness. community mental health facility has nati, Ohio to speak to several classes Objective three was arranged through a great potential. It provides an opportu- about mental health. Several groups of second faculty member. nity for health students, some of whom students volunteered for a practicum at may be in teacher education, to have Rol lman in which they helped with pa- contact with exceptional people and to tient recreation. Information About the Hospital Experience with those students pro- teach individuals with emotional/behav- Rollman Psychiatric Institute is a 146 ioral disturbances. It is hoped that r on- vided incentive for the more ambitious program discussed in this paper. A so- bed state-funded psychiatric receiving tact with these people will result in hospital.It provides shurt-term acute positive attitudes for health education cial worker at Rol lrnan suggested an academic program for patients, and this care for adults between ages 18 to 65. students. And, the partnership could The mean length of stay at the time of benefit the patients by infusing some became the basis for the placement of students in a personal health class. this project was 29 days. The major:ty of stimulation through learning in an oth- the patients have psychotic episodes erwise boring daily existence at a psy- and have been probated. Practically all chiatric facility. are on psychotropic medication in the The author, in preparation for this Objectives hospital for symptom relief. Most pa- paper, could find no literature dealing From the viewpoint of the university, tients have a variety of serious behavior- directly with the use of mental health there were three objectives for this col- al, economic, educational, and interper- facilities or hospitals as placements for laboration:(1) provide an additional sonal problems which have resultea in students in personal health classes or preservice teaching option; (2) develop one or more previous hospitalizations. more constructive attitudes through di- Iie problems are typically complex and rect contact with emotionally disturbed multidetermined. In most cases the goat Linda Olasov is an assistant professor of people; and (3) provide service to the of hospitalization is to return the patient education inthe Education Department, community, one of the university's mis- to the level of functioning he or she had Northern Kentucky University, Highland sions. in the community before hospitalization Heights, KY 41076. From the perspective of the hospital, was required. 181

, 1 p Arrangements development of topics because of sched- rience both for patients who serve as Four students from the personal uling problems and each health student students and for their tutors, the uni- health class volunteered for placement presenting two programs unrelated to versity students enrolled in health edu- at Rollman. Patients were also volun- each other in content. ce tion courses. The program gives students an opportunity to practice teach- teers and participated in the activities Student Reaction students offered. All students were at ing and gives patients an opportunity to least at the junior level. Except for one Almost all the students expressed participate actively, learn, broaden their who was not an education major, the some degree of anxiety or fear about experiences, and relieve the boredom of others had previous classroom expert- going to a psychiatric facility. However, institutional life. The real world and the ence through the practicum component by the end of their experience, all stu- ivory tower can meet halfway. of their Introduction to Education dents reacted with positive comments, o course (120-135 hours). sense of learning, growing, and self Recommendations for Future Students were supervised both by worth. Collaborations faculty members at the university and The following statements from journals kept by students express ther re- Several suggestions can be made to by hospital staff. A psychologist served those attempting to carry out programs as program coordinator and liaison be- sponses to their experiences: "I learned how lucky I am to hem a such as that described above: tween the two institutions and was (1) An individual on the hospital staff present for all sessions. All students family, job, and an education." "The experience was one-of-a-kind." "I learned what must see the need for interaction with were required to keep and submit to the university and be committed to their teachers a written account of their another side of the world is like." "I really liked it, and enjoyed myself." "Thanks for expanding servicestothe pati.mt reactions to each session. population. There are many difficnIt Of the students in the personal health the opportunity you 'lave given me to view a situation like this. It was a first for me, and I logistics to work out, e.g., identifica- class, four out. of 29 chose to make tion of appropriate patients, location, presentations to patients on a hospital feel I have learned a lot." "Mental illness seemed spooky to me before. Since my visit to times, and availability of university ward in two sessions, one week apart. students. University personnel can- The alternative was to hand in a formal Rollman's, I can see that these people just need help, care, and understanding." "Be- not carry out such a program without term paper. Three of these students inhouse commitment and assistance. were physical education majors with a ing at Rollman's gave me a real feelins of self worth, that someone really needed me. My (2) A hospital staff member should be minor in health education; the fourth present or readily available at all ses- was a business major. spirits were lifted greatly when the patients thanked me for coming to spend time with sions in order to alleviate student them and truly wanted me to retarn." apprehension and to handle any Health Presentations emergencies. Evaluation of the Project (3) Preservice teachers should have The students were able to choose any prior classroom experiences. One par- topic related to health and to present From the veiwpoints of both the uni- ticipant without this prior experience information about it. Length of the ses- versity and the psychiatric hospital, the had difficulty with his presentation sions varied in order to accommodate major objectives of this cooperative ven- and inte:action with patients. Such the needs of the presenter and patients. ture were acheived. Collaboration pro- students should only be involved if Of the four students who participated, vided future teachers with an inside they could team teach with a more two taught individually and iwo as a glimpse of a psychiatric facility. As a qualified student. team. They scheduled their sessions pilot project in a novel situation, it chal- (4) All students should come to the with the psychologist about two weeks lenged their flexibility and creativity. hospital the first time with someone in advance. One Tek before they were Programs were seen as successful and to present, they submitted to their in- they know, someone who can pro- worth continuing by all involved, in- vide feedback and support.Initial structor a topic, bibliographical refer- cluding preservice teachers, university teaching could be a team effort; solo ences, a brief outline of what they in- faculty, patients, and hospital staff. The teaching could follow when indicat- tended to do, and how they intended to programs given by personal health stu- do it. ed. dents reached many patients. The uni- (5) Careful coordination and schedul- The health students piesented a total versity instructor viewed the programs ing of topics is needed for students, of six programs on a ward for men with Rollman as a viable method for proviiing only two sessions of in- during a time when the patients were ploviding students with contact with struction. ordinarily restricted to the ward for shift exceptional people and for providing a (6) Educational activities either at the change. Each program lasted from 30 to unique alternativeto the traditional university or the hospital which 90 minutes. No individual or team pre- term paper. might alleviate anxiety and dissipate sented on consecutive weeks because of Student journals reflected a change in individual scheduling problems. The attitude toward institutionalized psychi- myths about psychiatric patients following topicslisted by presenter atric patients. Students generally be- would be helpful. Ideally, opportuni- were offered: (1) stretching exercises, came more confident in their interac- ties for training students in interview- basic first aid; (2) calisthenics, bandag- tions. All the students expressed enjoying and psychopathology, both ap- ing; and (3) starting c,nversations, comment and learning as a result of their proached from a practical "how to" edy movie. The overlap of topics was point of view, could be made avail- experience and urged continuance of able. These subjects are quite relevant not a problem due to a rapid patient this program as a future option for stu- turnover in the hospital, and presenters dents. for student volunteers both in func- of the topic were different. There was, tioning at the psychiatric facility and A community mental health facility in careers as classroom teachers. however, little st nse of continuity or can provide a mutually beneficial expe- 1 82

1 (1,Jf) TEACHING IDEAS 102

Using College Studentsas Senior Peer Teachers in Youth-to-Youth Health Education Anthony G. Adcock

A problem often encountered in college health strategy classes is how to make the learning meaningful to students. The conscientious instructor is oftenfrustratedbecause timecon- straints limit student practical experience in the education process. One innovative way to develop an effective hands-on experienceforprospective teachers is to have them serve as senior peer teachers in youth-to-youth peer teaching programs inthe public schools. Considerable evidence exists that peer teaching programs are an effective way of providing health education (National Institutes of Health, 1980). At Freed-Hardem.m College the first peer teaching model 1 developed in 1981 (Adcock, Chambers, Wilson,. 1981). It was prompted by local concern about the extent o i smoking in the public schout.Several members of the school board made an effort to ban the use of all tobacco products on school property. One result of the publicity was recogniticn of the need to develop a program which would help prevent young people from developing the smoking habit. It was believed that a program which would train high school students to teach anti-smoking content to elementary age youth could be effective in achieving this goal. Cooperation of the school board, school principals, and health teachers was assured. met with the high school principal and The college students conducted four tne health teachers to discuss the youth- training sessions with the high school Procedure to-youth anti-smoking program. students. The length of the sessions Two outstanding students who were The high school health teachers se- ranged from 60 to 90 minutes. At the willing to work with the high school lected 15 students to participate in the first session, the high school students students were selected from the college program. The bases for their selection were divided into five groups of three strategies class. The college students were ability to be positive non-smoking students each. The purpose and specific held planning meetings with the district role models and interest in the project. objectives of the program were identi- executive director of the Tennessee Di- The high school students were in the fied. At the second session, specific vision of the American Cancer Society tenth grade and were 15 or 16 years old. topics and activities were assigned to who suggested printed materials which The sixth grade was selected as the each group. Each group was responsi- the Society pi ovided. The students also focus for the program because few stu- ble for one presentation of approximate- dents were already regular smok( Is, but ly 45 minutes. The remaining sessions Anthony G. Adcock is an associate professor would soon be entering junior high were used to develop and refine each of health education at Troy State University, school where peer pressure to smoke presentation. Troy, AL 36082 would likely increase. Films and printed materials from the 183 194 American Cancer Society were used by teaching modules have been developed lege instructor serves as the resource the student groups. The college stu- for drug abuse and for the prevention of person but otherwise is as much a students also developed materials, and drinking and driving. One year, the dent as everyone else in the classroom. several of the high school studems had youth-to-youth program was included Experience has shown that a youth- ideas for materials which were iticorpo- in a state grant for a community-wide to-youth program must be carefully rated into the presentations. drinking and driving program, and the planned to be effective. The program Five sixth grade classrooms of stu- college students were paid a small sti- must be closely supervised by the col- dents participated in the program, con- pend for their work as senior peer lege instructor, and adequate time must sisting of five presentations during a teachers. be given to preparat.on before presenta- two-week period. Each group gave the Summary tions. Selection of the high school stu- same presentation each session, only to dents is also important to the success of a different classroom of sixth graders. Several benefits accrue from the use the program. They must be good role During the presentions, senior peer of college students ir. a youth-to-youth models who are self-confident enough teachers observed the high school stu- teaching program. Undergraduate stu- to present information to a group of dents as they taught and mct with them dents who are planning to become younger students. afterwards to discuss the experience health educators gain hands-on experi- Much effort is required to successfully and to offer suggestions for future ses- ence in program planning and in teach- conduct a youth-to-youth program us- sions. ing high school students. Since the high ing college students as senior peer In 1982 all students inth.: college schoolstudentsimmediately apply teachers, but the interest and excite- health strategies class were required to what they have learned, the college ment it creates are well worth the effort. participate in the youth-to-youth pro- students can see the outcomes of their --- gram. The program was organized in teaching in a short period of time. In Adcock, A. G., Chambers, V., & Wilson, J. much the same way except that the addition, both the high school and the (1981). A youth to youth smoking educa- college students were divided into five elementary students become enthusias- tion program for sixth grade students. teams consisting of two members each. tic about the program. Tennessee Journal ()f Health, Physkal Educa- tion, and Recreation, 20(1), 18-19. Each team worked with five high school Senior peer teachers returning to the National Institutes of Health, (1980, June). students to develop one module in the college classroom engageinmutual Smoking prNrams for youth. Washington, program. problem solving, and class meetings are DC: US Public Health Service, NIH 80- Since 1981, additional youth-to-youth times for sharing and helping. The col. 2156. Fil

184 1 r 1 1. TEACHING IDEAS 103

Judgments Required from the Residency Coordinator William N. Washington

The wordresidencyis discussed here and university as reflected by the com- can be considered synonymous with munity's perception of the quality of the field work, internship, and field train- the ach'Ries resulting from the relation- university's staff, faculty, students, and ing. Residency is a time when the stu- ship between the university, the stu- programs. The value of the residency dent can practice the various processes dent, and the agency. experience forthe student and the and responsibilities of a vocation under Residency coordinators may be asked accomplishment of an agency's objec- the supervision of a professional in the to perform in a specialized or general tive by using a student are all affected field. Such opportunities are generally area. For example, within the school of by the coordinator's judgments. found in the curriculum of university public health there could be several spe- The residency program may be con- professional schools such as public cialized areas such as health education, ceptualized as having at least four com- health, public administration, educa- nutrition,health services administra- ponents: (1) preplanning and program tion, medicine, social work, and certain tion, and population planning. In this selection,(2) residency selection and departments in other universities. specialized situatbn, a residency coor- placement,(3)residency experience, Theresidency coordinator, anemploy- dinator would relate only to one pro- and (4) program evaluatic. Preplan- ee, develops a communication link be- gram, such as health education. A coor- ning and program selection include tween the university and the communi- who functions as a generalist those procedures and activities neces- ty, locates residency sites, places stu- dinator. would relate to two or more specialized sary to obtain needed information from dents in residency, counsels students in areas. A generalist may function as the students, finding potential health-relat- respect to their residency experience, coordinato for all programs on the pro- ed agencies willing to act as preceptors, and in general coordinates all business fessional lvel. and selecting the appropriate type of relating to the residency program. The Functior ing as a residency coordina- program. Residency selection and residency coordinator coordinatesall tor requires making many judgments placement involve using information that effect the relationship between the pertinent to the particular experience William N. Washington is an associatepro- university, the student, and the agency desired by a student and then making fessor,the School of Applied Arts and Sci- in which the student is placed. The arrangements for the student to work at ences, Department of Health Science, San coordinator's judgment could affect the an appropriate facility. Field work de- lose State University, San lose, CA 95092 reputation of the professional school scribes the actual job experience. Pro- 1 85 1 op 111=111111111O gram evaluation analyzes all stages of gram before being considered for resi- must relate to program objectives. The the process relative to the successes, dency. placement decision should be based on failures, and suggestions for improve- The coordinator counsels the student what is best for the student, the univer- ment and consideration. with respect to the best type of residen- sity, and the agency. Judgments required from the residency. This judgment could be made after What about the reputation of the cy coordinator are discussed in terms of reflecting upon the background and ca- agency? The coordinator should exam- the four conceptualized componen ; of reer interest of the student. For examine statements made about and beliefs a residency program. Preplanning and ple,if a student interested in health held toward a potential preceptor and program selection is discussed in refer- education has had extensive community analyze all interactions with the agency ence to gathering information from stu- health education experiences and to support or refute statements or be- dents and making contacts with health proved competent, the coordinator mai liefs. The reputation of an agency is agencies; residency selection and place- recommend a residency experience in a important because the agency's reputa- ment is discussed in relation to informa- hospital setting. This new setting tion could be transferred to the profes- tion given to students about agencies should concentrate on skills that need sional school due to association alone, willing to act as preceptors; residency is development, such as skills in adminis- and association with a highly respected discussed in relation to on-the-job expe- tration. Working in administration may agency could help the community think rience; and program evaluation is relat- provide a more detailed introduction to highly of the professional school. Based ed to those judgments necessary to de- fiscal matters, personnel, and decision on these considerations, the coordinator termine whether the program meets its making relative to programs with which must make a judgment about the impor- objectives. the student had no previous experience. tance of an agency's reputation in residency placement. Preplanning and Program Contacts with Health Agencies The coordinatorshouldestablish Selection After the coordinator decides which standards that must be met by an agen- agencies to contact, and after contact cy being considered for preceptorship. Information frail Students h:s been made, the coordinator must These standards should be of quality that in no way compromises the general As much rel want information as pos- determine which agency is willing to take a student. The agency's willingness standard for excellence of the entire sible should be obtained from the stu- university. Of all the agencies indicating dent to help the coordinator choose goes beyond its agreement to place a student. hi this case, willingness infers a willingness to act as preceptors, the which students should have residency coordinator should choose those that experience.In professional schools, a sincere desire to provide the students with learning experiences and environ- have met or have agreed to meet the there is a good chance that some stu- requirements. dents have already had practical career ments in which they will be accepted experience equivalent to the responsi- and supported. In certain circum- bilities and tasks performed by gradu- stances, an agreement to place a student Inform Students About Agencies ates of the school, or equivalent to the does not include support and acceptance. The coordinator must judge the Several decisions should be made be- responsibilities and tasks a student is fore informing students about agencies expected to perform during a residency willingness of the agency, and make placement accordingly. willing to act as precept9rs. The first is experience. Depending on the student's to det-rmine which students to recom- desire or financial status, the student Competent Staff and Facilities mend to specific agencies by taking into may be working whiie attending school consideration the experience wanted by and, therefore may have difficulty fit- Students should be placed in agencies eakh student and the additional types of ting in a tesidency experience. In addi- with good facilities and competent staff agencies discussed by the coordinator tion, the university's program may or who have been adequately trained to do and the student. The coordinator may not require a residency experience the expected quality and quantity of should give the student an opportunity forallits students. Taking all these work. The agency staff should be more to interview with any agency. However, situations into account, the coordinator skilled than the student. Inadequate fa- the cool dinator must also provide guid- must judge which students need a resi- cilities may mean that the student ance to students concerning on which dency. would be unable to observe all the pro- agency they should concentrate their Students who enter a professional cesses involved in his assignment from energies, based on interests,back- school have various backgrounds and its beginning to completion. In such ground, and abilities. For example, experiences. They differ not only in cases. some assignments may be at- some students may be interestedin work experience, -but in academic prep- ternp4ed with insufficient input or tests, working at a particular agency because aration. Some students are interested in completed at another agency, or simply of its prestige, rumors from other stu- doing a residency soon after admission not completed. dents and friends, permanent employ- into the school. The coordinator must Agehcies areanxiousto provide ment opportunity, and/or staff composi- consider these factors and judge the placement for students for a variety of tion, but they may give little thought to appropriateness of residency for stu- reasons. Some agencies want students whether the agency can provide the dents. For example, the coordinator for cheap labor, status, or to do work necessary experience. The coordinator may want to ensure that the student none of (he agency's staff wants. Many should work with the students to clarify will perform competently in the resi- agencieF, however, have positive rea- potential positive and negative conse- dency. To increase this potential assur- sons for wanting students. The coordi- quences. ance, the coordinator may require the nator must judge the reasons for place- The number of students available for student to complete certain acaiemic ment agreement and the appropriate- placement varies from year to year and courses and/or spend a certain time (for ness of the experiences in relation to the from semester to semester. The coordi- example, one year) in the academic pro- university's program. The experience nator should try to have more place- 1 86 ment site opportunities than students to should continue t mge interviews ensure placement for alllf the coordi- for those students o have I,ot been nator has the philosophy that each stu- selected. lf,after se A.ral unsuccessful dent should have interviews with sever- interviews, a student seems discour- al agencies and that each agency should aged and disappointed, the coordinator be given the opportunity to interview should offer counseling, encourage- several students for each position, the ment, and special attention by arrang- coordinator should decide how many ing an interview after establishing that interviews each student should have the student has an excellent opportuni- and which students should be sent for ty to be selected by that agency. The interviews. To deal with this problem, potential for this student to be selected the coordinator could contact the agen- could be increased through the absence cies, tell them how many students are of competition;i.e.,the coordinator available for interviews, and ask how would send only this student to the many students each agency would like agency for an interview. coordinator could provide some techni- to interview. The coordinator can then In order the selection process to oper- cal assistance or recommend assistance check the files to determine which stu- ate smoothly, no student should go to resources. If the problem relates to the dents are interestedin the position an agency for an interview without pri- interaction between the student and available at each agency. Without show- or approval by the coordinator. preceptor, the coordinator should act as ing favoritism, the coordinator should an intermediary.Ifneither solution informallinterested students about Residency Experience works, the student should be trans- available positions and, using the first- ferred based on the desire of the student come, first-served method, refer the In most cases, the residency experi- and/or the p-eceptor. predetermined number of students to ence is an unfamiliar situation for students. They are in a new relationship agencies k r interviews. The first-come, Evaluation first-served rule might be relinquished with the residency coordinator and their if,after se , eral interviews, the same agencies. The coordinator will need to To determine the success of a pro- students are consistently first and, as a use keen senses to judge whether a gram it must be evaluated. The degree result, adtain an excessive number of student is having a successful residency of evaluation will depend on the evalua- interviews. An attempt should be made and should maintain constant commu- tion technique's sophistication with suc- to achieve a good balance in number of nication with the student to determine cess determined on the basis of evalua- interviews. whether the studentisdoing those tions from the student and preceptor. Sometimes after several interviews, taslagreed upon by the preceptor and The coordinator should make a compar- several students may be selected for coordinator. All key actors will be aware ative analysis of both evaluations, placement by more than one agency, of changes in the program they main- whether such evaluations are open-end- and several may be selected by none. A tain good communication. ed, objective, or a combination. The student who has been selected by more The coordinator should ask the stu- preceptor's evaluation should be com- than one agency should not be sched- dent directly whether the residency is pared to the student's to determine the uled for additional interviews. If more successful. The answer, whether ves or similarities and disparities. By compara- than one agency wants a particular stu- no, should be followed by an explana- tive analysis the coordinator can deter- dent, this student should be asked to tion.In addition, the coordinator mine the validity and significance of choose an agency. The coordinatoi should look for both verbal and nonver- evaluation. For example, if both student bal messages. For example, students and preceptor are given guidelines for may say one thing but mean another or writing an open-ended evaluaiion, but say little or nothing about their experi- the coordinator receives and this was ence. To understand nonverbal mes- followed inappropriate and misrepre- sages the coordinator should obtain ad- sentative evaluations, questions would ditional information about the work sit- exist about the evaluation's validity or uation from the preceptor or other significance. persons with whom the student works. From the evaluations should come An indepth, personal, and private dis- several recommendations for changes cussion with the student may disclose and new ideas for consideration. Stu- the true success of the residency. dents may suggest (1) courses or work If a problem exists, the coordinator experience that should act as prerequi- should first determine whether it relates sites to the nesidency, (2) no future to tasks being performed, interactions placement at thit agency, (3) no future with the preceptor, interactions with placement under a particular supervi- other employees, or a combination of sor, or (4) continuation of the past meth- these. Then, the coordinator must solve od of selection and placement. The pre- the problem. One possible solution ceptor may also give ideas to use in wouk. Lle counseling the student and/or future placement selection. The coordi- the pi :eptor. Another solution would nator must decide which suggestions be to-ansfer the student to another should be used in the future to help the department within the same agency or program continue to evolve into a better transfer the student to a new agency. If residency program. the problem relates to the task, the 1 87

1 9S TEACHING IDEAS 104 A Community Resource Class Assignment Ansa Ojanlatva, Ph.D.

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Ansa Ojanlatva is coordinator of the Depart- ment of Health Science, Louisiana State University, School of HPERD, Baton Rouge, LA 70803. 188 Community Health Education classes more students are normally assigned to source guides were forwarded for may effectively be used to introduce one project. The rest of the session is use by an area school district.) students to development of tools for used to formulate conclusions of the community action. An undergraduate project ahead. This translates to defin- seminar, Health Behavior and Commu- ing purpose, setting of goals and objec- 3. Veterans Resource Guide (VRG), nity Health Education, atCalifornia tives, and finally division of tasks to be Alcohol and Drug Abuse Program State College/San Bernardino includes accomplished. Services in San Bernardino Coun- from four advisement areas: health ad- For about five weeks the students ty,California,1982; (The guide ministration and planning,environ- work on their assignments, consulting was compiled by a veteran togeth- mental health and safety, health science with the instructor when necessa-y. A er with another interested student generalist, and community health edu- report is prepared, it is shared in class, and it is available for counseling cation. For many of them this is the first and evaluated by the peers (Form A) purposes.) course on community health education, and the instructor. Since these projects and for some of them it is the only such are designed and completed by the stu- course in the present curriculum. The dents, the final outcome and format 4. Counseling and Support Groups college is on a quarter system whichto vary from one to another. However, for Families with TerminallyIll some extentlimits the quantity of some cover letter information is often Children; work to te accomplished at one time, shared and includes name, address and and action programs to be completed by phone number(s) of the service(s), con- students will have to be reasonable. At tact person(s), time(s) and day(s) of 5. ABC's/Alternative Birthing Cen- the same time, the academic require- service(s), kinds of service(s) offered, ters Resource Listing for Southern ments of these students include more fee(s), population(s) served, type of care California; homework than normally found in (primary,secondary,tertiary),and many other institutions (1 unit of 5 or 1/2 whether the service can be reached by of 2.5 units pei quarter), providing 1/2 to physically disabled clients. 6. Guide to Ostomy Services, San 1 unit more credit per quarter. There- Although the project is a reasonable Bernardino/Riverside Metropolitan fore, out-of-class assignments are no' task for most students, about one in 15 Area; only desirable but required. The setting fails to comply with the requests. With is outstanding for health education the process of defining roles and assign- process. ing tasks, most of the difficulties are 7. Ulcerative Colitis: Alternatives to Often community activities require worked out early.It seems that the Surgery (including resources); and that individuals team up for action. Few students failing to complete the project of us can alone accomplish significant have personal problems which seriously tasks demanding interaction with peo- interfere with school work. 8. Services to the Newly Blind. ple. This concept is brought to the class- Another difficulty seems toarise room, and the following is an assign- when business establishments are comment students have to complete as par- pared with each other. This may be due tialfulfillment of the above stated to the competitive nature of such estab- course. lishments. Certain information simply The assignment itself has gone will not be available for comparison through many transformations in differ- purposes. ent types of classes, but it appears to Many of the students in this location work best here where its purpose is come back to school, because they want clear, where the time element is appro- to do something different in their lives. priate, and where the students are seri- Often these projects function as a mode ous enough to complete a started pro- to turn negative experiences into posi- ject. After this experience, most stu- tive ones. Sometimes the activity works dents move on to leldwork and may as a vehicle to learn something com- utilize the newly acquired materials. pletely different from the defined goals During the first week of class, the and objectives of the assignment. And a students are given a syllabus, and dicing few students have used the activity to with it they are asked to think about a either define future fieldwork experi- 4710 topic of major interest which eventually ences or to provide better tools for the could be developed into a community existing ones. Some of the projects have .1.40004.1. resource. Approximately half of the stu- been forwarded for use by the various 4.vcioingov.4.1. dents do truly come up with topics community groups. which are realistic possibilities for a pro- Examples of resources from the most ject. These alternatives are listed on the recent classes include: black board during the tollowing ses- 1. Child Abuse listing for San Bernar- sion, the instructor adds few, and some dino and Riverside Counties; of the students suggest additional ones as a result of brainstorming. Two dozen or more suggestions may be listed. 2. Teenage Alcohol and Drug Abuse Once all possibilities are discussed, Services.and Resources in San Ber- each student is asked to make a commit- nardino County and Surrounding ment and to initial one of them. Two or Metropolitan Areas; (These two re- 189 2 ( TEACHING IDEAS 105 Evaluating Health News

Michele J. Hawkins

Proliferation ofheakh information Purpose many arperiments or studies are needed in the popular press is increasing at to understand phenomena under study. dramatic levels (Broad, 1982; Culliton, The purpose of this educationalWhen studies are reported in thenews, 1987). Media sources that provide thismethod is to teach critical thinking skillswe are presented with one piece of a health information also have iffolifer- for analyzing health news to high schoolpuzzle. Only after several studies does ated. One needs only to pick up a news- and college students. In particular, stu-a more complete picture begin to paper or magazine to find that healthdents will be able to use criteriapro-emerge. receives heavyattention in todays press.vided to critically evaluate news stories. - Research yields new knowledge, Fluther, whlle the amount ofhealth news but uncovers new questions. When grows, the content is ever changing.Overview of the Teaching conflicting results occur, it often is be- What is healthy tc 'ay, may be found toTechnique cause the study may be slightly diferent be unhealthy tomorrow. Levin (1987) from those previously conducted, with states the approximate half-life of a so- Evaluating Health Newstakes twoa different population (men rather than called health fact is four years. Hence,class periods (50minutes each) tocom-women, teens rather than elderly). formal education can no longer teachplete. The fffst class period consists of - When examining health news, health facts that will remain intact duringlecture information regarding guide-specific criteria should be considered. the course of one's life span. Levinlines used to evaluate the healthnews. On day twv, provide several map- further states that dianging information The second class period is used to allowzines and newspapers and have stu- regarding health leads to substantialstudents to evaluate health articles. dents evaluate articles in class in small public confusion about what andwho to On day one, photocopy news sto-groups. During the last 20 minutes of believe, thus progressively diminishingries related to health (the localnewspa-class, let students report on their find- effectiveness of health messages. Com-per is often most relevant to students). ings. pounding the problem is the difficultyOn day two, give several magazines that the lay person has in understanding thecontain health news to students. (Stu-Guidelines for Evaluating information beingdisseminated (Yeaton, dents enjoy analyzing a wide variety ofHealth News Smith, & Rogers, 1990). magazines and tabloids. I recommend In response to this proliferation ofincluding several that have sensationalCredibility of the Source health information, the public must bestories, such as theEnquirer.) able to analyze the accuracy and rel- The lecture covers the following Who is reporting the health infor- evance of information it receives. Be-points: (1) Discuss importance ofana-mation? Is it a publication known for ing able to analyze this information is lyzing health news today (see introduc- printing sensational stories? Or is ita even more critical since the public gainstion and provide relevant examples). (2) publication that must check itssources mostof its health information outside the Discuss importance of understandingfor accuracy? Who conducted there- context of formal education (Miller, basic research when evaluating healthsearch? Was it a researchgroup under Sliepcevich, & Vitello, 1981). There- news. The following points maybe per-auspices of a universityor was it a pri- fore, teaching skills used to analyzetinent: vate organization? Who paid for the health messages critically becomes vi- - Health research involves testingstudy? Does the group havea "stake" in tal. The following teaching exercise is (studies). Studies usually are doneonethe findings, such as a drugcompany designed to teach these skills. at a time, providing educated guessesevaluating its own product? (hypotheses) about how living beings Michele J. Hawkins is with the Univer- function. Since human beingsare com-Study Design sity of Oregon, Department of School plex, one experimentor study rarely and Community Health, Eugene, OR produces complete results; therefore, What type of study was done- test 97403.

"t 90 2 (1 tube, animals, humans? Test tube and school uses drugs? To be able to gener- animal studies usually are done at the alize about the school, everyone in the beginning of research testingeffects of school should have an equal chance of being selected to be in the study. Draw- something (drugs, exercise) on humans. While these studies yield important in- ing names from a hat or taking every formation, the test done with human tenth name from an alphabetical listing random beingsyields the most information. How are examples that approximate many subjects are in the study? This is selections. important because many studies that Has the study been re- make headlines have few people in the peated? The more times the study is study. The larger the study, the stron- repeated with sbnilar results, the stronger the findings. ger the ftndings. What axe the characteris- Look for qualifying words tics of subjects? Arc theywomen, teens, such as "in animals" or "in some sub- elderly? One must be careful when jects." Are the results reported as facts generalizing results obtained from one or someone's opinions? Doesthe article group to another group. For instance, include what needs to be examined in many studies of cholesterol involve future research? What questions re- men and women who do not know the main? Does the article suggest that levels of cholesterol that pose a threat people change their behavior because for women. Was there a control group? of these results? Having a control group means that one group did not receive the treatment (drug, exercise, diet). At the end of the Broad, W. G. (1982). Science Magazines: The study, the group is exantined to see how second wave rolls in. Science, 215, 272-273. it differs from the group that received Culliton, B. J. (1987). Science sections in U.S. newspapers increased dramatically in the the experimental procedure. If the ex- past two years. Science, 235, p.429. perimental group differs from the con- Levin, L (1987). Every silver lining has a cloud: trol group, the change maybe attributed The limits of health promotion. Socialpolicy, to the procedure. summer, 57-60. How were subjects se- Miller, A.E., Sliepcevich, E. M., & Vitello, E. M. lected to be in the study? The strongest (1981). Health-related articles in the six lead- :ng women's magazines'. Content, coverage studies use a random sampling tech- and readership profile. Health Values, 5, 257- nique. A good example is using one's 264. school. If you only asked students in Yeaton, W. H., Smith, D., & Rogers, K. (1990). one class questions regarding drug use, Evaluating understanding of popular press would you be able to generalize or say reports of health research. Health Education Quarterly, 17(2), 223-234. that this percentage of students in the

191 202 TEACHING IDEAS 106

The Classics of Epidemiology: A Critical Thinking Approach Wesley E. Hawkins

In a recent article in theNew excitement of reliving simulated his- England Journal of Medicine,Fra- torical eventsa special brand of 11-)41. 44iy4fisi ser (1987) suggests that the essential excitement incurred by solving the characteristics of a liberal arts edu- mystery of disease occurrence in cation are "those fields that help populations. free students from the limitations of prior beliefs and experiences and Description of Method that teach important modes of thinking so as to prepare them to ask and Many aspects of epidemiology answer new questions"(p.309). may be taught through the Classic Fraser further argues that epidemiol- Studies Inquiry Simulation. This ogy is an example of a discipline that technique will be demonstrated for should bebut rarely isincluded teaching major research designs and in a liberal arts education: major rates used in epidemiology. Epidemiology has features that The Classic Studies and respective resemble those of the tradition- research designs and rates are illus- al liberal arts. ..it (epidemi- trated in Table I. ology) emphasizes method Objectives.The epidemiological rather than arcane knowledge content and general process/critical and illustrates the approaches thinking objectives are: given actual to problems and the kinds of data and historicalsimulation of thinking that a liberal educa- events for selected Classic Studies, tion should cultivate: the scien- the learner will (1) select and apply tific method, analogic thinking, the appropriate epidemiologicalre- deductive reasoning, problem- search design, (2) rply and calcu- solving within constraints, and late major epidemiological rates for concern for aesthetic values. testing Piypotheses, (3) determine in- (p. 30) events of classic epidemiologic stud- formation needed to testa hypothe- ies. This type of teaching strategy sis, Given the pedagogical promise of (4) reorganize and synthesize not only teaches specific skills in data for testing a hypothesis, and (5) epidemiology in the liberal arts, it epidemiology but also captures the seems appropriate to suggest teach- draw logical inferences andappro- ing methods that allow health educators to use the epidemiologic model. Tsb1e I. amok *Wks, Reward Nips, aid Lilo One such application is the Classic Classic Studies Epidemiological Research Designs Rates Studies Inquiry Simulation usingac- 'Toxic Shock Case-Control/Retrospective Odds-Ratio tual data and simulating the actual Syndrome Study

Framingham Longitudinal/Prospective Relative Risk Wesley E. Hawkins is an assistant Heart Study professorSchool and Community Kingston/Newburg Randomized Control Trials Relative Risk/ Health, University of Oregon, Eu- Fluoridation Study Attributable gene, OR 97403. Risk 1 92 21 3 priate conclusions after testing a hy- student tasks that meet content and given the increased demands on indi- pothesis. inquiry objectives of the lesson. (3) viduals for critical thinking in our Teaching Sequence. Thisteaching The final class session requires stu- more complex information age. strategy takes three to four class dents to present inferences drawn after testing hypotheses based on periods and involves three major Ast. D., & Schlesinger, E. (1956). The conclu- steps: (1) A background lecture is data from the Classic Studies. Stu- sion of a ten-year study of water fluori- conducted describing the major re- dents then are required to present dation.American journal of Public Health, search designs and major rates used this information in an oral presenta- 46, 265-271. in epidemiology. Two class periods tion and a class discussion format. Centers for Disease Control. (1980). Annual summary 1980: Reported morbidity and are required for this step. (2) In the mortality in the United States.Morbidity next class session, the Classic Stud- Conclusion and Mortality Weekly Report, 1977(26), p. ies Inquiry Simulations (Figure1) 293. are presented to students in a work- Educational techniques such as Dawber, T., Kannel, W., & Lye 11, L. (1963). she Class Studies Inquiry Simulation An approach to longitudinal studies in sheet or computer software format. the community: The Framingham Thc simulations include historical are needed for teaching critical Study.Annals of the New York Academy of narrative describing the origin, thinking skills. John Dewey's educa- Sciences, 107,593-599. events, and purpose of the Classic tionalphilosophy of emphasizing Fraser, D. (1987). Epidemiology as a liberal Study and actual data presented "how to think" rather than "what to art.New England journal of Medicine, .316 from the Classic Study with required think" seems even more relevant (6), 309-314.

NowtL amok Mai Inquiry Sims Classic Study #1: Toxic Shock Syndrome Study (Centers for Disease Control, 1980) Historical Narrative.In 1980, the Centers for Disease Control (CDC) had received reports from Wisconsin and Minnesota of women who had contracted a mysterious illness after the start of their menstrual period. The illness included symptoms such as confusion, aggression, and shock with very low systolic blood pressure. Physicians diagnosed this condition as an earlier identified children's disease: Toxic Shock Syndrome (TSS). As reports increased, the CDC began to investigate TSS. Their first report on TSS identified 55 cases,52of whom were women. Soon afterward CDC researchers conducted a quick telephone survey in which they contacted 52 womer who had suffered toxic shock syndrome and an equal number of their friends who had not. The women were questioned about their marital status. frequency of sexual intercourse, intercourse during menstruation, birth control practices, history of herpes or other vaginal infections, use of douches or sprays during menstruation, and use of tampons and sanitary napkins. Student Simulation for TSS Study.You have been employed recently as an epidemiologist at CDC. You are asked to examine all the factors listed above to determine if any are related to TSS. None of the variables show any relationship except for the factor "use of tampons orsanitary napkins." Your data show that of the 52 women who had suffered Toxic Shock Syndrome, 40 had used tampons, while only 10 of the controls (friends who had not contracted Toxic Shock) had used tampons. What type of research design was conducted in the telephone survey? Test the hypothesis that use of tampons is related to TSS by calculating relative odds or odds ratio. Show calculations of relative odds: For your homework assignment for the next class period, be prepared to discuss inferences you have drawn from testing the effect of tampon use on TSS. Be prepared to discuss how large the odds ratio will have to be to say thattampon use has an effect on TSS.

Classit Study #2: The Framinghant Heart Study (Dawber et al, 1963) Historical Narrative.In the 1940s, there had been much speculation by health officials on the causes of heart disease. In 1948 the U.S. Public Health Service and researchers at the Harvard School of Public Health initiated a study in Framingham, Massachusetts to determine risk factors related to heart disease. Student Simulation.Theyear is 1948 and you have been employed recently by the U.S. Public Health Service as an epidemiologist to study risk faaors related to heart disease. Your task is to follow subjects from Framingham for a ten-year period and obtain annual measures of serum cholesterol (the variable you are studying) and heart disease. You are asked to compute relative and attributable risk for your 10-year findings that found the incidence for heart disease for males ages 30-49 with serum cholesterol levels above 260 mg% as 186 per 100.000 while for males with cholesterol levels below 190 mg percent the incidence was 50 per 100,000. Test the hypothesis that serum cholesterol is a risk factor for heart disease by calculating relative risk. Show catcuhtions. In addition, what type of research design did you just conduct? For your homework assignment, be prepared to discuss inferences you have drawn from testing the hypothesis that serum cholesterol affects heart disease. Also be prepared to discuss the size of relative risk.

Classic Study #3: Kingston-Newburg Dental Fluorldation Study (Ast, 1956) Historical Narrative.A classic two-community (Kingston and Newburg. New York) experimental trial was the study of water fluoridation designed by David Ast (Ast & Schlesinger, 1956), who first believed that fluoride had no effect on dental caries. Newburgh would serve as the experimental community (water supplemented with fluoride to 1.1 and 1.2 parts per million (ppm). 'The non-supplemented .:ontrol community of Kingston would have its fluoride level unchanged at .1 ppm. The number of dental caries would be compared then to see if fluoride level hadan effect. Student Simulation.You are an epidemiologist assisting David Ast in this dental fluoridation study. You examine preliminary results and find that six to nine year-old children from the control community (Kingston) reported 23.1 decayed, missing, or filled (DMF) permanent teeth per 100 erupted permanent teeth while children from the experimental community (Newburg) exhibited 10 DMF teeth per 100 permanent teeth. Test the

hypothesis t.,at fluoride levels are related to tooth decay by calculating relative and attributable risk. Show calculations: . . Next, what type of research design was employed in this study? For the next class session, be prepared to discuss the inferences you have drawn from testing the hypothcsis that fluoride levels are linked to tooth decay. In addition, be prepared to discuss the size of relative risk.

