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

2. (b) Introduction.

   1. (1) The goal of health education is to provide instruction that allows youth to develop and sustain health-promoting behaviors throughout their lives. The understanding and application of these standards will allow students the ability to gather, interpret, and understand health information; achieve health literacy; and adapt to the ever-evolving science of health. The health education knowledge and skills should be presented to students in a positive manner to support the development of a healthy self-concept and responsible decision making. The standards will help students reinforce, foster, and apply positive character traits.
   2. (2) There are essential skills that repeat throughout six strands and embody the interconnection of health literacy. These skills include decision making, problem solving, goal setting, maintaining healthy relationships with self and others, seeking help and support, and recognizing various influences on health such as social, environmental, media, and genetic. These skills, developed early on and reinforced throughout a student's education, will foster mastery of health concepts. Health class educators are encouraged to partner with school counselors where available to schedule time for them to deliver classroom guidance lessons to help teach these essential competencies. In addition, areas in the standards related to abuse, neglect, violence, loss, grief, trauma, and suicide may directly affect some students in the classroom. Should the educator recognize signs of discomfort with instruction in these areas, students should be referred to the appropriate resource, identified ahead of such instruction, for additional help and support.

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

      1. (A) Physical health and hygiene education helps to prepare students for improved lifelong health outcomes. Learning about body systems lays the foundation for personal health and hygiene. Health literacy and preventative behaviors empowers students to make informed choices to support self, family, and community.
      2. (B) The mental health and wellness strand recognizes that the knowledge and skills necessary to manage emotions, reactions, and relationships are essential to reaching one's full potential. Students gain knowledge about social and emotional health, including developing a healthy self-concept, understanding risk and protective factors, and identifying and managing mental health and wellness concerns. In the early grades, students develop fluency around emotions and self-regulation and understand the relationship between feelings, thoughts, and behavior. In subsequent grades, students learn and practice appropriate ways to solve interpersonal conflicts, work to develop a positive self-image, and develop healthy self-management skills.
      3. (C) The healthy eating and physical activity strand addresses the importance of nutrition and physical activity to support a healthy lifestyle. Students apply critical-thinking and decision-making skills to make positive health choices. Students learn about essential nutrients, food groups, portion control, government nutritional recommendations, and the health benefits of being physically active. Students evaluate the connection between physical activity and nutrition and the prevention of chronic diseases.
      4. (D) By focusing on injury and violence prevention and safety, the standards promote student well-being and awareness of dangerous situations. Supporting student well-being and providing instruction in digital citizenship, bullying prevention, first aid, and identification of safe and unsafe situations creates empowered and educated students who are able to make decisions that keep themselves and others safe. Beginning in Kindergarten and continuing through high school, students gain knowledge and skills to support safety and wellness at school, at home, online, and in the community.
      5. (E) The standards under the alcohol, tobacco, and other drugs strand focus on a number of protective factors that develop empowered students who are able to make better-informed decisions, including understanding the impact of substance use on physical, mental, and social health. Through this strand, students learn key concepts about alcohol, tobacco, and other drugs, including the use, misuse, and physiological effects; short- and long-term impacts on health; treatment; risk and protective factors; and prevention. These concepts introduce healthy alternatives and ways for students to ask for and seek out help from parents and other trusted adults.
      6. (F) In the reproductive and sexual health strand, students identify the characteristics of healthy and unhealthy relationships and learn to use communication and refusal skills to set personal boundaries and develop strategies for responding to sexual harassment and abuse. Students describe the changes associated with adolescent development and explain the process of fertilization, fetal development, and the importance of prenatal care. Students also learn that sexual abstinence until marriage is the only 100% effective means of avoiding unplanned pregnancies and sexually transmitted diseases/sexually transmitted infections (STDs/STIs) as well as the legal, financial, and social issues associated with sexual health and reproduction.

