Pediatricians who want to help their communities achieve success in their health education programs should become familiar with the National Health Education Standards and the Youth Risk Behavior Surveillance System (YRBSS).

1. National Health Education Standards

The National Health Education Standards were developed in 1995 for schools to use in the development of an instructional program to enable students to become healthy and capable of academic success. The standards were developed by the Joint Committee on National Health Education Standards, which included the American Cancer Society, the American Public Health Association, and many other groups.

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The standards are as follows:

• Students will comprehend concepts related to health promotion and disease prevention.
• Students will demonstrate the ability to access valid health information and health-promoting products and services.
• Students will demonstrate the ability to practice health-enhancing behaviors and reduce health risks.
• Students will analyze the influence of culture, media, technology, and other factors on health.
• Students will demonstrate the ability to use interpersonal communication skills to enhance health.
• Students will demonstrate the ability to use goal-setting and decision-making skills to enhance health.
• Students will demonstrate the ability to advocate for personal, family, and community health.

The documents provide a statement of rationale for each standard as well as performance indicators, a series of specific concepts and skills that students should know or be able to perform by the end of grades 4, 8, and 11.

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The standards also define "health literacy." A health literate person is:

• A critical thinker and problem solver
• A responsible, productive citizen
• A self-directed learner
• An effective communicator

The standards promote many important concepts that pediatricians should be familiar with and that should be used to develop programs and advocate for health education in the community.

2. The Youth Risk Behavior Surveillance System

The YRBSS was developed by the Center for Disease Control and Prevention (CDC) to monitor priority health risk behaviors that contribute to the leading causes of mortality, morbidity, and social problems among youth and adults in the United States. The YRBSS monitors six categories of behaviors. Unintentional and intentional injuries:

• Unintentional and intentional injuries.
• Tobacco use.
• Alcohol and other drug use.
• Sexual behaviors that contribute to unintended pregnancy and sexually transmitted disease, including HIV infection.
• Dietary behavior.
• Physical inactivity.

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The YRBSS has 3 primary components.

• National, state, and local school-based surveys of representative samples of students in grades 9 through 12 are conducted by state and local education agencies as part of cooperative agreement activities with the CDC's Division of Adolescent and School Health.
• A national household-based survey of 12- through 21-year-olds was conducted by the CDC as a supplement to the 1992 National Health Interview Survey using a questionnaire similar to that used in the school-based surveys.
• A national mail survey of college students was conducted for the first time in 1995 among a nationally representative sample of students in 2- and 4-year institutions.

Data from the YRBSS are being used to:

• Monitor the progress in achieving 26 national health objectives for the year 2000.
• Monitor progress in achieving National Education Goal number 7, entitled "Safe, Disciplined, and Drug-Free Schools."
• Focus teacher training and instructional programs in school health education.
• Support comprehensive school health programs nationwide.

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How the pediatrician can use the YRBS data:

The pediatrician working in the school can usethe local YRBS data (if the study was conducted) as background information about the local community. This can be the basis for a presentation to school staff and other community members. Remember that school administrators, nurses, and school boards are more interested in tackling a problem if it is their problem!

The YRBS data allow the pediatricians to:

• Compare local YRBS statistics with state and national data
• Demonstrate the prevalence of certain health risk behaviors in his or her community
• Set priority behaviors to target
• Follow trends over time
• Monitor trends over time
• Design effective school programs based upon the needs and ages of the student population
• Educate school administrators, parents, and students about health risk behaviors
• Gain community support for the implementation of programs or funding to address relevant issues within the school