193 2n4 TEACHING IDEAS 107

someone else usually provides the pain. With discipline, the pain is a natural and Discipline: A Parenting Dilenuna realistic consequence of a person's behavior. Unlike punishment, discipline is rarely arbitrary; it asks that a child eval- Patrick K. Tow and Warren L. Mc Nab uate his behavior and commit himself to a better course of action (Glasser, 1965). Preventive behavioral management is 411111PWWINE2 the best approach to parenting. Man- agement guidelines need to be established early and explained in detail, along with possible consequences as a result of violating these guidelines. -051 The importance of parent-child communication is paramount in the prevention-behavior management continuum. Being able to discuss fully problems, potential crises, and the providing of parental support, can perhaps reduce the probability of future behavioral prob- tcr lems. Health problems pertaining to mental health, sexuality, mood modifiers, nutrition, and other related areas often center around a poor self-concept or self- esteem. If potential parents realize the importance of the development of their child's self-concept and facilitate open, aC1:1-2.2446:7 two-way communication, discipline techniques will be more easily understood and tolerated. The positive or negative development of the child depends on the parental attitudes, values, and discipline philoso- The philosophical continuum of pa- there are seldom any academic classes phy which many times emulates the rental discipline ranges from "child addressing the problems of parenting, positive or negative relationship they ex- abuse" on one extreme to "passive ac- we are often left with past disciplinary perienced with their own parents. ceptance of the child's unmanagable be- experiences as our only legacy of such Glasser (1965) suggests parents take havior" on the other. Repercussion to skills. the following steps in addressing be- disciplinary actions are both positive and The selection of behavioral manage- havioral problems: negative and affect both child and pa- ment techniques by a parent depends 1. Ask the child if what he/she did rental health. on the child s overt behavior which is was against your parental rules. Attempting to apply specific discipli- interfering with parental rules or guide- 2. Ask the child to evaluate himself nary measures to correct a child's un- lines. as to the reason behind his/her actions acceptable behavior can often be a matter Behavioral management is basically a or behavior. of trial and error. For each couple ex- set of procedures that, when appropri- 3. Collectively the parent(s) and child periencing parenthood, there will he ately applied, usually decrease undesir- shiuld devise a plan and commitment frustration and aggravation as well as able behavior and hopefully increase to do better. loveAnd delight. desirable behavior. These parental pro- 4. As a parent, explain you will not Parents admittedly make mistakes in cedures require experience and practice accept anything but a change in behav- their administration of discipline. Today to be successful. Punishment is defined ior. the effectiveness of the traditional method as administering an aversive conse- 5. Otherwise, specific consequences of corporal punishment is much in doubt. quence or withdrawing positive rein- of breaking the rules will be enforced. It is through this method that children forcement in order to reduce the In following these steps, parents should quickly learn "might means right." Since possibility of the recurrence of a task or build on the positive strengths of their demonstration of a maladaptive behav- children, control emotions, and facilitate ior (Azrin & Holz, 1966). positive communication. Patrick K. Tow is associate professor of Health Discipline is a state of order based upon Education, Department of Health, Physical rules and regulations. In its simplest Education and Recreation, Old Dominion terms,itis teaching people to follow The Role of Health Education University, Norfolk, VA 23508. Warren L. specific rules. Educational methodologies which al- M:Nab is associate professor of Health Ed- There is a major difference between low parents or prospective parents hy- ucation, School of Health, Physical Educa- punishment and discipline, however. In pothetically to recognize potential tion, Recreation and Dance, University of punishment, pain follows an act that problem areas, establish guidelines in Nevada, Las Vegas, Las Vegas, NV 89154. someone else disapproves of, and the disciplining children, and practice the 194 communication techniques which en- requires students to provide advantages need redress of any kind. Yet many prtr- hance the behavioral management pro- and disadvantages for each of the mea- ents have a way of misconstruing a wide cedure, certainly would be beneficial. sures cited. assortment of concerns as being a per- Prospective parents are not prepared, nor sonal matter deserving punitive action. One also sees that some concerns can do they realize what parental responsi- Step 2. Examine Potential Disciplinary bilities encompass. Education for par- be handled differently with a young child enthood segments of health education Problems than with a teenager. courses should involve a variety of After identifying specific disciplinary methodologies geared toward the pre- alternatives, the types of problems con- Step 3. Examine Specific Circumstances vention, management, and communi- fronted by new parents over the years and Determine a Reasonable Course of cation skills needed to cope with specific should be identified. After all, our so- Disciplinary Action ciety would like to believe its members behavior problems. This step requires students in the class In professional preparation programs, designate appropriate "punishment" health educators should provide nu- tailored to the nature of the "crime" to be paired off in couples simulating merous methodologies to students in- committed. Presumably the same logic two parents. would apply to the disciplinary prob- Ask the prospective parents to ex- volving disciplinary measures. Following amine each of the situations listed and is a procedure that has been successful lems created by children in a family. This second step requires students to list determine whether it truly constitutes a in providing students in health educa- bonafide disciplinary problem. The par- tion with parental behavioral manage- problems frequently encountered at ment experience. home for which disciplinary measures ents are then to determine the proper may be applied. Examples of some po- disciplinary action, if any, to be applied tential disciplinary problems would to each of the problems listed earlier. It Step 1. Identify Discipline Alternatives probably include: must be stressed to these pseudo-parents that concurrence should exist be- Chances are that students in your class 1. Talking back or "sasing" have had first-hand experience with a 2. Excessive TV watching tween them on the final decision. This variety of disciplinary measures em- 3. Use of profanity exercise can also be done individually to ployed by their own parents. Tap into 4. Staying out late without checking symbolize the single parent family. this valuable resource at your disposal. in Depend upon their past encounters to 5. Lying Step 4. Evaluation and Discussion of the help shape the preliminary portion of 6. Shoplifting Disciplinary Decision the strategy by encouraging them to 7. Fighting with peers The last step of this strategy involves identify a list of these measures. 8. Playing with matches convening the class to listen collectively After the brainstorming session, carry 9. Crossing streets without adult su- to and discuss similar or different ways out a class tally of the number of stu- pervision these prospective parents would har,dle dents having experience in each of the 10. Smoking cigarettes such disciplinary problems in their own measures listed. This will help students 11. Coming home drunk families. The opportunity to discuss the realize there is a commonality, though 12. Stealing money from parents reasons for variations in approaching the no absolute uniformity, in discipline 13. Crying or refusing to leave toy or same disciplinary problems should be practices among parents. It also allows candy section of store provided. students the opportunity to see there are 14. Horseplay leading to property many different and perhaps more effec- damage Summary tive ways to handle disciplinary prob- 15. Cheating at school lems. This list usually includes the 16. Accepting treats from strangers The pos:tive familial relationship can following disciplinary alternatives: 17. Neglecting household chores be an extremely rewarding and enjoy- 1. Corporal punishment (i.e., use of 18. Looking through pornographic able experience. The key, perhaps, is physical force). materials understanding the magnitude of the re- 2. Total loss of privileges (e.g., no TV, 19. Playing hooky from school sponsibility of parenthood, the prepa- music, or parties). 20. Running awafrom home ration of the predictable, and coping with 3. Home detention (i.e, grounded at 21. Eating snacks before meals the unpredictable behavioral manage- home for a period( rime; room con- 22. Drunk while driving ment difficulties that one may encounter finement). 23. Crying or refusing to visit doctor's as a parent. 4. Fines (i.e., suspension or reduced or dentist's office Even before anticipating a pregnancy, allowance; pay a penalty). 24. Smoking marijuana prospective parents should evaluate the 5. p,ssignment of extra household du- 25. Repeat traffic law offender needs and goals they hope to satisfy by ties (i.e., additional chores on top of reg- 26. Premarital pregnancy experi- having children. Every child should be ular duties). enced by daughter or caused by son a wanted child. In having children, par- 6. Verbal put-downs (i.e., belittle or 27. Violation of curfew on weekday ents should feel a sense of creative ac- scold). or weekend complishment in guiding and helping a 7. Curbing of privileges (e.g., earlier 28. Hitting the parent in anger child grow into a well-functioning adult. curfew, restrictions). 29. Hanging around with bad com- The parent is the most important teacher 8. Ignoring the problem (i,e., pay lit- pany the child will ever have. Helping their tle or no attention to the child). 30. Failing academically at school children through behavior management No doubt there are proponents and op- As one can easily surmise from this par- in developing positive physical, mental, ponents to one or more of these disci- tial listing of disciplinary problems, some intellectual, and social adjustments in life plinary techniques. Part of this step are major concerns while others do not can be a wonderfully rewarding expe- 195 rience for parents. Even the best parents the behavioral management of children. Health programs which include pa- make mistakes, but with proper knowl- The objective is tl provide as many rel- rental discipline techniques can provide edge, planning, and discipline experi- evant and reali: experiences as pos- assistance to young people to prepare ence, they can overcome many of the sible to inform students, as potentialfor parenthood, reduce certain predict- difficulties of child-rearing. Good par- parents, of the responsibilities in pre-able health problems, and hopefully en- ents will evaluate the discipline situation paring for parenthood. hance the overall health of the child and and respect the child as an individual, There is a need to dispel the unreal-parent in the process. satisfy the psychological and behavioral istic notion that as future parents they needs of the child, and provide the child will rear perfectly obedient children. with emotional security, sympathy, and Disciplinary measures come in many Azrin, N. H., & Holz, 0. C. (1966). Punish- understanding. tormsheld it disdain by some and ment, in W. K. Honig (ed). Operant be- In the majority of school systems, par- strongly endorsed by others. Effective havior areas of research and application. New enting and behavioral management skills expedmental behavioral management York: Appleton-Century-Crofts. are not included in the health curricu- techniques encourage effective parent- Glasser, W. (1965). Reality therapy. New York: lum. There is a definite need for cog- child communication skills through lis- Harper & Row. nitive and effective teachings regarding tening, critical thinking, and assertive- UI ness.

196 BEST CCFY AMIABLE 2( 7 TEACHING IDEAS 108

Counterbalancing Parental Concerns in Health Education Lorraine G. Davis Shirley Holder Hazlett

Across all parts of the United States, 2. Families with established regular making (Musom, 1979, February). De- comprehensive health education pro- patterns of interactions have the highest cision-making must be learned, applied, grams have been implemented, devel- rate of transfer of attitudes, values, and and the results continuously evaluated. oped, discussed, or at least considered. behaviors. Health education has a goal to assist in Because the primary purpose of school the provision of such skills. health education is to reinforce health Familial beliefs are transferred to chil- attitudes and practices being taught in dren through a process of imitation or 5. Telling a child about something does the home, full support from parents and modeling (Glover, 1978, March). As a not guarantee participation. Not telling a community members is always a goal of result of verbal and nonverbal interac- child about something does not mean helshe health education coordinators and cur- tions, the child emulates attitude and won't participate. riculum specialists. behavior patterns of the parents (Lion- If children are to become adults who Parental support is dynamic and on- tos & Liontos, 1981, October 11). Parents make responsible decisions about areas going; ways of obtaining the desired who take an active role in communicat- such as drug usage and sexuality, they support should be considered. The fol- ing with their children are more effective must be knowledgeable and informed. lowing statements may serve to estab- in the transferring of traits. The criticism The less a young person knows about lish support for the school's role in of a child's family practices is not under sex, the earlier he/she is likely to engage assisting with the development or re- scrutiny. Rather, the important of fam- in sexual activity (Gordon, 1981, April). sponsible health attitudes and behaviors ilial interactionis emphasized as the Adolescents informed about sexuality are in children. primary determinant of character devel- more likely to delay sexual relations opment. (Liontos, 1981). 1. The first five years of life are the most critical with regard to the development of 3. The bond between parent and child is Knoln ledge in and of itself, void of an proper attitudes and behaviors. the strongest of bonds; it will survivebut understanding of consequences of ap- the child needs freedom to explore new ,;ication, is not enough. The informa- During the early years, the family unit directions. Parents need to provide advice tion combined with an examination of serves as the basic reference group from and support during this process. short- and long-term consequences of which a child's attitudes and behaviors behavior is crucial in the decision-mak- are formed (Glover, 1978, March). Pa- Fortified with familiar guidance, the ing process. Responsible decision- mak- rental love, warmth, and caring support child must interact with society. He or ing is included in comprehensive health ace the foundation for future decision- she must exercise and expand the skill education. making (Gordon, 1981, April). Early of responsible decision-making. Feel- concepts become rather permanent. ings of capability and self-worth must 6. individuals who feel good about During these crucial development years, be carefully nurtured. Parents serve a themselves aren't as vulnerable for the public school has not yet entered primary role (Gordon, 1981, April) in this exploitation and are less likely to exploit into a position of influence. effort, but support makes the process others (Gordon, 1981, April). complete. The reinforcement of self-es- Self-esteem provides an essential mo- teem and personal worth provide con- tivational component in responsible de- sistency needed for the child's optimal cision-making. Children who feel good moral and social development. about themselves are not as easily vic- timized as people who feel inferior. 4. Neither reading about it nor wishing for Women who have self-worth are more it gives a person a skill; skills ale acquired likely to resist sexual advances (Kirby & through practice. Lorraine G. Davis is an associate professor Alter, 1980, November) and less likely of health in the Department of Health Edu- The child learns responsible decision- to promote undesirable situations. In- cation, University of Oregon, Eugene, OR making by practicing it at home and at dividuals who are loved and know it are 97403. Shirley Holder Hazlett is project di- school. Parents teach concepts such as less likely to participate in behaviors rector of the School Health Program, Cali- honesty, fairness, and self-respect which solely as attention-getting mechanisms. fornia State Department of Education, 721 are reinforced in the school setting. Thes? The home and school can combine ef- Capitol Mall, .3rd Floor, Sacramento, concepts contribute to the development forts to enhance necessary feelings of CA 95814. of a lifelong skill of responsible decision- self-worth. 197 2OR 7. Parents should charge the school with 8. Education is aimed at teaching people Glover, A. D. (1978, March). Modeling--a exposing children to the widest range of how to think and decide, not whatto think powerful change agent. The fourna, of views possible, for their decisions will be and decide. School Health, 48: 175-176. made iq an increasingly complex world. Gordon, S. (1981, April). The case for a moral Ignorance will not make decisions School health education enforcespos- sex education in the schools. The icurnal simpleronly more dangerous. itive health behaviors developed early in of School Health, 51: 214-218. life. Enhancement ofa capacity for re- Liontos, L. B., & Liontos, D. (1981, October Tomorrow's adults must adapt toa sponsible moral reasoning ratherthan 11). Discussion helps ease sex education world fraught with obsolescence of skills the inculcation ofa specific set of values hangups. Eugene Register-Guard. and continuous expansion and revision is the goal (Musun, 1979, February).The Muson, H. (1979, February). Moral think- of information (Thomas, 1978, Septem- above considerations are neither rigidnor ingcan it be taught? Psychology Today, ber). Children cannot merely be armed exhaustive. Their purpose is to maintain 12: 48-68, 92. with nutrition facts of the '80s for thean avenue of communication between Kirby, D., & Alter, T. (1980, November). The current "truths" may be revised in the experts rate important features and out- concerned parents and health educa- comes of sex education programs. The '90s. Parents and schools must assisttors. An understanding of the concepts children in learning to assess accurately lournal of School Health, 50: 497-502. the statements representmay help to al- Thomas, M. (1978, September). Back to and cope constructively with change. leviate some of the fears about the role basicsdo we want to go? The Journal of Basic survival skills in an ever-changingof the school in preparing peoplefor life, School Health, 48: 446. society include the ability to continue to particularly in tLose areas sometimes make responsible decisions in light ofthought to be in the sole educational new insights. domain of the home. The interchangeof ideas related to these thoughtsmay facilitate support for health education and assist families and schools in preparing children for the future.

198 2o TEACHING IDEAS 109

Incorporating Health Education Competencies Into a Content Course: The Disease Guidebook Project Joanna Hayden

With competencies necessary fordisease topics. All topics to be covered The second part of the Disease practice as a health educator identi-during the semester are written onGuide Book Project is a guide sheet. fied (National Task Force, 1985), it is individual pieces of paper, folded, andThis is a one to two page summary of the responsibility of those in profes-placed in a bag. Each student in turnsome of the information presented in sional preparation programs to pro-picks a topic out of the bag. Thisthe term paper. The guidc sheets vide experiences for students that willprocess precludes more than one stu-eventually will be compiled to form enable them to acquire these skills.dent from chosing the same topic. Itthe Disease Guide Book. The guide Courses focusing on program plan-also encourages student investigationsheets include: defmition of the topic, ning, teaching, or research methods,of a disease entity that may not have population at risk, etiology, signs and by their very nature, provide thesebeen a personal choice. symptoms, diagnosis, treatment, risk experiences. However, even a course The Disease Guide Book Project factors, and community resources with such as human disease, which is con-is divided into two parts, a traditionaladdresses and telephone numbers tent heavy, can incorporate activitiesterm paper and a guide sheet. The(Figure 1). For consistency, the guide that encourage acquisition of compe- term paper includes an introductionsheet is set up in the same manner by tencies. to the disease topic or historical infor-all students. It is required that stu- The Disease Guide Book is a projectmation, description of the populationdents contact local, state, and national that incorporates health education con-affected and those at risk, etiology,organizations and agencies related to petencies into a content course. Com-signs and symptoms, diagnosis, treat-their topic in order to request print petencies addressed through this proj-ment, and prevention strategics, cur-materials. Obtaining materials in suf- ect include: utilization of computer-rent research, community resources,ficient quantity for class distribution is ized sources of health related infor-and bibliography. Since it is difficult toencouraged, if materials are available mation, matching an information needlocate textbooks that contain all theavailable free of charge. with an appropriate retrieval system,information, this limits, to some ex- Parts I and II of the Disease Guide accessing principle online and othertent, use of textbooks and encouragesBook Project are submitted together date based health information, andinvestigation into periodic literatureto the instructor for grading. Part I is appiying various processes in acquisi-and various methods of data retrieval.graded as a traditional term paper. tion of resource materials (NationalInvestigation of reference sources other Part II, the guide sheet, is corrected Task Force, 1985). than textbooks is encouraged furtherfor errors and omissions and returned The initial step in the Disease Guideby requiring that references be cur-for rewrite. The rewritten guide sheet Book Project is student selection ofrent, no more than five years old. and the bibliography from the term To assist students in acquiringpaper tfien are returned to the in- Joanna Hayden is with William Pater- competencies needtrl for retrieval ofstructor. The instructor, or a student son Colley in the Depcatment of Health current periodic literature, an intro-volunteer, compiles the guide sheets Sciences, Ware, N1 07470. duction to library resources is sched-alphabetically along with the bibliog- uled. This dass session is conducte i in raphies, numbers the pages, and pre- the library by a reference librarian. Itpares a table of contents. The Disease indudes instruction on the use of on- Guide Book is now ready to be copied line databases as well as paper indexes in sufficient quantity for class distri- and other health related resources.bution. Addition of a cover in a heav- Use of indexes specific to the healthier gauge color paper gives a more professions is emphasized since stu-finished appearance. Spiral binding is dents tend to use the more general in-suggested. 1 99 dexes. Content and length of the Disease .ifeR'SMINIM Guide Book will differ each semester Definition/Description based on the number of students in Influenza is a contagious respiratory disease. the class and topics chosen. The Dis- ltddence/Population at Risk ease Guide Book has ranged from as The highest incidence is seen in children between the ages of 5 to 14. Adults over 65years of few as 28 pages covering 14 diseases to age and those w'th chronic pulmonary and cardiac disease are more likely to be seriously as many as 73 pages covering 35 dis- affected. eases. Etiology Since a substantial amount of time Influenza is caused by a variety of viral strains. It spreads through direct contact with infected person, or indicted contact through droplet infection. is needed to correct, rewrite, compile, and copy the completed Guide Book, Signs/Symptoms initial submission of materials must Abrupt onset of fever, muscle pains, headache, cough, chills, and weakness. take place at least six weeks prior to Diagnosis Diagnosis is made based on the presence of symptoms. the end of the semester with deadlines strictly adhered to. It is the instruc- Treatment/Prevention tor's responsibility to correct the guide Beal-est, oral hydration, and non-aspirin analgesics are used to relieve discomfort. Yearly vaccination is suggested to prevent infection in the following people: sheets quickly in order to allow suffi- persons over 65 years of age cient time for rewriting and resubmis- persons with chronic pulmonary, cardiac disease, and or metabolic diseases; children and sion. A deadline in one week for re- teenagers receiving continuous aspirin therapy; residents of chronic care facilities. submission of the guide sheet is suffi- Community Resources National Institute of Allergy and Infectious cient. If students do not meet the Diseases Office of Communications deadline, their topics are omitted from Building 31, Roorr 7A32 the final Guide Book. Their grades for Bethesda, Maryland 20892 the project can be reflective of this. (310) 496-5717 Although the Disease Guide Book Centers for Disease Control 1600 Clifton Road project requires ongoing involvement Atlanta, Georgia 30329 of the instructor, student fetdbackon (404) 329-3311 its usefulness makes it worthwhile. American Lung Association--Local chapter Along with providing practice for data retrieval skills, this project requires students to summarize information, meet deadlines, and identify and request information from community resources. Students complete the human disease course not only having gained knowledge, but skills anda useful resource tool as well.

National Task Force on the Preparation and Practice of Health Educators. (1985). A Framework for the Development of Com- petency-Based Curricula for Entry Level Health Educators.New York: Author.

200 211 TEACHING IDEAS 110

Politics and Health

Randall R. Cottrell

During Spring term, 1988, a phone numbers for their candidate's couple of students did not receive all course titled "Health Issues" was local (if available) and national cam- the information needed until the day taught at the University of Cincinnati: paign headquarters. This information reports were due. A combination of both graduate and had been z7otained by the instructor undergraduate students enrolled in prior to class from the local chapter of Student Reports and Information the class which was scheduled to meet The Loague of Women Voters. To Processing once a week for two and one half identify health issues on which to hours. Since it was a presidential elec- question candidates, a modified Each group was required to tion year and the Ohio primary would nominal group process method was prepare and submit a written report take place during the term, politics used and involved questioning stu- of information obtained. In addition, and health was one issue included in dents about what they considered to they were required to submit a diary the course. A learning activity was be the most important health issues of documenting efforts to obtain infor- developed to examine presidential today. Votes were used to establish mation for the project. The diary was candidates' positions on a variety of the ten highest priority issues. A to include copies of letters sent and health issues. A description of that description of this technique can be responses received and all phone con- learning activity follows. found in the book Community Health versations documented with the name Initial objectives of the project Planning (Green et al., 1980). of the person contacted, date, and were: (1) upon completion of the as- The process of identifying issues time. Further, each group was to signment, students would be able to was in itself a valuable learning ac- present orally their findings to the en- explain each presidential candidate's tivity. Students were forced first to tire class. Compiling, processing, and position on selected health issues and identify issues, then to prioritize them. discussing the information gathered (2) upon completion of the assign- In addition they were not only looking from oral presentations took one ment, students would be able to dis- at issues from a health perspective, complete class period. Tht name of cuss how politics impact health but also from a political perspective. each candidate was placed across the policies and decisions. Specific health Some of the issues identified involved top of the blackboard and issues were issues examined were to be selected AIDS funding, abortion, family plan- listed along the side. One issue was ex- by students and answers were to be ning, programs for the elderly, and ac- amined at a time with each group obtained via correspondence and/or cess to health care. reporting their candidate's position phone conversations with each All groups were told to obtain the on that issue. It was stressed that stu- candidate's local or national cam- most detailed information available dents were not to "campaign" for paign headquarters. regarding their candidate's position their assigned candidate, but just to on each issue. Students were en- report the facts. The class as a whole Procedures couraged to start this project im- then evaluated each candidate's posi- mediately and to be persistent since it tion on each issue and assigned one of On the first night of class, students might take several weeks and four rankings. A "+" was assigned were divided into groups of three and repeated attempts to obtain the infor- when it was decided that the each group was randomly assigned a mation. To help keep students on candidate's position was favorable presidential candidate, one who was task, the instructor obtained weekly toward the health issuu, a "" was as- still in the primary race, to research. verbal progress reports on efforts signed if the candidate's position was All groups were given addresses and groups had made to obtain informa- not favorable toward the health issue, tion and how successful they had a "G" was assigned when the informa- Randall R. Cottrell is an associate been. Five weeks were allotted for in- tion available was so general that an professor in Health and Nutrition formation gathering the minimum evaluation could not be made, and a Sciences at the University of Cincin- time period to use for this assignment. "?" was assigned when no information nati, Cincinnati, OH 45221. Even with the five week time frame, a could be obtained regarding that 201 212 candidate's position on the health tivity a failure? Absolutely not! This on a variety of issues (not necessarily issue in question. activity got stt. dents to examine the health issues), and to examine the role politics of heakh. During the discus- of politics in health. The following Results sion of presidertial candidates, other recommendations are made with important issues surfaced. Students regard to future use of this activity: Overall, theanking system realized that it is difficult to obtain This activity was developed for revealed many more "0" and "?" specific information necessary to use in a course designed ratings than " + " or " " ratings. In determine a candidate's position on primarily for health education general, most students were disap- important health issues. Some stu- majors, but it might also be of in- pointed in the quality of the answers dents questioned how we as terest in basic personal, com- they were able to obtain and the Americans could be informed voters munity, or public health classes. amount of effort it took to get the in- when we cannot obtain more than This activity should be tried with formation. Local campaign offices general platitudes from our political mature junior and senior level were able to supply literature, but candidates. As a class we considered high school students. Since the staff members and volunteers were how important politics are to health activity has implications related not able to answer specific questions. issues, how politics can affect funding to our political system, citizen- Calling national campaign head- of health programs, and how health ship, and becoming an informed quarters revealed a general willing- priorities can be altered with a change voter, the activity could be used ness to send literature, but once again in administrations. We also discussed as a joint health/political little specific information regarding how politics plays a role in the hiring science project. health issues. Two groups were told by of health personnel from the federal The activity should be tried with national campaign headquarters to level on down. other political campaigns. It send the specific questions and they might be easier to obtain infor- would respond in wrking. In one case Recommendations mation from candidates in- no response was received, and in the volved in local or regional races. other case the same general campaign This activity was successful in get- literature was sent a second time. ting students to critique the political Green, L. W., Kreuter, M. W., Deeds, S. G., So in light of the quality of infor- process, to become more informed on & Partridge, K. B. (1980). Health education mation obtained, was the learning ac- the presidential candidate's positions planning: a diagnostic approach. Palo Alto, CA: Mayfield Publishing Company.

202 2 13 FocusonContent

214 TEACHING IDE: iS 111

Addiction Inoculating Students Against Using Smokeless Tobacco

Melody Powers Noland and Richard S. Riggs

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JILL_

Photo: lint Kirby According to a recent report by tive in preventing use of smokeless et aL, 1979; Seffrin & Bailey, the Surgeon General of the United tobacco. A number of approaches, 1985) States, use of smokeless tobacco has however, have been shown to be effec- Development of social skills increased dramatically over the past tive in prevention of smoking be- needed to resist the temptation 10 years (Department of Health and haviors. Effective approaches in- to begin smokirig. This has been Human Services, 1986). Researchers clude: referred to as "inoculation," just now are beginning to investigate Emphasis on immediate "immunization," and "resis- approaches that might be most -ffec- physiological effects (such as in- tance training" (Evans, 1984). creased heart rate and blood "Inoculation" has been used in pressure) (Evans et a)., 1978) smoking and alcohol prevention Use of peer models to deliver (Evans et al, 1978; McAlister et a)., Melody Powers Noland and Richard S. interventions (Evans et a)., 1979; Hurd et aL, 1980; Evans, 1984; Rigs are associate professors of health 1978; McAlister, Perry, & Mac- Duryea, 1984.) This approachex- education in the Health, Physical coby, 1979; Hurd et al., 1980; poses young people to persuasive ar- Education and Recreation Department Seffrin & Bailey, 1985) guments or threatening messages to at the University of Kentucky, Lexi- Solicitation of public commit- use alcohol or to smoke that they are ngton, KY 40506-0219. ment not to smoke (McAlister likely to encounter in the future. By 205 2 1 5 familiarizing students with the argu- Student Objective ments before they actually hear them should be (1) that the response dis- in life situations, students are better putes the accuracy of the argument's The student will deliver effective main point or (2) whether the able to resist use of substances such as verbal counterarguments to specific tobacco or alcohol. The name "in- response indicates that the main point peer statements that encourage use of of the argument was irrelevant to the oculation" comes from the concept of smokeless tobacco. inoculating individuals with "germs" central issue. These criteria should be (social pressure to use substances) in Method described to class members, then order to facilitate development of class members helped to select or "antibodies" (skills for resisting pres- The teacher or a trained peer devise effective responses for various sure to adopt unhealthy behaviors) educator will divide the class into persuasions they have used or heard (McAlister et al., 1979). used. Write at least six or seven of groups of four or five, making sure these on the board and include both A brief explanation of concepts there are a few males in each group. involved in understanding the in- the persuasion and a counterargu- Groups will be instructed to select one ment that meets at least one of the oculation method may be necessary person in each group whom they will for students. Once the framework of criteria identified above. If students try hypothetically to talk into using have a notebook or take notes, ask the method has been learned, applica- smokeless tobacco. The person from them to write both the persuasive ar- tion to other content areas such as each group is told what students gument and the effective counterar- sexuality, consumer issues, nutrition, remaining in the room will be doing, gument in their notes. and other substance abuse areas is then asked to step outside in the hall. Figure 1 shows examples of pos- more efficient. Since the inoculation Small groups will brainstorm and sible persuasive arguments thatpeers approach has been used effectively in write down eight to 10 comments they might use to convince someone touse smoking and alcohol use prevention, would make to the student to try to smokeless tobacco and suggestions it is appealing that the same approach talk him into using smokeless tobacco. for effective counterargument also might be effective when used with Those students who are out in the hall responses. There may be other equal- smokeless tobacco. will be asked to return to the room and ly effective counterarguments. Ex- The subsequent teaching techni- rejoin their groups. The groups then amples are offered as a beginning que outlines a method which is in- will proceed to try to talk their student point for this instructional strategy. tended to develop skills among junior into using smokeless tobacco. and senior high school youth to resist Individuals within each group preuure to use smokeless tobacco. begin stating their persuasions for the Duryea, E. J. (1984). An application of inoc- This method would be introduced student to try smokeless tobacco, then ulation theory to preventive alcohol ed- subsequent to class instruction on ef- he or she responds to each comment. ucation. Health Education 15(1), 4-7. fects of smokeless and smoking tobac- Allow this process to continue fora Evans, R. I. (1978). A social inoculation strat- co. In this method, students are learn- few minutes (approximately five to egy to deter smoking in adolescents. In J. D. Matarazzo, J. A. Herd, N. E. Miller ing content of persuasive arguments, 10), then stop the activity. Ask some- & S. H. Weiss, (Eds.), Behavioral health: A practicing refutations to persuasive one from each group to read a per- handbook of health enhancement and disease arguments, and receiving feedback on suasive argument used to persuade prevention. New York: John Wiley, 765- responses. We recommend this the student to try smokeless tobacco. 774. method's use as a component of a The teacher or peer educator should Evans, R. I.,Rozelle, R. M., Mittelmark, M. B., Hansen, W. B., Bane, A. L. & more comprehensive program that in- write arguments on the board, then Havis, J. (1978). Determining the onset of corporates other effective ap- ask class members what they thought smoking in children: Knowledge of im- proaches previously discussed (i.e., would be a good student response in mediate physiological effects and coping emphasizing immediate physiological refusing the smokeless tobacco. Stu- with peer pressure, media pressure and effects, peer models to deliver inter- parent modeling. Journal of Applied Social dents in class will not have difficulty Psychology, 8(2), 126-135. ventions, and solicitation of public identifying persuasions to use the Hurd, P. D., Johnson, C. A., Pechacek, T., commitments). smokeless tobacco since these will be Bast, L. P., Jacobs, D. R. & Luepker, This method has been used suc- similar to persuasions students R. V. (1980). Prevention of cigarette cessfully in a junior high school class probably have heard from others in smoking in seventh firade students. Jour- by a peer educator that we trained. real life experiences. UsuaLy students nal of Behavioral Medicine, 3(1), 15-28. McAlister, A. L., Perry, C. & Maccoby, N. The peer educator received the will not have any difficulty in com- (1979). Adolescent smoking: Onset and method as detailed below, reviewed menting on persuasions to try smoke- prevention. Pediatrics, 63(4), 15-28. the method with us, and spent per- less tobacco. National Institutes of Health. (1986). The sonal time reviewing materials. The most important part of the health consequences of using smokeless tobacco. (DHHS Publication No. 86-2874). Be- Evaluations of the method hidicate lesson focuses on responses to per- thesda, MD: U.S. Government Printing that it was effective in meeting the suasions and not on the persuasions Office, lesson's objective. The classroom themselves. The teacher/peer Seffrin,J. R. & Bailey, W. J.(1985). Ap- teacher or a trained peer educator can educator should emphasize that proaches tc adolescents smoking cessation and education. Special services in the teach this method in one class session. criteria for an effective response schools, 1(3), 25-38. 206 It. 1

Persuasion:"It's not as bad for you as smoking." Response:It's really hard to compare smoking with the use of smokeless tobacco. Both products contain nicotine which is bad for your heart and both contain cancer-causing agents. Smokeless tobacco increases your risk for mouth cancer and cigarettes increase your risk for lung cancer. If you can get cancer from both products, neither one is safe. Persuasion: "All the guys are doing it." Response: That's not true. Only about 16 percent of males between the ages of 12 and 25 use smokeless tobacco. Persuasion:"It's coolit makes you look tough." Response:I don't see anything tough or cool looking about having that dirty stuff all over your teeth. Tobacco has nothing to do with being cool. Anyway, if I have to do that to be cool, 1 would rather not be cool. Persuasion:"All the coaches and athletes chew or dip." Response:All coaches and athletes do not chew or dip. While coaches and athletes may use smokeless tobacco more than others, the majority of them do not use it. Persuasion:"It doesn't smell bad like cigarette smoke." Response: Maybe you need to smell your own breath to see how bad it smells. Persuasion:"It gives you a buzz." Response: From what I have heard, it does give you a buzz (high), but that doesn't last very long and then you find yourself wanting another buzz, so you use more tobacco. The result over time could be a drug dependency on tobacco. I'd rather be drug free. Persuasion:"It helps you relax." Response:Smokeless tobacco contains nicotine which is a stimulant. Stimulants speed up the heart rate and can increase your blood pressure. I don't call that relaxing. Persuasion: "You are a chicken if you don't try it." Response: I really would be a chicken if I tried it just because you told me to. I think it is smart not to use tobacco. Persuasion: "Plenty of people have used it for years without having any problems." Response:Not all people who use snuff or chewing tobacco have health problems, but using smokeless tobacco increases your chances for having a number of 'lealth problems such as mouth cancers and gum diseases. I'd rather not ake a chance. Persuasion: "My grandmother uses snuff. You mean you're afraid to use something that doesn't bother my grandmother." Response: Jus,ecause your grandmother uses it doesn't make it safe or right. That was your grandmother's choice and not mine. I want to choose for myself and I choose not to try smokeless tobacco. Persuasion: "Chewing and dipping are not habit-forming like smoking cigarettes." Response: That's not true. Smokeless tabacco contains nicotine, and you can become dependent on nicotine. Just ask people who use tobacco regularly how hard it is to for them to stop.

217 207 TEACHING IDEAS 112

Addiction The 12 Puffs of Christmas

Warren McNab

glade Levet: 7-12 should not smoke. Students can use c lass The Twelve Puffs notes and their textbook if they cannot of Christmas Time Frame: 30 minutes recall enough mental, social, or physical reasons for not smoking. Materials: Transparencies, overhead The groups of students are then On the first day of Christmas, my projector, and a marking pen asked to combine these hazards/reasons with "The Twelve Days of Christmas" cigarettes gave to me Preparation and Implementation: Ciga- melody. The first sentence should begin, A whole lot of agony rette smoking is the largest single pre- "On the first day of Christmas, my ventable cause of illness and premature cigarettes gave to me"followed by 2nd day - Lots of stinky clothes death in the United States. A smoker's one of the reasons they identified for not 3rd day - Yellow teeth and fingers risk of death is much greater because of smoking "T"'^ rocedure is followed for the direct relationship smoking has to the 12 days..... 1its can be creative and 4th day - Two lungs with cancer coronary disease, lung cancer, emphy- put the reasons in any order. sema, and chronic bronchitis. The fifth reason listed should be 5th day - Leu Ko Pla Kia There are many mental, social, and spelled out phonetically, to indicate this 6th day - Ashtray-tasting kisses physical reasons for not Rmoking. An part of the song is emphasized differently important concept to emphasize to stu- and sung like "five golden rings" in the 7th day - Stressful nonstop air flights dents is that they always have a c hoice as original song. Groups can also create to whether to begin t a smoke (or continue their own title for their version. 8th day - Chronic emphysema to smoke). Each group then puts its list on a One creative method to help young transparency, which is eventually pro- 9th day - Coughing family members people cc .nprehend and remember pre- jected onto a screen. The class collec- 19th day - Richer thoracic surgeons viously identified reasons for not tively sings the 12 reasons given in the smoking is to combine these reasons songs the groups have written, or certain llth day - Terminal carcinoma with the melody of "The Twelve Days of selected songs may he sung if time is 12th day - Mourners singing softly Christmas" song. Upon completion of I im ited. the unit on smoking, the class is broken An alternative to this method is to into groups of five and instructed to have the class brainstorm reasons not to This activity provides an avenue to brainstorm at least 12 reasons why people smoke, and a recorder writes the reasons review material through group partici- given on the board. Class members then pation that emphasizes the negative as- select the 12 they would like to use as pects of smoking and reinforces the positive reasons one shouid not begin to Warren McNab is professor of health lyrics to "The Twelve Days of Christ- smoke. Discussions on how to verbally education, School of Health, Physical mas." say no to people offering cigarettes may Education, and Recreation, University The following is an example of this follow this activity. of Nevada, Las Vegas, NV 89154. completed task:

208 215 TEACHING IDEAS 113 Addiction Drive-A-TeenA Program to Prevent Drinking and Driving Susan Willey Spa lt tr

IMO%

Drive-A-Teen would never have and a high school guidance counselor question. Could accidents be prevented evolved had it not been for a group of who acts as a liaison between students if teenagers had an alternative way to dedicated and competent high school and Drive-A-Teen staff. The faculty ad- get home from social events that they students who welo willing to devote a visors have been impressed by the ma- would trust and use? The answer to this great deal of time and energy to the ture views of the students, yet con- question lead to the development of the program. Many of the student volun- cerned by the excessive nature of some Drive-A-Teen transportation service. teers had lost close friends in alcohol- of the alcohol related experiences they The service involves the use of parents, related accidents and were anxious to described. Students who all had had who volunteer to drive students home participate in a constructive way to experiences related to alcohol, drinkers when they are stranded, usually be- solve a difficult problem. Many of them and nondrinkers alike, shared a concern cause of their own or their friends' were extremely concerned about the ex- for their community and a strong com- drinking. Drive-A-Teen calls are fielded tent of the drinking behavior in the mitment to finding solutions to prob- by the local crisis telephone hotline. The teenage community, and they were lems caused by alcohol. telephone counselors help the caller to very much aware of their impact on the Early student activities centered assess the situation and to consider oth- younger students. Students also ex- around launching the transportation er transportation alternatives. If neces- pressed concern about the polarization The problem of teenage drinking and sary, the counselor calls the Drive-A- of friendships surrounding alcohol use driving is only partly reflected by avail- Teen parent volunteer to relay informa- and the prevalent attitude that drinking able statistics, namely, that 60 percent tion about the caller. The parents pick is an essential component of a good of alcohol related highway fatalities are up the students and take them home. time. It is significant to note that there among young people. Alcohol-related No names are ever used. are some students who by age 16 or 17 accidents are responsible for serious in- The transportation system works to have substantially modified their drink- jury and permanent disability. It is well prevent accidents in several ways. First, ing behavior; for them, the years of knowr that teenagers are overrepre- rides are offered to teens who are unsafe early adolescence involved the heaviest sented in the number of arrests made to drive or whose friends are unsafe tc alcohol use. for driving under the influence each drive. Second, teenagers can say to each Dkive-A-Teen activities art coordinat- year. The problem of teenage drinking other, "If you don't let me drive, I'm ed by three school faculty members who and drivirg is exacerbated by their inex- going to call Drive-A-Teen." Third, the act as program advisors: a project &rec- perience with both driving and drink- very existence of Drive-A-Teen has tor who coordinates all aspects of the ing. The problem may also be measured raised the consciousness of the entire program, a student activities coordina- by the anxiety felt by pk.rents as they community. Students often refrain from tor who is responsible for developing worry about their teens, waiting for that drinking before driving. Adult volun- and implementing student activities, most dreaded of all phone calls. DI ive- teers have becorm more aware of the A-Teen grew out of a community's an- problems involved. The message con- guish following a number of tragic acci- veyed to students is that drinking and dents and represents a community's de- driving is such a serious problem that Susan Willey Spa lt is health coordinaior and termination not only to end such Drive-A-Teen is willing to do almost Drive-A-Teen Project director, Chapel accidents but to foster responsible atti- anything to prevent it. The service thus HillCarrboro City Schools, Chapel Hill, tudes toward alcohol use. reinforces the existing alcohol education NC 27514. Drive-A-Teen began with a simple curriculum. 209 1 9 naires, interviews, and informal discussions. Parents and students will both be included. Records will also be kept for evaluation purposes on allDrive-A- Teen student committee functions. The peer education component will be assessed with pre- and posttests. This rather formidable task will be carried out with assistance from the Highway Safety Research Center, University of North Carolina at Chapel Hill. Drive-A-Teen has brought together people of different ages, backgrounds, and interests to address the problem of drinking and driving. Drive-A-Teen began in a southeastern university town with a total population of about 50,000 and a secondary student population of 2,500. It seems likely, however, that this program could be adapted to fit many communities. Any such programs must begin with students and with adults whom they trust. It is important to involve both the student "partiers" and the student "leaders." The need for parent volunteers is readily apparent. Parents must be willing to drive at odd hours with students whom they may or may not know. They must be committed to con- Students were involved in par- with alcohol. The experience of leading fidentiality, and they must be prepared ent volunteer orientation sessions, they discussion groups with slightly younger for those times when the students may helped to develop the system by which students gave them a greater apprecia- be taking advantage of the service. An Drive-A-Teen phone calls are fielded by tion for the problems associated with already existing telephone serviceis the crisiF phone service, and they spoke alcohol, and they had the experience of probably necessary.The telephone to their peers, personally and through helping to develop a new program in counselors must be carefully informed the media. Most important, perhaps, their community. about the purpose of the service, and they demonstrated by their interest and The interest Drive A-Teen has gener- they must be willing to help an often enthusiasm that the service was needed ated in the community has sparked an confused, sometimes scared young and that it would be used. expansion of activities into other areas teenager figure out if he or she really It was their efforts that provided the related to alcohol use. A committee of needs Drive-A-Teen. initial impetus for expanding the Drive- student volunteers has organized to Drive-A-Teen probably would not A-Teen program to address problems of meet with community officials to devel- have been effective without an already teenage alcohol use in other ways. The op recreation alternatives acceptable to existing alcohol education program. need to keep the student body as a both teenagers and parents. Students Students had already been exposed to whole well informed about the service, also plan to meet with representatives the problems surrounding alcohol use. coupled with the potential benefits of from the district attorney's office to dis- The active support of community lead- involving students more actively in the cuss the feasibility of developing sen- ers is crucial. Sound and available legal alcohol education program, encouraged tencing alternatives for young people advice is essential to provide legal pa- the staff to initiate a pilot peer education arrested on alcohol-related charges. rameters within which volunteers can program. The student peer educators The evaluation of Drive-A-Teen will function and to address questions as participated inthe training program reflect the diversity of its activities. The they arise. which involvedfactualinformation transportationservice provided over It is gratifying to see many teenagers, about alcohol, decision-making skills, 100 rides during its first year of opera- so long considered only as part of the clarification of values pertaining to alco- tion. There is no way to accurately mea- problem, becoming part of the solution hol, elements of group facilitation, and sure how many students avoided drink- as well. Teenagers and adults have a discussion of problem situations coming before driving or encouraged their found in Drive-A-Teen a forum where mon to teenagers. While the scope and friends to avoid drinking before driving ideas and problems can be openly dis- extent of the peer education program because of Drive-A-Teen; 1,owever, in- cussed. The problems of drinking and was limited by time and funds, it dem- formal discussions with students, par- driving are not going to be solved easily onstrated the potential of peer educa- ents, and t: achers suggest that students or quickly, yet Drive-A-Teen has given tion to augment both the transportation did infact become more responsible the citizens of one community the op- service and the existing alcohol educa- regarding drinking and driving. The portunity to take joint responsibility for tion program. The students involved staff will continue to gather information problems and to work toward a solu- learned to better understand and dis- concerning relevant attitudes and be- tion. cuss their own attitudes and problems havior through the use of question- 210 2 ,! TEACHING IDEAS 114 .111Elb