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

      1. (A) a local school district's control over the provision of human sexuality instruction to ensure that local community values are reflected in that instruction (Texas Education Code (TEC), §28.004(e)-(h));
      2. (B) the right of a parent or legal guardian to be informed of the provision of human sexuality instruction to their child and review the content of that instruction (TEC, §28.004(i)-(j));
      3. (C) the right of a parent or legal guardian to remove their child from any portion of human sexuality instruction without penalty to the child (TEC, §28.004(i));
      4. (D) the centrality of abstinence education in any human sexuality curriculum (TEC, §28.004(e)); and
      5. (E) the right of a parent or legal guardian to be informed of and consent to an abortion performed on their pregnant child (with judicially authorized or medical emergency exceptions) (Texas Family Code, Chapter 33).
   5. (5) Educators also should be aware of and abide by the statutory prohibition on taxpayer resource transactions between state governmental entities, including public schools, and abortion providers or an affiliate of an abortion provider (Texas Government Code, Chapter 2272).
   6. (6) Statements containing the word "including" reference content that must be mastered, while those containing the phrase "such as" are intended as possible illustrative examples.
   7. (7) Students should first seek guidance in the area of health from a parent or legal guardian.

3. (c) Knowledge and skills.

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

      1. (A) analyze the cost, availability, and accessibility of health care services;
      2. (B) analyze methods of overcoming barriers related to solving health problems; and
      3. (C) analyze the influence of laws, policies, and practices, including those related to disease prevention, on health-related issues.

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

      1. (A) evaluate positive and negative effects of various relationships on physical, emotional, and social health;
      2. (B) apply communication skills that demonstrate consideration and respect for individual differences and perspectives; and
      3. (C) evaluate the effectiveness of conflict resolution techniques in various situations.
   3. (3) Mental health and wellness--developing a healthy self-concept. The student develops the capacity for self-assessment and evaluation, goal setting, and decision making in order to develop a healthy self-concept. The student is expected to describe how internal and external factors influence self-esteem.
   4. (4) Mental health and wellness--risk and protective factors. The student recognizes the influence of various factors influencing mental health and wellness. The student is expected to formulate strategies for combating environmental factors that have a detrimental effect on mental health.

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

      1. (A) describe the impact of positive stress on building resiliency and promoting mental health and wellness;
      2. (B) discuss the impact of choosing healthy self-management strategies for stress, anxiety, depression, trauma, loss, and grief on mental health and wellness;
      3. (C) research and explain the behaviors associated with eating disorders and their impact on health;
      4. (D) discuss how the use of suicide prevention resources such as the National Suicide Prevention Hotline reduces the likelihood of suicide; and
      5. (E) research and discuss data on and prevalence of local, state, and national suicide rates among various groups.
   6. (6) Healthy eating and physical activity--food and beverage daily recommendations. The student analyzes and applies healthy eating strategies for enhancing and maintaining personal health throughout the lifespan. The student is expected to design a realistic, long-term personal dietary plan that promotes individual and family health.

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

      1. (A) compare and contrast the impact of active and sedentary lifestyles on overall health; and
      2. (B) develop a physical fitness profile using appropriate technology.

   8. (8) Healthy eating and physical activity--nutrition and physical activity literacy. The student will obtain, process, and understand basic physical activity and nutrition information needed to make health-promoting decisions. The student is expected to:

      1. (A) analyze the progress of short- and long-term goals in achieving appropriate levels of physical activity, improving personal physical fitness levels, and making healthy personal food choices; and
      2. (B) analyze marketing and advertising techniques in health product and service promotion.

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

      1. (A) research and discuss the social and economic impact of chronic conditions, including obesity, heart disease, and diabetes; and
      2. (B) create a plan for accessing community and digital resources that can assist in developing healthy eating and physical activity behaviors.
   10. (10) Injury and violence prevention and safety--safety skills and unintentional injury. The student identifies and demonstrates safety and first aid knowledge to prevent and treat injuries. The student is expected to discuss risk-taking behaviors, including driving under the influence and distracted driving, and their associated consequences.

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

       1. (A) discuss and evaluate ways to respond to harmful situations that involve weapons; and
       2. (B) develop educational safety models for children and adults for use at home, school, and in the community.

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

       1. (A) discuss and analyze consequences resulting from inappropriate digital and online communication such as sending and receiving photos, sexting, and pornography; and
       2. (B) assess the legal and ethical ramifications of unacceptable behaviors in digital and online environments.

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

       1. (A) identify and respond to situations requiring intervention for victims of bullying, cyberbullying, or harassment; and
       2. (B) promote strategies for prevention and intervention of all forms of bullying and cyberbullying such as emotional, physical, social, and sexual.