Addiction Analyzing Cigarette Smoke David M. White and Linda H. Rudisill

The results of a ten year study (1975- 1984) indicate a clear relationship be- Teacher Input tween teenagers' perceptions of the Iwill not ask you to sample these harmfulness of cigarette smoking and items as I describe them. When I have their smoking behavior. As the percent completed the discussion, you can then of high school students who think ciga- decide if you want to try them. Remem- rette smokers harm themselves (physi- ber, if you do not want to try it, your cally or in other ways) has increased grade will not be affected. from 26.8 percent to 64 percent, the percentage reporting daily use has decreased from 26.8 percent to 18.7 per- Point to balloons cent (U.S.D.H.H.S., 1985). This evi- The product that we are analyzing is dence supports what most health edu- associated with over 500 gases and sev- ca tors have believed for years eral thousand chemicals. Since I would instruction about health risks of smok- have to go to a lot of trouble to bring ing is crucial, especially in the elemen- you over 500 gases, I just brought two of tary and middle school grades. them in balloons. This balloon contains The following describes alesson some carbon monoxide. Joe, after I de- about the health risks of smoking that scribe the other chemicals, would you has proven to be interesting and effec- please inhale the gas in this balloon? tive. This lesson places the student in This gas is odorless, colorless, and, al- the unusual position of analyzing tobac- though this amount should not hurt co smoke by "sampling" some of the you, this gas is deadly. When you use ingredients separately. It not only em- this product, your blood transports five phasizes the health risks of smoking, to ten times more carbon monoxide but also encourages the student to be a than normal. This is because carbon more intelligent consumer by providing monoxide binds to hemoglobin about an experience in product analysis. 240 times more strongly than oxygen Teachers who enjoy using "props" does. should like this one. Though materials Focus required may present some difficulty if How many of you have ever received Now, Joe, I know what you are think- they must be transported from room to products in the mail to sample, such as ing. Why should only a guy try this. room, they are easily assembled and soap, shampoo, or toothpaste? The Sue, I would like you to choose a bal- critical to the impact of the instructional makers provide a small amount for us to loon and try it, too. Remember, if you activity. Materials needed include the try and then we decide if we want to use the average amount of this product following: four balloons, a small glass purchase the product. Suppose we daily, you will lose six to eight percent jar of flour, a small glass of chocolate could sample one of these products by of your body's oxygen carrying capaci- syrup (about one cup), and a small glass breaking it down and trying the main ty. jar of clear syrup, such as Karo syrup. ingredients, thatis, by analyzingit. The following is an example of a (Teacher may want to discuss the mean- Point to other balloons "script" of this lesson that has been ing of analyze). We might know much I have put another of the gases from used with junior higl- age students. The more about a product if we could ana- this product in these balloons. This gas instructor should adjust the vocabulary lyze it rather than simply trying a small is hydrogen cyanide. Hydrogen cyanide is for other age groups. sample. The purpose of this lesson is to a gas that has been used in the gas help you analyze a product that is used chamber. When you use the product we by millions of people in the United are analyzing the hydrogen cyanide David M. White is an assistant professor of States.Itspopularity, however, has paralyzes your cilia (teacher may need Health Education at East Carolina Universi- been declining for several years. (Em- to explain the functions of the cilia here) ty,Greenville, NC 27858. Linda Harrill phasize here that it is important not to for 20 to 30 seconds. Now, Carl, would Rudisill is a teacher of health and physical comment on what the product is until you and Judy sample this ingredient by education at Ashley Ir. High School in Gas- instruction is complete. Have students breathing the gas in these balloons? I'm tonia, NC and adjunct-professor of health write the name of the product on a sheet fairly sure that the amount I have in maintenance at Gardner-Webb College in of paper when they think they have here will not hurt you; however, re- Boiling Springs, NC. guessed correctly.) member thatthis gas paralyzes,or 2 1 1 221 freezes, your cilia for 20 to 30 seconds Before this day is over, approxi- try it? If you received a box in the mail each time you use the product. mately 4,500 young people will have and on the outside these facts were tried or started using this product. By Printed, would you try it? Hold up the jar of flour the time they graduate from high Have students name the product. school, half the nation's teenagers will End the lesson with a statement about InthisjarI have alittle arsenic. have used this product, 18 percent on a the importance of making wise deci- Kathy, would you sample this for us daily basis. sions which influence your life in posi- later? I have clean spoons for both you About one and one half billion of tive ways. For example, the teacher and Tom. Arsenic is a silvery-white, these products are used by 54 million might say, "You have the power to tasteless, poisonous chemical used in Americans for an average of about 27 influence your future in vital ways. The making insecticides. It looks like flour each day. The substances in this prod- choice is up to you. No one can keep you and that is what it is mixed with in this uct are the primary cause of 360,000 from smoxing, and it definitely will af- jar. Arsenic is associated with the prod- known deaths a year, an average of fect your entire life, however short or uct we are analyzing. 1,000 deaths a day. longit may be. Why start and get Using this product is one of the hooked? But, if you want to smoke, go Hold up glass jar (about one cup) of largest self-inflic ed risks a person can ahead, it's your life, but it's the only one chocolate syrup take. It is responsible for more prema- you will ever get. The only safe cigarette In this jar I have a brown stiLky sub- ture deaths and disability than any oth- is an unlit cigarette." stance. If you use the average amount of er known agent. More people die from using this U.S. Dept. of Health and Human Services: the product we're analyzing, your body Use of Licit and Illicit Drugs by America's will collect about a cup of this brown, product than seven times our annual High School Students, 1975-1984 (1985). sticky substance a year. Tom, would death toll from highway accidents. Washington, DC: U.S. Government you put your finger in this jar and then A pregnant woman who uses this Printing Office. U.S. Dept. of Health lick your finger? Susan, I know you will product may be affecting the health of Human Services publication no. (ADM) help Tom with this. her unborn child. Comparing users 85-1394. with nonusers, users have a higher per- Refer students to jar of clear syrup centage of stillbirths,agreater number of spontaneous abortions and prema- This substance is a poison. It can kill ture births, and more of the infants die a instantly in its pure form, but I have few weeks after birth. The chi:d's long- mixed it so that it will not kill you. It term physical and intellectual develop- looks like clear syrup, so that is what it ment may be adversely affected. is mixed with. This poison is habit- This product will stain your teeth, forming. It speeds the heart rate an and users often have bad breath. extra 15 to 25 beats per minute, or as You might say, "Surely a person can many as 10,000 extra beats a day. Also, stop using this product whenever he it constricts the blood vessels and quick- wants to." My reply is "not necessari- ens breathing. George, would you sam- ly." Remember the habit-forming sub- ple this for us? Remember, a one drop s tance we mentioned. Withdrawal injection of this substance would cause symptoms for using this drug often in- death! Jean, you are so cooperative in clude tension, irritability, restlessness, class, and I think George would feel depression, anxiety, difficulty in con- better if someone else were doing this. centrating, overeating, constipation, di- Another thing, when you use this prod- arrhea, insc-nnia, and an intense crav- uct, this poison reaches your brain in ing for the product. only seven seconds. If it were not for A few things that I have not men- this ingredient, people would probably tioned are: not be interested in long term use of this product. If you use this product, you are Now, are you all ready to sample a 1,000 percent more likely to die from few of the ingredients in this product? lung cancer than those who do not use Before you answer, I guess I should tell it. you more. (The following list of facts You are 500 percent more likely to may be discussed or the teacher may die of chronic bronchitis and emphyse- want to add others and delete some ma if you use it. from this list.) Average users of this product are 70 If you start using this product now percent more likely to die of coronary and continue, you should expect to lose artery disease. They also tend to suffer six and one half years of your life. from more respiratory infections, such If you use it a lot, your chances of as colds, than nonusers do. dying between the ages of 25 and 65 are Finally, this product is so danger- about twice as great as for those who do ous that four rotating warning labels are not use this product. required by law to be on the package. Over 100,000 physicians have quit If you were sent this product in the using this product. mail to sample, would you be likely to 212 2- TEACHING IDEAS 115

Addiction Promoting a Natural High Catherine J. Paskert

Ever since the mid-seventies when the National Institute on Drug Abuse reported that informational drug education programs were often ineffective in deterring youthful substance abuse, there has been a shift to more broad- based curricula. The evidence that cognitive approaches were sometimes counterproductive and may have influenced some youngsters to experiment with drugs signaled a need for change. Trial balloons were launched to find teaching methods better suited to drug education. Many educators responded by developing and trying different techniques, and the literature was soon flooded with ideas. None claimed to be magic bullets, but affective approaches and especially valuing activities were imorid regarded as having a potential for influencing young people to adopt a drug free lifestyle. Consequently, drug education programs today are mostly multidimensional. Important cognitive features such as basic information about alcohol and drugs remain, but there is an overall greater emphasis on a wide variety of affective and experiential learning activities which aim to help students develop coping skills that have application to everyday living. One of the most effective and endur- ing valuing strategies is the "Love List" or "Twenty Things That You Love To Do" (Simon, Howe and Kirschenbaurn, 1972). This learning activity, "Feeling Good," is a variation of the "Love List" and is based on the theory that people have an innate need to temporarily alter consciousness or "get high" wh:ch they will satisfy chemically if they failto achieve it in more natural ways, e.g., sports, movies, music, dance, travel, art. This activity also recognizes that drugs are used and abused for many reasons, but the desire to feel good or get high is what actually may be at the

Catherine I. Paskert is an associate professor NIii in the Department of Health Professions at NV 3, Montclair State College, Upper Montclair, Ny 1 N N N) NJ 07043. 213 LZsi copy AMBLE 2 23 root of drug taking (Weil, 1972; Weil nate any of these adjectives?" :Jote: Discussion and Rosen, 1983). Some students will recognize that The purpose of "Feeling Good" is the pleasurable physical and psy- The groundwork for acceptance of two-fold. It aims to demonstrate that chological effects derived from par- recreational drug use was set in the alcohol and other drugs are used and ticipation in legal or socially sanc- 1960s at a time when drug taking was abused for a variety of reasons and that tioned activities are not unlike the frequently a political statement. Drug the very pleasures which are often at- pleasure seeking effects often asso- use today is more casual. Among ado- tributed to chemical highs can be ciated with substance abuse. The lescents in particular it is often viewed achieved naturally; thatisto say, initial reaction of others may be in the same context as going to a movie through health-promotingactivities. that surely none or very few of the or an athletic event, and its social ac- "Feeling Good" helps students arrive at adjectives are related to drug use. ceptabilityatpartiesiswidespread. the important conclusion that the plea- When such variations in student Moreover, the problem is both complex sures which drug users associate with responses occur, and they often and deeply rooted; young people con- their chemicals of choice are also experi- do, it may be partly a function of tinue to use and abuse drugs in unprec- enced by people engaged in legal or experience. Tessler (1980) reports edented numbers. socially sanctioned activities. This is an that there are important differ- Educational approaches that appeal appropriate activity for students in jun- ences in the opinions of junior and to the thrill and glamour of life on a ior high school through college and also senior high school drug users and natural high, instead of scare tactics, is suited for use with educators, par- nonusers about why kids use can be effective vehicles for reaching ents, and community groups concerned drugs. Thenonusergroups in the young people at all levels of drug expe- with the prevention of youthful sub- Tessler study identifiedpeer pres- rience. Most student populations instance abuse. sureandescapeas important moti- clude some youths who are drug free and determined to keep it that way, Description vating factors, whereas the user groups discounted the influence of many who are undecided, and others 1. Ask students to list five or more of these and a third factorexperi- who will use/abuse drugs no matter their favorite things to do. Make it mentation. The majority of users what. This learning activity can provide clear that this is their private list (53.47 percent) claimed that "feel- important and much needed reinforce- and that they will not be required ing good" was thprincipal reason ment for those who are drug free as well to share its contents. for using drugs. as those who are undecided, and could 2. Instruct students to match each 6. Continue by asking students why also be instructive to the drug users by activity on their list with an adjec- they think people do drugs. Ask sending the message that "feeling tive that best describes their feel- them to identify reasons that are good" is not an exclusive feature of ings during or after participating in typically given to explain drug tak- drug taking. All young people need to the activity. ing and list the responses on the be reminded that, yes, there are alterna- 3. Compile a listing of adjectives on chalkboard. Among the factors tives to drinking and drugging, and the chalkboard. To expedite the that will likely be suggested are: these natural high alternatives appear to process and increase student in- peer pressure, curiosity, availabil- be gaining momentum. Thisisevi- volvement, ask several students to ity, to escape, cope, rebel, and get denced by the occasional media cover- come to the chalkboard and alter- high. age of school community sponsored nate taking turns recording adjec- 7 Conclude by discussing the idea events such as mini-marathons which tives when volunteered by class- that although people take drugs encourage student participation with mates. When all adjectives includ- for a variety of reasons, getting slogans that exhort, "don't get high on ing their own have been noted on high is a key factor, and for many drugs, get a natural high." the chalkboard, instruct recorders this may be the most critical ele- There is widespread agreement that to sit down. ment. At this point a case can be getting turned on to themselves is the 4. Ask students if any activity on made for getting turned on to single most important high for young their list of favorite things to do is something else 11-atisfun but, people today; it is prerequisite to a drug illegal or socially unacceptable. If unlike drugs, isTt iter physically free lifestyle, one that is focused o.; so, ask if they will share only the nor psychologically damaging. Or, achieving pleasure via natural rather word that is paired with the illegal put another way, doesn't hurt so than chemical means. The challenge is activity and circle adjectives that much and in so many ways, i.e., clear: we must convince them that "do- an, so identified. shattered personal relationships, ing drugs" is neither the best nor the 5. Clarity at this point is especially poor grades, declining health, and only ticket to "feeling good." important. The teacher might be- possible drug charges. Most of the Simon, S. B., Howe, L. W. & Kirchenbaum, gin by saying, "these adjectives, reported benefits of drug use can H. (1972). Values clarification (a handbook with possibly a few exceptions (cir- be achieved in more accepted and for teachers and students). New York: Hart cled words) describe how you say natural ways. Remind students Publishing Company, Inc. you feel when engaged in your that this was illustrated by the fact Tessler, D. J. (1980). Drugs, kids and schools. favorite socially acceptable activi- thatvirtuallyalltheadjectives Santa Monica: Goodyear Publishing ties. Think about this: do these which they used to describe feel- Company, Inc. words, including those circled, ings associated with socially ac- Weil, A. (1972).l"he Natural Mmd. Boston: also describe how persons using cepted activities were also descrip- Houghton Mifflin. drugs might possibly say they tive of drug taking. Doing drugs is, Weil, A. & Rosen, W. (1983).Chocolate to feel?" "Do some, most, or all of dernonstratably, not the only game morphine: Understanding mind-active drugs. Boston: Houghton MifflinCompa- them apply?" "Could you elimi- in town. ny. 21 4 TEACHING IDEAS 116

Addiction Alcoholics Anonymous: The Utilization of Social Experience in the Classroom Robert G. Yasko

Alcohol abuse is America's number away from including awareness-raising time for grading. A special case occurs one drug problem. Nearly 105 million activit es because of accountability of when students cannot complete the Americans (18 years of age and older) issues. A.A. project for reasons beyond their are considered to be drinkers, i.e., they One of the most effective learning control. The instructor usually is willing have had at least one drink of beverage experiences is having students attend to renegotiate the project with a differ- alcohol during the past year (Carroll, an "open" A.A. meeting after the factu- ent activity (e.g., article critique or film 1985). Among American high rchool al knowledge of alcoholism has been review). students, 93 percent have tried drink- presentedwhich must be the founda- The following guidelines are dis- ing, and 71 percent drink at least once a tion of any prevention effort. This meet- cussed in class prior to attending A.A.: month (Schlaadt & Shannon, 1986). It is ing is open to non-A.A. persons as well 1. Students are permitted to go in estimated that there are 3.3 million as members. These meetings are the small groups (two or three) with class- problem drinkers among youth in the most accessible and vary in format, but mates, friends, or relatives. 14-17 age range-19 percent of the 17 usually they are of the speaker type; 2. Students are not permitted to take million of this age group (Hafen & Brog, generally a leader and two or three any classroom material (pencils, or pa- 1983). Approximately 90 percent of col- speakers who relate their storieshow pers). lege students report drinking during it was with them, what happened, and 3. If students attend an A.A. meeting their academic career. Furthermore, it is how it is now (Maxwell, 1984). I have in their local community, they should conservatively estimated that there are found that first-hand attendance at not be surprised to see someone there at least 10 million alcoholics in the Unit- A.A. meetings accomplishes something they know. ed States (Johnson, 1980). a book can never doawareness (by 4. The A.A. meeting is approximately For five decades, Alcoholics Anony- seeing, hearing, and listening) of what 60 minutes long. mous (A.A.) has been working success- becoming alcoholic is like. Thus, the 5. Students may be asked by an A.A. fully for men and women from every objective is not just understanding alco- member why they are in attendance. kind of background. Virtually all per- holism, but awarenesswhich is an in- Their response should be: "My name is sons in our society have been exposed valuable educational experience. Fur- .I am a student at to alcoholism in some form or other, thermore, A.A. is one of the most effec- and was asked to observe an 'open' and it has caused us great consternation ti v e methods of attaining and A.A. meeting for a health education and confusion. Alcoholism affects every maintaining sobriety and this program class." aspect of society and it has been esti- not only is helpful to the alcoholic, but 6. Students also should be prepared mated that 36 million Americans are can also be an excellent program for for a "cigarette smoke environment," affected by living with the alcoholic or personality development of all persons, although A.A. is beginning to hold non- by having close contact with one (Max- alcoholic or nonalcoholic, drinkers or smoking meetings. well,1976).Beverage alcohol abuse nondrinkers (Twerski, 1984). The instructor can add to the cogni- leads to more problems for individuals, tive domain by asking questions that families, and society as a whole than Implementation of Alcoholics stimulate discussion in the affective do- any other drug in the United States. Anonymous in the Classroom main. Affective instruction (which is based on the rationale that behavior is The Objective of Alcoholics Throughout the United States and personal) can assist individuals to ac- 4nonymous as a Learning Canada, A.A. is found in most towns knowledge control over and responsi- Experience and cities. A.A. can be located through bility for their own behavior. As a re- the local telephone directory, newspa- sult, attitudes about beverage alcohol St. Pierre and Miller (1986) encourage per office, police stations, hospitals, or are identified, discussed, modified, and awareness as a priceless educational by contacting local priests or ministers. conformed (Dennison et al., 1980). The tool for providing insights which trigger At the beginning of the semester, stu- instructor can utilize the following ques- cognition and synthesis of information. dents are provided with a course sylla- tions to stimulate discussion in the af- Alcohol educators should not be lured bus outlining evaluation procedures. fective domain when the written cri- During the same class period, the A.A. tique is dule in class: project assignment is given. The assign- Robert G. Yasko is an instructor in health ment is discussed in detail. Each stu- 1. What were your thoughts before education at The Pennsylvania State Uni- dent will submit a written critique of his attending the A.A. meeting? versity, McKeesport Campus, McKeesport, or her experience two weeks prior to the 2. What were your thoughts during PA 15132. end of the semester in order to allow the A.A. meeting? 215 3. What were your thoughts while Conclusion Dennison, D., Prevet, T., & Affleck, M. leaving the A.A. meeting? (1980). Alcohol and behavior: An activated The author has utilizedthe A.A. education approach. St. Louis: C.V. Mos- 4. Does A.A. benefit our society? experience not only at the college level, by, 77-78. 5. Explain the basic nature and opera- but with high school teachers, coaches, Hafen, B.Q. & Brog, M.J. (1983). Alcohol, tional p,ocess of A.A. nurses, as well as with adults who en- (2nd ed.). St. Paul: West Publishing Co. 6. Did you have any misconception of roll in a drug or alcohol awareness class. p. 102. what becoming alcoholic was like? The open meetings of A.A. offer a Johnson, V. E. (198). I'll quit tomorrow: A 7. How large was the A.A. meeting wealth of data to the interested learner. practical guide to alcoholism treatment. New you a ttended? York: Harper & Row Publishers, p. 1. This resource has been grossly under- Maxwell, M.A. (1984). The A.A. experience: A 8. Are there any differences between utilized, and valuable as learning from a female and male alcoholics? close-up view for professionals. New York: book may be, it cannot compare with McGraw-Hill Book Company, p. 9. 9. How do you now feel about drink- the wisdom of experience. The feedback Maxwell, R. (1976). The booze battle. New ing? is overwhelmingly positive, and though York. Ballantine Books, p. 6. 10. What is irresponsible and inap- this awareness experience is difficult to Schlaadt,R.G. & Shannon, P.T.(1986). propriate beverage alcohol use? assess, the value and contribution it Drugs of choice: Current perspectives on 11.What characterizes responsible makes to student growth warrants its drug use (2nd ecL). Englewood Cliffs, NJ: and appropriate use of beverage alco- use. Prentice-Hall, Inc., 146-147. hol? St. Pierre, R. & Miller, D.N. (1985-86). Fu- ture directions for school based alcohol 12. Would you recommend the A.A. Carroll, C.R. (1985). Drugs in modern society. meeting as a learning experience for a education. Health Education, 16,(6). Dubuque, IA: Wm. C. Brown Publish- Twerski, A.J. (1984). Self-discovery in recovery. future health class? ers, p. 5. Center City, MN: Hazelden Educational Materials.

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216 2 J; ..7EST COPY AM E TEACHING IDEAS 117 "Can A Bike Run On Beer" Addiction Melvin H. Ezell, Jr.

Each year approximately 50,000 peo- manner of drinking employed. The sub- as a function of increasing blood alcohol ple lose their lives on our nation's high- jects next selected a bicycle and were concentration. Final scores for the sub- ways and at least 50 percent of these encouraged to practice riding through jects in Group I were all one hundreds deaths involve a person under the influ- the test course. The test course itself while those in Group II ranged from ence of alcohol (CPWT Report,1982). was approximately two hundred yards forty to sixty-five. Blood alcohol concen- Such accidents are usually attributed to in length laid out on a smooth grass trations for Group I remained below a combination of physical and behavior- surface, free of obstacles, and reason- 0.01 while subjects in Group II recorded al impairments involving visual re- ably safe (Figure 2). blood alcohol concentrations of .12.16. sponse and acuity, reaction time, con- Once subjects felt comfortable with All subjects in Group Il were, therefore, centration, and overall judgment (Edlin, the task, they were required to traverse classified as legally "drunk" according 1982). Furthermore, as shown in Figure the course until each one attained base- to the laws of South Carolina. 1, the probability of being responsible line scores of at least ninety. Scores for ar automobile accident involving a were determined by subtracting five Discussion fatality increases significantly as blood- points for each error, defined as touch- alcohol concentration increases (Per- ing either boundary line with the front The results produced through the rine, 1971). wheel, from an arbitrary perfect score of demonstration "Can A Bike Run On one hundred. Beer" were expected and provided the Next, the subjects were served beer at dramatic, objective illustration of the Purpose the rate of three ounces per fifteen- relationship between blood alcohol concentration and the ability to perform a The purposc! of the event, "Can A minute interval for Group I and "as requested" for Group II. Breathalyzer gross motor skill. Furthermore, partici- Bike Run On Beer," was to dramatically pants and spectators readily generalized and objectively demonstrate the rela- tests were administered by members of the South Carolina Highway Patrol to the results to the skill required to oper- tionship between blood-alcohol concen- all subjects at thirty minute intervals. ate a motor vehicle. The generalization tration and the performance of a gross Following the breathalyzer test each was encouraged by the presence of po- motor skill. The selected skill contained subject was again required to complete liceofficers,breathalyzer equipment, many of the same elements involved in traffic accident displays, and brochures. driving an automobile. Therefore, the the bicycle course as previously described. Participants and spectators were asked participants and spectators were en- numerous questions and made com- couraged to generalize the results which Results ments regarding the amount of alcohol discouraged driving under the influence they typically consumed followed by of alcohol, Baseline scores established prior to driving, swimming, and skiing. the ingestion of beer indicated that all Through the demonstration, questions, subjects could successfully complete the and comments, it appeared to the writer Procedure test course at or above the selected level and to others that a meaningful bit of of competency (ninety or above or not Eight male subjects, each a moderate education was taking place. The ulti- more than two errors). mate results of such education are spec- to occasional drinker, were selected Subsequent scoresfor subjectsin from the Corps of Cadets of The Cita- ulative. However, if only c ne DUI was Group I were all ninety or above while averted, the demonstration was worth- del, The Military College of South Caro- scores for subjects in Group II declined lina,to participate in the demonstra- while. tion. Each subject was required to read and sign an informed consent statement Recommendations which described the nature and pur- The following recommendations are pose of the demonstration and indicated that some risks of injury were pres- offered to those who might wish to ent in the task. conduct a similar demonstration: The subjects were then randomly as- Establish a meaningful philosophy for signed to one of two groups: Group I conducting such a demonstration and "The Sippers," or Group II "The Chug- secure administrative support. Obtain assistance from local and state gers." Each group was named for the law enforcement agencies. Publicize the event on campus and beyond to include appropriate high Melvin H. Ezell,lr.is a professor in the school and college groups. Notify news- Department of Physical Education, The Cit- paper publishers and TV stations, mak- adel, The Military College of South Caroli- ing certain that they are properly edu- na, Charleston, SC 29409. cated regarding the nature and purpose 217 227 of a demonstration. This should be ac- -'111F-4FAVi, . complished through a written statement .. .. prepared by those conducting the demonstration. 70 Select an area similar to the one previously described. Intramural athletic fields and football stadiums are most 60 appropriate if adequate spectator areas are available. Subjects should be "drinkers" and, of 50 course, of legal age to consume alcoholic beverages. An informed consent statement should be read and signed by 40 each subject and a witness. Beers should be purchased by those conducting the demonstration an(' 30 served to the subjects in cups. Avoid assistance from beer distributors. Bicycles should be provided in a vari- 20 ety of sizes, all appropriate for riding on a grass surface. 10 Faculty and student assistance should be recruited to perform the following tasks: 1_ 1 1 J Scorekeeper to record amount of beer <0.01 0,03 0.05 0,07 0.15 0.17 0.19 0.20+ consumed, blood-alcohol concentra- Blood Alcohol Concentration, Percentage tion, and task performance score. (From Perrine et al., "Alcohol and Highway Safety: Behavioral and Medical Aspects." NHTSA "Barkeeps" (two) to serve beer to the Tech. Report, DOT HS-800-599, 1971.) subjects as instructed and to report such information to the scorekeeper. rstill,'Lec.1;9-;7-4,'%1 1;s- Head referee to count the number of \*;.?" . errors and report the score to the scorekeeper. Assistantreferees(four)to throw "flags," indicating errors, and reporting to the head referee. Police officers(four) to operate breathalyzers and report results to the scorekeeper, explain procedures, provide displays, and literature. Announcer to keep spectators informed regarding results as posted on the scoreboard as well as to provide occasional comments. (i.e. "reaction time worsens by 50 percent as BAC reaches 0.10"). "Can A Bike Min On Beer" was co- sponsored by The Citadel's Department of Physical Education and the Col- legewide Committee on Alcohol Aware- ness. The writer wishes to express appreciation for assistance to Dr. Debbie Miller who conducted a similar demonstration at The College of Charleston.

Ed lin, G. & Golanty, E. (1982).Health and wellness.Boston, MA. Science Books In- ternational, p.281. Perrine, M. W., Waller, J. A. & Harris, L. S. (1971). Alcohol and highway safety: Be- havioral and Medical Aspects. U.S. De- partment of Transportation. Report from the Committee on Public Works and Transportationt(..the 97th Congress, 2nd A Scoreboard (4' x 16') C Displays Session (1982, Sept. 23). Report No. 97- B Group I. Group II D PA and Breathalyzer 867,p.7 E Spectator Area 218 TEACHING IDEAS 118

Add:ction Once Upona Synapse: A Drug Education Simulation in Three Acts William M. London

In order to facilitate rational, criti- Mate) :als cal thinking about psychoactive those illustrated by the simulation) "Once Upon A Synapse" is a sim- by which drugs are believed to affect drugs as they relate to personal neuronal communication should be health and political controversies, in- ulation which is to be performed as a three-act play. The only instructional presented to conclude the lesson. struction about basic pharmacologi- Such mechanisms include: (1) alter- cal principles is important. Just as material needed for the actual simulation is a chart placed at the front of ing membrane permeability; (2) instruction about sexual physiology mimicking neurotransmitters; (3) can reduce "magical thinking" about the room on which is listed the dra- blocking neurotransmitters from sexual relations (e.g., pregnancy can- matis personae (see Figure 1). The chart should be large enough to be binding to receptors; (4) altering not result from one's first coital expe- synthesis of neurotransmitters; (5) rience), instruction about pharmacol- readable by the entire class. The ri- diculous names of the characters list- blocking reuptake of neurotransmit- ogy can reduce thinking about drugs ters; (6) altering release of neuro- as if they were magical potions. ed on the chart invariably generate laughter throughout the activity transmitters; (7) altering deactiva- The main problem in teaching tion of neurotransmitters; and (8) about pharmacology is the complex- thereby making the technical nature of the topic less intimidating. altering storage of neurotransmit- ity of the topic. Instructional activi- ters in vesicles (Ray & Ksir, 1987). ties are needed that can make diffi- The simulation should be proceed- cult" pharmacological concepts as ed by a brief lecture on drugs and the real, relevant, interesting, and com- nervous system. Recommended ma- Procedure prehensible for students as possible. terials for this preliminary lecture Students are seated facing the The purpose of this articleis to include overhead transparencies that center of the room in a U-shaped describe such an activity that can bi illustrate: (1) the structure of neu- formation with a gap of about five conducted in college level health rons; (2) the movement of sodium feet at the midpoint region of the science classes and, possibly, at the and potassium ions across the nerve curve. The seating arrangement is secondary level as well. The activity, cell membrane (which in the essence used to represent two nerve cells "Once Upon a Synapse," can be of the nerve impulse); (3) the move- (neurons) in the brain and the syn- completed in about 45 minutes. The ment of neurotransmitter molecules apse between them. The seating ar- behavioral objective is to enable stu- from presynaptic vesicles to postsyn- rangement with the initial position- dents to describe various mecha- aptic vesicles; and (4) the reuptake of ing of the characters is diagrammed nisms by which psychoactive drugs the neurotransmitters by the presyn- in Figure 2. have been theorized to alter normal aptic neuron. Following a brief lecture on neu- neuronal functioning and thereby An overhead transparency that rotransmission, the activity pro- produce psychological effects. lists various mechanisms (including ceeds in three "acts". In Act I, nor- At a minimum, abodt 10 students are needed to effectively illustrate the mechanisms. A class of 20 to 40 students makes the simulation clearer and more entertaining. Ethel (or, technically, Ethyl) Alcohol a depressant drug Coco Cocaine a stimulant drug Neil Neuron a nerve cell Nellie Neuren a nerve cell that receives input from Neil Neuron William M. London is an assistant pro- Norman Neurotransmitter a chemical messenger sent by Neil Neuron fessor in the health education program Vic (or Vicki Vesicle) a storage bin for chemical messengers from Neil Neuron at Kent State University, Kent, OH Rita Receptor a receiver of chemical messages sent to Nellie Neuron 44242.

219 22 mal transmission of an electrical man. (This may also generate some The participant raises his or her arms message across an excitatory syn- playful humor!) If in the teacher's and then places them back down. This apse is simulated. (Normal trans- judgment, there is a big enough signals the next participant over to do the mission in an inhibitory synapse can group, the reality of the simulation same and continues down the line Neil also be simulated in a second run may be enhanced by designating Neuron participants to point 2. The arm through Act I.) Act II illustrates how more than one participant to play raising and lowering procedure is likely alcohol affects normal transmission. each lead role. Each participant not to be familiar to students as "the wave": Act III illustrates how cocaine affects assigned to a lead role is designated a popular pastime in recent years for normal transmission. as part of Neil Neuron, Nellie Neu- spectators at sporting events. Each stu- The teacher begins by requesting ron, or Vic (Vicki, if preferred) Ves- dent's arm raising and loweringrepre- volunteers for the "lead" roles in the icle depending upon seating posi- sents the movement of sodium and po- play: Rita Receptor, Norman Neuro- tion (see Figure 2). tassium ions across the cell membrane at transmitter, Ethel (or, technically, The teacher directs the actionas each point along the neuron. Ethyl) Alcohol, and Coco Cocaine. follows: Step 2: Vic(ki) Vesicle (point B) opens To help students to relate to the Act 1: Normal Neurotransmission at up and releases Norman Neurotrans- lock-and-key relationship between an Excitatory Synapse mitter into the synapse. receptors and neurotransmittets, it Step 1: The nerve impuise begins with Step 3: Norman Neurotransmitter is advisable to choose a female to the participant seated at the dendritic binds to Rita Receptor (point C). (A hug play Rita and a male to play Nor- end of Neil Neuron (point A of Figure 2). or even a handshake will do.) Step 4: A wave begins at point C and proceeds along Nellie Neuron to point D). Step 5: Rita Receptor releases Norman Neurotransmitter. Step 6: Norman Neurotransmitter is Back of Classroom pumped back into Vic(ki) Vesicle. (This process, known as reuptake, replenishes the supply of neurotransmitter mole- receptor site (Rita Receptor) cules). Participants are asked to becre- ative and improvise how reuptake should look. if If the teacher decides to simulate [C] an inhibitory synapse, I recommend having a wave continually repeating in Nellie Neuron that stops repeat- synaptic neurotransmitter ing upon the binding of Norman cleft (Norman Neurotransmitter) Neurotranemitter to Rita Receptor. in a vesicle Vic or vicki Vesicle) The teacher can process Act I by asking the class to brainstorm howa drug that reaches the brain could conceivably disrupt the normalneu- rotransmission process simulated postsynaptic neuron presynapdc neuron (Nellie Neuron) by the class. Students who have (Neil Neuron) ideas on this matter should be instructed to "become" the drug and [ID] act out the ideas that they brain- [A] storm. In Act Il and in Act III, the teacher nerve impulse ends nerve impulse begins can direct the class to simulate hypothesized actions of two commonly abused drugs: alcohol andco- A caine. The teacher may decide to \ / pass up Act II and Act III if students Coco Cocaine teacher respond well during the processing Ethel Alcohol of Act I. Act II: Alcohol is Imbibed Front of Classroom Step 1: A wave begins at point A. Step 2: Ethel Alcohol interferes with the propagation of the wave. Ethel might want to hold some participants' hands 220 down. Step 3: No release of Norman Neuro-Step 7: The teacher explains that the Conclusion transmitter. No wave begins in Nellie interference with reuptake along with The actions of psychoactive drugs Neuron. binding of cocaine to special (unsimu- at the neuronal level can be a daunt- Teachers can explain that many lated) receptor sites may explain the ing topic of study. "Once Upon a scientists have lost confidence in the stimulation effects of cocaine. Some re- Synapse" makes the topic real, rel- hypothesized mechanism illustrated searchers also believe that the severe evant, interesting, enjoyable, and in Act II which suggests that alcohol depression experienced by some chronic comprehensible for students by fa- interferes with membrane excitabil- cocaine users may result from failure to cilitating group interaction. ity. Many now believe that,like replenish the supply of neurotransmitter Indeed, the simulation can be other central nervous system de- (Gregler & Mark, 1987). used primarily as a group energizer pressant drugs, alcohol may mimic Much more than after Act I, after for drug education programs that the neurotransmitter, gamma-ami- the demonstrations of Acts II and III, emphasize social support and skill nobutyric acid, which has inhibitory students are likely to have ideas on building strategies. effects when it binds to its receptor other ways that drugs can act at the Facilitators should be prepared for site (Ray & Ksir, 1987). neuronal level. Thus, at this point, outbursts of laughter and friendly the teacher should repeat the brain- teasing of the student, In the lead Act III: Cocaine is Administered storming session. The teacher can roles. The cit ssror nvironment Step 1: A wave begins at point A. then compare the students' brain- will appear chaoticut will actually Step 2: Vidki) Vesicle (point 8) opens stormed list of mechanisms with the be carefully choreographed. Stu- up and releases Norman Neurotrans- teacher's own list on overhead dents tend to want to "get it right" mitter into the synapse. transparency (as described above and thus will tend to cooperate with Step 3: Norman Neurotransmitter under "Materials"). Teachers a facilitator who is well-prepared. binds to Rita Receptor (point C). should ask students to imagine the Step 4: A wave begins at point C and psychological effects resulting from proceeds along Nellie Neuron to point D. each proposed mechanism of drug activity. Gregler, H.L. & Mark, H. (1987). Medical Step 5: Coco Cocaine stops Rita Recep- complications of cocaine abuse.New En- tor from releasing Norman Neurotrans- It is not so important for students gland Journal of Medicine,315, 1495-4500. mitter. (Cocaine interferes with there- to be able to recite the names of Ray, 0. & Ksir, C. (1987).Drugs, Society, and uptake process). various neurotransmitters or to ex- Human Behavior (4th edition).St. Louis: Step 6: Waves continually repeat from plain the specific hypothesizedac- Times Mirror/Mosby College Publishing. point C to point D. Students can easily tions of specific drugs. Emphasis of relate this to the intensified experiences the discussion should be on general produced by cocaine administration. concepts of neurotransmission and drug actions, and how these relate to drug effects.

231 221 TEACHING IDEAS 119 According to recent surveys parents are now considering alcohol abuse a serious problem that the schools should address. This is a change from recent Investigating the Social Aspects years when "drug abuse" was the major concern. In fact, parents were often relieved to discover that youngsters were of Alcohol Use "only drinking" and not using other substances. This reawakening of popular interest in the prevention of alcohol abuse provides an opportunit, for program development. So the problem faced by health educators is not one of , gaining support for a program but, I. IL\ rather, one of responding in ways likely to have an impact on the lives of students. One does not have to visit many classrooms to note that there seems to be a great deal of confusion about what ought to be included in an effective alcohol education program. At least four different types of programs are in use. While -7- there is generally some overlap of the different types of programs, it is useful to identify each type so that strengths and weaknesses can be noted. One predominant type is the biologi- *`& ` cal emphasis. Teachers using this ap- .00 . ,---,--- proach emphasize the impact of alcohol on the body. Students are acquainted --_-----,,\ N-\% .- with the properties of alcohol and how it N\ functions in the body. While the knowl- #--:- edge of alcohol effects on the body is an important aspect of any problem, it is not Addiction sufficient. First of all, the factors that influence individual decision-making and Tom V. Savage the choice to drink or not to drink are not given consideration. In addition,many of these programs have a negativeem- alcohol at any time. In addition, this ap- material. Police officers, reformed el- phasis. It seems to be assumed that if proach fails to emphasize decision-mak- coholics, counselors from alcoholism re- students are made aware of all of the ing and tends to have a negative flavor. habilitation programs, films, and field terrible things that alcohol does to the A third approach, more common than trips are the major ingredients of this body, then students will not drink. we would like to admit, is the "evils of approach. While many of these re- A second type of a program in the alcohol" approach. These programs em- sources might be worthwhile, most of schools tends to confuse alcohol and al- phasize moralizing and preaching to these progiams lack focus. coholism education. The major thrust students about w:ty they should not here is on alcoholism and the dangers of drink and how evil it is. Such programs And though there are elements of becoming an alcoholic. In fact, this em- tend to use scare tactics that emphasize these four approaches that might be use- phasis has become so popular that the the horrible consequences of drinking. ful in designing an alcohol education author is usually inundated in alcohol The usual results of these classes are program, they all lack some critical ele- education courses with ques:ions about knowing glances passed among stu- ments. alcoholism and how one can tell if he or dents, communicating that they know The first step in developing an alcohol she is an akoholic. Once again, while better than fi e teacher and that the education program involves clarification some of this information is useful, al- teacher is out of touch with reality. Stu- of the goals and purposes of thepro- cohol abuse should not be confused with dents often assume an adversarial posi- gram. This helps guide both the content alcoholism. Any individual may abuse tion of defending drinking and attempt selected for study and the activities stu- to refute the moralistic arguments of the dents will experience. teacher. More than one of these types of What should be the goals and pur- classes have been brought to an embar- poses of a sound alcohol education pro- rassing conclusion when a student asks gram? Perhaps the major goal should be Toni V. Savageis an associate professor in the the teacher, "Do you drink?". to help students make responsible and Department of Curriculum and Instruction, A fourth approach may be labeled the intelligent decisions about their drinking Texas A&M University, College Station, TX "resource blitz." These programs feature behavior. It must be recognized at this 77843. a daily procession of resource people and point that complex factors are involved 222 2n in the decision to drink. An alcohol edu- 2. Why do many people think drunk- cation program must address these enness is funny? complex factors. Learning about alcohol 3. Why is getting drunk the goal of is only one part of this process. Students many people when they drink? need to address the sources of attitudes 4. Poll your classmates. How many of and behavioral expectations that influ- them think getting drunk is desirable? ence individuals to drink to the extent 2. Why do ru think these elements Why do they feel that way? that they abuse alcohol. Above all, the were selected for inclusion in the adver- 5. Construct a blood alcohol level program must have a realistic focus and tisement? chart that shows the probable changes in one that avoids adversarial relationships 3. What is the message of the adver- behavior associated with different betwe.en teacher and student. tisement? changes in the blood alcohol level. Another component that should be 4. What attitudes and behaviors does The project of different students and addressed in alcohol education pro- the advertisement seem tr oe reinforc- their task card projects should be shared grams is that of the social context of al- ing? with the class and discussed. At this cohol use. The social environment and 5. What impact do advertisements point, it might be helpful to address social reinforcements or sant.fions have a have on the attitudes and behaviors of some of the common myths surrounding strong impact on the attitudes and be- people? alcohol use. haviors of individuals. There are many 6. What information is not included in aspects of the social environment that these advertisements that is important to Another rather subtle source of infor- send messages to individuals regarding know? mation about alcohol use is the content appropriate drinking behaviors. As a follow-up, the advertisements of television programs and movies. One way of beginning a study of the could be grouped, and a summary made While some types of beverage alcohol social aspects of alcohol use is to pose the of the common elements and messages may not be advertised, there is a consid- following questions: Why do people they seem to convey. For example, does erable amount of drinking behavior por- drink? What satisfactions do they get the fact that nearly all advertisements trayed during the programs. from drinking? How do individuals in- portray alcohol use in settings that are One interesting approach is to divide fluence their drinking behavior and pat- exciting, sexy, and fun have any impact the class into the teams and have them terns? What drinking behaviors and pat- on our views of when alcohol should be conduct a television survey. Simple sur- terns are taught in our culture? used? vey forms can be developed and differ- Several interesting projects can in- A rather subtle source of information ent students assigned a particular view- volve students in the search for answers about alcohol use, one that is often over- ing time and program. They should be to these types of questions. Students looked, is the cartoon. Cartoons relating asked to identify the program, the should be allowed to gather data, state to alcohol use are plentiful. They appear number of times alcohol was mentioned their findings, and analyze the impact regularly in newspapers and magazines. or used, the context of the drinking, the that social reinforcement has on their at- Just the fact that cartoons with alcohol- purposes for which alcohol was used, titudes and behavior. The role of the related themes are so plentiful is a useful the consequences of the usage, and the teacher should be one of suggesting bit of information to discuss. As cartoons number of times any other beverage was questions and sources of information are collected, they could be grouped ac- mentioned or used. and prompting students to evaluate the cording to common themes. Cartoons Students are often surprised to dis- meaning of the data. can be found illustrating nearly every cover that other beverages are men- Societal attitudes are influenced in reason that could be given for drinking. tioned only rarely luring the context of both obvious and subtle ways. Some of The following questions could be asked: any given program It is almost as if no the more obvious means might be 1. What is the message of the cartoon? other beverages were available. through advertisements that promote 2. Why do you think drinking behav- After a period of time, perhaps a week, various forms of beverage alcohol. ior is portrayed as humorous? the results can be tabulated and pre- Other, mo..c subtle, means might be 3. What reasons are given for drink- sented to the class. They might pay spe- found by analyzing the content of caring in this cartoon? cial attention to the context of alcohol toons, television programs, and movies. 4. How valid are those reasons? usage. How many times was it used to Analysis of advertisements is a project 5. Why do you think the cartoonist enhance sexuality, to relieve tension or many teachers have utilized. The first chose this topic? stress, to escape an unpleasant situa- step involves collection of advertise- 6. What influence do jokes and car- tion? Once again the students should be ments, usually from various popular toons have in shaping attitudes and be- asked to state the types of messages that magazines. When undertaking this proj- haviors of people? are being sent about the use of beverage ectit is useful to have students identify A Eecond method to use with cartoons alcohol. the magazine where the advertisement is what is called a task card, which is a A sound alcohol education program vas found. This is helpful when identify- way of individualizing student involve- must include several components. It has ing the audience for which the adver- ment. A task card might consist of a car- been the purpose of this paper to suggest tisernent was intended.It should be toon related to drinking behavior, along ways of investigating one of the compo- noted that television commercials could with a series of questions or tasks to be nents that is often overlooked, that of the also be included in the investigation. As completed by the student. For example, social aspects of alcohol use. An under- advertisements are collected, the follow- a cartoon might be presented that relates standing of how these complex forces ing questions can be posed: to drunkenness. The following ques- influence attitudes and behaviors can tions and tasks could be included: help move students toward the goal of 1. What does the advertisement 1. How is drunkenness portrayed in responsible decision-making. show? this cartoon? 11111 223 233 TEACHING IDEAS 120

Addiction Drug Use, Misuse and Abuse as Presented in Movies

Kerry J. Redican, Barbara L. Redican andCharles R. Baffi

Movies representa form of the mass media and are an important instrument of communication. Analysis of the effects that movies hamon people has produced much debate among professionals from a variety of disciplines. Regar&Pss of the standa person takes, however, the potential Influence of movieson people's knowledge, attitudes and behavior cannot and should not be underes- timated. Health behaviors presented in movies often can be interpreted as "norms" to viewers. To the health educator, these implied "norms" may not be the ones most conducive to healthy lifestyles or reduction of risk taking behaviors. Examples of implied "norms" might be the way drug use is presented in movies. Many movies imply that people use substances to better enable them to cope or for recreation and imply that these reasons make it all right to use drugs. In an effort to have students evaluate how movies present drug use, the following learning activity was developed. Thic activity has been used in junior andnior high school classes, as well as health education workshops for teachers and other health profesrionals. The activity has been well received by these groups.

This learning opportunity is designed to be a definitive way to analyze how Kerry!. Redican is an associate profes- to stimulate student discussion drug use is presented in movies. regarding how movies present drug sor of health education at Virginia Structure of the Learning Tech, Blacksburg VA 24061. Barbara use. Since movies do represent an ad Opportunity L. Redican is a registered nurse in form and since people interpret Blacksburg VA. Charles R. Baffi is an movies in different ways, this learning As part of a course assignment in associate professor at Virginia Tech. opportunky should not be considered health education, studentscan be 224 23 ,4 Directions: For the film being observed, respond to the following statements by circling one of the following choices located beside each statement. sA= Strongly Agree A= Agree = Undecided = Disagree SD= Strongly Disagree NA= Not Applicable (drug-related scenes not in film) Note: Information regarding scoring can be found under the Scoring and Interpretation Section. Number of drug use scenes in the film Generally the scene in the film or movie: (1) Encourages or condones the use of mood modifying substances. SA A U D SD NA (2) Does not show the negative effects of using mood modifying substances. SA A U D SD NA (3) Promotes use of mood modifying substances as a solution to boredom. SA A U D SD NA (4) Associates the use of mood modifying substances with fun or pleasure. SA A L I D SD NA (5) Encourages the use of mood modifying substances as a problem-solving behavior. SA A U D SD NA (6) Suggests that use of mood modifying substances ia a "norm" (in other words "everyone is doing it!"). SA A U D SD NA (7) Portrays people who abstain from using mood modifying substances as immature, not adult, or "nerds." SA A U D SD NA (8) Shows an easy solution to the results of misus.e or abuse of mood modifying substances. SA A U D SD NA (9) Portrays the hero or heroine as one who uses mood modifying substances. SA A U D SD NA (10) Portrays the use of mood modifying substances as a means of enhancing performance (intellectual, physical, spiritual, etc.). SA A U D SD NA

Scoring and Interpretation asked to pick out a certain film and use the instrument in Figure 1 in Step I: Scoring: Use the following method of scoring your responses: evaluating how drug use is presented. ISA]Strongly Agree = 5 points ln order to maximize the discus- IA]Agree = 4 points sion on movies, it is best to observe the KJ]Undecided = 3 points ID]Disagree 2 points following points. (SD]Strongly Disagree = 1 point Don't let students review INA] Not Applicable = 0 points movies that are considered out- Step II: Add your points as follows: rageous in terms of their drug Statement 1: Points content. For example, movies such as Animal House or Statement 2: Points Cheech and Chong films Statement 3: Points portray unrealistic drug-taking behaviors. Statement 4: Points ln any given analysis, be sure to have students determine if any Statement 5: Points closure was reached regarding Statement 6: Points the negative side of drug use. For example, some films may Statement 7: Points glorify drug use initially, but as Statement 8: Points the movie proceeds. it is easily seen that drug use is interfering Statement 9: Points in the person's life. Statement 10: Points

Summary Total Points: Points Step III: After you have added up the total points, place an "X" on the appropriate point on the following line that best represents your total Once again, the purpose of the points. Once you've placed the "X" that represents the total points, learning opportunity is to stimulate you can easily see the film's position regarding drug use. classroom discussion. Hopefully, as "Anti" Drug Use "Pro Drug Use an end result, the student and teacher Position Position will watch movies with a keener eye and an insight as to how drug use is being presented. 10 20 40 50 Step IV: Comments regarding analysis of movie (e.g. what kind of closure was reached?) 215 225 TEACHING IDEAS 121 Learning About Alcohol Drinking Attitudes and Motivations by Examining the Vocabulary of Drunkenness William M. London Addiction

According to editors of the Dic- minutes depending upon what (if any- part of the purpose of the activity by, in tionary of American Slang,"the concept thing) the teacher decides to omit from effect, discouraging them from discuss- having the most slang synonyms is drunk" the method described below, the dynam- ing what the use of such words to mean (Wentworth & Flexner, 1975). The dic- ics of the group, and the size of the group. drunk implies about common attitudes tionary listed 353 of these synonyms (The activity can be carried out with any of Americans toward drunkenness. How- (Levine, 1981) and 323 synonyms in its class size.) ever, at the secondary school level, the appendix. Spears (1986) listed over 1,870 teacher may need to compromise out of synonyms, while Abel (1985) listed over Method respect for community standards.) Brain- 1,620 slangterms defmed as intoxicated," storming continues until there are about "drunk," or various degrees of drunken- The teacher asks each student 30 seconds during which no new re- ness. to draw a line down the middle of a piece sponses are made. From a prepared list Reasons for the vastness and of paper. Students are given a minute to of synonyms for drunk (which can be richness of our vocabulary of drunken- list on the left side of the page, as many assembled from Abel, 1985; Levine, 1981; ness are not clear (Abel, 1985). How- words (including slang words) meaning Spears, 1981; Spears, 1986; and ever, semanticists have sulnested that snow as they possibly can. This is fol- Wentworth & Flexner, 1975) with syn- how we use language to name things lowed by a brainstorming session so the onyms having the same first letter clus- affects how we perceive things (Postman teacher can write all words generated by tered together, the teacher reads aloud. & Weingartner, 1969). Thus, our vo- the students on the chalkboard. The task In processing the activity, the cabulary of drunkenness reflects our cul- is intended to confound students, and teacher asks the class why it was so much ture's attitudes, values, and thoughts most groups will struggle to generate 10 easier to generate words for drunk than about the use of alcohol (Abel, 1985). words. The teacher must be careful not words for snow. After a brief discussion, An important role of alcohol to give students too much latit.ule be- the teacher explains that Eskimos have educators is to facilitate open discussion cause some especially sophisticated 30 different words for snow, including about attitudes and motivations related groups may come up with many more one for falling snow, one for "snow on to drinking and drunkenness. The pur- words if allowed to use words that refer the ground," one for "drifting snow," pose of this art icle is to describe how that to types of snow. and one for "blowing snow." The large can be accomplished by using our vo- Students then are given a minute number of words reflects the impor- cabulary of drunkenness to provide in- ta list on the right side of the page as tance of perceiving various aspects of sights about alcohol in American soci- ards (including slang words) nature central to Eskimo culture (Cross, ety. . t.c.;drunkas they can. This, again, 1979). The teacher facilitates discussion The activity is recommended as awed by a brainstorming session in about what the vast number ofsynonyms part of alcohol education for students in wnich the teacher records student re- for drunk implies about attitudes toward secondary schools, colleges, and univer- sponses. Students tend to know enough drunkenness in popular American cul- sities. It also has been used successfully synonyms to enjoy the challenge of filling ture. as part of inservice training for school the board with brainstormed responses. In groups of four to six, students personnel. The activity can take from as This brainstorming tends to be accom- are asked to discuss what the nature of little as 45 minutes to as long as 90 panied by frequent outt ursts of laughter synonyms for drunkenness implies about in response to many of the words, includ- common motivations for drinking in ing those words typically regardedas America. Students generally note that William M. London is an assistant profes- profane. most of the words connote violence or sor in the health education program at (To discourage students from destruction (e.g., stoned, bombed)or Kent State University, Kent, 01-1 44242. calling out profane words may defeat silliness (e.g., blotto, schnoggered), al- 226 2; though a few have more mild connota- Abel, E. L. (1985). Dictionary of alcohol use tions (e.g., tipsy, high). The teacher re- and abuse: Slang, terms, and terminolo- convenes a meeting of the entire class gy. Westport, CT: GrPenwood Press. and asks for volunteers to share what Berglas, S., & Jones, E. E. (1978). Drug choice as a self-handicapping strategy inre- they concluded in their groups. sponse to noncontingent success. Journal During the ensuing discussion of Personality and Social Psychology, 36, the teacher may wish to present relevant 405-417. Cross, D. W. (1979). Word abuse: How the viewpoints of scholars for students to words we use use us. New York: Coward, critique. For example, Levine (1981) McCann & Geodiegan. suggested that violent words are directed Levine, H. G. (1981). The vocabulary of drunk- at what "might be thought of as ordinary enness. Journal of Studies on Alcohol, 42 , 1038-1051. or everyday consciousness" and thus the Postman, N., & Weingartner, C. (1969). Teach- appeal of getting drunk "is the anticipa- ing as a subversive activity. New York: tion of a break with ordinary conscious- Dell. Spears, R. A. (1981). Slang and euphemism. ness." Middle Village, New York: Jonathan Dav- Synonyms such as "woofled" id Publishers. connote a degree of self-handicapping. Spears, R. A. (1986). The slang and jargon of drugs and drink. Metuchen, NJ: Scare- Tucker, Vuchinich, & Sobell (1981) pro- crow Press. vided experimental evidence that some- Tucker, J. A., Vuchinich, R. E., & Sobel!, times people drink alcohol as a self- M. B. (1981). Alcohol consumption as a self-handicapping strategy. Journal of Ab- handicapping strateff. Berg las & Jones normal Psychology, 90, 220-230. (1978, p. 406) defined a self-handicap- Wentworth, H., & Flexner, S. B. (Comps. & ping strategy as "any action or choice of Eds.). (1975). Dictionary of American Slang, 2nd edition. New York: Crowell. performance setting that enhances the opportunity to externalize ( 'r excuse) failure and to internalize (reasonably accept credit for) success." They suggested that, for those who are uncertain about their competence, to fail at a task due to the self-handicapping of drunkenness normally is preferable to failure that clearly indicates stupidity or incom- petence. Thus, self-handicapping might be part of the motivation for some people to "woofle" themselves before such challenges as test-taking, proposing a first date, and getting up to dance at a party. Since students are asked to discuss the lesson in their small groups, the activity can make some students noticeably uncomfortable (perhaps, especially, those students who tend to deny their own alcohol abuse or those who have significant others who abuse alcohol). The small groups provide students an opportunity to express their feelings and to receive social support. The teacher should be available and responsive to students who wish to discuss further their reactions to the activity. Some students may be encouraged to seek help and the teacher must be prepared to offer appropriate referrals.

237 227 TEACHING IDEAS 122 Aging Helping College Students Understand the Older Adult Margaret J. Pope

Our society has seen a tremendous with the world outside their limited On the days the older adults came, increase in the number of people over environment. the classroom was arranged with the the age of 65 and in the past decade, an The approach taken to try and allevi- desks in a circle. This allowed the older awareness of their problems and some ate these misconceptions was to invite adults to sit among the students and to possible solutions have surfaced. Doc- five adults from the Retired Seniors Vol- feel more relaxed and at ease. Each tors, gerontologists, social workers, unteer Program to class. All were over older adult was given an opportunity to therapeutic recreators,hospital and 65 years of age and they were still active relate personal information to the stu- nursing home administrators, and psy- members of the community. dents, including living arrangements, if chologists recognize the problems of In preparation for these visitors, the married how long, the number of chil- this growing population, and many class was divided into groups with a dren, and social interests. The older health educators are aware of the gap discussion leader. The following broad adults visited the classroom for three that exists between the older adult and topics were chosen as discussions areas: days and during this time, good rapport the college student. (1) social life, (2) income and retirement, developed between them and the stu- Teaching a unit on aging in a health (3) exercise and keeping fit, (4) transpor- dents. Some of the students became so education class at the university level tation, and (5) safety and crime. The interested in the adults that they made this author aware of the many students developed questions pertinent planned to visit them in their homes. possibilities for older adults and college- to each area. These were collected by The experience seemed to be invaluable age students to communicate. There is a the discussion leader to use as points of to both generations. definite need forinter-generational discussion with the older adults. At the conclusion of the class on the communication, and the opportunity Following are some of the questions last day the older adults visited, the for mutual understanding of problems that the students asked the older adults: students wrote individual evaluations, should be afforded the health class and guided by the following questions: the older adult. What do you do for entertainment? Do you feel isolated and lonely? Did you think this was a good learning As an introduction to the unit, the experience? students were administeredatest, Do you find it hard to live on a fixed income? Did it change any of your thoughts about "Facts on AgingA Short Quiz" (Pal- older adults? more, 1977). This test contains only 25 Do you exercise regularly? If so, what type of exercise? Would you like to see this practice contin- items, takes only a few minutes to com- ued in this class? plete, is easily scored, and gives a good Do you feel bad? Do you feel safe in your environment? The evaluations revealed that the stu- indication of misconceptions about ag- dents previously had a number of mis- ing. The scores on this short quiz Have you fallen or had a personal accident in the last five years? conceptions about the olderadult. showed that the students possessed lit- Many were surprised how actively in- tle accurate knowledge about the older Has a crime of any kind been committed against you or your partner in the past five volved these people were in community adult. Some of their misconceptions and social activities. Most of them had were: The majority of old people are years? Do you ever think of death? assumed that older adults were in nurs- senile with defective memories; old peo- ing homes or health care facilities. They ple are all alike; old people are unable to Do you have a lot of medical bills that are brought about by your personal health prob- were also amazed at the amount of learn anything new; physically they feel mental clarity older adults possessed. bad all the time and are totally incapable lems? What method of transportation do you This encounter seemed to change the of any type of exercise; and they are students' stereotyped opinion of the mentally withdrawn with little contact use? Dv you feel safe using it? older adult as a senile member of an Would you want to live in a nursing institution. They became aware that the home? older adult can still be a viable and Margaret I. Pope is professor, Health, Phys- Would you want to live with your chil- contributing member of society. ical Education and Recreation Department, dren? Jacksonville State University, Jacksonville, What is your biggest problem in day-to- Palmore, E. (1977) Facts on AgingA Short AL 36265. day life? Quiz. Gerontology, 17 (4). 228 2 3 s TEACHING IDEAS 123

tivity, discussion questions can be raised to highlight the analogy between getting to know a tree with its unique qualities As Oldas Trees and getting to know older people as individuals rather than as stereotypes. For example: 1. For those of you who were able to Yaasp find your tree, how were you able to find it? 2. What were distinctive features with each of your trees? 3. Did you feel environmental wear on your tree? 4. You may have identified your tree with a rough exterior, but how would IA_ you judge the interior of your tree? Do you thinkitstillproduceslife- maintaining fluids to its branches and leaves? Can you tell that by looking just at the outside of the tree? 5. How can you tell that your tree is still alive? Is there any evidence? (leaves, fruit, etc.) 6. How many seasons do you think your old tree has seen? Can you imagine the story this tree could tell if it could Aging relate what it may have seen over the years? 7. How can you relate getting to know a tree with getting to know an older person? MINA. - The discussion can lead students at this point to realize the effort to identify a tree from the rough, wrinkled exterior, and how much easier it might be to iden- Glenn E. Richardson and Susan Bicknell tify individuality in older people. The analogy can be drawn that as the old, Ageism, a form of discrimination Dyads are formed with one member of rough exterior of the tree houses its life based on old age, is a powerful, socially the dyad blindfolding (blindfolds are processes, so older people, though aged, reinforced prejudice existing in our sod- provided by the instructor) the other still have within the throb of vitality. ety. One method to combat ageism in the student. The blindfolded students are And sometimes we don't see the interior educational setting is experiencing the turned around two or three times to lose where there is so much warmth, excite- following activity, As Old as Trees. their sense of direction and then in- ment, and love. The class is given a blank sheet of formed by the inst:uctor that their At this point a discussion of the aged paper and asked to draw a symbol that partners will lead th( m to a tree within a as a source of wisdom, spiritual strength, represents their perception of old reasonable radius. Tlry are instructed to comfort, and other integral sources of people. They are given time to complete get to know the tree so that when they living would be treated. For a more de- this task, and a few are asked to share return without a blindfold, they will be tailed description of these thoughts, see their drawings and give explanations. able to identify the tree. The dyads go the article "Ageism: Need We Discrimi- Generally, symbols such as rocking out, each to their own tree, and the stu- nate." ' chairs, wheelchairs, nursing homes, and dents, mostly by touch, become ac- After the discussion the students are canes emerge from the participants in quainted with the root systems, the tex- returned to the class, given another piece this activity. ture of the tree surface, the knots and of paper, and asked to draw a symbol of Leaving the drawings and the class- branches if within reach, and other dis- "old age." Drawings of wine bottles, room, the group (in good weather) is tinctive features. The student, when books of life, owls, trees, and oth,r sym- taken outside near a group of trees. satisfied that helshe knows the tree, is bols representing the concept of improv- led back to the instructor at a central ing with age and sources of wisdom Glenn E. Richardson is coordinator of Allied place, turned around two or three times emerge from the students. A look at their Health Studies, Department of Health and and then the blindfold is taken off. first picture and a comparison with the Physical Education, Texas A&M University, When all have returned, the students second picture lead to an interesting dis- College Station, TX 77843. Susan Bicknell is who were blindfolded attempt to locate cussion of change. a Health Education Major in the Department their trees. Generally, students are suc- of Health and Physical Education, Texas cessful M this endeavor; then the other 'Jose, N. L., and Richardson, G. E. Ageism: A&M University, College Station, TX member of the dyad is blindfolded and need we discriminate. Journal of School Health, 77843. the activity repeated. Following the ac- Vol. 50, No. 12 (September, 1980), pp. 419-421. 229 239 TEACHING IDEAS 124

Chronic Diseases Digging for Healthy Hearts: A Simulated Archaeological Dig for the Prevention of Cardiovascular Disease

Wesley E. Hawkins

In recent years, health profession- ered (Northwest Regional Educa- hypothetical civilizations that would als increasingly have targeted younger tional Laboratory, 1972). be high risk and low risk for cardiovas- audiences such as high school and The teaching technique described cular disease. For example, based on college students for education on risk below, named "Digging for Healthy risk factors identified in past research factors related to cardiovascular dis- Hearts," uses an inquiry approach to on cardiovascular disease (e. g., smok- ease. Various teaching methods have assist young persons in examining the ing identified from the Framingham been implemented in providing learn- relationship between personal cardio- study), artifacts such as old cigarette ing experiences about the prevention vascular diseaserisk andlifestyle lighters would be buried to represent of cardiovascular disease. Teaching habits. Specifically, the inquiryap- the high risk behavior of smoking. For techniques have ranged from the di- proach that will be described in this the low risk civilization, artifacts such rect lecture method to more experien- article is a simulated archaeological as old cans of low fat foods (e.g., tuna tial teaching methods such as inquiry dig that depicts a hypothetical high fish cans) would be buried. problem solving techniques, the latter risk and low risk civilization forcar- Students are told to pretend they being the focus of the present article. diovascular disease. are archaeologists and to start digging The inquiry technique emphasizes for artifacts in their assigned areas. problem solving and discovery rather Purpose Students are asked first to hypothesize than direct transferral of information which artifacts represent a low risk or from teacher to student in the tradi- The major purpose of the Digging a high risk civilization. During the tionallectureclass.As Kime, for Healthy Hearts Teaching Tech- second class period, student stories of Schlaadt, and Tritsch (1977) who nique is to utilize an inquiry and prob- the civilizations are presented. At the advocate the use of inquiry in health lem solving approach in educating third and final class meeting, research education noted, "the teacher's basic high school and college students about findings on risk factors related to car- task is to provide data to assist stu- risk factors and preventive health diovascular disease are presented. dents in their search for relevant data. behaviors related to cardiovascular After presentation of risk factors by The teacher is a primary motivator disease. the instructor, students are asked to (extrinsic) in the approach to learning compare and contrast health behav- as a task of discovering something Overview of the Teaching Technique iors of our present American civiliza- rather than learning about it" (p. 142). tion with their own fictional civiliza- More specifically, the inquiry tech- The Digging for Healthy Hearts tions derived from the archaeological nique is a problem solving process that technique requires three 50 minute dig. first requires the student to gather, class periods for completion. The first analyze, and categorize data for con- class period is the simulated archaeo- Behavioral Objectives cept formation, and then formulate logical digand requires students to use generalizations about the data gath- an inquiry problem solving approach examining the relationships of per- (1) After visual inspection of arti- Wes Hawkins is an assistant professor sonal cardiovascular disease risk and facts from the simulated archaeologi- in (he Department of School and lifestyle habits. Simulating an actual cal dig, the student will categorize Communiry Health, University of Ore- archaeological dig, artifacts are bur- artifacts as representative of health gon, Eugene, OR 97403. ied representing health behaviors of behaviors as either at-risk or preven- 230

1 U tive in relation to cardiovascular dis- the health behaviors of their fictional The first task of the instructor is the ease. civilizations with those of behaviors of establishment of an outdoor dig site (2) After visual inspection of arti- modern United States individuals in where artifacts can be buried easily. facts from the simulated archaeologi- terms of cardiovascular health and Dig sites can be located on school cal dig, the student will write a mini- disease. grounds or close to the school. Un- mum three paragraph fictional story Specific Procedures for used gardens, wooded areas, stream describing health behaviors for car- Implementation or creek beds, sand beach areas, or diovascular disease for the hypotheti- sawdust piles can simulate an ar- cal civilization and a minimum three Specific procedures will be dis- chaeological dig site. paragraph fictional story describing cussed within the context of the three Next, the instructor buries artifacts health behaviors of the high risk civili- class periods required for completion that are representative of (1) a low risk zation. of the Digging for Healthy Hearts civilization and (2) a high risk civiliza- (3) Thc student will list a minimum teaching technique. In addition, the tion related to cardiovascular disease. of four major risk factors related to lesson plan for this technique is pre- Artifacts for the high risk civilization cardiovascular disease based on find- sented as Figure 1. include such items as old cigarette ings from the Framingham study and packages, cigarette lighters, contain- Type A behavior research. First Class Period: Simulated ers of high-fat food products such as (4) The students verbally will com- Archaeological Dig Utilizing canned meats, an old blood pressure pare and contrast, in class discussion, Inquiry Approach. cuff, and a genealogical diary showing

Figure 1. Lesson Plan

Unit Title: Prevention of Chronic Disease Unit Da te.

Conceptual statement: Knowledge of preventative health Time. behaviors will reduce the risk 01 cardiovascular disease. Grade Objectives: I. After visual inspection of artifacts from the stimulated Teacher archaeological dig, the student will categorize artifacts as representative of health behaviors as either at-risk or pre- Teaching points ventive in relation to cardiovascular disease. 2. After visual inspection of artifacts from the simulated archaeological dig, the student will write a minimum three paragraph fictional story describing the health behaviors for the hypothetical low risk civilization for cardiovascular disease and a minimum three paragraph fictional story describing the health behaviors of the high risk civilization. 3. The student will list four risk factors related to cardiovascular disease based on findings from the Framingham Heart Disease Study and from Type A behavior research. 4. The student will verbally compare and contrast in a class discussion the health behaviors of their fictional civilizations with the present day United States in terms of cardiovascular health and disease. Content (progression) Learning activities Evaluation for activities I. The Framingham Study 1. Stimulated archaeological dig in 1. Examination of sign at dig site to a. Purpose outdoor setting. Bury artifacts that determine if student correctly 1. Study conduct in Framingham, depict a high risk and a low risk identified collection of artifacts as Mass. to determine factors civilization for cardiovascular belonging to low risk or high risk related to cardiovascular disease (e.g., LOW RISKrunning civilization for cardiovascular disease. disease. shoes, low fat food containers; HIGH 2. Examination of written paragraphs of b. Methodology RISKcigarette lighters). Have fictional accounts of health behaviors 1. Longitudinal studyfollows groups designate whether artifacts of high risk and low risk civilizations. persons over time and then belong to high risk or low risk by 3. In class written quiz asking students examine which factors writing on large blank signs at the to list four major risk factors of related to cardiovascular dig sites. Next, have students write cardiovascular disease as identified by disease. minimum of one paragraph descriptions the Framingham study or by Type A 11. Findings from Framingham Study of the high risk and the low risk behavior research. (risk factors identified). civilization in terms of health 4. Teacher observation of student a. Smoking behaviors. response of comparison and contrasting b. Diet 2. Student presentation of stories. of their particular civilizations with c. Obesity Have artifacts displayed. present day American civilization. d. Family History of Cardio- 3. Instructor presents findings vascular Disease from research related to cardiovascular III. Findings from Rosenman and disease. Friedman linking Type A behavior 4. Class discussion comparing and to coronary heart disease. fictional with actual civilization in the United States. 231 211 generational deaths from heart dis- format. Students are asked to read remember this stuff a lot better this ease. Traces of the low risk civilization their fictional stories to the class, de- way." include artifacts such as exercise arti- scribing the particularcivilization facts (segments of racquet balls or chosen. Summary parts of old tennis rackets), low fat food artifacts from wooden fruit con- Third Class Period: Instructor's We would do well to reconsider the tainers such as apples and oranges, Presentation of Research Findings of importance of inquiry as an educa- low fat chicken, tuna, etc. canned meat Risk Factors Related to Cardiovascular tional technique for health education. containers, a genealogical diary not Disease As Goodlad, Stoephasius, and Klein showing family patterns of deaths due (1966) noted two decades agoduringa to cardiovascular disease, and a per- In the third and final class period, period of significant curriculumre- sonal date book with a stressful, heavy held inside in a traditional classroom form, "Many curriculum builders seek schedule but with planned relaxation format, the instructor presents back- to organize their fields around the pri- and scheduled exercise. ground information on risk factors mary structural elements of each dis- High risk and low risk artifacts are related to cardiovascular disease as cipline: the concepts, key ideas, prin- kept separate when buried in different identified in the Framingham, Massa- ciples, and modes of inquiry. It is as- areas at the dig site. Burying artifacts chusetts heart disease study and from sumed that understanding these ele- in this manner allows students to Roseman and Friedman's (1971) re- ments (rather than merely possessing hypothesize whether artifacts repre- search linking Type A behavior with the facts) gives the students the intel- sent health behaviors as a high risk or coronary heart disease. After presen- lectual power toattackunfamiliar a low risk civilization in relation to tation of the risk factors is completed, problems and enables them to grasp cardiovascular disease. To evaluate the instructor, in a class discussion intuitively the relationship of new this objective, blank signs are placed at format, asks students to compare and phenomenaalreadyexperienced. d'fferent areas of the dig sites. After contrast their fictional civilizations Ability to think inductively becomes a examiningartifacts for their particular with our present American civilization built-in goal, and teachers are enopur- group, students are instructed to des- in terms of health behaviors and car- aged to let students discover meanings ignate their particular site area by diovascular disease. for themselves" (p. 15). writing on the signs in large lettering Inquiry techniques such as the either "High Risk Civilization for Digging for Healthy Hearts teaching Cardiovascular Disease" or "Low method are needed for students to Risk Civilization for Heart Disease." discover the meaning of what effect Next, students are directed to write their health behaviors can have in a minimum three paragraph fictional relationship to cardiovascular disease. story describing the health behaviors of a low risk and a high risk civilization for cardiovascular disease. Students Iwould like to dedicate this article torny are urged to make stories creative, father, Eugene Hawkins, who died of fun, and exciting while describing the cardiovascular disease on the day this health behaviors of a civilization. Each article was submitted for publication. student is asked to complete this as- Student Reactionto Digging for He was my teacher, my friend, andmy signment as homework and asked to Healthy Hearts mentor for life. share the story at the follow-up session held indoors the next school day. Stu- Goodlad, J., Steophasises, R., dr Klein, M. Various reactions from students in (1966).The changing school curriculum. dents are asked to bring their artifacts anintroductorypersonalhealth New York: Fund for the Advancement and visually present them as they read course in a large midwestern univer- of Education. and discuss their stories with the class. sity were positive. Examples ofcom- Kime, R., Schlaadt, R., & Tritsch, L. (1977). ments are: "It was a fun way to learn Health instruction: An action approach. En- Second Class Period: Presentation of glewoodCliffs, NJ: Prentice-Hall, Inc. about heart disease, " "The digwas McCollum, J. & Davis, R. (1972).Instructor's Student Fictional Stories Describing fun and I learned a lot about prevent- manual development of higher level thinking Low Risk and High Risk Civilizations ing heart disease," "I thought itwas a abilities. Portland, OR: Northwest Re- for Cardiovascular Disease crazy idea to start with, but it was fun gional Educational Laboratory. and I learned a lot, " "I liked writing Rosenman, R. & Friedman, M. (1971). The The second class period is held central nervous system and coronary the stories about the civilizations, it heart disease. Hospital Practice, indoors in the traditional classroom was a fun way to learn, and! think I will 6(10):87-97. 23 2

2 -I 2 TEACHING IDEAS 125 Chronic Diseases Cancer: A Mini-Documentary

Stephen C. Corey

From time to time, most health educa- particular area of cancer. On this card are 17. Skin cancer tors get the urge to deviate from stan- several questions which he/she will re- 18. Cancer of the esophagus dard methods of instruction and try search and discuss. They are also given a 19. Cancer of the stomach something that might be out of the ordi- title for themselves and may choose their 20. Colo-rectal cancer nary but profitable at the same time. For own name. As an example, a student 21. Thyroid cancer those broad topics such as cancer or chooses cancerous tumors. His card will 22. Hodgkin's disease heart disease, which tend to take days or read: 23. Leukemia weeks to cover, a mini-documentary Dr. ,leading oncologist 24. Cancer in children might bt: just the thing to use. This pro- from Harvard. 25. The American Cancer Society gram is meant to be set up like 60 Minutes I.What are tumors? Two students must be chosen to fill the or 20120 but involves each student as a 2. What are two different types of spots of commentator and interviewer. specialist in his/her own field. The whole tumors? The commentator's job is to introduce class can be given the opportunity to not 3. Any special tests for them? the show and make some concluding only produce but be the "stars" of their 4. Any special symptoms from statements at the end, while the inter- own television show. The purpose of the them? viewer is responsible for accepting the 3 documentary is to allow the students The rest is left up to him. He must find x 5 cards from the specialists, introduc- freedom to select an area that interests the correct answers and be able to report ing them, and asking the questions. (The them while also enabling them to be cre- his findings on "TV." The following is a students who have the most enthusiasm ative in communicating their findings to list which could be consulted for the re- and originality seem to be best suited for others. Videotaping the show enables maining cancer topics. these roles.) A small "set," consisting everyone to view the finished product 1.Physiology of the cancer cells possibly of chairs, a table, and a lamp and reinforces the material once again. 2. Cancerous tumors should be constructed so that the 3. Most common causes of cancer camerman can focus on both of the How the Mini-Documentary Works 4. Cardnogens "stars" at once. To avoid confusion and 5. Warning signals of cancer allow continuity of the show while vid- Each student chooses a 3 x 5 card on a 6. Tests for cancer eotaping, a list should be posted so that 7. Treatments for cancer everyone knows when his or her inter- 8. Most common cancers in women view is coming up. The specialist takes 9. Cancer of the uterus his seat on the "set," gives his 3 x 5 card 10. Breast cancer to the interviewer, and when all is quiet, 11. Most common cancers in males the cameraman gives a "ready . .ac- 12. Lung cancer tion!" Stephen C. Corey is group health claim ap- 13. Cancer of the prostate gland As soon as the interview is finished, prover with the John Hancock Mutual Life 14. Cancer of the testes the next specialist comes up and gets Insurance Company. He can be reached at 15. Cancer of the larynx ready to go. The interviewee may also P.O. Box 682, Mansfield, MA 02048. 16. Oral cancer wear a lab coat and a stethoscope to add 233 213 to the total effect. If each interview lasts Drugs Infr lious Diseases one to two minutes, the whole show can 1.Stimulants 1. Virus be completed in a single class period. 1Depressants The students may be evaluated on 2.Bacteria 3.Hallucinogens their degree of research and their ability 3.Fu ngi 4.Drug abuse 4.Protozoa to answer the questions correctly. With a 5.Drug misuse little enthusiasm, originality, and even 5.Pathogen 6.Antibiotics humor, a fairly monotonous topic can be 6.Incubation period 7.Antiseptics developed into an exciting and refresh- 7.Active immunity 8.Analgesics ing educational tool. 8.Passive immunity 9.Tranquilizers Even though cancer is a prime exam- 9.Diphtheria 10.Narcotics ple of the topics which could be used, the 10.Whooping cough 11.Cross tolerance 11.Tetanus mini-documentary does not need to be 12.Reverse tolerance limited to cancer only. Therefore, topic 12.Poliomyelitis 13.Main effect lists for drugs and infectious diseases are 13.Measles 14.Side effect included for future mini-documentaries. 14.German measles 15.Addiction 15.Mumps 16.Withdrawal syndrome 16.Chickenpox 17.Over-the-counter drugs 17.Common cold 18.Medicine 18.Influenza 19.Food and Drug Administration 19.Tuberculosis (FDA) 20.Infectious mononucleosis 20.Tolerance 21.Infectious hepatitis 21.Synergism 22.Alcohol

234 244 TEACHING IDEAS 126

Consumer Health Consumer Health:Medical Quackery Carolyn E. Cooper

An important aspect of consumerism should make enough copies of each ad 2. want cure for ailment that is the evaluation of messages that are to ensure that when students are placed medicalpractitionershave conveyed in advertisements for health in groups, each group will have two difficulty diagnosing and care products or services. Only through advertisements and each group member treating educated analysis can consumers decide will have a copy of both advertisements. 3. believe they have had poor which purported health care products Also, if possible, have different adver- quality or unsympathetic are quackery and which are legitimate. tisements for each group so that no two medical care Since young adult consumers constitute groups will have the same ad. 4. believe they cannot afford a a large target audience for advertisers, it physician or a "high-priced" is beneficial to teach analysis skills to Content Material specialist students at the college level. Moreover, college students have indicated that Before students gather in groups to 5. dissatisfied with their general they are interested in quackery and analyze the advertisements, it may be appearance and do not think helpful to conduct a brief lecture on the a physician will solve the fraudulent health practices as a consum- problem. er health topic (Gaines, 1984). following subject matter (Ensor, Means, Therefore, a lesson plan was devel- & Henkel,1985; Olsen, Redican, & 6. cannot accept the inevitable Baffi, 1986). process of aging, i.e.,bald- oped to provide university students enness, gray hair, or wrinkles rolled in a lower division geileral health education course with information I. Medical Quackery II. Propaganda Advertising Techniques about medical quackery and the oppor- A. Definitions Used to Persuade Consumers to Buy tunity in small group discussims to 1. nostrumunproven and a Particular Health Product generally unscientific, se- A. Bandwagoneveryone is doing analyze health care advertisements. The or taking it lesson's objective was to equip students cret "remedies" forill- nesses B. Snob Appealonly theprivi- with the knowledge and analytic skills leged few use this product requisiteto making decisions about 2. quackspurveyors of misinformation about the C. Testimonyit worked for me, so whether or not advertisers are guilty of it will work for you quackery. The following lesson plan treatment of disease,ill- may be implemented either during one ness or a condition D. False Imageyou will be like or two class sessions (depending upon B. Common Characteristics of someone else (possibly a movie Quackery star or athlete) if you use this the quantity of content covered) as a product component of a larger unit on consumer 1. product or service being ofhealth. feredisa "secret" remedy E. Rewards Appeal--free gift with that is not available from any product or upon signing up for service Preparation for the Lesson other source 2. sponsor claims to be battling F. Humor appealuse of jokes or Prior to class, photocopy advertise- the established medical pro- catchy songs ments of suspect health care products, fession because it does not G. Just Plain Folksordinary peo- services, or programs. (The author se- accept his/her discovery ple use this product, just like you lected advertisements from the two ma- 3. remedy or productissold H. Scientific Evidencedoctors jor newspapers in Los Angeles, the Los door-to-door or by mail order recommend this product Angeles Times and the Herald Examiner, in advertisements I.Non-verbal Appealextensive addition to the gossip tabloid, the Na- 4. treatment isvaluable for a use of pictures tional Enquirer. These newspapers ad- wide variety of illnesses J.Underdog Appealwe're num- vertised such products as diet pills, sun- 5. anecdotes and testimonials ber two, but we try harder screens,anti-balding ointments, and are used to support claims various programs for weight reduction, 6. overnight success is claimed Small Group Discussions acupuncture, smoking cessation, foot 7. scare tactics are utilized surgery, and impotence.) The teacher After advising students of their task 8. free trial packages of medi- to analyze these health care advertise- cine or free first visit ments to determine if they are quack- Carolyn E. Cooper is a graduate student in C. Characteristics of People Who ery, randomly assign students to the Master of Public Health Program in the Are Prey to Quacks groups so that each group consists of Department of Health Science at California 1. want instant cure for painful, five to six students. Distribute the pho- State Univergity, Northridge, CA. chronic, or incurable disease tocopies of advertisements, discussed 235 245 above,to each group. (Each group question 3. The teacher may want to in fact, the majority were selected from should have two different advertise- visit each group briefly to answer questions and to observe group members' theLos Angeles TimesandHerald Examin- ments to analyze.) er(perceived by the students to be con- Distribute a 4x6 index card to each interaction. Allow 20 to 30 minutes for siderably more reputable newspapers this exercise. group. The cards contain the following than theEnquirer).Also, students found questions, which will be answered col- Have students select a spokesperson it interesting that advertisements per- lectively by the group members. to present each group's answers before taining to impotence were located in the 1. What is the product, remedy, or the entire class. When discussing their groups' advertisements, spokespersons business section, advertisements about service being promoted? baldness were in t1_ sportssection, and 2. Who do you believe is the intend- should also comment on dissenting weight loss advertisements were in the ed audience? opinions, if significant. For example, it women's feature section. 3. What type(s) of propaganda adver- may be interesting for the class to hear tising techniques are being uti- why three members strongly supported lized? the opinion that an ad was quackery 4. What is the promised outcome? while three other members had the op- Ensor, P.G., Means, R.K., & Henkel, B.M. 5. What characteristics does the ad posite opinion. (1985). Personal Health (2nd ed.). New have that may make you suspi- An unexpected issue that arose when York: John Wiley and Sons, 286-289. cious of quackery? the author implemented this lesson was Gaines, J. (1%4). A study of the consumer 6. Do you believe this advertisement the origin of the advertisements. Stu- health interests of selected college stu- is quackery? Why or why not? dents were curious to learn which dents. Journal of School Health, 54 (11), 437-438. Write the names of propaganda tech- newspaper co-tained which advertise- Olsen, L.K., Redican, K.J., & Baffi, C.R. niques, outlined in Section II of the ment. The class expressed the belief that (1986).Health Today (2nd ed.). New content material, on the chalk board for most of the advertisements were ob- York: Macmillan Publishing Co., 554- students to refer to when responding to tained from theNational Enquirer,when, 560.