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

       1. (A) analyze how substance misuse and addiction to alcohol, tobacco, drugs, and other substances impact family and community health;
       2. (B) analyze the importance of alternative activities to drug and substance misuse and abuse; and
       3. (C) identify individual and community protective factors and skills that prevent substance misuse and substance use disorders.
   15. (15) Alcohol, tobacco, and other drugs--short- and long-term impacts. The student identifies and analyzes the short- and long-term impacts of the use and misuse of alcohol; tobacco; drugs, including prescription drugs; and other substances. The student is expected toevaluate the impact of laws relating to the use and misuse of prescription and over-the-counter drugs, alcohol, tobacco, and other substances on self and community.
   16. (16) Alcohol, tobacco, and other drugs--treatment. The student recognizes and understands the options for treatment and how to seek help related to the use and misuse of alcohol; tobacco; drugs, including prescription drugs; and other substances. The student is expected to identify ways to support and assist someone who shows signs and symptoms of alcohol, tobacco, or drug use and misuse.

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

       1. (A) discuss risk-taking behaviors such as drinking and driving with their associated legal, social, and physical consequences;
       2. (B) analyze physical and social environmental influences on the misuse and abuse of prescription drugs in places such as school, sports, or entertainment; and
       3. (C) design a public health information campaign related to safe havens, where to go for help, or reporting drug-related behaviors.
   18. (18) Alcohol, tobacco, and other drugs--prevention. The student analyzes information and applies critical-thinking skills to avoid substance use and misuse and recognizes the benefits of delayed use. The student is expected to develop strategies for preventing use or misuse of alcohol, tobacco, and other drugs, including opioids.

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

       1. (A) compare and contrast effective and ineffective methods of communicating emotions in healthy dating/romantic relationships and marriage;
       2. (B) analyze behaviors in romantic relationships that enhance dignity and respect; and
       3. (C) examine how a healthy marriage can provide a supportive environment for the nurturing and development of children.

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

       1. (A) identify community resources to support individuals who have experienced sexual harassment, sexual abuse, sexual assault, dating violence, and sex trafficking;
       2. (B) evaluate the importance of reporting to a parent or another trusted adult sexual harassment, sexual abuse, sexual assault, and dating violence involving self or others;
       3. (C) discuss how refusal skills can be used to set limits and boundaries to avoid behaviors that increase sexual risk;
       4. (D) analyze factors, including alcohol and other substances, that increase sexual risk and that affect setting, perceiving, respecting, and making decisions about boundaries; and
       5. (E) evaluate influences and pressures to become sexually active and why it is wrong to violate another person's boundaries and manipulate or threaten someone into sexual activity.

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

       1. (A) analyze the significance of hormonal, physical, emotional, and social changes in males and females and their relationship to sexual health;
       2. (B) list factors such as heredity, environment, STDs/STIs, and the mother's health and nutrition that can affect fetal development from conception through birth; and
       3. (C) describe the emotional changes that may occur during and after pregnancy, including postpartum depression, and identify resources for support and treatment.

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

       1. (A) analyze the options available to teenage parents such as parenting or the process of adoption and the legal rights of parties involved;
       2. (B) evaluate long-term or lifetime effects of bacterial and viral STDs/STIs, including infertility and cancer;
       3. (C) identify community resources, minors' right to consent under certain circumstances, and the importance of parent or other trusted adult support for STD/STI testing and treatment;
       4. (D) analyze the effectiveness and the risks and failure rates (human-use reality rates) of barrier protection and other contraceptive methods, including how they work to reduce the risk of STDs/STIs and pregnancy;
       5. (E) identify the effectiveness of vaccines in preventing the transmission of the most common types of HPV, a virus that may cause genital warts and head and neck cancer, cervical cancer, anal cancer, or other cancers that may occur in males and females;
       6. (F) analyze the benefits of abstinence from sexual activity, including focusing on personal development and encouraging individuals to build healthy relationships not complicated by sexual involvement;
       7. (G) assess support from parents and other trusted adults and create strategies, including building peer support, to be abstinent or for return to abstinence if sexually active;
       8. (H) investigate and summarize legal aspects of sexual activity with a minor person, including the legal age of consent, statutory rape, aggravated sexual assault, sexual assault, and indecency with a child; and
       9. (I) investigate and summarize current laws relating to sexual offenses such as sexual harassment, abuse, and assault.

Source Note:The provisions of this §115.39 adopted to be effective August 1, 2022, 46 TexReg 2756.