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236 TEACHING IDEAS 127

Environmental Health Environmental Health Simulations: Island City and Production Glenn E. Richardson, Alan Burns, and Janet Falcone

Often itis difficult for students to Students are divided into groups of 6. One person should be responsible enjoy concepts associated with environ- eight or more people (the number can for maintaining parks and natural areas mental health because it is difficult to vary based on the number of tasks) and on the island. apply personally. Simulation activities each group is given the following setup: 7. Someone is responsible for remov- are often beneficial and make a unit The piece of poster paper is placed in ing and burning solid waste. (Note: Be more interesting by helping students the middle of the group. Students are sure itis permissable to burn bits of understand the complex issues associat- instructed that this is their island where paper; if not conduct the activity where ed with environmental control. The they live and cannot leave. It is their you are permitted to do so or delete this purpose of this paper is to give two responsibility to keep it clean and beau- part of the activity.) examples of simulation activities that tiful. Each group is given a bag of mate- The instructor begins with the city are fun, mimic or simulate environmen- rials as described. Each student is given sounds at very low volume and every 30 tal dilemmas, and allow for active par- a bean to represent themselves on the seconds or so turns up the volume ticipation by many students. island and may draw a small home and slightly until it is quite loud by the end select his or her automobile. A factory of the activity. Additionally, the instruc- Island City (incense) where they work is also placed tor should drop coffee or tea grounds on the island and lighted. The water The purpose of the Island City simu- into the water source, causing the stu- source (cup of water), and waste dispos- dent responsible for the water source to lation is to have students understand al site (ash tray) are also located where the environmental problems associated go through the filtering process. they deem appropriate. A commercial The activity continues until the chaos with growth and to sense some of the area of the island should be selected frustration of city planners who deal and confusion reach a breaking point. with the vroblems. The materials and with stores, an area designatedfor Discussions should revolve around parks, national forest, and wildlife pre- questions related to frustration associat- what they represent in the story are as serve. follows: ed with controlling population growth, 1. Poster paper (2' x 3') is the is- The activity begins with the following coordination of environmental control instructions: services, and cooperation among serv- I. Every 10 seconds a new bean is ices when growth is so rapid. Incense represents factories. added to the island, which represents Cups, coffee filter, and water rep- population growth. Production reont the water treat:nent plant. 2. Another car is addedevery min- /'Uncooked bearo, represent peo- ute. 1 he purpose of this activity is to simu- ple. 3. Add another factoryevery two late developing, refining, using, and !'. Ash trays are uscas incinera- minutes. recycling of products. The student will tors. 4. Torn paper is addedslowly, yet experience some of the frustrations as- 6. Newspaper is solid waste. constantly. sociated with reclaiming raw materials. 7. Coffee and tea grounds are water Each student is given atask during The materials necessary for this simu- pollutants. the process. The following are repre- lation are as follows: 8. Tape recorded city sounds representative of the tasks: 1. Three 3" x 3" x1/2" squares of sent noise pollution. 1. One person maintains the cleanli- playdough, each a different color (red, 9. A non-aerosol spray or perfume ness of the water supply. white, and blue) for each participating spray represents air pollution. 2. One person builds new homes for group. 10. Small toy cars represent the 2. A clear wrap and label for each means of transportation. every set of three beans. Group consensus is necessary to determine placement group.Labels should have products or they go to a shelter which the home such as car, airplane, milk carton, and builder makes. book written on them. 3. Two people help to coordinate the Divide the class into four groups (de- Glenn E. Richardson is chair of the Depart- subdivision and roadways connecting pending on the size of the class) and ment of Health Education at the University give each group red, white, and blue of Utah, Salt Lake City, UT 84112. Alan the homes and factories (draw in roads with pencil). squares of playdough wrapped in clear Burns is a health and physical education wrap labeled as a particular product, i.e. major in the Department of Health and 4. One person adds people and cars. 5. Another person adds the factories. car or airplane. There will be five steps Physical Education at Texas A&M Univer- He or she needs to get group approval to this method, each step taking 5 to 7 sity. Janet Falcone is in community educa- minutes. tion in the A&M Consolidated School Dis- within 10 seconds before placing the factories. Step / (Raw Materials to Parts): The trict, College Station, TX. first step is for each group to take "raw 237 2 4 7 materials" (playdough squares) and else from it, utilizing ,he same materials dough. This can represent the human construct the parts for the product indi- and parts. exposure as the people work with some cated on the label. For example, if mem- Step 5 (Restoring):he recycled prod- raw materials. The students will be so bers of the group are constructing a car, ucts are passed ba,lc to the original intent on making their products that then wheels, body, bumper, and lights groups. The groups should now try to they will forget that they are beingex- should be manufactured but not assem- restore the product to its original raw posed to the "contaminants." The anal- bled. Note: All or part of the playdough material state (three squares of red, ogy is that many times people are so may be used for manufacturing parts white, and blue playdough). It will be intent in making money that they forget but any that is not used will remain virtually impossible to do this because the health consequences of exposure to behind as waste. the colors will be mixed due to the their products. Step 2 (Assembling): Moving clock- stickiness of the playdough. Discussions will revolve around the wise between groups, the students pass Students will be asked to smell their issues of depletion of raw materials, their manufactured parts to the next hands following the activity. They will factory hazards, assembly line stress, group so that every group has parts smell the distinct smell of the play- recycling, and economic issues. made by a different group. The groups are to act as assembling factories and put the product together. Step 3 (Consumer Use): Groups then pass their finished products clockwise again to the next group This is the consumer stage The ultimate outcome is that the product will be used and worn out. The car may get into a wreck or the milk carton smashed Step 4 (Recycling) The products are now passed to the next group to be salvaged and used for another purpose The students are to take the worn out or wrecked product and make something

238 BEST COPY AMME 2 ,1 TEACHING IDEAS 128

Family Life Education Reducing Anxiety About Teaching a Human Sexuality Program Louise Row ling

One of the problems for schools in the from adolescents to the teacher. 6. Small group discussion can occur development of a human sexuality pro- 2. Present the three general ways of after each question and answer gram is the inadequate preparation of responding to personal questions and/or after the activity as a whole. teachers, many of whom feel anxious, proposed by Finn (1981): answer Issues that may be considered are: embarrassed, and h rful of questions honestly, refuse to answer, equiv- the impact on adolescents of the adolescents willask.Preparation of ocate or lie. Further exploration of responses, how participants felt, teachers of human sexuality at a preser- these can then develop response how difficult the research was. A vice or inservice level should aim to ease guidelines: ensure educational va- general summary should focus on some of this discomfort (McCarthy, lue, be comfortable, be aboveboard participants describing what they 1983). (Finn, 1981). had gained from the exercise. Health educators have frequently 3. Orient the discussion toward re- used rehearsal behavior as a means of sponding to questions in human Feedback on the Activity preparation forfuture events. sexuality lessons. Produce a ques- M7Guire's (1969) concept of psychologi- tion box and ask participants to Particiiits have stated that the activ- cal inoculation adds to the belief that ity: examining a situation, and practicing write on a sheet of paper (anony- forced them ,o personally confront ways o cope with it before it is experi- mously) any questions they think many issues about sexuality educa- encerl ,,hould help reduce anxiety and that an adolescent may ask that tion; develotcor ingskills.These beliefs they would feel uncomfortable or have difficulty responding to. The under the guise of completing an were coi,,bined with Finn's (1981) on the questions assignment, opened up topics of how to deal with personal questions box iscollected, discussion with friends and family, from students, to develop a cognitive typed up, and a sheet of the ques- topics previously not broached; behavioral technique that would enable tions handed out to the partici- highlighted the need for the avail- teachers or trainee teachers to: pants in the next session. (The ability of simple straightforward in- anticipatecontroversialquestions session leader may also have add- formation on sexuality for adoles- from adolescents relating to sexuality ed some questions.) Examples cents; prepare responses that they would could include: "Do girls like it as much? Are you a virgin? Is it dan- made them feel more comfortable in feel comfortable verbalizing dealing with questions from adoles- gain experience in using "the lan- gerous to masturbate?" 4. Participants then prepare respons- cents. This was based on the belief guage of sex." that it would be harder to deal with The last aim attemptedtofulfill es to all the questions by discuss- these questions among their "same Bruess and Greenbera's (1981) criteria ing with friends and family and/or age" group rather than with adoles- fo ,. sex educata-s through reading. cents in the classroom. "The teacher sex (!ducation 5. At a subsequent session, partici- The author has used this process suc- needs to be able to use the language pants are divided into small cessfully a number of times at the pre- of sex easily and naturally, especial- groups. (The session leader has service level and believes it could be ly in the presence of the young." prepared question boxes, one for each group, with the questions on equally as effective in inservice pro- individual sheets of paper.) Each grams. Implementation of the Activity group sits in a circle, one partici- Bruess, C. & Greenberg, J. (1981).Sex educa- 1. Initiate a discussion focussing on pant selects a piece of paper and tion: Theory and practice.Wadsworth: Bel- the handling of controversial is- asks the question of the person mont, CA. sues in the health curriculum. Of- opposite. That person responds, Finn, P. (1981). Hey, Teach! Do you drink! ten issues such as drugs and sexu- preferably not reading a prepared Journal of School Health, 51(8),538-542. ality involve personal questions answer, but giving the general McCarthy, W. (eu) (1983).Teaching about sex. idea of a planned response. The The Australian experience.George Allen & box is passed on around the circle Unwin Sydney. McGuire, .J.(1969). The nature of atii- Louise Bowling is a lecturer in the Health until all questions have to be asked tude, -id attitude change. Lindzey, G. Education Department at Syu'l.ey Institute and responded to. (The length of 'Irons; F. (eds).Handbook of social of Education, P.O. Box 63, Camperdown this activity wiH depend on the p. Otology,Vol.3,Addison Wesley: 2050 New South Wales, Australia. number of questions.) Reading, MA. 239 249 TEACHING IDEAS 129

Family Life Education Are.You Ready for Prime Time Birth Control?

Pamela Wild and Linda Berne

Grade Level:9-12 (7-12 for high risk or money, inability to express concerns to use birth control successfully." (The students) or emotions about sexuality, and igno- teacher should review the rules for Time:Two class periods, 50 minutes rance of or mis:nformation about laws brainstorming.) Tell students there are each on confidentiality and age requirements about 30 skills and challenge them to Materials:Questionnaire, paper, pen- for obtaining contraception. come up with 15 or more. Give 15 min- cils, chalk board Because life planning is so critical utes for this activity and move among to opportunity in today's world, learning groups, prompting ideas. Concepts: If a couple has sexual in- the skills to contracept and becoming Pull groups together and make a tercourse, they must perform many skills motivated to use them are major needs master list of skills. Have students write to use birth control effectively and avoid of teens and adults who currently are or them on a sheet of paper with three a pregnancy. It is harder for teenagers to will be sexually active. Rather than columns to the right labeled "easy to be effective contraceptors than for older asking "Why do teens become preg- do," "hard to do," and "impossible to adults. nant?" we should be asking "What pre- do." Ask each student to make four vents a teen from avoiding pregnancy?" copies of their sheet or make four pho- Teacher Background: "Why are Instruction to affect attitudes, knowl- tocopies. these kids getting pregnant when clinics edge, skills, and behaviors is necessary give away free birth control?" is a to help youths achieve positive rela- Homework: Say "For homework, question commonly asked by those who tionships, sexual health, and maturity. give your 'skills survey' to four people are concerned with teen pregnancy. not in this class. Ask them how easy, Perhaps the answer lies in the fact that of Objective: The student will identify hard, or impossible each skill would be the annual abortions performed in the skills needed to be an effective for them to do now if they were sexually United States, less than a third are to contraceptor, determine those in which active. Try to have both sexes and adults teenagers. Adults, who should have the he/she has competence, and develop the as well as teens answer your questions. knowledge, maturity, resources, and life skills that would be difficult or impos- Record their age and sex, but not their experiences that would enable them to sible to perform. name on the sheet. We will discuss your prevent unintended pregnancies often results on (day due give three days)." don't do much better than teens. Procedure: Say "We have already During the interim days, teach about For adults or teens to prevent discussed how it takes skills to remain contraception. pregnancies, a multitude of skills must abstinent when there is so much pressure be learned and used. Teenagers, however, today to be sexually active. Let's review Seccion 2Activity 2: As students must clear additional hurdles: denial of some of the skills you need to avoid enter class, give each the questionnaire impending behavior, believing that unwanted sexual behavior" (see Berne and have them rate their own comfort! nothing can happen to them, failing to & Wild, 1988). Write the skills students skills and write why the skill is easy, see consequences of behavior, immobi- suggest on the chalkboard. hard, or difficult (20 minutes). Have lizing fear or guilt of being "found out" students get out their homework surveys or "planning it," lacking transportation Session 1Activity 1: Say "It takes and review each skill one at a time, many more skills for a person who is asking for reasons why they and other PamelaWild is with the Children and having sexual intercourse to avoid an people they surveyed ranked the skill as Youth Services of Chattanooga, T N. unwanted pregnancy or STD. Divide they did. If you sense denial, play devil 's Linda Berne is professor of health edu- yourselves into groups of four. Brain- advocate to bring the discussion to real- cation at the University of North Caro- storm and write down all the skills you ity. If you sense embarrassment, move lina, Charlotte. can think of that a person must perform the discussion to "third person."

240 25(i After going through the list, ask involved in a pregnancy if I were sexu- strong and weak skills as well as other students to identify the most difficult ally active. personal strengths and weaknesses as a skilis and circle them. Have students "2" - I might become involved in a possible contraceptive user. break into groups and brainstorm sug- pregnancy if I were sexually active. 3. What could you do to improve gestions and solutions to help a person "3" - I would become involved in a your birth control consumer skills? overcome the difficulty in carrying out pregnancy if I were sexually active. the skill. Share with the class afterwards Explain why you gave yourself the Berne, L.A., & Wild, P.J. (1988).Teen sexual and record ideas. Ask for "thumbs up" rating that you did. behavior: A leader's guide to practical strat- and "thumbs down" as to whether they 2. Give detailed explanations of your egies with youth. Reston, VA: AAHPERD. think the solutions would work.

Processing Questions: ARE YOU READY FOR PRIME TIME BIRTH CONTROL? 1. Can a person be sexually responsible without using contraception? Imagine you are a sexually active when I can not get them free at a clinic. 1 If you are too embarrassed or timid person but are not ready for a preg- 14. store birth control in a cool, to do these skills, are you mature enough nancy. Rate your ability to do the follow- dark, and dry place. or in the right relationship to be having ing birth control skills: 15. practice applying and remov- sex? Why? Why not? ing birth control method prior to sexual 3. Whose responsibility should con- (1) ft would be eat for me to... intercourse. traception be? Why? (2) It would be had for me to... 16. use a birth control method 4. If two people equally share the (3) It would be impossible for me to... correctly every time I have sexual inter- pleasures of sex, how can the responsi- course. bilities be equally shared? 1. admit to myself that I'm going 17. use a backLp method of birth 5. What could society do to assist to have sexual intercourse. control or abstain for the first four weeks sexually active teens in being better 2. admit to myself that I could get taking the pill. cont.raceptors without encouraging pre- pregnant or impregnate my partner. 1 8. remember to take pill at the marital sex? 3. talk about my/my partner's same time each day, or remind partner. past sexual experiences to see if one or 19. use more than one method Closure: Ask students what they both of us could be carrying STDs. (pill and condom) for more protection. would like to do with the new informa- 4. talk with partner about needing 20. touch my sex organs to apply tion they learned. Some possible service birth control and which method is best for and remove birth control method. projects are: both of us. 21. touch partner's sex organs to Write a letter or send a student 5. before having sex, deciding help apply or remove birth control method, delegation to talk about findings with with partner what we would do if a preg- 22. apply birth control in front of the health department, school, local nancy does occur. my partner. newspaper, family planning council, or 6. get transportation to clinic or 23. stop myself during sexual legislator. doctor's office foreplay to apply birth control methods. Tour local clinics and rate their 7. go alone (or with partner) to 24. stop sexual partner during services as being accessible or "user health department, public clinic, or pri- foreplay to apply birth control methods. friendly" to teens. vate doctor's office. 25. remember possible side ef- Develop an educational pamphlet 8. talk to strangers (doctor, nurse, fects of my birth control method and or radio public service announcement counselor) honestly when they ask me know what to do if they occur. directed toward sexually active teens. questions about my sex life. 26. carry birth control with me, or Participate in peer counselor train- 9. have an internal pelvic exam, get it before sexual foreplay begins. ing to help learn and teach skills that or go with my partner for a pelvic exam. 27. return to clinic for regular students have problems with. 10. ask questions when I don't medical check ups. Write a creative skit for a teen understand the instructions. 28. remember to get more birth audience and give performances. Allow 11. read and understand the in- control items before they run out. the audience to interact in a discussion structions that come with birth control 29. continue to educate myself of the issues. methods. and learn new information on birth con- 12. buy birth control methods in a trol methods. Evaluation: drug store or out in the public eye. I. Rate yourself: 13. pay for birth control methods 45 Copyright 1990 P. Wild & L. Berne "1" - I probably would not become

. 241 25 CEST COPY AVMAKE TEACHING IDEAS 130

Family Life Education "Hey! How Did That Baby Live in That Test Tube?" David A. Birch

Health education, like other academic fer is a procedure allowing women with students understand cognitive aspects areas, often relates directly to current blocked or missing Fallopian tubes to related to invitro fertilization and em- issues and events extensively covered carry a baby in the uterus and subse- bryo transfer: by various media. A current issue gen- quently give birth. Prior to institution of Using a drawing, chart, or model, dem- erating media coverage, invitro fertiliza- this procedure, these women were con- onstrate to students the path the egg cell tion and embryo transfer or "test tube sidered to be infertile. normally follows through the Fallopian babies" has created curiosity among Following births in England and Aus- tube to the uterus, after ovulation. both adults and children. tralia,thefirst American "test tube Using a drawing, chart, or model, ex- However, even with extensive media baby" was born in January, 1982. The plain to students the ramifications of coverage, not everyone understands the term "test tube baby" is a misnomer blocked or missing Fallopian tubes on a procedure involved with invitro fertil- since the procedure involves no actual woman's ability to have children. ization. Part of this confusion can be test tu'oe. Using the same drawing, chart, or mod- traced to the commonly used term "test Using r,.rtility inducing hormones to el, explain to students how an egg cell is tube baby." The author, in his experi- cause ovulation at a specified time, a removed from the body after ovulation, ence with junior high school students, long tube with a syringe is inserted at fertilized in a petri dish, and inserted became aware of many students whose the time of ovulation through an inci- into the uterus. perception of invitro fertilization includ- sion in the abdomen and used to pull A:ow students to make their own au- ed a live baby and a test tube. Thus, to fluid containing the egg cell from the diovisual aids and to explain and review some students,the question, "Hey! ovary. The egg cell is then deposited the situations listed above with their How did that baby live in that test into a petri dish which has an environ- classmates. tube?" is not as ludicrous as it may ment similar to that inside the Fallopian Students should also be given an op- seem. tubes. portunity to discuss related affective is- Another contributing factor to this Sperm cells from the father are then sues. A classroom discussion of the fol- misunderstanding is the tendency for deposited into the petri dish so that lowing questions will provide this op- both children and adults to look at or fertilization can occur. If fertilization oc- portunity: listen only to the headlines and not the curs, the egg cell is inserted into the Do you feel medical science has gone too details of a story. Thus if a child, or even uterus through the vagina. If the fertil- far with invitro fertilization and that an adult, hears only "test tube baby," it ized egg implants itself into the wall of scientists are, in effect, "playing God"? is easy to imagine misconceptions that the uterus, prenatal development Is it more appropriate for a couple that is could occur. should continue. infertile because of blocked Fallopian Because itis an important current While this procedure offers hope to tubes to opt for invitro fertilization or to health issue that could impact upon our some couples, there are objections to adopt one of the many children a?',ble society, these misunderstandings and this procedure. Objections focus on is- for adoption? misconceptions can and should be dealt sues such as the possible discarding of Should embryos that have developed with in health education classes. There abnormal embryos, the potential risk to deformitiesbefore implementation be are many areas in the health education offspring from the procedure, the cost discarded? curriculum which would relate directly of the procedure, and the idea of physi- Should private and public health insur- to invitro fertilization and embryo trans- cians and scientists "playing God." ance plans cover the cost of invitro fer. The following information and fertilization and embryo transfer proce- teaching ideas should assist the health Vocabulary dures? educator in covering this topic. To understand the procedure, stu- The issue of invitro fertilization and dents should become familiar with the embryo transfer or the "test tube baby" Background following vocabulary words:uterus, issue stimulates interestinall age Invitro fertilization and embryo trans- Fallopian tubes, ovulation, egg cell, groups. Hopefully, the suggestions list- menstrual cycle, fertilization, infertile, ed above will provide health educators sperm cell, and embryo. with ideas for students at various levels. It is a current health issue with interest David A. Birch is with the Department of Classroom Activities Educational and Cultural Services,State and implications for all segments of our House Station 23, Augusta ME 04333. The following activities should help society. 242 9 k) TEACHING IDEAS 131

Family Life Education Actions Teach Better Than Words: Teen Life Theater and Role Play in Sex Education Peggy Brick

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"Here comes the Teen L;fe Theater," I called "Sex Pressure" in which Robin play, is a powerful method of educating shout as 12 young actors dressed in and Tony arrive at the front door and for responsible sexuality. Many sex edu- logoed blue tee shirts run onto the stage discover a note saying that Robin's par- cators, busy "winning the battle" (Dick- and begin to introduce themselves. "I'm ents won't be home until late. Tony man, 1982), developing curriculum, and Margo and I wish my mother would try presses to come in, hut Robin refuses: fielding questions, need to be reminded to understand me." "I'm Leo and I wish the family has a strict rule about boys in that improvisational theater may be the Ididn't have VD." "I'm Marni and I the house when Mom and Dad are not quintessential tool. Here the important wish my brother wasn't gay." "I'm Cal there. He insists; she resists. He gets ingredients of effective sex education and I wish my friends wouldn't pres- angry and leaves, taunting, "Why don't coalesce. As students get into the act, sure me to smoke." When the introduc- you grow up?" At the end of the perfor- they gain self-confidence, explore relations are over, the individual scenes mances, the actors remain in their roles tionships,critique behavior, develop depicting problems of adolescent life while the audience questions,chal- skills in communication and decision- begin. The audience of students, par- lenges, and even joins them in trying making, learn to understand different ents, administrators, and board of edu- alternative solutions. A few weeks later points of view, and dernystify sex. In cation members is confronted with 12 the board of education votes unani- our school, the Teen Life Theater now unresolved dilemmas, such as the one mously to fund this improvisational the- provides a model that encourages role- ater, thus adding a new dimension to playing activities in the regular class- the sexuality education program at rooms. In both formats students have a --`wight Morrow High School in Engle- unique opportunitytopractice con- wood, N.J. fronting problems in their own lives. Peggy Brick, recently retired from teaching After fifteen years teaching sexuality Our experience leads me to believe that Human Behavior, is Director of Affirmative education, I am convinced that this ex- improvisational theater should be a fun- Teaching Associates in Englewood, New Jer- periencing of adolescent dilemmas damental part of the family life educa- sey and sexuality educator at Planned Par- through life-like skits presented by the tion curriculum and basic in the prepa enthood of Bergen County, New Jersey. theater troupe, or in classroom role- ration of sex educators. 243 253 Although family life theaters have be- chine exercise. One student begins a about adolescent life that are the es- come popular in a number of youth machine-like action with an appropriate sence of Teen Life Theater. They brain- agencies during the past ten years (Na- sound. Others slowly add on, fitting storm all the problems they might want tional Clearinghouse for Family Plan- into the building machine, which finally to explore, select several, and divide ning Information, 1982), few are sup- slows down and stops. Relaxed and into small groups to plan. They work on ported by a board of education as part of energized, students are already practic- three areas: (1) The scene. Where and the regular school program. Ours, initi- ing acting skills: perceiving, respond- when is the incident occurring? What is ated by a small grant from the county's ing, imagining, creating (Siks, 1977). beyond the scene in the present? in the Planned Parenthood, has been funded During the early weeks, the director past? in the future? (2) The characters. since 1981 by a board that values this emphasizes the most fundamental skill, Who are they and what are their rela- direct method of confronting adolescent concentration, as students struggle to tionships? (3) The Conflict. After discuss- problems and appreciates the fact that solve a variety of acting problems. Stu- ing these issues, they plan the basic in our multi-ethnic community, the dents must focus on each body sense, actions and try them out. Theater is unusual in its ability to attract making "the object real" and trying to When they feel some satisfaction, or if students from a variety of groups. It is a share their experience with their audi- they are stuck at some point, they reliving example of the intergroup cooper- ence. They practice with half the troupe turn to the whole group to work further ation and friendship that the board ad- "on stage" while the other half ob- with the director and present the germi- vocates. serves. As the actors learn to focus, nating skits. Two boys are at urinals; During its first two years, the troupe distractions are ignored and phoniness one has a painful burning sensation, performed at the state teachers' conven- disappears; forgetting themselves, they and they're off on a discussion of STDs. tions, at institutes and workshops train- "solve the problem" with increasing Three girls are in a locker room with one ing teachers as family life education credibility. By being alternately actors refusing to smoke and suffering the educators, and at a wide variety of and audience, students learn to evalu- jeers of her friends. A girltells her schools, churches, community organi- ate when actions seem real and are boyfriend that she is pregnant. Parents zations, and youth groups. Within our communicated effectively. are upset with their son's interracial own district they performed in health, dating. A shy boy and girl struggle, behavioral science, English, and biology Learning to Improvise merely to say "hello." A girl tries to get classes and in a number of mini-assem- her alcoholic father to stop drinking. blies. Each performance is custom de- Soon the students are ready to solve Each skit will have a fixed beginning signed. During a session, following the larger problems by improvising a varie- and end, but no final resolution to the performance of six to twelve skits, the ty of scenes together. "You are on a conflict. The aim of the Theater is to audience may also get into the act. boat. There's hardly room for all of you. involve members of the audience in the It's beginning to sink. It goes under." crisis and leave them to work out their "You are climbing a hill. It's very rocky. own solutions. Training the Theater Troupe A strong wind comes from the summit. Teen Life Theater is an extracurricular You reach the top and the view is beau- As students present rough skits, the activity, and 15 to 20 members train tiful." "You are all lifting a heavy box. director utilizes a number of techniques after school for two hours two days a You need more people. Gently now, to help develop the drama being impro- week. The members also study the is- up, up." Those observing are watching vised. These methods facilitatethe sues they are working on through read- for concentration so complete they can deeper exploration of character and sit- ing, interviews with authorities, and feel the cold water, the strong wind, the uation and never instruct the actor in films. Each receives a copy of R. Bell's heaviness of the box. how to act. The director's job is to help Changing Bodies, Changing Lives (1980) as Next, students experiment with be- students discover the right action in their a basic resource. In addition, many of coming different characters. The entire character and situation in some of the the actors are taking or have already class mills slowly around the room: following ways: (1) Act out an event taken the Human Behavior course "You are 75 and going for your daily that occurred before the present scene, taught by my co-advisor and me. The walk." The director gives actors time to to help "see" what caused this situa- course and the Theater complement become the character. Some will be tion; or act out a future scene to under- each other lany ways. healthy, striking with vigor; others will stand the result of present actions. (2) At tl ling of each rehearsal, be crippled, plodding with difficulty. Reverse roles. (3) Double: the director or ttinte .(Spolin, 1963) defuse E.ch time, actors create their own char- another actor stands behind the charac- anx:e low nself-conscious- acter according to their own feelings. ter and while shadowing the actions, ness coup spirit. We start by Later, actors will take much more time occasionally speaks a thought or feeling sta- and one by one call to develop the characters in skits for the character may not be expressing. (4) ou e. r1 a ( razy way, the group performance. For now, they are trying Coatrapuntal argument: two actors in ec chnique adapted 1. Jin a to experience themselves in another's conflict, speaking simultaneously, as- r'ivback Theater). Next, a body, imagining how that body reacts. sert their own argument without re- -) the center and creates Grad aally, these exercises change sponding to each other. (5) Repeat the a tion," an action using self-col iscious posturers into persuasive scene in pantomime.(6) Freeze the both voi. She moves in front actors. Actors will need considerable scene and ask the characters questions: of another ,.nber who imitates her, rehearsal in creating meaningful skits, "Did your mother treat you differently and, as she returns to her place in the but for most of them, their acting now before she remarried?" "Do you get circle, evolves her own action. The proc- will be natural and real as compared along better with other teachers?" ess is repeated as each invents, is imitat- with most amateurs. "Have you ever had a long-term rela- ed, laughed with, encouraged. They are ready to begin "playmak- tionship with a boy?" (7) Freeze the A final warm-up might be the ma- ing" (Siks, 1977), developing the skits scene and have each character assess 244

2c t how the scene is "working" for them. (8) Change the pace if skit is serious, and make jt into a, comedy; if it's fast, "cool it." (9) "Physicalize" what's happening: for example, a child being "torn apart" by the parents' divorce. (10) Have a character monologue with the audience. After eight weeks of this training, students are ready to perform before real audiences and to answer the challenging questions that will follow. We start off performing for classes within the school, but soon, we are out in the community and the responses reveal the impact. Parents report they had no idea that adolescents had so many problems. Teachers say the skits help them understand their students' attitudes toward school. An administrator writes _At that the skits made his students aware of their own disruptive and aggressive behaviors. A minister saysithelps members of his congregation realize the need to develop a sex education program for the young people of the church. A professional whispers she wishes she had had the opportunity to see such a program when she was a child being sexually abused. Role Play in the Classpiom There are, of course, significant differences between the Theater and classroom role play. Teen Life Theater is a voluntary, extracurricular activity directed to produce an entertaining as well as educational performance. In the classroom, however, I must be justified in taking time from other academic ac- heady solutions. But when students act, tive decisions in imaginary situations tivities to have students play-act. Some emotions and complexities surface and listed on their assignment sheet: (1) You teachers are uncomfortable with this the situation is experienced more fully. are both 14 znd are considering having idea, worrying, as one wrote at a recent Acting allows students to experience intercourse for the first time. (Students workshop, that students will "goof off." themselves and others as whole persons almost unanimously select abstinence And one administrator complained that in real-life contexts. With emotion-laded for this one.) (2) You are both 23, living he couldn't evaluate my lesson because material such as sexuality,I find this together, wanting to finish graduate the students were role playing and he approach indispensable. It is an effec- school before you get married. (3) The couldn't "see me teach." tive prelude to honest discussion, seri- man is 33 and the woman is 28; you are Both of these perceptions are mistak- ous writing, valid learning, and reten- married; you do not want to have any en. Yes, students do enjoy the acting, tion. children because a child would interfere but through it they are dealing with Although seeing a Teen Life Theater with your career plans. In each case, the roblems of real life. I find students to performance reduces student fears of couple must record their decision, note be very serious about that. As for my acting and makes my task in the class- why they selected the method they did teaching, I believe it is especially skilled room easier,Istill use a number of and what steps they would need to take and meaningful when I am facilitating strategies to encourage the maximum to implement their decision. After the role play. Here I am demonstrating that possible participation in role play.I couples complete their work, the class the information students are learning in want everyoneto experience them- discusses the choices: explaining, argu- my class is not just for knowing but for selves as someone else,to gain the ing, revising as they hear each others' using. Role play, more than any other empathy that comes from "being anoth- reasoning. in-class pedagogical technique, forces er." Here are three of the methods I use. This exercise is valuable for several students to apply learning to life. Al- For the first, students take on a role, reasons. It normalizes talking 'co a part- though the same dilemmas can be ex- but do not act in front of the class. ner about birth control. In enables stu- amined in writing assignments and in Desks are arranged in twos and, as dents to apply their knowledge of con- discussions, the problems tend to re- students arrive, they divide into cou- traception in specific situations. It dem- main cognitive, often subject to glib and ples. Each pair will negotiate contracep- onstrates that people of different ages 245 BEST COPYAt" 25 must communicate openly if they are to for replacement. The scene then contin- predate their values and attitudes to- be sexually responsible.Finally,it ues until a two-minute warning signals ward family and sexuality; to enhance makes clear the difference between the end. student self esteem; and to increase making a decision and acting on that Following this drama, I might do a skills in decision-making and communi- decision. This exercise is as close as I different kind of processing: (1) Have cation. Only when students apply have come to breaking down the inhibi- each player share reactions about the knowledge to life are these goals real- tionsthat prevent contraceptive use role and feelings toward the other play- ized. Role play helps achieve this transi- among some sexually active adoles- ers. (2) Have the class discuss the inter- tion. In role play, students practice their cents. personal dynamics that developed dur- new leamings in life-like situations. As A second method I use to facilitate ing the scene. (3) Discuss how the scene they examine relationships between ac- student comfort in role play is placing relates to the students' own lives. Care- tors, as they defend their values in a students first in small groups. (Often ful processing is essential to successful particular scene, as they take pride in they may select their own group with role play. The teacher's questions help resolving a family crisis, as they com- the stipulation that there is at least "one students understand the significance of municate a strong belief, their knowl- male, one female, one black, and one what has happened so they gain insight edge is becoming personal and real. white" in each.) The group's first task is into their own feelings and into human Through role play, sex education comes to reach agreement on what the main behavior. to life. character should do in each of five situa- Once students are accustomed to role tions. After the group has completed play, our procedures become more in- Bell,R. (1980).Changing Bodies, Changing this assignment, it chooses one to act formal. Anonymously, students submit Lives: A Book for Teens on Sex and Relation- out for the entire class. This seems to be on file cards problems they would like ships.New York: Random House. non-threatening and almost all students to see enacted. I'll read a card, ask for Dick:n, I. R. (1982).Winning the Battle for enjoy taking part in these skits. Sex Education.New York: Sex Informa- volunteers, and develop the scene on tion and Education Council of the U.S. After each group rehearses and acts the spot. The school year is never long National Cleannghouse for Family Planning out its skit, as in the Theater, members enough to explore all the problems stu- Information. (August, 1982). Improvisa- stay in role while the class questions dents continue to submit. tional Theatre: An Effective Outreach and challenges. Since others have al- and Education Medium.Information ready come to their own conclusions Evaluating the Effects of Teen Services Bulletin. about each scene, discussion is guaran- Playback Theater,Innovative Studies. teed to be lively and meaningful. Theater and Classroom Role Play S.U.N.Y., New Paltz, New York, 12561. A third method demonstrated by At a time when everyone is searching Siks, G. B.(1977). Drama With Children.New Martha Roper at Syracuse University in for hard data on the effects of sex educa- York: Harper & Row. 1981 involves all the students as part of Spolin, V. (1963).Improvisation for the Theater. tion, the evaluations of our programs, Evanston, Illinois: Northwestern Uni- a support system for the actors on stage. to date, are soft: responses, both written versity Press. For example, for a scene in which John and oral, from audiences and sponsor- is telling his mother and dad that his ing organizations, taped interviews girlfriend, Jenny, is pregnant, the class with members of the Teen Life Theater would divide into three groups: one troupe, both as individuals and together supporting John, one supporting his in a group; hundreds of student jour- dad, and one, his mother. Each group nals and essays that include discussion would receive a card describing its char- of theater performances and classroom acter; "Jenny's mom is 44 years old, and role play. There are no statistics to docu- has two younger children: Brian, 10 and ment significant behavior change as a Sam, 13. She has been a comrIter pro- result of participation in improvisational grammer for five years and enjoys her theater. There are only the subjective work but worries that she leaves he reports of both participants and observ- children alone too much. Her salary is ers. important for thefamily,especially My interviews with Teen Life Theater since John plans to go to college next members show that they believe the year. She frequently speaks with disap- Theater has had a positive effect on their proval about teens who are sexually lives. Many report increased feelings of promiscuous. She has just come home self-confidence. from her aerobics class." Teen Life Theater also benefits its The card is read and the group selects members through the strong bonding a person to play the role. The group that develops between them. The The- makes suggestions to its character and, ater nurtures friendships and gives stu- during the enactment of the scene, can dents a positive identity. make recommendations in writing. The Student responses reinforce my own character can also leave the scene and conclusions from teaching over 1,500 ask another member to continue the students: improvisational theater is an action. essential tool for the sex educator. It To begin, characters move to the front facilitates the implementation of four and, after introducing themselves, start basic goals: to provide adequate knowl- the action which continues until there is edge of human sexuality in its physical, a natural break. The actors are iold to psychological, social and moral dimen- return to their groups for coaching or sions; to help students clarify and ap- photo: Greg Meeker 246 256 TEACHING IDEAS 132

Family Life Education

Abortion Attitude Scale*

Linda A. Sloan

Perhaps the greatest crisis a contemporary teenager might face is having an Abortion Attitude Scale untimely, unwanted pregnancy. Since Directions: This is not a test. There are no wrong or right answers to any of the statements, so more adolescents are sexually active and just answer as honestly as you can. The statements ask you to tell how you feel about legal at younger ages than in past generations, abortion (the voluntary removal of a human fetus from the mother during the first three the likelihood of its occurring has months of pregnancy by a qualified medical person). Tell how you feel about each statement reached epidemic proportions in recent by circling one of the choices beside each sentence. Here is a practice statement: years. The pregnant teen has two major SA A SlA S1D D SD Abortion should be legalized. options: carrying the pregnancy to term (SA = Strongly Agree; A = Agree; S1A = Slightly Agree.: SlD = Slightly Disagree;D or abortion. Disagree; SD = Strongly Disagree) Abortion, although legally available in Please respond to each statement and circle only one response. No one else will see your the U.S. for almost a decade, has not responses without your permission. ceased to be a highly volatile and hotly SA A SlASID D SD

cortested issue. Counseling the expec- 5 4 3 2 1 0 1. The supreme court should strike down legal tant mother on the abortion option is abortions in the United States. often inadequate because of three major 5 4 3 2 1 0 2. Abortion is a good way of solving an unwanted intervening factors: (A) The counselor pregnancy. frequently has personal biases about the ; 4 3 2 1 0 3. A mother should feel obligated to bear a child option;(B)It is difficult for the adoles- she has conceived. cent to identify her values about abortion; (C) Making the decision under the 5 4 3 2 1 0 4. Abortion is wrong no matter what the circum- pressure of pregnancy may result in a stances are. different outcome than making a deci- 5 4 3 2 1 0 5. A fetus is not a person until it can live outside its sion about abortion in a noncrisis setting. mother's body. Although health educators can have 5 4 3 2 1 0 6. The decision to have an abortion should be the little impact on the personal biases of the pregnant mother's. counselor, they are in ideal positions to 5 4 3 2 1 0 7. Every conceived child has the right to be born. help students explore their values con- 5 4 3 2 I 0 8. A pregnant female not wanting to have a cerning abortion in nonthreatening cir- child should be encouraged to have an abortion.

cumstances. Chances of long term nega- 5 4 3 2 1 0 9. Abortion should be considered killing a person. tive effects are reduced when one's be- 5 4 3 2 1 0 10. People should not look down on those who haviors are compatible with one's be- choose to have abortions. liefs. Thus, helping students identify 5 4 3 2 1 0 11. Abortion should be an available alternative for unmarried, pregnant teenagers.

5 4 3 2 1 () 12. Persons should not have the power over the life or death of a fetus.

5 4 3 2 1 0 13. Unwanted children should not be brought into *Health educators are reminded of the highly the world. sensitive, controversial nature of this topic. 5 4 3 2 I 0 14. A fetus should Ew considered a person at the Though there is an urgent need to help teen- moment of conception agers, it is also imperative that the classroom teacher abide by district policies. those beliefs without the pressure of ex- cause students to internalize the advan- tenuating circumstances may eventually tages of preventing pregnancy rather Linda A. Sloan is an assistant professor in the aid them in making the best personal than having to cope with it once it oc- Department of Health and Physical Educa- choice if they ever face the situation. The curs. tion, University of North Carolina at Char- experiences provided in the classroom lotte, Charlotte, NC 28223. may also create such dissonance as to 247 25 7 The health educator has little difficulty Classroom Uses: Note to Teacher on Scoring: locating information on tHe history of Health teachers can use this instru- abortion, the medical techniques, and Step 1Reverse the point scale for items ment in several ways: 1, 3, 4, 7, 9, 12, 14. groups to speak to its advantages and 1. To generate discussion. Step 2Total point responses for all disadvantages. What may be more dif- 2. For pre-post testing on abortion ficult to acquire is an instrument which items. somewhat objectively measures at- unit. Step 3Provide students with scoring 3. For students to administer to par- scale. titudes toward abortion. To meet this ents and report. need, the author has dc.i.c.Aoped and val- 4. For students to administer to 70-56 Strong pro abortion idated the following Abortion Attitude friends and report. 55-44 Moderate pro abortion Scale for use with teenagers. The valida- 5. For students to compare results 43-27 Unsure tion process involved interrater agree- from various groups. 26-16 Moderate pro life ment, pilot testing, reliability estimates, 6. To use as a background for debate. 15-0Strong pro life III factor analysis to determine unidimen- 7. To explore ranges of acceptance of sionality and hypothesis testing. The abortion (in case of rape, incest, genetic scale was administered to populations defects, etc.). including high school and college stu- 8. To combine the scale with use of dents, active Right to Life members, and values clarification techniques such as a abortion service associates. The test ex- values continuum, popular song lyrics, hibited a high total test estimate of reliability (.92) and five hypotheses were etc. supported on the construct validity assessment. Right to Life members' mean scores were 16.2 while abortion service associates' scores were 55.6. All other groups' mean scores fell in the middle range.

248 r,) TEACHING IDEAS 133

Family Life Education Marriage Yesterday and Today

Margaret J. Pope

In the Unites States today, more divorce syndrome of today's society. Conflict in Marriage than 90 percent of the population will The objective was to discuss with four Communication During Conflict marry at least once. Statistics indicate married couples how they resolve Resolving Disagreements that one half or more of these mar- their marriage problems. This in- riages end in divorce, a rate that has volved discussion of communication Stn4cture of Fqmily been rising steadily since World War as well as other problems that arise Children II. The median length of marriages when two people marry. Four couples that end in divorce is seven years were invited to visit the class on an ap- (Nass, Libby, & Fisher, 1984). Four pointed day. Each groupofstudents out of five who divorce will remarry Two had been married over 50 developed questions pertinent to all and many will marry more than twice. years and the two were college stu- broad topics. These were previewed Why should so many marriages end dents who had married within the in class the day before the couples within such a few years? Marriage ex- year. The class was to investigate, visited. perts cannot provide one clear answer through discussion, some of the On the day of the visit, desks and (Payne & Hahn, 1986). There is, problems each couple had faced in chairs were arranged in a circle and however, a general agreement among adjustments to marriage. The same apple juice was served. This allowed physicians, sociologists, mental health questions were asked of the young guests and students to socialize before counselors, and ministers that many couples and those who had been mar- the discussion began. The topic both problems that confront people in ried for over 50 years. The purpose groups of couples discussed longest marriage could be avoided if there was to draw comparisons between age was "conflict in marriage." Student in- were a more realistic approach to groups and their approach to adjust- terest in resolving disagreements be- marriage. ment problems of marriage. tween married couples was high and People tend to marry those of In preparation for the visit, the guests were willing to discuss their similar background in age, race, class was divided into groups, each solutions. One of the questions to the education, intelligence, religion, with a student leader. The instructor older couple was, "How have you held economic status, and family. One of suggested topics that could be used your marriage together for so long?" the keys to a successful marriage is for discussion and asked the class for The two young couples were more in- communication. Effective com- suggestions. Students were told they volved with the "economic and finan- munication involves being respon- could not -isk questions that were per- cial security" topic. sible for working out problems as they sonal or offensive to the guests. There is no formula for a success- occur, being a good listener, and not Broad topics chosen for discus- ful marriage; however, through being defensive as disagreements or sion were: preparation, recognition of potential differencesarise(Hamrick, problems, and opportunity for discus- Anspaugh, & Ezell, 1987). The key to sion with married couples, students healthy disagreement is communica- Readiness for Marriage can become more ready for this step tion. Adjustment Problems in their lives. The four married While tcaching a unit on Marriage Age couples' visits to the classroom and Family Relationships in a health Compatibility facilitated opportunity for student education class at the university un- Emotional growth through personal interaction. dergraduate level, I decided to initiate Maturity Interests Evaluations of the process were a different approach to th- marriage- positive. Students indicated that this was a meaningful experience that Margaret!. Pope is a professor of health Economic and Financial Security caused them to begin to think more education at Jacksonville State Univer- Financial Goals seriously about marriage and sity, Jacksonville, AL 36265. Occupation of Each Partner problems that might arise. 249 259 TEACHING IDEAS 134

Family Life Education Teaching Abstinence to Today's Teens Dee Gibbs Smalley

Again, we confront a dilemma incrs to question what should be dis-that most teens are looking for an the family life curriculum. Is it pos-cussed and how it should be presentedexcuse to abstain. In 1980, the teen sible to take a positive stance on absti-to students. (Alan Guttmacher Insti-services program at Atlanta's Grady nence and still provide necessary in-tute, 1989). Memorial Hospital found that of the formation to those teens who are In a 1986 poll, "American Teensthousand or so girls under age 16 in engaging in sexual activities? If it isSpeak: Sex, Myths, TV, and Birththis program, many wanted to learn possible, how do family life educatorsControl," conducted by Louis Harrishow to say no without hurting any- approach the issue of abstinence withand Associates, one thousand teensone's feelings. The key to the their their students in a manner to accom-were asked their opinions on a num-final decision rests in their decision- modate both groups - those electing tober of issues. Two of the questionsmaking skills, their assertiveness, and abstain and those who have chosen toincluded; (1) Why do teens not wait to their ability to communicate their values become sexually active. have sexual intercourse until they areand feelings concerning abstinence. A vast majority of parents andolder; and (2) What reasons are most In light of these critical facts, the teachers alike support abstinence as a useful in convincing peers toiait to following 55 minute lesson is a sugges- curriculum topic. Forrest and Silver-have sex until they are older? (Peter-tion for those teachers who lack cur- man report that one survey revealedson, 1988). ricula materials but share the desire to about 25 percent of teachers cited ab- Peterson reports the top four rea-teach abstinence. While the lesson is stinence as the most important mes-sons given by teenage girls for notdesigned for middle school and junior sage they have for their students.wanting to have sexual intercoursehigh school studcnts, it easily can be However, it, like most issues involvingrevolved around dangers of diseases,adapted for older students. sexuality, is not an easy topic to dis-such as AIDS and herpes - 65 percent, cuss in a classroom filled with 30 fif-and the danger of pregnancy- 62 per-Instructional Objectives teen-year-olds. To complicate mat-cent. Fifty percent of the teens wor- ters even more, abstinence curricularied about what their parents would The student will (1) recognize the and supplemental instructional pro-do if they found out, and 29 percentimportance of sexual abstinence and grams arc lacking in quantity as wellfelt that ha-ing sex would ruin theiridentify consequences of failure to as quality. Therefore, teachers fre-reputativa ',Peterson, 1988). abstain and (2) identify and practice quently elect to develop their own The 1986 Harris Poll reported thattechniques of assertiveness. teaching materials. This leads teach-teens felt pressure by other teenagers to go further with sex than they wanted. Set Dee Gibbs Smalley is the health andSince both males and females felt this pressure, those curricula materials physical education curriculum devel- Begin the instruction by writing opment coordinator for Memphis Cityshould be utilized which contain ac-the phrase "human sexuality" on the tivities essential to helping teens learn Schools, Memphis, TN 38104. board. While this is visible to students, how to resist this sexual pressure. It isexplain that although they are sexual so vitally important to empower youthbeings, it is important not to act out on to resist peer pressure. Such assertive-every sexual feeling until they are ness skills have lifelong value. How-mature enough to accept responsibili- ever, educators must be alert to teens'ties for their consequences. Inform concerns where resisting peer pres-students that the purpose of this les- sure is involved. It is not always easy to son is to recognize the importance of say "no" even after learning the skillsexual abstinence and identify conse- (Peterson, 1988). quences ot failure to abstain, and to Leo reports in TIME that studiesidentify and practice techniques ofas- arc surfacing which present evidencesertiveness. 250 2 Instruction Ask students to compare men- Inform students that many ado- tally the reasons given for becoming lescents are not prepared to deal with Write three headings on the board sexually active with possible conse- the pressure often exerted by a mem- for all students to see. The headings quences of becoming sexually active. ber of the opposite sex to become should read: (1) Reasons Frequently Ask them to identify the list of reasons sexually active. Therefore, being able Given by Teens for Becoming Sexu- which would have a greater impact on to say "no" assertively to a pressure ally Active, (2) Reasons Frequently their lives both now and in the future situation may be very helpful. Explain Given by Teens for Postponing Sexual and the plans, dreams, and goals they that by knowing how to deal with these Activity, and (3) Possible Consequences have set for themselves. pressures, students will have more of Becoming Sexually Active. Explain to students that the deci- control over their lives and will be able Begin with heading number 1. Al- sion to become sexually active or to to make wiser decisions. low students to brahistorm reatons remain abstinent is theirs - a decision Distribute a copy of the Handout that teens may become sexually ac- only they can make. Unfortunately, - Lines(Figure 1) to each student. tive. As ideas are presented, list them pressures abound in society. Pressures Have students write their response to on the board underneath the heading. from the media as well as peer pres- each "line." After students have com- Allow sufficient time for students to sure force many adolescents to be- pleted the assignment, provide volun- generate as many reasons as possible. come sexually active before they are teers with an opportunity to share Reasons may include pressure from physically, emotionally, and financially their response. If sufficient time re- peers, fun or pleasure, feel grown up, prepared to deal with the consequences. mains, have students select the most love, curiosity, hold onto girl/boyfriend, Continued on page 253 lonely, rebelling against parents as Fire I. Handout-Lines seen on TV or movies, or to escape problems at home. Allow for interac- DIRECTIONS:Read each statement car:fully. Write a response to each of the following. tion between students. I. Come on! Everyone is doing it! Response: Move to heading number 2. Have students brainstorm reasons that teens 2.If you really love me, you'll do it! may postpone sexual activity. As be- Response fore, list them or the board when genn.rated. Reasons may include wait- 3. If you won't have sex with me, I won't see you again. h until married, fear of pregnancy, Response: fear of getting a sexually transmitted 1. Don't be afraid of what others will say. disease, AIDS, afraid parents will find Response: out may be painful, against religious beliefs, against value system, might 5. Having sex with me will make you a real man/womar interfere with future plans, not ready Response: for responsibilities of a baby, not physically or emotionally ready, might ruin 6.1 promise we'll get married someday. reputation, or simply didn't want to. Response: Again, ,meourage discussion between 7. Don't you want to try it to see what it's like? students. Response: Finally, direct students' attention to heading number 3. Ask students to 8. But 1 have to have it or I'll die. think of possible consequences of be- Response: coming se;:ually active. List them un- 9.If you get pregnant, we'll get married. der the heading as students generate Response: their ideas. Consequences may include, but are not limited to, unwanted preg- 10. You know you want it as much as I do. nanry, sexually transmitted diseases, Response: AIDS, dropping out of school because of pregnancy, damaged reputation, hav- 11.lf you love me, prove it. ing to seek a job to svport a child, Response: changed relationship with boy/girl- 12. Come on, take a drink. It will get you in the mood. friend, parents, and friends, losing self- Response: respect, and fc,..nng differently about oneself. 251 2 1 TEACHING IDEAS 135 Family Life Education Group Discussion on Contraceptive Issues Barbara A. Rienzo

The problems and consequences of mination of education, lower job/career The following exercise is an effective unplanned and unwanted pregnancy possibilities,increasedrates of child method of introducing the topic of birth are ll documented in the literature. abuse, and birth defects, such as mental control and facilitating discussion about Sol, of the costs to the mother, child, impairmect and limo deformity. Most motivational issues surrounding the use and society include high infant mortal- healthand educationprofessionals of birth control/contraceptives by sexu- ity rate, high rate of low birth weight or agree on the need for prevention of ally active young adults. It is appropri- premature babies, higher risks of hyper- unwanted pregnancy. ate for high school, college, and adult tension, toxemia, and other complica- Although we do not yet have a per- groups. tions of pregnancy, interruption or ter- fect contraceptive method many un- Initially the educator has the students wanted pregnancies could be prevented take a half-page of paper and writ" through consistent use of an effective whether they are male or female at thy contraceptive. There are a variety of top. No names or distinguishing marks Barbara A. Rienzo is an associate pr-iessor reasons given for non-use of contracep- should be used to preserve anonymity. inthe Department of Health Edu«aion, tives among youth. These include igno- The class is then instructed to listen to UniversityofFlorida,Gainesville,II. rance, unavailability, lack of motivation, the following situation. They will later 32611. the desire to become pregnant. be asked to write down their reaction. 252 The instructor tells the class: (The fol- b. Do you think the response is about contraception? lowing may be modified to fit th2 specif- realistic? 3. Relationships ic audience) c. What are the implications or a. Does birth control responsibil consequences of the '- ity vary with the type/intensity "You have been going out with this sponse? of the relationship? person for some length of time. 5. The instructor makes it clear ...1at 4. Sex Roles You really care for him or her and the discussion should be among a. How do female sexuality ste- have had a nice time this evening. the persons in the inner circle only reotype influence birth control? You've been to a romantic dinner andno personal attackson other 1.Is a girl/woman bad/loose if with candlelight and to a movie, people are permitted. (Speak in she is prepared for sex? and now you're back at your place. "1" statements). 2. When a woman says "no" is You are both feeling affectionate The instructor may need to initiate she serious? Is she taken se- and things begin to get 'hot and discussion by asking the persons in the riously? heavy.' You realize that you'd real- inner circle to read the responses aloud b. How do male sexuality stereo- ly like to make love with this per- to the group, and then use active listen- types influence birth control? son (You had not had sex with him/ ing skills to elicit their thoughts and 1.Is a guy always out for all he her before)but you don't have feelings. The discussion time should be can get? any contraceptive available. What splitevenly between the same-sex 2.Isit OK for a guy to say would you do?" groups, and the instructor should allow "no"? a few minutes at the end of class time to 5. Sexual behavior-- The instructor tells the students to summarize the session. Often, addition- a.Is sexual intercourse the only consider the situation silently and to al time must be spent during the next satisfying end/goal of lovemak- write down on their papers as honestly class period to summarize the discus- ing? as they can what they think they would sion and allow students to express their b. Are there alternatives to sexual do in that situation. The teacher should feelings and thoughts about the exer- intercourse? be sure to have students write down cise. c.Is"planned" sexlessexcit- their answers without talking to others The major ideas generated through ing?Does sex have to be to ensure that individually considered fllis exercise are: spontaneous to be good? responses are recorded. As the students 1. Responsibility for birth control-- This exercise provides an opportunity finish writing (allow approximately five a. Whose responsibility is it? for students to participate actively in minutes), have the students fold their b. How do you share the respon- class and to identify those issues which sheets of paper in half. The teacher sibility? contribute in important ways to their should collect the sheets personally, c. How do you take responsibil- decisions regarding contraceptive be- shuffling them as they are handed in to ity? havior. The teacher-facilitator has the preserve anonymity. When all the pa- d. What obligation(s) does the responsibility to initiate (when neces- pers are collected, the instructor directs male have in an unplanned sary), summarize, and clarify issues the class to form a circle of chairs (usin, pregnancy? from each group's responses. Both about half of the chairs) in the cent«. 2. Communication-- teacher and students can benefit greatly room. Meanwhile, the students' pap 3 a. How do you talk about birth from the insight achieved through talk- should be separated into male and fe- control with a partner? ing with and listening to other individ- male responses. After thisis accom- b. When is a good time to talk uals. plished, the teacher instructs allthe males to sit in the inner circle. The class is told that this is a "fishbowl" exercise with the following rules: 1. All the persons in the inner circle are allowed to participate in the Teaching Abstinence to Today's Teens discussion. They are the only ones permitted to talk. 2. There should he enough chairs in Continued from page 251 the inner circle for all members of one sex plus one empty chair. assertive response, the most dever but it can be a terrifying experience 3. The persons inthe miter circle response, and others. under other conditions. must remain silent. They' may only Again, explain to students that the listen. If they wish to say some- decision to become sexually active or The Alan Guttmacher Institute. (1989). Risk thing, they must take the empty and responsibility. New York: Author. chair in the inner circle. to remain abstinent is theirs - a deci- Forrest, J. D., & Silverman, J. (1989). What 4. The persons in the inner circle will sion only they can make. Briefly re- public school teachers teach about pre- be given the responses of the other view the possible consequences of venting pregnancy, AIDS, and sexually transmitted diseases. Fami6, Planning Per- sex by the instructor. The students becoming sexually active, Stress that a spectives, 21 (2), 65-72. are instructed to discuss the re- sexual relationship can be a most grati- Leo, J. (1986, November 24). Sex and Schools. sponses in terms of by answering fying experience when a person is pre- Time, 54-63. the following: Peterson, L. (1988). The issue- and controversy- a. How do you feel about the pared physically, emotionally, and fi- surrounding adolescent sexuality and ab- response(s); nancially to deal with the consequences, stinence.S1ECUS Report 17(1), 1-8.

253 263 TEACHING IDEAS 136

Family Life Education Developing and Rejuvenating Relationships Jane W. Lammers

For some people, developing per- three weeks, with one week being sonal relationships is very difficult. devoted to each relationship. A help- Equally as difficult for some is main- ful technique for insuring that the taining a continued interest in an old participant completes the activity is relationship. As Peck (1978) de- to provide an activity sheet for plan- scribes, relationships go through var- ning and recording the results (see ious stages, and hard work is nec- Table 1 for an example of Week One). essary for relationships to flourish. In the first week, the participant is An ideal time to learn about rela- to renew a relationship with him- tionships and their intricacies is dur- self. He is asked to analyze how well ing the developmental period of ad- he has been taking care of himself by olescence, when teenagers are very writing down three things that he concerned about establishing ties with does to care for himself and listing in their peers P.nd are testing their in- another column three things he does dependence from the immediate fam- not do. Some examples that can be ily (Erickson, 1982). Yet, while the recorded in the "does not do" col- new relationships are being devel- umn might be general health habits oped, old relationships need to be that are recognized as beneficial for maintained and nurtured. By partic- health: for example, exercising reg- ipating in the following activity, one ularly, getting adequate sleep, eat- is able to experience caring for sev- ing well-balanced meals, managing eral different types of relationships stress, meditating, playing, and not in his life. usiag tobacco. He then chooses some The activity works well with teen- specific thing that he will do every- agers but is applicable to anyone day for himself for one week and who desires renewal in a relation- records the planned activity on a ship. College students, whose ages particular day in a weekly log (each range from 18 to elderly, have ben- day's activity may be the same or all efited from the experience. In health or some may be different). Examples education classes, the activity inte- might include meditation for 15 min- grates well into the human sexuality utes, walking for 20 minutes, going section, where a major emphasis is to a movie, eating breakfast, not learning how to develop and appre- smoking cigarettes or chewing to- ciate a variety of relationships with bacco, or eating more fresh fruits family and friends (Educational De- and vegetables. At the end of each loved one, either a family member or velopment Center, Inc., 1983). day, the participant records in the a close friend. To analyze the current The overall goal of the activity is to daily log what he did each day. At status of the relationship with the help an individual experience devel- the end of the week, he writes a person, the participant writes down opment and nurturing of a relation- summary paragraph that describes three things that he does on a reg- ship. Specifically, the participant will the success or failure in being good ular basis to nurture the relationship renew a relationship with himself, a to himself, feelings during the expe- and three things that he could do. loved one, and one or more other rience, plans for the future, and Examples might include 15 minutes people he does not know very well. general comments about the activi- of uninterrupted conversation with The time allotted for the activity is ty, including how he might do it if the other person without talking he tried it again. about himself, rubbing the person's lane W. Lammers is in the Department During the second week, the par- back, washing the person's car, send- of Health Education at the University of ticipant renews a relationship with a ing a card of appreciation to the Central Arkansas, Conway, AR 72032. 254 t; .1 individual for his contribution to the be someone in one of his classes, his mary paragraph reporting what hap- participant's life, takins the person employer, a fellow worker, a neigh- pened, how the participant felt about out to eat, or keeping the person's bor, or someone he has been want- the experience, how others respond- house clean. For one week, the paring to meet. Each day for one week, ed, and how the experiment might ticipant chooses something to do the participant chooses something be redone. everyday for the other person with- he will do to enhance a new rela- Generally, most students willing- out telling the person he is doing tionship without letting anyone know ly participate in the activity; but, this for an assignment and records about the project. '.2:ach day may be with encouragement, those who are his planned activity in a daily log. At devoted to establishing a relation- initially apprehensive usually bene- the end of each day, the participant ship with the same person or a fit most from the experience. Assign- records what he has done. At the different person. Some examples of ment of the activity may be all that is end of the week, a summary para- ways to enhance the relationship necessary to encourage the student graph is developed to describe suc- might be to initiate a conversation, to initiate the beginning or renewal cesses, failures, feelings, and re- ask someone to go to a movie or of a desired relationship. Many stu- sponses. The participant is asked to party, offer to run an errand for dents write in their reports that be- report what changes he might make someone, or just compliment some- cause of the activity they began a if he were to do the activity again. one. The participant lists the plan for new relationship with someone they The final week is designed for the each day in the daily log and then, had wanted but had been too afraid participant to establish a relation- after each day is completed, he will to meet in the past. Some have used ship with someone or several other record what was done to enhance a the activity as an opportunity to people whom he does not know new relationship. At the end of the re-establish old ties with family and week, the participant writes a sum- friends that previously had been very well. Such an individual(s) might severed by a disagreement. Some students even become philosophi- (Worksheet) cal. One student wrote after having Week One: Renew a relationship with yourself. completed the project: A. Analyze how well you have been taking care of yourself. Write down three things I have found the smallest of seeds sown that you do or do not do on a regular basis. sincerely will grow if cared for. Just like the seeds sown, a relationship needs to be Things 1 do for myself Things 1 do not do for myself nourished. A cared for relationship will grow and produce much beneficial fruit. An ignored one will wither. Relationships are active and can be directly influenced 2. by the care given them. (Anonymous, 1988) 3. In summary, health educatorscan provide opportunities for students Choose something you will do everyday for yourself for one week. (Each day's to develop skills that will enhance activity may be different or all may be the same.) In the left hand column, write what youplan to do the quality of their lives. Caring for each day. In the right hand column, write what youdideach day. a relationship is an example of one My daily plan What Ir id skill that can be developed. The Day I activity discussed provides a practical approach to learning how tocare Day 2 for oneself and others. Withprac- tice,individuals, whether in the Day 3 home, workplace, or community, can begin to demonstrate their con- Day 4 cern for themselves and others and thus becom healthier people. In the Day 5 final analysis, healthy relationships make for healthy people. Day 6 Anonymous, (1988). Paper prepared for health education general education course. Day 7 Educational Development Center, Inc. (1983). Haviv., friends. The teenage health teaching moth r.. C. At the end of one week, write a summary paragraph that describesyour success or Department of Health and Hu- failure in being good to yourself. Describe your feelings during the achvity,plans for man Services (contract #200-79-0922). the future, and general analysis of the activity. Erickson, E. (1982). Thelife cycle completed: A review.New York: W .W. Norton & Co. Note:Each week, the activity sheet would be modified. Peck, M. S. (1978).The road less traveled.New ..ork: Simon & Schuster. 255 265 TEACHING IDEAS 137

Family Life Education Courtesies and Rights Within Relationships

Bethann Cinelli and Robert Nye

Crooks and Baur (1987) refer to this as the "inclusion-response foundation." They describe this term as the "little things that count in a relationship." Often these behaviors may go unnoticed and, therefore, are taken for granted. These may include offering to help with a chore, opening doors, or being complimentary. Therefore the purpose of this activity is to help students distinguish be- .. tween what they perceive to be cour- Courtesy,n., pl. -sies: 1. courteous rItionship. As the course progresses tesies within the relationship as well as behavior 2. a polite or considerate act tiscussing helping and doing things (Gurlanik, 1984) what they perceive to be individual - each other, then to jealousy and rights. Right, n.: 1.whatis right, just, etc. honesty, many students become con- 2. a power, privilege, belonging to one fused, frustrated and angry over ex- Activity by law, nature etc. (Gurlanik, 1984) pectations and what partners should Human relationships present and should not do for each other. This Instruct students to form small many challenges. For many people is most evident when discussing cour- these include developing, building groups that are co-ed with ap- tesies within a relationship. One can proximately four or five students. For and maintaining of primary relation- notice quickly that students have not ships and possible marriage. 1 here the next 15 to 20 minutes, each group yet defined for themselves the dif- will be asked to list the most important are also many factors to a lasting love ferences between courtesies and relationship. Rosenman has iden- courtesies(there is no mention of rights nor what to expect or demand rights at the; time)that they would like tified these as: self-acceptance, ap- within relationships. preciation of one another, commitment, good communication, realistic Table 1.Examples of a Courtesy List from Class Discussion expectations, shared interes's and the Not interrupting your partner when he or she is speaking ability to face conflict effectively Opening doors (Rosenman, 1979). Being on time As part of a Love and Marriage Calling your partner if you are going to be late Picking up after yourself class, students are encouraged to Being honest develop their own definition of love, Showing respect for partner identify desirable traits they want in Not leaving hair iithe sink their potential mate, and then look at Telling your partner there is a change in plans Remembering important dates (birthdays, anniversaries) partner interactions which may be Allowing time for friends detrimental to or may enhance their Allowing your wife to work Filling the gas tank when empty Bethann Cinelli is an assistant profes- Wife being given money for herself Not drinking directly out of cartons in refrigerator sor of health education, West Chester Not embarrassing your partner in public University, Department of Health, West Not smoking in bed Chester, PA 19383. Robed Nye is a Putting toilet seat down after use professor of health education at West Paying attention or listening when your partner is talking Being supportive of partner's career Chester University. 256 266 extended to them by their partners. that check marks actually may indi- extended to everyone at all times, and To record their responses, give each cate "rights" rather than "courtesies" that there may be relationship rights group a large (36" X 30) sheet of within a relationship. These "rights" which people define for themselves newsprint paper and a marker. Tell are viewed as what is just, rather than which may need to be identified early students that they may work within the as a courteous or considerate act. The in the "getting to know each other" classroom or may choose to work in inst, actor should note that confusion stage. the hallway or other available rooms. over courtesies and rights can be When the lists have been com- devastating to a relationship. What Conclusion pleted, the iastructor will attach them one partner may see as merely a cour- (an example of common responses tesy, the other may believe is a right This activity is designed to offer can be found in Table 1) to walls which must be observed. the students an opportunity to show around the room. Students then are how, in actuality, (1) rights are often asked to read over the lists while the The follow-up discussion will confused with courtesies, (2) com- instructor also reviews them. then address differences between munication between partners is es- However, the instructor will place a courtesies and rights. Students will sential in order to define courtesies check by the items which actuallymay also be asked a key question about and rights, (3) partner expectations be considered to be individual rights how they feel when an expected cour- need to be defined and (4) because of rather than courtesies. At this time, do tesy is not extended to them. Often varying backgrounds, what one not tell students why you are checking they will express feelings of anger, dis- partner may consider to be a courtesy any particular item. Ask the groups to appointment or disillusionment. It the other partner may consider to be discuss each other's lists. As the ques- then can be pointed out to them that a right. tions and comments trail off, ask stu- perhaps this is an indication that they dents why they think that you have view the expected behavior as a right Crooks, R. & Baur, K. (1987). Our sexuality. checked certain items. If time is im- rather than as a courtesy. The denial California: Benjamin Cummings, 226-- portant, after these lists have been of a courtesy should not generate the 228. checked, go right to the question of degree of anger some students ex- Gurlanik, D. B. (1984). Webster's new world "why" these items were highlighted. hibit. In different:7g between the dictionary. New York Warner Books, 111, After students offer their sug- 144. two, students r- 3cuss that there Rosenman, M. (1979). Loving styles. Engle- gestions, the instructor can point out are universal which should be wood Cliffs, NJ: Prentice 1:iall.

267 257 TEACHING IDEAS 138

First Aid and Safety CPR Drilling Revisited Mark J. Kittleson

In 1980, this author published an arti- encouraged by the American Heart As- sponsiveness. Keep track of how long cle that discussed a possible alternative sociation and the American Red Cross. each task takes. Be especially aware of in teaching Cardiopulmonary Resuscita- A critical part of single rescue CPR is the length of the pulse check. A rough tion (CPR). Entitled CPRDrilling,its the learning of various "parts" which idea for time should be as follows: main premise was that a great deal of include: mouth-to-mouth resuscitation, CPR instruction is spent observing an- proper compression rate and depth, Task Seconds other person performing CPR. The au- moving quickly from the chest to give Min.Max. thor contended that much of this ob- two ventilations, combining chest com- serving could be reduced by more effi- pressions with two ventilations, as well 1. Determine Unrespon- cient classroom management. as learning the steps to initiate CPR. siveness 4 8 Over the past several years, the ideas In Kittleson's study (1986), each of (call for help) suggested in the 1980 article have been these skills were broken down and each 2. Open Airway, listen refined and researched. This article will skill is practiced by an individual until for breathing 7 13 discuss four specific techniques that can mastered. Once mastered, the individ- 3. Give two full breaths 13 19 be used in a CPR class to enhance the ual can "combine" these parts. An indi- 4. Check Pulse 17 29 learning of this critically needed bkill. vidual is placed in a group of three, with (tell somebody to call Bloom (1974) stated that on-task be- each person responsible for a key com- an ambulance) rescuer havior is a critical component to learn- ponent of the task. The is the Observer's Role:Your job is to make ing any skill. Most of Bloom's research, person performing the actual skill; the certain that the rescuer performed each as well as many of Bloom's followers, timeris the individual who uses a stop- specific criteria successfully. You are to have only analyzed cognitiveshills. watch to detect speed;tne observercare- make certain that proper position of the Could such a theory be effective in a fully monitors the performance of the rescuer (as well as the victim) occur, at psychomotor skill such as CPR? Little, if rescuer. Each of the three individuals all times. Stop the rescuer if necessary any, research has been done to support rotate a role when the rescuer completes to point out an error. this concept. his/her task. Altogether, there are four Have each person rotate after five Kittleson's research (1986) showed specific tasks to complete. complete performances. that Bloom's time on task concept is This format will allow the instruc- relevant to psycnonlotor skills. He also tor(s) to spend time with those individ- went on to shc w how Cratty's theory of uals needing special assistance. It also Task Two: Proper Ventilation progressive part practice can also affect sets the tone of the class that each CPR instruction (Cratty, 1973). person is not only responsible to learn This task is to get the rescuer comfort- Cratty believes that in order to learn a CPR, but also is responsible to assist able with the idea that he/she is to move complex skill, one must first break the others in the learning of that task. quickly from the chest when giving the skill into several specific parts. Only two ventilations. after mastering these specific parts can Task One: Initiating CPR Rescuer's Role:Start in chest compres- on,- put the skill together. sion position. When you hear the timer The skills needed to learn single res- Rescuer'sRost_Imagine you have say "go," leave the chest,give two full cue CPR forms the basic of learning walked into the room and you see "An- ventilations, go back to the chest posi- CPR. Once such 3kills are mastered, nie" lying here. Although you do not tion, and wait until the timer says "go" other techniques such as two person know it at the time, Annie is in cardiac again. Make certain that you ventilate CPR can be taught. However, single arrest. Go through the proper steps of effectively and that you pinch thenos- rescue CPR is the major technique now determining unresponsiveness, calling trils and open the airway sufficiently. .If for help, opening the airway and listen- you get confused, or getbehind in the ing for breathing, giving two full sequence, stay on the chest until you breaths, and checking the pulse (while hear the word "go" again. Mark J. Kittleson is an assistant professor in calling for somebody to get an ambu- Timer'sRole:When the rescueris health educationinthe Department of lance). ready, say the word "go." Keep your Health and Physical Education at Youngs- After you have finished taking the eyes on the stopwatch.Every six sec- town State Universiti,--ungstown, OH. pulse, position yourself to perform onds say "go" loudly to the rescuer. He is also an instructor-ti.:iner in advanced CPR. Once your hands are on the chest, Keep the watch running at all times; do first aid for the American Red Cross as well you can sit back. not stop and reset each time. For exam- as an instrIctor-trainer in CPR forthe Timer's Role:Start the stopwatch once ple, say "go" at start, six, twelve, eigh- American I rt Association. theperson starts checking for unre- teen, twenty-four seconds, etc. 258 2fiS Go for thirty seconds, stop, and con- hands on the chest. Tell the rescuer the infant :esuscitation can also be broken tinue for another 75 seconds. time that this particular cycle took. down to increase teaching effectiveness. Observer's Role: Your job is to make Also note how long it took for the For example, the student who practices certain that the mannikin is resuscitated compressions, as well as the movement two person CPR can concentrate on completely. Make sure that the head from chest to mouth (and back). "CPR Switching" only, or a student can tilt, chin lift is performed correctly, that Observer's Role: Make certain the indi- practice ventilations on an infant. Once the nostrils are being pinched, and that vidual properly compresses, properly these specific skills are mastered, stu- the rescuer's mouth completely covers ventilates, as well as properly finds dents can combine these skills to per- the mouth of the mannikin. Finally, hand position. The time for each cycle form the entire sequence. make certain that the rescuer finds the should range between 13.5 to 15 sec- mannikin's xiphoid process before plac- onds, although the time between leaving hands on the mannikin's chest. ing the chest, and returning to the chest Bloom, B.S. (1974). Time and learning. Amer- Have each person rotate roles after (after breathing) should take no longer ican Psychologist, 29, 682-688. completing one thirty second and one than six seconds. Cratty, B.J. (1973). Teaching Motor Skills. En- 75 second. glewood Cliffs, NJ: Prentice Hall, Inc. Putting It into Practice Kittleson, Mark J. (1986). Analysis and com- Task Three: CPR Compressions parison of cardiopulmonary resuscita- These progressive part practice ses- tion methodology among college stu- The objective of this task is to make sions should only be utilized after see- dents. Unpublished Dissertation. The certain that the rescuer is able to per- ing and practicing the general CPR se- University of Akron, Akron, OH. form proper chest compressions within quence. How that practice is done is up Kittleson, Mark J. (1980). CPR drilling, Health the allotted time period. to the individual instructor. This author Education, 11, 22-23. Rescuer's Role: Position yourself on the pairs up each student, then directs the chest, ready to do cardiac massage. Do student in each CPR step (without actu- 15 proper chest compressions within al ventilation and chest compressions). 8.5-9.0 seconds.Stop,receive your It is important that this general practice time, and repeat 10 times. is done before the progressive part prac- Timer's Role: When the rescuer starts tice sessions to acquaint students with compressing,startthe stopwatch. the overview of CPR. To use the pro- When he/she completes the 15 compres- gressive part practice without a general sions, stop the watch. Tell the rescuer understanding of CPR would not allow his/her time. Reset the watch, and ready total learning to occur. yourself to time the person once again. Each task, with three individuals per Observer's Role: Make absolutely cer- group, can be accomplished within a tain that the rescuer is compressing 10-12 minute time period. Additional properly. Also, observe whether the groups can be taken care of in one of the rescuer has unnecessary movement (e. following ways: g., bobbing head). 1). Placed at additional manikins to Rotate after completion of 10 cycles. practice critical tasks such as mouth-to- mouth breathing, and chest compres- Task Four: Combining Breathing sions. and Compressions 2). Placed at a non-mannikin area to practice the entire CPR sequence on a This task has the objective to put member of the group. Obviously, chest together two of the previous tasks to compressions and ventilations are not form one fluid motion. permitted. The observer also serves as a Rescuer's Role: Position yourself on the timer. mannikin's chest. At yolown discre- Completion of each of the tasks usual- tion, start 15 chest compressions. After ly provides a solid foundation of mas- completing 15 compressions, move to tering the specific skills needed for CPR. the mannikin's head and give two full Students also find this an acceptable breaths. After giving tv% o breaths, go method in that all students are involved back to the chest, and pc sition yourself at all times. By observing, assisting in on the mannikin's chet (making sure individual performances, and in actual you find the xiphoid process). After practice, CPR skills are enhanced. getting into this position, you may sit Kittleson's research (1986) analyzed back. these specific tasks on effectiveness to Repeat after hearing your time eight teach single rescue CPR. The results of times. his study showed this approach to be Timer's Role: When the rescuer starts more efficient at teaching CPR skills compressions, start the watch. When when compared to the traditional meth- the rescuer completes the two breaths od of instruction endorsed by the Amer- and returns his/her hands to the chest, ican Heart Association. stop the watch. Do not stop the watch Although not statistically tested, until the rescuer has placed his/her skills involving two person CPR and 259 269 TEACHING IDEAS 139 First Aid and Safety The Improvised ManikinHomemade CPR Equipment Mardie E. Burckes

Asta.;/

"The Improvised Manikin" is an ana- tomic dummy which the Nebraska De- partment of Health-Emergency Medical Services designed to teach CPR in the Nebraska public schools. This manikin can be made by following the simple directions included in this article. The Nebraska Department of Health has given permission to reprint the direc- .hF: ?, . ,.4 .A;4... ': 'al ,4 t° i. '1,0,' u,rr.ijol. tions for making the manikin, although the author has made some slight t t ^-4U'I'd"-,crzillfZiett changes. X ' The manikin is made of the following 4. Put a shirt on the pillow and a hand- when using the improvised manikins. materials: pillow, styrofoam head, rub- kerchief on the manikin's neck; ar- Because styrofoam is porous and diffi- ber bands or tape, safety pins, t-shirt, range the head, bag, and pillow as cult to wash, each participant should handkerchief, Laerdal chest piece and shown. Pin the bottom of the shirt use a four inch square of wax paper steel chest band (optional). snugly near the pillow. with a slit in the middle to cover the Directions The manikin could cost as little as mouth of the manikin when ventilating. 1. Poke hole with a pencil or cut hole $1.00 or as much as $50.00 depending For sanitary reasons the styrofoam head through the mouth to the hollow cen- on whether the Laerdal chest band and and plastic bag should be removed and ter core of the styrofoam head. chest piece is used. If the chest piece discarded after every few classes. The 2. Tape or use an elastic band to hold a and band is not used, a clorox plastic price of thisis negligiblestyrofoam plastic bag to the neck. A small gar- head ($1.00), plastic bag (free) and could bage bag (12" x 18") or grocery plastic bottle cut into a 4 inch band could be placed over the pillow as a chest piece, save a disease outbreak in the school. bag both work well. To practice with "Improvised Mani- 3. Place the plastic bag under chest but the edges should be taped or pad- piece if one is used, otherwise place ded because they could be rough. kin," place the dummy on its back and the bag under the pillow. (The Ne- Why use an improvised manikin? follow steps from the American Heart braska Department of Health uses a Many times schools cannot get regular Association or the American Red Cross: pillow) If the bag is placed under the CPR manikins from various agencies or Shake and shout, call for help, tilt the chest piece, the head can be tilted cannot afford the price tag of $600 for head back to open the air passage, look, back to open the airway and the chest a commercial CPR manikin. Also an listen, feel, 4 quick breaths, pulse, call will rise when air is blown into the improvised manikin works well in the for help, find proper hand position, mouth. public schools because it is lightweight cadence: 1 rescuer for an adult 15:2, 4 Marche E. Burckes is with the School of and can be transported easily from one cycles of 15:2 in one minute, repeat or 2 HPER, University of Nebraska at Omaha, class to another. rescuer,5:1following the instructed Omaha,NE 68182, A few safety rules should be followed procedures. 260 2 TEACHING IDEAS 140

structor must go out of his or her way to provide encouragement. Although you must be cautious and not go overboard, try to find something good in even rather poor results. Encouraging and promoting confidence is part of your job as an Teachhig the Four instructor. One trick found to be successful in promoting confidence is the continual of First Aid reinforcement and practice of specific skills. For example, the first day of class, and each class hereafter, the author has a small portion of daily dass time devoted to obstructed airway maneuvers and to bandaging. By the end of the course, the students have mastered a Mark J. Kittleson rather complicated procedure involving obstructed airwayfor both conscious and unconscious victims. They are so First Aid, I now believe, can be an ex- students to read specific chapters (and to sure of their ability to do thr procedure citing and rewarding subject to teach: an be responsible for this information), you, properly that there is no doubt in their opportunity to see students develop as the instructor, can devote more time minds they can come to the aid of a chok- skills that can be of utmost service not to the other three C's. ing victim. only to themrelves but to others suffer- To let your students realize the seri- The students are also proficient at ing from illness or injury. Unfortunately, ousness you attach to their readings, bandaging--so much so that they can some instructors (including this author) give daily quizzes on required readings. apply a sling, various head bandages, have been guilty of terribly dry and un- Any student who does poorly on one or shoulder, chest, and hip bandages prop- rewarding courses. I believe an exciting two of these quizzes will quickly make it erly within thirty seconds. and practicai approach to teaching first a point to study ahead of time. aid, which I call "The Four C's of First A method this author uses to encour- Aid," can provide the basis for an effec- age cognition (besides lecture) is to 4"1 tive course. Each of the four C's is provide all members of the first aid equally important, for without one, the courses an old first aid final. This final, Number ThreeCooperation other three cannot be maximized. develoi-ed more than five years ago, does have some outdated material, but it 01.0, 4""Nif is an excellent tool to promote study. The third C also falls under the re- These tests are for students to keep. sponsibility of the instructor. Since acci- Number OneCognition They are to put down only answers they dents or illness have a tendency to bring are sure of, and to look up the answers to many people together, a first aider is Nord questions of which they are unsure. rarely alone. He or she 1111.1e learn to They are allowed to work in pairs, cooperate and to deal with knowledge- Cognition, or the knowledge of first groups, or alone, and can use any re- able as well as uninformed people in the aid, is an obvious essential. Without source for answers or clarifications. This proper knowledge, a student could not subject of first aid. 235-item test is used throughout the A dassic example given by this author make appropriate choiceschoices quarter; every class meeting has some is a personal account of my initial oppor- which could place the life of the victim in time devoted to its use. It is especially tunity to use first aid skills. As I came jeopardy. Although cognition is the basis handy during a quiz or major tests. The of first aid, it is not necessarily the sole upon the scene ;mmediately after an ac- students who finish their quiz early can cident, two men were discussing (rather goal of a first aid course, and it is not the work on this "final" while others are sole responsibility of the instructor. heatedly) what the proper steps should finishing. This prevents much idle time. be to aid an older women with a scalp Cognition is the prime responsibility of Also, this provides an opportunity for the student. If an instructor is forced to injury. While the heated discussion one-on-one assistance to those students turned into a heated debate, I maraged lecture on textbook material, what is the desiring such help. to sneak in to treat the victim. Soon purpose of using a text? By requiring thereafter, the two men started hitting each other. I am still amazed at that incident. While somebody was lying on the Number TwoConfidence road bleeding profusely, two men were fightMg over proper procedure. Stu- Mark I. Kittle:con is an instructor of Health dents must be continuously reminded Education in the HPE department at Youngs- that they must learn to deal effectively town State University, Youngstown, OH It seems rather foolhart o pxvidea with "know-it-alls." This author usually 44555. He is also certified as an Instructor- first aid course and not have students incorporates two to three simulations Trainer in First Aid with the American Red apply their skills. One of the main rea- during the course, and often role-plays a Cross and Instructor-Trainer in CPR with sons people decide not to administer first "know-it-all" person (without letting the American Heart Association. aid is their lack of confidence. The in- the class realize what is happening). 261 271 Eventually the students develop effec- tremely important that the instructor en- tive skills in dealing with this type of courage creative thinking. We all learn to person. apply slings using the triangular ban- Cooperation is also encouraged by as- dage, but how many people carry trian- signing specific tasks and grading on gular bandages with them? A person cooperation rather than procedure may have to use a shirt, jacket, or some (without the students' knowledge that .0. `,` other item. cooperation is what is looked for). Give t The instructor needs to provide time tests and have two people work on them for the student to improvise certain first together (nothing provides more realistic aid equipment such as splints, ban- pressure than assigning fifty true and dages, litters, and other transporting de- false questions and giving the students vices. ten minutes to answer them). Also, give Specific examples that can be utilized certain accident situations for which stu- are to require of students that they obtain dents (as a group) must list appropriate ; a triangular bandage and some other first aid procedures. Students realize piece of clothing. They learn their ban- that not everybody interprets everything dage first with the triangular bandage, the same, and all have different perspec- and later in the course they experiment tives regarding first aid treatment. with their extra clothing. I also encourage them to practice applying the bandage (sling, forehead, scalp, etc.) on themselves. Number FourCreativeness Conclusion -.mod Murphy's Law ("If anything can go wrong, it will.") is a most appropriate The chances of having an ambulance quote to relay to your first aid class. As or a first aid station within easy access instructors of first aid, we must try to prepare students in all dimensions of after an accident are rare. Chancesare you will be twenty miles from nowhere first aid. This author has found the "Four when an accident occurs. Thus, it is C's" of first aid an effective attempt to ex- I/ meet these needs. 111

262 2 7 TEACHING IDEAS 141

First Aid and Safety

Mock Disaster: An Effective Lesson in Preparation for the Real Thing

Gary M. English and Cathie G. Stivers

The use of mock situations in first and (4) listing proper treatments for this session. Instead, students are ex- aid is not new, but effective uses of the injury described in the mock situa- pected to gather to work with other mocks are not easily found in the tion. The goal of this exercise is to members of their group in deciding literature. Through trial and error a' resolve the situation by correctly Hen- what their group's mock will be, mock exercise has been developed tifying these four criteria. gathering props, and working out the that serves as a learning tool and is axe the exercise is completed logistics needed to complete theas- evaluated easily. and class members have gained an un- signment: During this "open" class This exercise takes four class derstanding of what is to be expected period, the instructor should be avail- periods to complete. of them, students are divided into able to clarify any questions the stu- working groups to prepare for the dents may have. First Class Introduction major mock. Althougb is is not important that each group have an equal Third Class - Mock Disaster, Round number of students, it is imperative As an introduction to the upcom- that there is an even number of One ing major mock, a variety of "mini groups. Once groups are formed, the mock" situations are provided to en- major mock forms are distributed During this class period, groups courage students to begin thinking (see Figure 1), and group planning that were designated as victims during about staging a mock situation. A begins. At this time, group members the first class period will enact their series of 3x5 cards which identify are encouraged to share phone num- mock situations. Rescuers designated specific injuries, signs and/or bers so that members can contact at that same time will demonstrate symptoms of victims of accident or ill- each other to arrange additional their first aid skills by rescuing the vic- ness are distributed among class meetings outside class. tim group. members. Once cards are distributed, In concluding the first class individuals form informal groups of period of this exercise, the instructor three to four members and discuss Fourth Class - Mock Disaster, Round provides, via overhead projector and Two their mock situation in terms of (1) transparencies, an example of a com- identifying the situation, (2) listing pleted mock situation form for stu- props that could be used to enhance dents to view (see Figure 1i). When The format for this class period is the scenario, (3) listing signs and students see a completed form, many identical to that of the preceding symptoms associated with the injury questions are answered and much class. However, groups will change confusion is resolved. Finally, half the roles, allowing everyone the oppor- Gary M. English is a doctoral can- groups are designated as victims and tunity to perform as a victim andas a rescuer. didate and graduate tr -.thing assistant the other half as rescuers, for the third in the Department c;fealth "NW- class period. don, Physical Educe m and Leisure Role of the Victim Programs at the University of New Second Class - Group Planning Mexico, Albuquerque, NM 87131. The group's members selected to Cathie G. Myers is an assistant profe-- play the roles of victims must fill out sor in the Department at The University Because of the time involved in their mock forms completely. It is im- of New Mexico. developing the mock situation, the portant to stress to members of the class does not formally meet during victim group that theyare to 263 273 "1:4 _VV4. itA!

A ,q

Names:

Major Mock SituationVictim Report I. Uescribe the situation you -re going 'co display: A bus on its way to the airport has overturned. You are among the first people to arrive at the accident scene. After surveying the situation, you find that two passengers have been anjurvd. List the injury(s) of each individual and the signs or symptoms for those injuries. List the most severely injured individual first, followed by the next serious to the kast serious. Victim 1 1. Injury: Sio,ns and symptt.ins: Glass fragmems ill face. Bleeding around the face and head. 2. Injury: Signs and symptoms: Vehicles antenna penetrated the victim's cheek. Hieeding from the mouth, some teeth may be missing. 3. Injury: Signs and symptoms: Unsure?? Victim's pulse is weak and rapid, the skin is cold and clammy, and the victim appears to be pale.

Victim Z 1. Injury: Signs and symptoms: Fracture of the left forearm. The arm is deformed between the wrist and the elbow. 2. Injury: Signs and symptoms: Unsure?? There is no pulse at the radial artery. However, there is extreme pain when the hand is held or touched. 3. Injury: Signs and symptoms: Unsure?? The victim is complaining of pain in the area where his chest came into contact with the seat in front of him. II. What is the proper treatment for each victim? List treatments in the order in which they should be done. Assume that a good patient survey has been completed. Victim 1 Treat for shockmaintain the ABC's; keep body temperature stable; elevate the lower extremities; reassure the victim; find and treat the source of the shock. If there are teeth missing clear the mouth and femove any broken teeth. Remove the antenna if it is still impaled in the cheek, unless this is too difficult: then stabilize and bandage around the object. Hold a gauze pad inside the cheek as well as outside. Do not leave gauze inside the mouth unless you're holding it. Do not attempt to remove any large fragments of glass. Apply a sterile dressing to wounds and bandage. Do not apply pressure to wounds (doing so may cause further damage). Transport immediately; stabilize the victim; keep the victim on his or her back. Victim 2 While performing the secondary survey it was noticed that there was extreme pain when the left hand was touched. The pain was evident from the fingertips to the point of the suspected fracture. It was also noticed that there was no pulse at the radial artery. An occlusion should be suspected and corrected before splinting. The rescuer must move the arm to allow circulation to be restored to the hand before splinting. Immobilize the arm by splinting above ae.i tl.elow the suspected fracture sight. Once the arm has been immobilized, place it in a sling. Exam. le the chest area for deformities t! .e may indicate a fracture Look for the signs and symptoms of a flail chest place thevictim in ei lying or sitting position or wftitevi comfortable. III. Explain why you put the victims in the order that you did. From the signs and symptoms, it was apparent that victim 1 was going into shock. To prevent the shock from progressing, it was decided that this person would be treated first. Victim 2 was treated second. The problems with this indieidual became more serious as time passed. The fracterc was not a major concern; however, as time passed, the pain in the extremity became severe. The chest pains were attributed to the victim corning into contact with the front seat and did not appear to be very serious. IV. What props will you use, or how will the rescuers find the information they need to figure out what happened? Victim 1: Wire (for the antenna), broken glass around the accident sight, Chiclets (for the broken teeth). Victim 2: A short round board to portray the tracture sight; a chair to suggest the front seat.

264 27.1 demonstrate, or act out, the victim sessing their rescuers' performanef..), Proven Success and Popularity scenario whicl. they developed. All once the mock situation has con- members of the woup must be totally cluded. Criteria include questions The use of the mock situation in familial with their own simulated in- such as "Did the rescuer find all the final weeks of a semester of college- juries and treatment for those injuries, injuries without help?" "Were correct level first aid courses has proven to be as they will assist evaluating effec- treatments given to those injuries?" successful in assessing students' com- tiveness of treatments rendered by "Were treatments done in correct prehensive first aid knowledge and rescuers. order of priority?" "Did rescue team practical skills. An added feature of To assist the rescuer, the victim members work well together?" This this procedure is its popularity with may tell the rescuer of symptoms that assessment,alongwiththe students. can't be seen; however, the victim instructor's evaluation of how well Creativity elicited by this activity should only reveal the symptom when rescuers performed, determines a adds to the excitement. In one in- the rescuer assesses that particular grade for the affective learning com- stance, members of a group of Native body part. ponent of the mock situation. American Indians decided they would These two compol.ents comprise add to the confusion of the mock Role of the Rescuer the majority of the evaluation process. situation by speaking in their native A final component, then, is added to language in order to see how rescuers While victims prepare for mock the mock to assure that individuals would react. In another situation,a situations, rescuers should wait in a within the group contribute equally. victim group displayed a spelunking hallway or nearby classroom where Each individual is asked to list, cn a accident and required rescuers to they cannot see the victims in prepara- separate sheet of paper, members cf work in a darkened room under a long tion. Durhig the wait, the instructor his/her group and to relate whether low table. Other sit7,- tions have in- reads the situation from the victims' each member (1) contributed more cluded skiing or can.eing accidents, major mock form. It may be neces- than cther group members, (2) con motor vehicle accidents and gang sary, at this time, for the instructor to tributed equally to the group effort or fights. Possibilities are limited only by remind rescuers to think carefully (3) contributed less than other group student imagination. about the situation they are about to members. encounter. Rescuers may -,ed to be reminded especially that there may be situations in which the best thing to offer, in terms of aid to the victim, is reassurance. Appropriate examples include an epileptic coming out of a seizure, or an accident victim with a suspected fracture of the thoracic vertebrae. The rescuers may choose to work as a group or as individuals, but communication among rescue group members is encouraged strongly. The mock is completed only when all victims have been attended and their conditions stabilized.

Evaluation

There are several ways to evav....(te student performance during a mock situation. To assess cognitive aspeetL of first aid, the instructor must critically review each "treatment" section of the mock planning form. Since each victim identifies his/her lir ,lt.ment for each injury, the victim is in the best position to assess correctr,ess of treatments rendered by the rr-icuer. Because of this, victims are asked to complete an evaluation sheet as- 275 265 TEACHING IDEAS 142 =IMMEW First Aid and Safety The Importance of Child Safety Seat Education

Karen D. Li ller

with their younger children or are using safety seats improperly. Students can serve as role models for their family and friends and, eventually, role models for their own children and future generations. CSS education should include strategies shown effective through research and program implementation and evaluation. A C&S program should be comprehensive and address many reasons cited for low rates of compliance. An example of a two session high school CSS program follows. These sess:3n.s probably will take place over three or four class periods. However, instructors may shorten or lengthen the time and tailor the topics, depending on the particular setting and curriculum in use.

Student Participants

Injuries are the leading cause difficulties in use, confrontations with Male and female students of childhood death in the United States toddlers, inaccurate beliefs and assess- should be randomly assigned to each (Baker & Waller, 1989). Total motor ments of accident risks, and lack of role other to serve as a parenting unit. If there vehicle injuries are the leading cause a models contribute to parents' reluc- is an unequal number of males and fe- death of children between the ages of 0 tance in using CSSs. males, two females can be paired or two to 14 in every state (Baker & Waller, Because many of the parents males, because there are many single 1989). Based on these injury statistics, it of today's young parents did not use parents today who bring a friend or ac- is logical to assume that parents would CSSs, this behavior has not been rein- quaintance to parenting educationses- comply with safety seat laws by always force& Therefore, CSS education should sions. Also, if there is an unequal number using a child safety seat (CSS) for in- be available to parents and young adults. of students in the class, groups of threas fants and toddlers. Although all 50 states High school students enrolled in health, can be used. Groups of "parents" should have now enacted CSS laws, less :han 50 life management, parenting, and other sit together in a large circle. Topics for percent of three-year-old and four-year- related courses also should receive this teaching sessions are shown in the Ses- old children, respectively, were re- education. Although most of these stu- sion 1 and Session 2 boxes. strained, 411985 (Fo&s, 1989). Research- dents are not parents, they do partici- CSS education should be taking ers have suggested that CSS expense, pate in activities, such as baby- sitting place in schools and other locations such infants and toddlers, which often re- as prenatal and postnatal classes (Ker- quire students to be responsible for nish & London, 1986) and pediatricians' Karen D. Liller is an assistant professor and obstetricians' offices. Other health at the University of South Flwida Col- children in a motor vehiue. Also, parents of students may not L using CSSs settings such as pharmacies should have lege of Public Health, Tampa, FL 33612. 0.:S material available. Communityen- 266 27f; vironments such as daycares or pre- of CSSs. This is a life-saving skill that hasedy of childhood motor vehicle injuries and schools also should have information to a definite place in our clas.srooms.Thedeaths. With education, legislation, and im- share with parents. Materials for in- goal of CSS education is to make aproved CSS technology in place, schools and structors and community settings may significant impact on decline of the trag-communities can help make this a reality. include pamphlets, booklets, or videos available through local and state transportation safety groups, in addition to national sponsors such as the National Session 1 Highway Traffic Safety Admini. tration (NHTSA) or the Americau Academy The instructor will: of Pediatrics (AAP). This material may need to be revised so that it is targeted I. Discuss laws, penalties, and safety features of approved infant and toddler CSSs. (A for the audience, reflecting age, cul- convertible infant/toddler seat may be used.) tural diversity, and socioeconomic sta- 2. Discuss availability of seats at a reduced cost through loaner1.-ntal community tus. programs. Although CSS legislation has 3. Have available various models of child safety NM, with directions and names of vehicles been in effect for a decade, children in which they fit. These are available from manufacturers and loaner programs. Demon- continue to be injured and killed in strate proper use of an infant and toddler CSS with dolls. motor vehicle accidents. Strict proponents of passive restraints such as air 4. Allow each parent to properly place a doll in both the infant and toddler scats. If time permits, have each parent place the doll and CSS in the instructor's vehicle or other bass and automatic seat belts believe available vehicles. Each student must do this properly! that passive devices are the answer to occupant protection. However, even if 5. Have each parent group discuss difficulties of using a CSS. Have them work with their these restraints become standard in ev- partner/s to document questions or concerns that will be discussed at the next CSS session. ery motor .mhicle, parents still will need to be educa!ed about CSS use with these devices. -AMIMMIIIME.111=1:! Individuals must be active in their own safety. For parents and others who care for young children, this also includes becoming active in children's safety. Session 2 Parenting and related classes in schools provide excellent opportuni- The instructor will: ties for introducing and reinforcing use 1. Ha\ : each paup of parents read their questions and concerns to the rest of the class. The ir structor will answer the questions and conduct a brief discussion session.

Baker, S. P., & Waller, A. E. (I 989). 2. Re view importance of using CSSs for both infants and toddlers. Childhood injury-state-by state mortality facts. Baltimore:The Johns 3. Discuss and role-play parent/child interactions that will improve parental compliance. Hopkins Injury Prevention Center. The instructor will need iother teacher or student to assume the role of the toddler. Foss, R. D. (1989). Evaluation of a community-wide incentive program to 4. Recruit local patentswho consistently complywith child safety seat laws to join th These parents can be lccated through various injury or safety groups in the community Amer- promote safety restraint use. Allow these parents to respond to questions and concerns from the class. ican Journal of Public Health,79, 304-306. 5. Have the class view videos of parent "testimonials" on importance of using CSSs..This Kernish, R., & London, L. (1986).Strat- should not be used for "shock value" but should emphasize that the health of the infant egies to increase the use of child and toddler is dependent upon the parent, even when riding in a vehicle. safety seats-An assessment of current knowledge.(NHTSAReport No. 6. Have each class member write one or . wo paragraphs on benefits of CSS education and DOT HS 807 116). Washington, DC: how each class member will implement this behavior now (if possible) and in the future. National Highway of Traffic Safety Administration (NTIS No. DIN H22- Complete the session by providing each class member with a certificate for successful 82-A-07197, Task 4). completion of the CSS education program.

267 277 TEACHING IDEAS 143 HIV/AIDS AIDS "To Tell the Truth"Gaming Activity: A Teaching Method Jon W. Hisgen

The AIDS epidemic has created a T ree c mtestants are given a set of Questions public outcry for effective and creative answer. a wtek before the wtivity; they AIDS education at all grade levels. What review their narefully to learn accurate I. Why is AIDS such a great problem has come out is a plethora of lectures, pronunciauon of all words used. During in our world? discussion materials, and talking-head the interview, a group of five panelists 2. What is your opinion about self- audiovisual materials. The activity I have ask questions of any of the three con- ueating an illness that is supposedly developed asks students to look at the testants, for a two-minute period. After untreatable? billion dollar a year AIDS quackery the questioning, the rest of the class 3. Who is at high risk for AIDS? business. The students make use of the decides who the real doctor is and why. 4. What is ARC? technique from the old television game All three contestants provide some ac- 5. Where did you get your MD degree? show "To Tell the Truth" to discover curate AIDS information, but only one 6. If I wanted AIDS information from who are the charlatans and who is the will answer every question correctly. A someone other than a doctor to whom reliable doctor. AIDS charlatans are very discussion of each contestant's answers, should I turn? knowledgeable so some of the answers beliefs, and philosophy should follow 7. What is the most dangerous AIDS presented by each participant are accu- the identification of the real doctor. treatment on the market today? rate; students must sort out the false The mtivity begins with the intro- 8. What is AZT? statements from the correct and appro- duction of the three contestants. When 9. Since the AIDS virus attacks the priate re gponses. asked by the announcer to "state your immune system what type of AIDS '1">)e following are the objectives of name and occupation," Contestants #1, products do you think people are likely this teaching method. The student will: #2, and #3 all respond: "My name is Dr. to sell to the unknowing AIDS patient? (Jane, James) Bluemner and I am a 10. What is the greatest problem 1. Differentiate between accurate specialist working on treatments for teachers face educating about AIDS? and inaccurate AIDS information. AIDS patients." 11. What is an AIDS guerrilla clinic? 2. List the qualities of a health The announcer then states: "Pond 12. What is L-721 and do you think it charlatan. exposing genitals to the sun at should be legalized? 3. Analyze AIDS information sc 4:00 o'clock, cell injunctions these 13. Do you believe in AIDS testimo- to determine the accurate medical spe- arc some of the treatments offered for nials? cialist. AIDS, a disease ripe for questionable 14. What can Americans do to fight 4. Identify questionable practices. cures. Dr. Bluemner has been a physi- AIDS quackery? cian specializing in the study of the HIV 15. Why does quackery thrive so much The activity involves interviews of virus for the past five years. The doctor in our society? three contestants, all claiming to be a has researched retroviruses at the Center 16. What is DNCB and why do AIDS reliable AIDS specialist. Only one of for Disease Control since 1985 and is patients use it? them answers all questions accurately. presently studying drugs that might 17. Is DNCB legal? If so, why? The other two can respond with either prevent these viruses from entering the 13. What do you think should be done correct or incorrect information. host nucleus. Dr. Bluemnerrecently won by people in a place where they are in the American Meal Association re- contact with a known AIDS patient? search scholar:m:1rd. We will begin the 19. How is AIDS transmitted? questioning wit!I panelist #1." 20. Huw could a person reduce his/ Jon Hisgen is health coordinator for The panel sts, in turn, read the fol- her risk of exposure to the AIDS virus? the Pewaukee Public Schools, Pewaukee , lowing 21 questions, asking any of the 21. If you knew someone in your WI 53072. three contestants they chose. family with AIDS what would you do?

268 "I 3 Answers for Contestant #1 type of opportunistic, rare cancer that 11. Clinics that sell bogus health affects AIDS patients. treatments. I. Acquired immune deficiency syn- 17. It is a chemical used by photogra- 12. A drug that can be made from drome is a worldwide concern because phers in processing film. health food store ingredients. Further so many people are ignorant about the 18. Realize that if you do not engage research needs to be done before legal- disease. in high-risk behaviors like anal, homo- ization. 2. Self-treatment plays right into the sexual sex or sharing needles with this 13. I support solid research like Dr. hands of the money hungry charlatan. person you decrease your chance of Levy's that has shown many men became That is what they want. having the infected person's blood or stronger after following a macrobiotic 3. Men who have had anal sex with body fluids enter your body. lifestyle. other men since 1977 and people who 19. Mixing of blood or blood prod- 14. Become educated as to the styles share drug paraphernalia, specifically ucts with an infected person's blood or and techniques of the quack in our so- needles, are examples of persons ex- body fluids. ciety. Be skeptical! hibiting high risk behaviors. 20. Abstinence, having only one sex 15. The government needs to make 4. AIDS related complex (ARC) is a partner, and use of condoms will defi- laws that will scare these charlatans off. pre-AIDS condition with such symptoms nitely lower AIDS risks. 16. A drug that has FDA approval for as severe weight loss. 21. Show him/her the love and con- warts. 5. I received my degree from Loma cern I felt for him/her before hashe 17. Yes, but for warts, not AIDS. Linda Medical School in San Diego, contracted the disease. 18. Let doctors try promising new California. drugs with sound dietary practices on 6. The Public Health Service and the these people without FDA intervention. Center for Disease Control have some Answers for Contestant n 19. Sex, transfusions, and crossing up-to-date materials. placental barriers to unborn children. 7. An $800 treatment for pills con- 1. There is no ultimate AIDS cure in 20. Develop a respon sible macrobiotic taining mice immune system substances the foreseeable future. lifestyle of diet, meditation, no intrave- after being given the AIDS virus. Instant 2. Certain macrobiotic lifestyles like nous drug use, and safe sex with death! meditation and whole grain and veg- condoms. 8. A drug that has been shown to stop etable diets are the only successful 21. Get him/her to macrobiotic AIDS symptoms in some patients. treatments that can be selfftaught. counseling. 9. Most of these treatments promise 3. Anyone who gets the AIDS virus to strengthen immunity. in their blood or body fluids. 10. Developing guidelines for teach- 4. It is a pre-AIDS condition with Answers for Contestant #3 ing about the disease within the values diarrhea, extreme weight loss, and de- and concerns of every student's family. pressed immunity. 1. Acquired immune deficiency syn- 11. A place where questionable AIDS 5. I received my MD degree at the dromeis a major problem because people treatments are sold or practiced. University of California and my nutri- are panic stricken whenever anyone says 12. It is a product made of a fat called tionaconsultant's degree from the the word. We need to educate! lecithin that was purported to hinder the Wholistic Health Clinic in Sacramento. 2. I think most people cannot self- AIDS virus from attacking healthy cells. 6. The HEAL group presents sound treat and must be guided by competent, I think it should be approved for experi- AIDS information. trained physicians. mental use by willing patients. 7. Mail order bottles of T-cells to 3. Gays, needle sharers, prostitutes, 13. Only if the testimonials say the replace AIDS ravaged T-cells is an ab- hemophiliacs, and infants of infected disease is a killer. solutely absurd treatment. mothers. 14. Become knowledgeable of thc at- 8. A drug shown to lessen AIDS 4. The beginning stages of the infec- risk behaviors and the seriousness of the symptoms. tion. infection once cont-acted. 9. They should buy Dr. Revici' s herbal 5. The State University of New York 15. People will grab at aR:). iin remedy but they end up purchasing blood at Stony Brook with postgraduate work when their life is at stake. The, t.hey serum contaminated with hepatitis B in the Bahamian AIDS research institute. Lve nothing to lose. awl AIDS. How utterly stupid! 6. New York's HEAL group has many 16. A chemical that diminishes the 10. Farents unwilling to allow sound educational materials and many new purplish lesions of Kaposi's sarcoma, a health information for their kids. treatments.

269 279 7. $10,000 treatment of thymus gland 15. Because quacks are looking for a extract that is available in France. The first contestant is the person who quick buck and people are al ways looking gave all correct responses. Contestant 8. A quack product that claims to for a quick cure. alleviate AIDS symptoms. #2 discussed health and nutritional 16. A drug that has been shown to treatments that, though they were harm- 9.1 believe my life extension prod- help with Kaposi's sarcoma, an oppor- ucts like BHT are the only effective less, involved claims that were loaded tunistic cancer with purple splotches. with half truths and outright false state- AIDS treatment on the market. 17. Yes, it is available in clinics like 10. Our teachers' lack of knowledge ments; one should encourage an AIDS mine throughout the country. patient to consume a sound, balanced of the most successful I IDS treatments. 18. Show care for the AIDS patient so diet but not the one promoted Ly 11. ME :,es that are forced to sell sound he/she will feel better and live longer. macrobiologists. Contestant #3 ex- tatments because the FDA has harassed 19. Anal intercourse, blood transfu- changed many false and dangerous at into hiding. sions of infected blood, mixing of body 12. An effective AIDS drug that U.S. treatments and iaeas with his/her pa- fluidsharing of needles, and sex with tients. ai;.1 Israeli rsearchers have found sue- pi t...titutes. -:sful in preventing AIDS. This approach could be used for 20. Injections of bee pollen, garlic, or other areas of health education. Ques- 13. If a person has been told he will blue-green algae beefs up the immune dL the,' I believe in personal accounts. tions and answers are prepared by the system. teacher, but, depending on the interest 4. We must realize that our medical 21. Have him/her become a part of 'em has so little to offer that alter- and capabilities of the students, could be my life extension program. \vritten by the.. students themselves. ,les must be explored.

270 TEACHING IDEAS 144 HIVIAIDS AIDS/HIV Teaching Ideas Barbai a Beier, J. Leslie Oganowski, Richard A. Detert, and Kenneth Becker

AIDS/HIV education is essential for the understanding and pre' ention of the disease. AIDS/HIV is a complex issue and thus demands a multifaceted approach. The condition may be viewed as a disease issue, a decision-making issue, T-cells white HIV a sexuality issue, and a death and dying blood cells cells issue. A series of four teaching ideas are Necessary Materials: the skin remains uninjured,it holds presented as they address each of the 1 lunch size paper bag for each what's inside the body in and keeps the AIDS/HIV issues. The teaching tech- student rest safely out. niqtrs are as follows: 2 lunch size bags for teacher dem- b. Reveal a break in the skin by tear- onstration ing part of one bag. Have students name 1. "Understanding AIDS/H1V" markers or crayons ways a break could occur (cuts, scratc hes, a disease issue prepared envelope for each student burns, scrapes, br)ken bones, surgery, 2. "Who Do You Trust?" a deci- intravenous drugs, ear piercing, tattoos, sion-making issue Activity: punctures). 3. "A Safer Sex Continuum" a 1. Instruct the students to color or c. Toss some objects into the bags sexuality issue decorate their bag to represent the skin. representing foreign bacteria, viruses, 4. "The Living Years" a death 2. Review the steps that take place or germs. Explain that our blood con- and dying issue when a germ enters the bod hv having tains white blood cells that fight germs. each student put parts of the blood (from One kind of white blood cell (mac- ACTIVITY #1: their envelope) in the bag. The teacher rophage) moves through the blood and "UNDERSTANDING AIDS/HIV" demonstrates by placing in the bag each tissues to surround and "eat" germs. Obiective: After the bag demonstration, !ype and explaining the action; i.e., Toss some macrophage cells into the the student will be able to describe how white blood cells rust, to the place where bag. I-HV breaks down the immune system to germs enter and attach to the germ to d. T-cells are another type of white allow the development of AIDS. make it less dangerous to the persm. blood cell that help fight germs. T-cells 3. Introduce the functions of the im- attack and des:-..oy viruses. Add T-cells Preparation: Prepare envelopes for each mune system. A healthy immune syszmi to the. bag. Stress that some T-cells serve student with the following shapes repre- works to destroy nearly all types of as "command cen ters" for the body's senting parts of the blood involved i n the germs, including many bacteria and vi- battle against germs. immune system. Place the Illy in only ruses. e. Another kind of white blood cell is three of the envelopes. 4. Writeimmun( )n the board. Have called a B-cell. Add the B-cells to the a student tell what is meant when some- bag. B-cells produce chemicals called one says he/she is "immune" to some- antibodies. Explain that antibodies can thing (protected/safe). destroy viruses and other germs. 5. Conduct the following demonstra- f. Explain that some antibodies, even Barbara Beier, J. Leslie Oganowski, tion of the activities of the immune sys- after destroying some germs, stay in the Richard A. Detert, and Kenneth Becker tem in fighting germs. body to protect in case there is another are members of the faculty at the Uni- a. Hold two bags to represent the skin exposure to the same type &germ. Thai versity of Wisconsin-LaCrosse. as a barrier to keep germs out. As long as is immunity.

271 281 g. Ask students "What hr pens when Necessary Materials.. the rest of the class by asking whether a the 'command center' in a real battle is 4 large brown paper bags num- consequence of reaching into one of the destroyed?" Conclude that when germs bered I to 4 bags could result in a) pain, b) broken attack the white blood cells (T-cells) 2 mouse traps fmgers, or c) the presence of blood? that control the body's immune system, 1 large rat trap Then ask again who might be willing to they can cripple the body's ability to 2 blocks of wood take the risk. fight off infection and diserse. table 7. Teacher places remaining risk h. Ask who has an "H" in his/her takers in the front of the room and asks envelope. Toss the "H" into the bag. Activity: them one more time if they are willing to This represents an HIV condition. AIDS I. Ask for three volunteers to come take the risk. If yes, mN tV bags up and is caused by a virus called HIV (human forward who are willing to take a risk. ask the risk takers to turn around. By immunodeficiency virus). HIV destroys Describe the risk as selecting one of the now, most risk takers have quit! the "command centers" 'T-cells) of the paper bags. Volunteers will be asked to 8. Of course, the teacher stops the immune system and the body cannot blindly reach to the bottom of the bag activity at this point as students could fight off certain infections. and grab whatever is in ;.t. If it is the get injured if they actually reached into i. The person with HIV does net block of wood like the one on the corner bag #3. The bag contents are now re- usually of HIV infection directly of the t3ble, they will receive a desig- vealej. the person with AIDS usually dies from nated amount of money. 9. Follow-up discussion: otherdiseases that the body can no longer 2. Ask for three volunteers who will a. Ask the risk takers to tell the group fight off. assist the risk takers in their adventure. what their assistant whispered in their Instruct these volunteers to move to the ear. Time Frame: The bag activity itself can other side of the room. b. Did all the assistants see the same be completed in a 30-40 minute class 3. One at a time, ask each of the three contents? period. The preparatury information assistants to open each of the bags and c. Discuss how the risk takers thought could take one class prior to the activity. look at the conteats. Ask them to be they could "beat the odds." Questions about symptoms of HIV, expressionless as they view each of the d. Discuss comments that encour- children with HIV, and feelings associ- bags. Then ask each of the assistants if aged/discourage.; each from stopping or ated with having an "H" in his/her bag there is a block of wood in at least one of continuing with the activity. could take varying amoun.s of time. the bags. Once verifieask (one at a e. Finally, discuss what risks each are Do discuss witN the ciasz the chances time) if he/she would be willing to take willing to take; which would not be safe of "having an HIV in his/her bag" and the risk of reaching blindly into one of risks; what risks are invelved with AIDS/ the risks of infection. Include a discus- the bags. Some will say no; some, yes. HIV conditions. sion of caring for the feelings of people 4. Ask each assistant to meet a risk who are infected. taker and quietly whisper in his/her ear Time Frame: This activi,y takes between what was seen in the bags. Then instruct 20-40 minutes to complete. The time the risk taker to whisper the same mes- frame may vary depending on grae?, ACTIVITY #2: sage to one other person in the room. level and the number of comments made "WHO DO YOU TRUST?" Once all three have additional informa- or points raised during the discussion. tion about the contents, ask each of the Objective: At the completion this risk takers if he/she is still willing to take activity, students will be able to discuss the risk. Those who say "no" can Iv ACTIVITY #3: the benefits and consequences of tak ig seated; those who are still willing to "A SAFER SEX CONTINUUM" risks. continue remain standing. 5. Provide some more information to Objective: At the completion of this Preparation: Before students eater the the risk takers (and the rest of the class) activity the student will be able to iden- room, the teacher places objects inside by revealing the contents of bag #1. tify means of transmission of AIDS/ each of four large brown paper bags: Then reveal the contents of bag #2 by HIV on a safer to unsafe continuum. (bag #1. one mouse trap that is not set; unsetting the mouse trap withfolded bag #2 = one small mouse trap that is set; piece of paper. Ask again which risk Prepiration: When discussing the issue bag #3 = one large rat trap that is set; bag takers would still be willing to blindly of AIDS in the classroom, one way to #4 = one block of wood). reach into one of the two remaining introduce safe and unsafe sexual prac- There is one block of wood on the bags. tices is by using the "Safer Sex Con- corner of the table. 6. Ask the assistants to provide a bit tinuum. This activity would be pa.t of more information to the risk takers and a larger unit on sexuality or sexually 272 252 transmitted diseases (STDs) and would ACTIVITY #4: Stilted conversations be utilized once the students had devel- "THE LIVING YEARS" I'm afraid that's all we've got. oped a degree of comfort in discussing sexual topics. Objective: At the completion of this You say you just don't see it activity, the student will be able to ver- He says it's perfect sense Matedials Necrasaa: balize his/her reactions to AIDS as a You just can't get agreement chalkboard and chalk death and dying issue. In this present tense (or newsprint and marking pens) We all talk a different language Erfrvalign: One effective way we found Talking in defense. Activity: to address AIDS as a death and dying 1. Introduce the topic by having stu- issue was to play a song that many Say it loud, say it clear dents consider the methods of transmis- students may have heard on popular hit You can listen as well as you hear sion of the HIV virus and sexual prac- radio stations. "The Living Years," re- It's too late when we die tices. Place the continuum shown at the corded by Mike and the Mechanics, was To admit we don't see eye to eye. bottom of the page on the chalkboard. played and students were encouraged to 2. At this point, ask the students to follow along with the printed words. So we open up in quarrel "place" a sexual activity on this con- Introductory statements may include: Between the present and the past tinuum on the appropriate position so as "Think about the words and what they We only sacrifice the future to indicate the "safeness" or "riskiness" say about death and dying," or, "As you It's the bitterness that lasts. of t11.3 behavior. As each behavior or listen to the words of this song, think sexual activity is suggested, the ele- about your thoughts on death, dying, So don't yield to the fortunes ments inwilved in ranking that behavior and AIDS." You sometimes see as fate in that pos *ion should also be disc ussed. It may have a new perspective This method involves the students in Materials Necessary: On a different day analyzing each sexual activity based tape: "The Living Years," by Mike And if you don't give up, upon their knowledge of the transmis- and the Mechanics And don't give in sion of the HIV virus. It is also a method printed words to the song You may just be OK. that could be useful in introducing sen- tape player sitive topics such as masturbation, Say it loud, say it clear condom use, and anal intercourse. You can listen as well as you hear 3. Clarification of certain activities is The Living Years It's too late when we die a productive outcome of this activity if To admit we don't see eye to eye. students are allowed to engage in open Every generation discussion and ask questions. For in- Blames the one before I wasn't there that morning stance, one popular misconception dis- And all of their frustrations When my father passed away covered with this approach was that Come beating in your door. I did't get to tell him some students considered a sexual mo- All the things I had to say, nogamous relationship to mean having I know that I'm a prisoner I think I caught his spirit sex with "one person at a time. To all my father held so dear Later that same year I know that I'm a hostage I'm sure I heard his echo Time Frame: This activity takes be- To all his hopes and fears In my baby's new born tears tween 30 and 50 minutes to complete I just wish I could have told him I just wish I could have told him depending upon 1) the level of knowl- In the living years. In the living years. edge of the students, 2) the degree of comfort with discussing sexual topics, Crumpled bits of paper "The Living Years," Mike and the Mechan- and 3) the amount of discussion time Filled with imperfect thought ics (1988), Atlantic Record Corporation, 75 allowed. Rockefeller Plaza, New York, NY 10019.

283 273 TEACHING IDEAS 145 Mental and Emotional Health Stress Manifestations Among Adolescents: Actions, Situations, and Body Responses

Chai les Regin

Grade Level: 7 - 12 lems." This activity is designed to ad- in the head or stomach areas because dress such issues. Specifically, the ob- they get headaches or upset stomachE If Time Frame: 50 minutes jectives of the activity are to: appropriate, this can be shown using an overhead projector and a transparency Materials: Gumby handouts, blank 1. Describe how the stress response of Gumby. Gumby transparency, overhead projec- can affect a person 's physical well-being. The second step is designed to help tor, transparency marker. Note: any ap- 2. Demonstrate both similarities and students identify current and past sources propriate, genderless figure can be sub- differences in ways adolescents handle/ of stress. Tell the students that stress is stituted for the Gumby figure illustrated. mishandle stress. both positive (eustress) and negative 3. Provide a supportive forum for a (distress). The line down the middle of Background Informatin The im- discussion regarding common ways the handout separates positive and nega- pact of stress and stress related diseases adolescents respond to stressful situa- tive stressors. Direct the class to fill in is a major concern in American society. tions. the circles with terms that represent cur- Either the mismanagement of stress or 4. Identify and describe how adoles- rent distressful and eustressful sources the use of maladaptive coping strategies cents can reveal distress and eustress in their lives. Examples might include among adolescents plays a significant sources in their 'Ives. math class at school, a brother, or for role in the major health problem areas older students, their boss at work. (En- identified in the Surgeon General's re- The teacher will need enough courage them to be specific rather than port on health promotion and disease "Gumby" handouts (sec next page) so writing general terms such as school, prevention. These problem areas include there is one for each student. In addition, home, or work.) Also mention that some teen pregnancy, sexually transmitted the insuuctor will need enough Gumby stressors can be placed on both sides of diseases, mental illness, suicide, and handouts reprc heed on a second color the line. The horizontal line near the homicide. so that there is one for each small group bottom of the handout separates current into which the class will be divided. from past stressors. Direct the students Preparation to reflect upon former stressors that they Implementation have "set aside" or have dealt with and In the first rew classes of a stress label the circles below the line with management unit, it is important to es- Distribute a copy of Gumby to each those past situations or people. tablish similarities/common stress student. Explain that the figure is a The third step is designed to help sources among students. This "we all representation of themselves and that students identify how they behave when have stress in our lives" sensitization they will use it to explore how stress they have or have had too much stress in allows for greater feelings of openness affects their lives in both a positive and their lives. Direct the students to write and a possible reduction of the feeling of negative manner. descriptions between the present stres- "I am the only one who has these prob- The first step is designed to help sors stating how they behave in both students identify how stress affects the negative and positive stressful times. body. Direct the class to shade in the Positive behavior examples include areas of Gumby that represent the parts singing, exercising, or feeling happy Charles Regin is an assistant profes- of their bodies that are affected by too and smil ing. Negative behavior examples sor of health eduction in the School of such stress. For example, some students include yelling, picking on people,or I lealth, Physical Education, and Recre- will shade in the hands because. their overeating. lit the arca of past stressors, ation at the University of Nevada, Las hands get cold when they experience too ask students to identify the behavior that Vegas, NV 89154. much stress. Other students will shade helped them deal with the stressor. Ex

274 S amples include talking with a friend or family member or seeing a counselor at sc hool. At the conclusion of this three-step process, form small groups of three to five students. Distribute the second Gumby handout and direct the students to fill out a composite that represents the group's eustress and distress situations. The teacher can conclude the activity with these small group discussions or can have one pei son from each group describe their Gumby composite.

Variations

There is a great deal of flexibility in this activity. Depending upon the age, readiness, and educational needs of the 0 students, one, two, or all three steps can be completed. The number of examples can be varied at the beginning of each step, to help students fill in the circles or spaces between the circles. It is also possible to use the Gumby figure so that the circles and spaces WSNTAT between focus on specific health education topics, such as smoking, teen preg- Phs-r nancy, or AIDS. The activity can easily be integrated into other classes that deal with these areas. This is accomplished by first describing a specific controversial situation (e.g., a teen pregnancy). The students then fill in the circles with positive and negative behaviors (e.g., 0 tell parents, don't tell anyone) and the spaces in between with anticipated reac- 0 tions by others (e.g., anger, fear, support). Drawing shown smaller than it should be for actual use by students.

Note: This activity is adapted from N.L. Tubesing and D.A. Tubesing, 5truc_tured Exercises in Stress Management (Duluth: Whole Person Press, 1983), pp. 21-27.

285 TEACHING IDEAS 146 Mental and Emotional Health An Introductory Activity for Adoiescent Communication and Intimacy

G. Greg Wojtowicz

The purpose of this student activity (Steinberg, 1985). In addition, the focus macy, communication skills, and is fourfold: 1) to provide students an of psychosocial development shifts from knowledge of behavioral scripts in order opportunity to use intimacy as an effec- same sex groupings to opposite sex in- to: tive communication tool, 2) to familiar- teractions. This process supports the 1) identify five components of a be- ize students with the concept of "behav effective translation of real values into havioral script, ioral scripts," 3) to aid student transi- decision making skills and real behav- 2) identify three issues related to tions into opposite sex age groupings, iors into problem solving techniques. adolescent development, and 4) to use the concept of "scripting" This exercise in communication allows 3) list two characteristics they appre- as a classroom management technique the student to practice intimacy skills in ciate in other people, and in order to structure effective student a controlled environment. 4) begin to appreciate the unique el- groupings. This learning experience de- ements of other personalities. velops an awareness of individual be- Behavioral Scripts havior characteristics and supports the Methods development of communication skills "Behioral scripts prescribe as they relate to intimacy, interpersonal standard ways of behaving in given The activity begins with a discus- behavior, and social cognition. settings" (Jones, Shainberg, & Byer, sion of important issues related to ado- 1985). These predetermined, uncon- lescent social development, communi- Adolescence and Intimacy scious ways of thinking and acting de- cation, and behavioral scripts. Impor- termine the who, what, why, when, and tant terms such as autonomy, intimacy, The ritualistic behaviors learned where of any specific behavior. Script- and identity should be defined and dis- during childhood are given practical ing helps to integrate personality. Fail- cussed. A numbered "behavioral script" meaning during adolescence. Adolescent ure to do so results in esteem fragmen- activity sheet (Figure 1) is used to allow developmental issues such as autonomy, tation (Jones et al., 1985). This activity students to identify components of their intimac y, and identity are critical as they allows students to identify the varied own behavioral script. Each activity sheet relate to behavior. Schools serto in- components of their scripts and gives is identified by a number that corresponds stitutionalize peer relationships, thus them an opportunity to match their script with the numbers next to student names teaching the adolescent how these is- with peers who have similar interests. on the class attendance list. Students ar..1 sues are linked to emotions. The adoles- The technique can be adapted to fit told to put their number on their sheet cent who establishes intimate relations any classroom time frame at the junior and also write that number on a foam with peers is challenged to socialize and and senior high school level. In addition, cup provided by the teacher. Students communicate in both ideal and practical the activity can be effectively used to place the cups on a desk or chalk tray in terms. Consequently, "peers play an solve problems associated with the numerical order and then are given suf- extremely important role n socializing structuring of student groups. It requires ficient time to complete the questions on adolescents into roles of adulthood" students to use those communication their activity sheet. skills essential to functioning as an ef- When they have finished, scripts fective member of an activity group. should be posted throughout the entire G. Greg Wojtowicz is an assistant room, avoiding crowding in any one professor of health education in the De- Objectives arca. Students then circulate around the partmelof Health Education and room and read each script. When they Physical Education, University of Ala- This technique is designed to finish, they are instructed to c hoose three bama at Birmingham, Birmingham, AL achieve the following four behavioral to five scripts thai matched their inter- 35294. objectives: The student will use inti- ests by copying the numbers found on 276 2c E. those sheets. Thereafter, students place aslip ofpaper that bears their own number in the cups that correspond with thcir choices. YOUR BEHAVIORAL SCRIPT The teacher should participate in the activity along with the students. Before the students are allowed to col- Sharing information about your script can be a rewarding way to meet lect the slips in their cup, the teacher people and develop new friendships. Complete the following survey by should check each container and place a placing information related to you and your script in the spaces provided. slip in each empty cup. In this way, each Thereafter, the scripts will be posted and you will be given an opportunity student will be chosen at least once and to meet those individuals who matched your script. Do not put your name will become part of at least one group. on this sheet! When all are fininshed, students collect their containers and record the numbers found on the slips. They now My favoritecolor food have the numbers of the students who chose them and the numbers of the scripts sport music group they have chosen. The teacher then reads the names and numbers on the attendance video TV program sheet, so that the students can match names to numbers and generate a list of My height is feet inches individuals they will meet. Students are instructed to move I am left/right handed about the room in order to meet each person on their list. A time limit should Clothes I like to wear be placed on this in order to leave sufficient time for a summary of the activity. Students are told to ask peers for specific information as to why they were chosen and to record the appropriate What I like to do on weekends information on their activity sheet. Be- fore the end of the period, the teacher can summarize the activity by leading an open discussion about the experience. Teachers may choose to record the components of different scripts on the board. My hobbies are The next class begins with grouping the students according to individual choice. All matches (students choosing each other) can become part of a group. Depending on the size of the class, this activity usually generates two to three # large gioups, a number of smaller groups, and a number of couples. The teacher should divide these groups into smaller units using student input to maintain as many matches as possible. This class period can be used to identify unique personal characteristics of individual students, interests of

287 277 groups, and hobbies Ihpred by the entire Conclusion school students are more comfortable class. and more effective when allowed to The groups formed can be used to: This activity provides students with participate in same sex groupings. How- 1) support development of social the opportunity to develop communica ever, repeated use of this activity can aid skills within opposite sex groups, Lion skills essential to social cognition the transitir_%n into opposite sex group- 2) facilitate student interactions in- and psychosocial development. Adoles- ings. Studt'nts who lack proactive social volving decision making and problem cents who experience success in class- skills tend to somewaat 7..4rded at solving, room activities and develop effective the beginning of the activity. However, 3) structure role playing activities, socialization techniques may develop after they warm to the task, they tend to and positive skills that will carry over into approach me experience with enthusi- 4) group students in order to develop adulthood In addition, teachers can use asm. classroom simulation games. this technique to structure effective ac- References Groupings consisting of matches tivity groups. Ford, M. (1982). Social cognition and social made by the students can improve the This scripting methodology is suc- competence in adolescent developmental effectiveness of group work by im- cessful for two reasons: 1) students are psychology.Developmental psychology, 18, proving attention span, increasing mo- motivated to work together because they 323-340. tivation, and augmenting student inter- like one another and 2) task outcomes Jones, K.L, Shainberg, L.W., & Byer, CO. actions. are easier to achieve because students (1985).Dimensions ofhuman sexuality. Materials needed for this activity exercise an autonomy or ownership of Dubuque, IA: Wm. C. Brown Publishers. are as follows: behavioral script activity the experience after they choose mem- College Division. sheets, a master sheet identifying each bers of the gioup. Katchaciourian, H.H. (1989). Fundameruals student, foam cups, small slips of paper, This technique is most effective at of human sexuality (5th ed.). Orlando, FL: tape for posting the sheets, and an activ- the high school level (especially grades Dryden Press, Holt, Reinhart & Winston, ity content outline used to record infor- 11 and 12) because opposite sex rela- Inc., p. 268. mation associat ;d with intimacy, tionships become the primary focus of Steinberg, L. (1985). scripting, and communication skills. psychosocial development. Junior high Adolescence. New York: Alfred A. Knopf, Inc.

278 25S TEACHING IDEAS 147 11111111. Mental and Emotional Health SHOW AND TELL Developing an Appreciation of Diversity

Kathryn Katzman Rolland

This two-part lesson provides a ve- Objectives process, especially such aspects of the hicle for high school and college level exercise that related to how difficult it students to examine the range of common Realizing that the class would en- was to select something, v.:fat thoughts needs and desires they share in terms of compass subject matter that is contro- helped them to make the final decision, human fulfillment. In addition, the ex- versial, emotional, and even frightening, and what single feelirgiemotion their ercise works well as a trust-building I dec ided to begin with an exploration of special "thing" elicitel. These notes experience. a more "neutral" conceptthe con- would serve as personal reference mate- tinuum of human values. (Obviously, rial dining the next meeting of the class. Introducfion these are the same values that transcend (How does it make you feel? What is it and impact upon our attitudes toward that you respond to? Did you have a College students, majoring in AIDS and people with AIDS.) I have difficult time making a decision? are education, gathered for the first class in found that discovering similarities fa- helpful guidelines.) Students were in- a course that would deal with incorpo- cilitates a more honest and sensitive structed not to discuss the assignment rating materials about AIDS/HIV in the exploration of di ffet ences at a later time. with any other class members until the elementary and secondary school cur- My objective was to provide a forum class met aroin. riculum. Like the students in the urban where students could experience the center in which most of them will similarities of their human needs in a Lesson Two: As I entered the class- eventually teach, the class encompassed way that was at once personal and yet room the following week, the anticipa- a wide range of diversity. They were offered adequate room for privacy, if tion and excitement were apparent. male and female, ranging in age from 20 needed. Students were talking animatedly with through 50, African-American, Euro- each other and their enthusiasm was pean-American, and Latino, straight and Procedure infectious. I began the class by telling gay, single, married, divorced and cur- them that I would go first and that each and y cohabiting, returning students, one Because a homework assignment person would go as he or she was ready. pregnant female, single parentsand is an integral part of the lesson, a pre- I would not call on them but everyone from a variety of economic strata. liminary explanation of the teacher's was expected to participate before the At the first class meeting, they eyed expectations is required as part of a end of class. In this way, they could me and each other somewhat warily. previous lesson. attend to each individual report instead Their concern, though unspoken, was of thinking, "three more people and it's palpable. Would they be comfortable in Lesson One: As an assignment for my turn to go." A recorder kept track of this class? Would they feel out of place? the following class, each student was key phrases as the discussion progressed. Would they have anything to contribute? instructed to "bring to class something As educators, and particularly as health that has a special meaning for youthat Thne Frame educators, we know these concerns well. makes you feel good." The only caveat was that living things had to be repre- The class required 60 minutes for all 20 sented by photographs or drawings. students to complete their reports, but I Kathryn Katzman Rolland is afaculty Realizing that I was asking students to have subsequently conducted the class merher in the Department of Health reveal a portion of themselves to "al- in less time. It is important for students and Physical Education,11 timer College most strangers," I included myself in the to know how long they will have to of the City University of New York, New activity. Students were instructed to discuss their "show and tell" when the York City. record their informal thoughts on the Continued on page 281 279 28, TEACHING IDEAS 148

Mental and Emotional Health Teaching Self-Awareness Through Idiosyncrasies Patrick K. Tow, Beverly Johnsonand Patricia N. Smith

Pet peeves, annoying habits, or of an underlying problemcan only family squabbles started. Married eccentricities, whatever theymay be compound the gravity of a conflict and students, in particular, called, are behavioral idiosyncrasies are able to make it more difficult to resolve. The compose a list of chronic irritations which everyone exhibits tosome de- degree to which someone finds certain displayed by spouses. Students, who gree. These peculiarities develop over behaviors offensive varies according are also parents, will certainly have a time as a result of convenience, lazi- to one's relationship to the offending list of pet peeves about their children. ness, or ignorance; however, most of party. Pet peeves tr I to be exagger- In short, every stuck at will find us are more aware of others' idiosyn- some ated when a person who is trustedor personal relevance in this lesson. cratic behavior than of our own. Self- loved fails to line up to one'sexpecta- awareness is an elusive quality. tions.Nevertheless, a tendency to- Classroom Procedure By itself, a behavioral idiosyncrasy ward idealization and infatuation might not be considereda problem of should be tempered with a healthy Ideally, students should be askedto great magnitude. At best, it may bea dose of reality. Peopleare not gener- minor annoyance in an otherwise ideal compile anonymously a personal list ally aware of theirown idiosyncrasies, of pet peeves or annoying behaviors character whose presence is appreci- however obvious thesemay be to oth- they note in others, allowing students ated and enjoyed. At worst, it may be ers. ;-chavioral habits may become an considerer4 an extreme annoyance freely to express personal thoughts unconscious part of one's everyday witl.aut fear of socia! reprisal requiring remediation. Whetherma- or a repertoire. Thus, overallawareness of violation of persond privacy. After jor or minor, an annoying habitserves idiosyncrasies could bring a refreshing collecting thelists,the instructor as a source of chronic irritation in a enlightenment to relationships. relationship. should cite items from the lists openly to the class. The students should pub- Educational Merits of Strategy Background licly vote on each petpeeve in the following manner: a raised fist with This t.:aching strategy has real thc thumb up means that the habit is When people fail to recognize and world application that may be rooted perfectly tolerable by the voter'sstan- put idiosyncrasies into proper per- in a lesson plan dealing with family spective, continued growth and devel- dard; a thumbs down vote reflectsan living or mental health. Thestrategy intolerance for the habit. At the opment of interpesonal relationships serves as a suitable vehicle to teach can be stunted. The crux of a critical instructor's discretion,a third voting self-awareness as well as anawareness option may be crossed interpersonalconflictcan remain of others. It brings to arms to indi- a level of con- cate indecision on the part of the stu- unaddressed while time and attention sciousness that which seldomis dent. are consumed over minor points of thought about until interpersonal Teachers are not obligated to make antagonism. The continual masking conflicts surface. Even on theseocca- distinctions between majoror minor sions, some people insiston denying Patrick K Tow is an associate professor their part in a disharmonious relation- behavioral problems, since thestudents will be value voting. This is in the Department of HPER at Old ship. pal: of the dilemma which they need DominionUniversity,Norfolk VA This lesson is not designed to to sug- resolve during the voting 23529-0196. Beverly Johnson is Chair- gest specific solutions but reveals, process. person of the Department of HPER at instead, a perspectiveon the trials and The following is a list of behavioral Old Dominion University. Patricia N. tribulations of relationships ingen- idiosyncrasies developed by students Smith is an English teacher at Norview eral. Anyone growing up with siblings in classes on family life education and High School, Norfolk, VA 23513. will remember annoyancesover which mental health: 280 2"U Is inattentive during conversations Makes major purchases without SHOW AND TELL Leaves toilet seat up consulting Continued from page 279 Bites his/her fi agernails Brings guests home with little or no Flirts with others warning when theassignment is presented. (Three Sleeps to an excess Doesn't wash hands after using toilet to five minutes is more than adequate.) Is preoccupied with television Wastes water or electricity Another 30 minutes was needed to ad- Doesn't flush toilet As one can see, chronic habits equat, ,ly process the information and Interrupts conversation found to be irritating range from the feelings presented. (In a high school Squeezes toothpaste tube in middle most commonplace to the preposter- class with 30 students, we broke up into Leaves cap off the toothpaste tube ous. The instructor may elect to go six small groups and completed the as- Bathes or showers infrequently through this listing selectively or to signment in 38 minutes.) Cuts fingernails or toenails in bed have students derive their own lists Shows affection publicly anonymously. Reactions Changes underwear infrequently Drinks direcCy out of milk container Conclusion The examples that student.s selected Boasts about accomplishments were diverse and included such items as Doesn't rinse tub after use In the final analysis, what has been an adopted son's birth certificate, crys- Leaves clothing or shoes lying around accomplished?First, students be- tals in a leather pouch, photos of pet cats Nags come more aware of their own behav- and dogs, a nephew's photograph, sev- Dresses slovenly ioral idiosyncrasies and not only those eral stuffed animals, a credit card, two Tells little "white" lies of others. Second, they come to grips portable cassette players, and a Bible. Curses or swears with the fact that their actions also can (Obviously, the choices will vary de- Is negligent about doing chores be a source of annoyance to others. pending upon the age of the partici- Drives with a "lead foot" on gas pedal Third, they are not alone in their per- pants.) What was wonderfully exciting Borrows without returning things ceptions of vhat constitutes irritating every time I have used this lesson was Borrows without asking permission behaviors. Hoofully, some will come the ease with wtich students saw the Stays out late without calling to realize that minor, irritations often connections md similarities among Is negligent about keeping physically are blown out of proportion. Last, a themselves. For example, a "walkman" fit humorously anecdotal discussion of reflected the importance of music in the Gossips or passes rumors past, present, and future living experi- students' lives, especially as a stress Is tardy or late frequently ences with spouses parents, friends, or management technique. Pets gave un- Snores during sleep siblings is beneficial for those wanting conditional love and did nia give advice. Picks his/her nose to imp,: interpersonal relation- The common threads that students identify are: security self-worth and self- Eats too fast or too slow ships. esteem , accompli shment, trust, intimacy, and desiA.s. An assigned reading from Maslow's Toward a Psycho/ogy of Be- ing (2nd ed., 1968, Van Nostrand) can be utilized at this point. A discussion of these basic human needs provides an avenue for discussion of ways in which society provides enabling opportunities as well as the kinds of barriers that exist. Students are asked to focus first on personal experiences and then to identify the similar ways they feel society has helped turd hindered their development. Discussions about stereotyping, prejudice, and stigma can be an appropriate follow-up to this lesson.

2 9 1 281 TEACHING IDEAS 149

Nutrition Can You Name TheseFoods? Eileen L. Daniel

This learning activity can be used in a wide variety or ways in either a nutrition class or in a health education curriculum. Activities which are student-oriented are an interesting and exciting way to present a specific topic within a 111111111M curriculum. A favorite activity of mine (and my students) is "can you name these foods?" Five or more foods are listed on an overhead projector or blackboard by ingredients only. Students are then asked to try and identify the food. Though most students fail to determine the food by ingredients only, the activity generates hvely discussion and laughter! Some examples of topics which can be addressed from this activity are: What information is on a food label? Order of ingredients indicates the M1111114111 order of their predominance in the food. Additives are listed by their chemical name. Food colors :ire listed as "natural or 440\44111, artificial color," not by their chemical ePw"" name. The different forms of sugar used, i.e., dextrose, corn syrup, corn sweet- ,914%;111114110 eners. Risk versus benefit concept in using Can you name these foods by seeing 3. Corn syrup solids, partially hydro- additives. their ingredients only? genated vegetable oils, sodium cassein- The changing American diet which 1. Water, hydrogenated coconut and ate, dipotassium phosphate, monogly- incorporates fabricated and conve- palm kernel oils, sugar, corn syrup sol- cerides, sodium tripolv-phosphate, arti- nience foods in increasing numbers. ids, sodium casseinate, dextrose, poly- ficialflavors,beta carotene and Nutritional implications when we sorbate 60, natural and artificial flavors, riboflavin. change from foods like juices to sugar- sorbitanmonostearate, carrageenan, 4. Sugar, dextrose, citric and malic based imitation products. guar gum and artificial color. acids, sodium citrate, natural and artifi- 2. Dehydrated tomato, corn sweeten- cial flavors, tricalcium phosphate, vita- The activity can also be implemented ers, modified food starch, sugar, non- min C, cellulose gum and artificial color. by having the students bring in their fat dry milk, salt, monosodium gluta- 5. Sugar, gdatin, adinic acid, sodium own ingredient lists from foods found at mate, butterfat, partially hydrogenated citrate, fumaric acid, artificial flavor and home or in the supermarket. Taking coconut oil, dehydrated onion, artificial color. turns, they can display their lists and color, mono and diglycerides, silicon have fellow students try to guess the dioxide, sodium casseinate,dipotas- food. Answers: Whichever way the activity is sium phosphate, natural and artificial 1. Cool-Whip non-dairy pre- flavor, citric acid, and BHA. whipped sented, it has always generated much topping interest and discussioninnutrition, 2. Lipton Tomato Cup-A-Soup foods, and diet. Many students arevery Eileen L.Daniel is an instructor in the 3. Cremora non-dairy creamer surprised at exactly what goes into the Department of Health Science, State Univer- 4. Tang foods they eat, particularly sugars and sity of New York, Brockport, NY 14420. 5. Jello gelatin (any flavor) additives. 282 2 0 9 TEACHING IDEAS 150

Nutrition "Digesting" Health Information Richard A. Crosby

Ideally, health educators are in a state of neverending search for better methods. Sharing is bound to be the best contributor to this search. In sharing, the author has found this play to be a highly motivating approach to the teaching of the digestive system. "What Happened to the Apple" is geared toward upper elementary aged students, but works quite well with "low achieving" junior high school stu- ents. Audience participation allows all class members to become involved and h Iterested. After the narrator closes the play, stedents may want to try different roles. The play takes no more than five minutes to perform and can easily be repeated. Hopefully, students will memorize the apple's path with enthusiasm.

What Happened to the Apple?

Characters: Apple, Stomach, Small you. SmallIntestine: Your carbohydrates Intestine, Large Intestine, Mouth and Apple:But how did I get here? will be burned for energy and your Teeth, and the entire audience Audience: You came down the esopha- protein can be used for growth and App/e: That girl just picked me up. Oh gus! repair of the body. No! Stomach:Oops! Looks like my rest is Audience: Hey small intestine! How Mouth and Teeth:Let's grind this apple over. I've got to get busy and diges are you going to absorb the apple? into small pieces so the stomach won't more food. It sure is rough work break- Sma//Intestine:Well, I must admit, It have to do it. Teeth, when you're fin- ing up carbohydrates and protein. But, won't be an easy task. I'll have to have ished, have the tongue move the small- at least there is no fat coming in this help from my friends, Liver and Pancre- er pieces back to the throat. Mouth, you time. I hate breaking up fat! as. turn on your hoses and wet this food Audience:Hey, stomach, Do you like Apple:There's not much of me left! down with saliva so that the thriat your job? But I'm st4ll here. The small intestine won't complain when it swallows. Stomach:Most of the time my boss didn't use all of me. Istill have my Apple:It sure is dark in here! Where treats me pretty well, but every now roughage and some of my water. am I anyway? and then he delivers the wrong kind of Audience:Here comes the large intes- Audience: You, apple, are in the stom- food and I go on strike! tine. ach! And you look more like applesauce Apple:Whoo! Where am I going now? Large Intestine:I'm gonna be glad to after what the mouth and teeth did to What's happening to me? get that apple in meI like roughage. Audience:Don't you know apple? I'll soak up that leftover water as well. Your time in the stomach is up now; Narrator:The large intestine did soak you have to go to the small intestine. up the apple's leftover water. Then the Small Intestine: Ican't wait to absorb large intestine compacted and eliminat- Richard A. Crosby is with the Department of you into my bloou, apple! ed the roughage from the body. The Health Education at Central Michigan Uni- Apple:But what will happen to me body was grateful to the apple for pro- versity, Mt. Pleasant, MI 48859. when I'm in your blood? viding so many good nutrients. , 283 29 3 TEACHING IDEAS 151 Nutrition

Nutrition Is the Name of the Game Paula R. Zaccone

Classroom approaches that preach the eating habits complement habits of exer- n.ount the balls on a bulletin board in a do's and don'ts of health practices have cise for the maintenance of good health calendar arrangement. For the purpose wen tlwir day. The effect of television, and in the prevention of disease. The of integrating nutrition education into video and audio recording devices, and coach whose responsibilities include the daily curriculum, each day may the bombardment of advertising dictate guiding athletes toward proper physical begin with the disclosure of one state- that educational methods aiming to cap- conditioning may find that this teaching ment which also bears the date. ture an audience must appeal as ente technique can be adapted to the specific Weekend messages could be addressed tainment. Today itis not enough for sport interests of a particular team, e.g., on Mondays and Fridays. Brief nutrition health educators to appear before their wrestling, football, basketball, baseball, and tennis discussions could precede students with scientific facts and a sin- track and field, hockey, etc. other learning activities scneduled for cere interest in their delivery. Style and Tennis, a sport which has gained the day. process of delivery are as important as popularity in recent times because of its the health message in determining the value for players of all ages, can aid in the The concepts that are to appear on duration of effect. development of coordination, speed, each of the "tennis balls" are as follows: Studies indicating why children and endurance, and accuracy. Introducing 1. A "tennis nut" is a protein. adults watch television (Lvl?., 1972; its techniques and terminology along T: Whereas "health nuts" have been Robinson, 1972; Schramm, Lyle, and with nutrition education further com- described for their tendency "to spend Parker, 1961) give educators clues for municates that habits of eating and exer- inordinate amounts of time maintaining planning class activities that are enter- cise are both determinants of health and promoting their health" (Bedworth, taining and informative. Teaching meth- status. 1982), tennis nut refers to one who is fre- ods and learning activities that are amus- For implementation of the tennis quently occupied by tennis play (T:Ten- ing, relate to the interests of students, theme, 31 "tennis balls", 4-inch circles, nis). and that carry a health message are more need to be cut from paper or cardboard. N: Nutritionally speaking (N:Nutri- likely to draw interest from both young Each ball bears a statement of nutrition tion), "nuts of the edible kind are and mature students. information. In the statement, one or sources of protein, fats, the B vitamins, What follows is an approach to nutri- two terms are underlined that have sig- and some minerals. tion education that can be appropriately nificance for both the game of tennis and employed by the health educator in a good eating habits. 2. The body is the court for the food variety of educational settings. The Nu- The "tennis balls" are distributea to we eat. trition Is the Name of the Game approach the students, and each in turn introduces 1: The tennis court is the place where may be useful to the health or physical the statement to the class. A discussion the sport is played and the outcome is educator who aims to teach that good of the statement on the ball as it applies determined. For the doubles game, the to the sport of tennis and to good habits court is 36 fe...et in width and 41/2 feet of nutrition follows. narrower for the singles game. Teachers in search of means bo inte- N: The body is the place where the Paula R. Zaccone is an associate professm grate nutrition education into an already effects of eating habits are determined. Health Education at Seton Hall University, crowded academic schedule may find I Eat within the boundaries of mod- Department of Health, Physical Education, thisapproachuseful.Classroom eration. & Recreation, South Orange, NI 07079. teachers and school nurses may elect to T: The tennis court is marked by two 284 29 baselines, which are tl.v end lines of the eludes when one side wins two out of 10. Pace your eating or you'll suffer in court, and two sidelines. three sets. the end. N: Eating, too, has its limitations N: Amino acids provided by both T: Pace, the rate of movement or which need to be regarded for the main- dairy and plant sources combine to form length of steps taken, is an important tenance of good health. Excesses of even complete proteins which will best serve factor in eNecuting tennis strokes. the most nutritious foods can become the body's needs for proteins. N: Slower rates of eating will allow for contributors to fat storage and the inci- efficient mastication and processing of dence of some diseases. food for digestion, absorption, and elimination. Furthermore, a controlled iIIII 14 eating pace allows the stomach to send 4. Eating a variety of foods is good T cues of satiety to the brain and the quan- offense. "gnallilin%.. ity of food eaten to be held in check. 1: Offense generally applies to being in Problems related to eating too quickly control of the ball or having the ability to ...... 1.. fes1111111.11M011111ft (ingestion, nausea, diarrhea, and con- attack t le opponent. The player who is meeressuliOUNOSsmus .m...... IffilesessmesumillIfill ...... --__ stipation) may be avoided by adopting about to serve is the offensive player. , IluilOWINIO;MININUM;;; slower-paced eating habits. N: Eating a variety of foods allows the I.:312::::1_1.1:11.:::ulmi I body to produce antibodies to :ounteract WI:::;;;;;;;;;;t: i harmful bacteria, assures an intake of es- 1.8.11...... 4 11. 1. Raisins, 2. apples, 3. bananas, sential nutrients, and protects the body ::::::::EiriE#7 and 4. nuts are forehand ("four hand") \::...... \ 17 , from acquiring toxic levels of potentially ,.7:li / foods. harmful substances. T: The basic drive which includes a backswing and a follow through using the whole arm is known as the forehand. 5. Eat green and yellow vegetables N: Each of the four foods listed can be which score for good health. eaten by hand, requires almost no prepa- T: The accumulation of points made Tt ration, and can also be convenient and in the game occur as love, 15, 30, 40, and nutritious as snacks. game. N: The accumulation of important nutrients such as vitamins A, C, and K, 12. Fats may be backhanded in their iron, potassium, and fiber is provided by II appearance. green and yellow vegetables. T: A backhand drive is contacting the ball with the back of the hand turned in the direction of motion. 6. Vegetables without salt are a com- N: Whereas fats may add flavor, their plete set. presence in foods often times is invisible. T: The player/s who is/are first to win The moisture in cakes and pastries may six games win(s) a set, providing there is be attributable to fats which contribute to a margin of at least two games over the the high caloric value of these foods. Eat- opponent. A set is extended until this ing an excess of fatty foods has been as- margin is achieved. sociated with the accumulation of plaque N: Vegetablos derive minerals includ- on the walls of arteries, a condition that ing sodium fron, the soil in which they 1 is not easily identified. grow. Processing may cause more sodium to be a,A.:.led. Thus, adding more salts to foods .ncr .ase the blood volume 13. Dieting is often the need that fol- and is risky to those who are susceptible lows an overlswing. to high blood pressure. Vegetables 9. Serve fruits and vegetables for T: A common error in which the served without salt as an additive are meals and snacks. player uses too much backswing or fol- nutritionally complete. T: The method of putting the ball into low-through frequently results in the play is called a serve and is done by a ball landing too wide or too long. player who stands with both feet behind N: Binge eating, periods when eating 7. Carbohydrates are body power. the base line and within an imaginery habits take on an "overswing," causes T: Power is the ability to provide sud- continuation of the center mark and the the body to store excess calories as body den force to the ball. side line. fat. Furthermore, some theorists main- N: Carbohydratesareexcellent N: Furnishing the body with fruits tain that overeating during periods of suppliers of suddenly needed energy for and vegetables also provides the body rapid cell division may permanently in- the body. In plants, sugars and starches with vitamins, minerals, water, and fiber crease the propensity toward overfat- are present along with vitamins and in useful combinations. Sugar derived ness during inactivity and in adulthood. minerals, and thus provide excellent from fruits and vegetables supplies the food sources of body energy. body with the energy needed to metabolize these nutrients. Because of 14. Overeating is not your foot's fault. 8.Proteins from animal and plant their high nutritive density, fruits and T: A foot fault is a foul committed by sources make a good match. vegetables are superior to "empty the server who enters an area other than T: Tennis competition generally con- calorie" foods as snacks. that behind the base line within the 285 295 imaginery extension of the center mark N: Those who eat in search of psYcho- tion and communication with a partner and side line or who changes position by logical comfort would do better to find on a court that is wider than for singles walking or running throughout the de- less self-defeating methods of coping. play. livery of the service. Try exercising or becoming involved in N: This statement addresses the non-food related hobbies that expend hazards that are evident from eating an rather than store surplus calories. excess of sugar. Tooth decay and obestity 18. Aim to have meat, fish, poultry, are just two of the consequences related or to excessive sugar in the diet. Other dis- eggs at least twice daily. orders of the cardiovascular and diges- T: To aim is to direct the ball to drop in tive systems have been associated with a a specific spot on the court. surplus of calories derived from "empty N: These food items share the nutri- 1/ tive values of protein, fats, niacin, calorie foods. thiamin, iron, and other minerals. Ef- forts should be directed toward their consumption at least twice daily. 19. Milk products are needed for good form. T: Players demonstrate good tennis form with efficient execution of tennis strokes and strategies. N: This statement suggests the need N: Milk, cheese, yogurt, even pud- for overeaters to take control of theirown dings and ice cream made from milk con- eating habits. It serves no useful purpose tain nutrients important for building and to blame eating binges on others. They maintaining strong bones and teE th. may have nothing to gain or lose by the Found in milk products and specifically overeater's gains (i.e., "My foot caused responsible for the strength of body me to overeat"). Accepting 1'esponsibil- structures, are vitamin D, calcium, ity for one's own eating habits and fit- phosphorus, and protein. ness status is a healthy approach toward coping with disappointments. 20. Rush the net, but pause through lb dinner. 15. "If You Drink Alcohol, Do So in T: Dashing totho front of the Moderation" (USDA, USDHHS, 1980) is forecourt to play the ball as it crosses the a slice of good advice. net or drops over is known as rushing the T: A slice is a short, choppy stroke in net. which the ballis hit downward with N: This statement points to the im- 23. Milk is a good partner to many backspin and is aimed to bounce away portance of controlled eating patterns. foods. from the opponent's reach. Reasonably paced ingestions of food that T: A tennis partner is a teammate in N: A brief slice of nutritional advice is allow for pleasant conversation add to doubles play. to avoid excessiveness in the drinking of the enjoyment and longevity of the eat- N: In addition to its vitamin and min- alcohol. For healthy, non-pregnant ing period. Habits that encourage eral constituents (vitamin A and D, ribo- adults who choose to drink alcohol, the awareness of quantity eaten and portion flavin, calcium, phosphorus), milkcon- recommendation made by the National control enable the diner to acquire feel- tains protein ideally suited for use by the Research Council (USDA, USDHHA) is ings of satiety that would escape the body when it combines with amino acids to do so in moderation. speed eater. from grains and vegetables. The amino 21. No single food is perfect. acids from milk and plant products are 16. Let your mind, not your tummy, T: Single play takes place when an in- good protein partners. be the judge. dividual player opposes one other player 24. Sugar is the opponent of good den- T: The official who makes the deci- in competition. tal health. sions regarding play tournaments may N: No one food provides the body T: The player/s on the other side of be the referee, umpire. CI lines judge. with all the substances needed to carry the net during play is/arean opponent(s). N: Sensations o; thirst and hunger on its physiological processes and to N: Sugar combines with acid in the alone are not accurate indicators of the maintain health. This statement invites a mouth to produce decay-causing bac- body's needs for liquids and food. Habits discussion of the need to eat a variety of teria. Particularly when sugar lingers on of meal planning to ensure adequate in- foods (#4) and the relative values of the teeth of children,it opposes good take of all .lutrients and regular replace- foods. While milk is considered to be a dental health. ments of water lost by perspiration and highly nutritious food, it fails to meet the excretion are reliance on wisdom, rather body's needs for iron and vitamin C. 25. A well strung meal has dental floss than impulse, for good nutrition. Fish, often said to be "brain food," is a as its follow through . T: Tennis rackets may be strung with 17. Avoid using food to bounce back worthy source of protein, but lacks the carbohydrates the brain requires for fuel. nylon, steel wire, or sheep gut. There is from disappointments. some concern that string tension that is T: The term bounce back in tennis may 22. Doubles of sweets can bring doubles too tight my contribute to painful "tennis refer to the ability of the ball or player to of troubles. elbows, an inflammation of the point rebound after a hard hit. T: The do-Wes gmne requires coopera- where the tendons that straighten the 286 2.,.r,, elbow attach. A follow through is the con- ons need not come in a cardboard box tinuation of movement after contact with bearing the picture of an athlete. Instead, the ball is made. breakfast foods should be a combination N: Using dental floss after meals and of those from the basic four food groups: before brushing will aid in removing grains, dairy, fruits and vegetables, and cariogenic food particles and plaque meat, fish, poultry, or nuts. from the teeth. 26. Eating should be neither torment, 31. Calories add (ad) in. nor a tournament. T: Ad in refers to the point advantage to the server. This follows deuce. A point T: A tournament is a contest among advantage to the receiving player would players to detertnine a champion. idli:::1.111.Igilli. be called "ad-out." 0 inNI . 1111, N: Discussion about many attitudes N: Here, the concept of homonyms, I . Ik and food-related habits that result in un- 1141 1:1 Ia:47a: ...... /A words that sound alike but are different healthy eating habits may evolve. Some se...... -ormINISMIIIIIIIMMI111111.1m1 examples are eatia:::: and drinking con- in meaning, would appropriately be in- faINEPOO11111110Ensumma tests in which overindulging is encoth tegrated in a language arts and nutrition 111eissoms-NNI11aii11111Mus1111111IONINIMa aged, contests of rapid weight loss, education lesson. Calories derived from estsossmosiumma....-fismou...... -1,...... using foods as rewards, and practices second servings, snacks, and rich des- serts add into the total caloric intake. No 1.::::::mmt-:::::,/...... -__-_. that encourage anxiety with eating such .....=s...:-.., as force feeding and eating in stressful amount of will can erase the program- ,,,...... ----_-_.., environments. ming of an ingested calorie to carry out ::::::-.1:::::. , its fuel-serving function...... ,r:BEHEE-::...iir 27. Sis make the playing rough. T: The playing of highly skilled 32. Winning is easy to digest. players according to their ranked ability T: To earn success or to achieve prog- is a practice which has been designed to ress is winning for some players of ten- ensure challenge and competition nis. among players. N: Taking responsibility for one's pat- N: Seeds and skins from various plant terns of ingestion to restrict certain foods (fruits, vegetables, nuts) as as foods and drinks, and putting sound nu- roughage in the digestive system and aid tritional habits into practice is winning, the body to rid itself of waste products. whether it be in the battle of the unsightly bulge or in the fight against risk 28. For effective elimination, take in factors. fiber, fats, and water. In the process it is important to realize T: An elimination tournament is one in that what you eat is as important as which the loser is disqualified from whether you lose or gain. Harm to health further play. may occur as a result of excesses of fats, N: Fiber functions to bind waste salt sugar, or calories. Moreover, nutri- products for removal from the body. Fats ent imbalances promoted by fad diets and water lubricate the digestive tract so and willfully induced starvation with that processing of food for digestion and hopes of achieving quick fat loss may be excretion is facilitated. losing pounds without winning the ben- 29. Water and sunshine make a dandy efits of good nutritional status. deuce. T: Veuce in tennis refers to the score being tied at 40-all. Bedworth, A. The health educator as health N: The need to rep:ace body fluids nut. Health Education, 1982, 13 (2): 27-28. lost during perious of exercise and heavy Lyle, J. Television in daily life: patterns of use perspiration cannot be overemphasized. overview. In RubPnstein, E. A., Com- With higher temperatures, the body's stock, A., & Murray, J. P. (eds.). Televi- need for water increases. sion and Social Behavior, Vol. 4. Washing- ton, DC: U.S. Dept. of Health, Educa- tion, & Welfare, 1972, pp. 1-32. 30. "The breakfast of champions" is Robinson, J. P. Toward defining the functi(ms daily. of television. In E. A. Rubenstein, Cu. 1- T: Champions are those who acquire stock, A., & Murray, J. P. (eds). Television the greatest number of wins and are de- and Social Behavior, Vol. 4. Washington, termined to be in first place at the end of DC: U.S. Dept. of Health, Education, and the event. Welfare, 1972, pp. 568-601. N: Breakfast is considered to be in Schramm, W., Lyle, J., & Parker, E. B. Thlevi- first place with regard to its importance sion in the lives of our children. Stanford: Stanford University Press, 1961. for supplying the body with fuel and nu- United S'ates Depts. of Agriculture and trients required for each day's activities. Health and Human Services. Nutrition An additional consideration is the nu- and your health: Dietary guidelines for tritional fact that the breakfasts of champi- Americans, 1980. 287 297 TEACHING IDEAS 152

Personal Health Sun Smart: A Peer-Led Lesson on the Effects of Tanning and Sunningon the Skin Mary Elesha-Adams and David M. White

Many adolescents and young adults 2. Provide opportunities for under- 5. Students should be able to iden- spend a great deal of time sunning. graduate health education majors to tify the harmful effects of tanning Some university students even sched- gain practice experience. beds and other indoor tanning devic- ule classes and jobs around prime es, including skin rashes and eye sunning time. It has been our expe- Development and Implementation injuries, and complications from over- rience in teaching personal health Sessions are coordinated by the exposure, such as wrinkles and skin courses that not only do students health educator at the University cancer. typically have a number of miscon- Health Service in cooperation v. ith 6. Students should be able to de- ceptions about sun exposure and skin the Department of Health, Physical scribe safer sunning techniques, such cancer, but the information we pro- Education, Recreation and Safety. as use of sunscreens, protective cloth- vide often has little or no influence on The peer educators may register for ing and sunglasses, hats and visors, their behavior. Because almost all of the experience as an independent and avoiding tanning between 11:00 the more than 500,000 cases of non- study project and receive from one to am-2:00 pm when the sun's rays are melanoma skin cancer developed each three semester hours of academic strongest. year in the United States are consid- credit, depending on the scope of 7. Students should be able to de- ered to be sun-related, and recent involvement. scribe self-examination procedures studies show that sun exposure is a Peer health educators are trained for skin cancer. primary factory in the development in a preservice workshop. They de- of melanoma (American Cancer So- velop teaching materials, role play Materials and Resources ciety, 1988), we clearly needed to instructional sessions, and work on The one-hour SUN SMART ses- find more effective ways of delivering group facilitation skills, then are as- sions are informal, and comments health education. To address this signed in terms to lead SUN SMART and questions are encouraged through- need, we developed a peer-led lesson sessions. SUN SMART sessions have out the presentation. A colorful hand- on the effects of tanning and sunning. been requested most frequently dur- out developed by the peer health By designing the course to be led by ing spring semester when students educator is given to each participant peers, we also addressed another prepare for spring vacation and sum- and referred to often during the pre- need at the university level. Peer mer activities. sentation. The handout describes saf- teaching can provide valuable, prac- er sunning tips, defines SPF, lists tical experience for health education Objectives majors before their formal student common suntan preparations and their teaching or internships. The SUN SMART session has the SPF, and identifies medications that The goals of the SUN SMART following objectives. increase sun sensitivity. Free sun- sessions are to: I. Students should be able to de- screen and t-shirts reinforce safer scribe complications caused by sun- sunning behavior and encourage at- 1. Enable participants to make in- tendance. We also used the following formed decisions regarding sunning ning including premature wrinkling, cataracts, and skin cancer. commercially produced materials, as and encourage safer sunning behav- reinforcements: ior, and 2. Students should be able to identify medications that increase the like- I. "Sun Sense," a brochure de- Mary Elesha-Adams is a health edu- lihood of sensitivity to the sun, such veloped by Johnson & Johnson that cator in the Student Health Service at as birth control pills, certain antibiot- emphasizes the use of SPF and sen- East Carolina University Greenville, ics, antihistamines, and Accutane. sible sun protection. NC 27858-4353. David M. White is an 3. Students should be able to de- 2. "Skir Cancer. Early Preven- assistant professor of health educa- termine their own skin type and de- tion, Early Detection," a brochure tion in the Department of Health, fine sun protection factor (SPF). developed by the North Carolina De- Physical Education, Recreation, and 4. Students should be able to list partment of Human Resources that Safety at East Carolina University, two recommended methods to re- illustrates a 10-step procedure for Greenville, NC 27858-4353, lieve sunburn. checking for skin cancer. 2 88 3. "Progress Against Cancer of knowledge about safer sunning. Thus is not necessary to check areas of the the Skin," published by the National far, participants have been almost body unexposed to the sun when Institutes of Health, a resource for exclusively white, female, and aged checking for skin cancer. peer health educators. 18 to 23. Although almost all (98 percent) knew that people with ex- Conclusion Applications cessive exposure to the sun were at The SUN SMART program has In addition to presentation at res- high risk for skin cancer, 17 percent proven to be effective in increasing idence halls, peer health educators did not know that redheads and knowledge and awareness of safer have provided SUN SMART demon- blondes were at high risk, 13 percent sunning and has provided an oppor- strations at two university health fairs. did not believe that fair-skinned peo- tunity for health education majors to Instructors of university personal ple were at high risk, and 12 percent gain valuable practical experience. health and wellness courses can in- did not realize that people who sun- Preliminary results indicate that this corporate SUN SMART into the ex- burn often were at high risk. Thirteen teaching idea can be beneficial to isting curriculum. The program can percent of the students inaccurately students, faculty, and staff. An eval- also be presented to high school stu- believed that the chances of devel- uation of the effectiveness of this dents in classes or organization and oping skin cancer were reduced each approach in changing sunning behav- club meetings. time the skin darkens through tan- ior is currently underway. ning. One-fourth (25 percent)did not Typical Misconceptions About realize that the majority of the aver- This project was funded, in part, by Sunning age person's total lifetime sun expo- the P'orth Carolina Division, Ameri- We developed a pretest for use sure is in the first 20 years of life. In can Cancer Society, Inc. during the SUN SMART sessions terms of screening and detection, 22 The authors would like to thank that focuses on high-risk groups and percent did not think that the skin Jerri Harris for her expert editorial behaviors, detection and treatment shoukl be examined at least once assistance. of skin cancer, and perceived level of yearly and 23 percent believed that it American Cancer Society. (1988). Cancer facts and figures--1988. New York: Author.

299 289 TEACHING IDEAS 153

Personal Health A Quick and Easy Check for Foot Problems Dianne Boswell O'Brien

The Foot Powder Test about three steps; for example, a right- The test assists a teacher in recognizing left-right or left-right-left. This is a dis- potential problems of students who will be Did you ever wonder why your pants tance of about ten feet. asked to participate in endurance or sports or skirt move slightly to the left or to the Before walking onto the newly pow- activities.Itis especially helpful in recog- right after you have been walking? If dered surface, take about six natural steps nizing problems in adult populations. your slacks appear to be turning to the so that your normal walking cadence and A person who has a dominate right left after you have been walking, then pattern are established before you strike foot may take a longer stride with the you are probably taking a longer stride the powdered surface. right kg. People who are right-handed with the right foot than you are with the often have a dominate right foot. left foot. One way to check to see if your If your right foot is dominate it may stride length is the same with both legs also be larger. You can also see size by Stride length is to measure the distance between foot- comparing your right and left footprints. prints. A simple powder test will tell you Once you have walked through the If your right footprint is larger you should how long your stride length is with each powdered surface take a tape measure make certain to try on the right shoe first leg. and measure your right stride length by when fitting new shoes. If the right slikw measuring the distance from your left is large enough for your right foot thon big toeprint to the heel of your right foot- the left shoe should also be large enoug; print. Measure your left stride length in for your smaller left foot. the same way.

Everyone needs a footprint test Toeing Out or Pronation Good foot health results from intelli- Stride length gent decisions about exercisehabits, foot (right leg) care and shoe selection: Much can be learned from just interpreting footprints. The simple footprint test given in the following paragraphs will indicate some individualized foot care needs. To the Teacher: This article is suitable for students and adults who may be in a 6 to 7 degrees avc rage pronation (illustration 1) health or fitness class. To perform the test with large groups, purchase a roll of butcher paper from a restaurant supply house. The To perform the test, just cover a dark cost will be approximately fifteen dollars. floor with a sprinkle of foot powder. Then Purchase stamp pads from a book or station- walk barefooted in a straight line through ery supply shop at a cost of about five dollars. the powder. Your footprints should be Divide the paper into fifteen-foot sections clearly visible. The powdered surface and give each person a section of time paper. (Illustration 2) should be large enough to accommodate Have each person ink their feet with the stamp pads. Perform the test as directed, but omit the part of the test which directs the person The average toe-out position or pron- Dianne O'Brien is an assistant professor of to take several strides before 5tepping onto ationis 6 to 7 degrees (See Illustra- health education in the Department of Health, the paper. When ink is used, the person will tion 2). Toeing out increases with age Physical Education, Recreation and Dance step directly onto the paper. When checking and weight increases. Toeing out de- at P ii, State University, Murray, KY the footprints, consider the first few steps as creases as walking speed increases. 42001. In 1980, she was named the outstand- a gaining momentum. The last two steps (Cailliet,1978) People who have ex- ing young professional and given the Mabel should be investigated as the person's more tremely pronated feet tire easily and of- Lee Award by AAHPERD. natural stride. ten experience leg pain. 290 3 (4 The following exercises when done re- Reading a footprint will give a person peatedly (15 times once a day) for sev- an indication of a flattened transverse eral weeks will strengthen T.uscles in arch. the feet and legs wh;ch help to control Some people have inherited naturally pronation. Recommended activities are: flat feet. However, the older or heavier (1) Strengthen muscles in the calf of the person's transverse arches may be ab- leg by holding on to a chair and rising normally depressed. This flattening of on the toes, (2) Strengthen muscles of the transverse arch may cause calluses the feet by picking up pencils with the on the metatarsal heads (ball of foot). toes, (3) Strengthen feet and legs by (See Illustration 4). These calluses may standing with weight on the outer bor- be padded with commercially available ders of the feet and curl toes inward and felt pads which are designeu to relieve upward. the pressure on the calluses. Foot Strain

Foot strain may occur in the under- metatarsal (Illustration 5) exercised foot and pronated foot. The head person who exercises infrequently and noo 0 0 00n then decides to walk a long distance or In order to adequately diagnose the engage in a Saturday ball game is a likely problem, assistance of professional help candidate for foot strain. Since 857r of is recommended. For children, early the foot problems are caused by ill- treatment is of utmost importance. chosen footwear, the lack of proper shoes is also a culprit in creating foot strain. Poor body mechanics and abuse through Distance Between Footprints overuse or improperly fitting shoes can To measure the distance between create excessive stress on the muscles abnormal weight here on footprints, draw an extended line from and ligaments of the feet, thus causing metatarsal heads the edge of the big toe through the most chronic foot strain. Foot strain produces indented part of the arch. Do this for aching legs and feet. For brief bouts both feet. Then measure the distance be- (acute) of foot strain, rest and proper (Illustration 4) tween the lines (See Illustration 6). foot wear are recommended. For long- term (chronic) foot strain, professional help should be sought. When foot strain persists over long Metatarsal pads and heel pads will help periods of time, pronation and a flat- relieve the pressure on the transverse big toe tened transverse arch often accompany arch. Metatarsal pads should be placed most indented the condition (Cailliet, 1978). behind the metatarsal heads. Strength- part of the arch ening the arches of the foot, practicing Flat Feet good walking mechanics and correct footwear will help the problem. When When the transverse arch (arch going there is persistent pain, a person should across the foot) is flattened, a footprint see a podiatrist. will be noticably lacking the "normal" Exercises for strengthening the foot 2 to 4 inches curve on the inside border of the foot were listed previously. They should be (See Illustration 3). average horizontal accompanied by exercises which st:etch distance between the achilles tendon (Cailliet, 1978). For footprints example stand about two feet away from the wall and lean toward the wall. Place both hands on the wall and lean toward (Illustration 6) the wall keeping both feet flat on the floor. Feel the stretch on the back of the calf of the leg. Hold the position at least The average horizontal distance be- 20 seconds. tween footprints is 2 to 4 inches. The horizontal distance between footprints will be influenced by width of pelvic gir- Pigeon Toed Walk dle and overall body size. A larger frame In aduhs a pigeon-toed walk (Illustra- needs a wider base of support. tion 5) may be a result of improper me- average arches low chanics of the joints which are not located Shortened Big Toe arches feet noticeably flat in the foot. For example, improper align- ln some footprints the great toe ap- ment of the knee jcint and other mul- pears to be shorter than the second toe (Illustration 3) tiple causes will cause the feet to turn (Illustration 7). This condition is often inward. called Morton's toe and is usually in- 291 herited. In the average foot, metatarsal Overlapping Fourth and F'fth I should bear twice as much weight as Toes metatarsal II. However, because meta- A footprint that shows toes overlap- tarsal I is short, metatarsal II must bear ping or together may indicate improper additional weight. Therefore, calluses footwear that squeezes toes (Illustra- may form under the metatarsals (Call- tion 9). When shoE. press the toes to- liet, 1978). gether soft corns between toes may result. If soft corns between toes occur, separate toes with sponge rubber or lambs normal bone length wool to prevent further pressure (Cail- of the metatarsal I liet, 1978). Check shoes which may not allow toes to spread during walking. Sometimes a shoe repair shop may me- chanically stretch a shoe in order to pro- short metatarsal I vide more toe room.

00o%

(Illustration 7)

A pad under metatarsal I will relieve some of the pressure from metatarsal II. Foot exercises listed above will also help to strengthen muscles which are often strained by this condition. (Illustration 9) Big Toe Turns Inward If the big toe turns toward the second Score Cird toe (Illustration 8) there may be source of pain between the big toe and the sec- Good foot health results from intelli- ond toe. This condition may be caused gent decisions about exercise habits, foot by wearing improperly designed shoes. care, and shoe selection. Good decisions A person with this condition should :an be seen in a person's footprints. Take check to see if the toes of shoes allow the foot powder t-st and see how you adequate spread of toes when feet are score. bearing the weight of walking. Shoes which force toes into a pointed position should be discarded. Cailliet, R. (1978)Foot and Ankle Pain.Phila- delphia: F. A. Davis Company.

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(Illustration 8) 292 3 Association for the Advancement of Health Education 1900 Assoction Drive, Reston, Virginia 22091 (703) 476-3437

MISSION STATEMENT

The mission of the Association for the Advancement of Health Education (AAHE) is to advance health by encouraging, supporting, and assisting health professionals concerned with health promotion through education and other systematic strategies.

PURPOSES AND OBJECTIVES

The basic purpose of AAHE shall be to promote the advancement of health education by providing a focal structure for the encouragement, support, and assistance of persons interested in concentrating their professional efforts on the improvement of health through the development and conduct of effective health education programs in educational institutions and other community settings.

In fulfilling the above stated purposes, AAHE seeks to:

1. Provide information, resources, and services regarding health education to professionals and the lay public. 2. Enhance a public awareness of the nature and purposes of health education. 3. Enlist support in the development, implementation, and evaluation of health education programs. 4. Foster the development and program implementation of the philosophical basis of health education practices. 5. Promote and interpret research relating to school and community health education. 6. Promulgate criteria, guidelines, and evaluation procedures for assessing the effectiveness of preservice, inservice, and continuing professional education of health education personnel. 7. Determine curriculum needs and assist in the development and mobilization of resources for effective health education at all levels of education. 8. Facilitate communication between school and community personnel, and between professionals and the lay public, with respect to current health education principles, problems, and practices. 9. Provide leadership in establishing program policies criteria and evaluative procedures that will promote effective health education programs. 10. Inform the membership of current and pending legislation related to AAHE interests and, upon request, provide professional and technical assistance in drafting pertinent legislation and related guidelines. 11. Mdintain effective liaison with Wher national health education organizations.

31'3 HealthEducation TeachingIdeas: Secondary RevisedEdition

Association for the Advancement of HealthEducation

American Alliance for Health, PhysicalEducation, Recreation and Dance 1900 AssociationDrive ISBN 0-88314-529-4 Reston, Virginia22091 BEST COPYAVAILABLE 30.1