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Health Education in the Elementary Schools

Terms in this set (495)

-An effective curriculum has clear health-related goals and behavioral outcomes that are directly related to these goals. Instructional strategies and learning experiences are directly related to the behavioral outcomes.

-An effective curriculum has instructional strategies and learning experiences built on theoretical approaches (for example, social cognitive theory and social inoculation theory) that have effectively influenced health-related behaviors among youth. The most promising curriculum goes beyond the cognitive level and addresses health determinants, social factors, attitudes, values, norms, and skills that influence specific health-related behaviors.

-An effective curriculum fosters attitudes, values, and beliefs that support positive health behaviors. It provides instructional strategies and learning experiences that motivate students to critically examine personal perspectives, thoughtfully consider new arguments that support health-promoting attitudes and values, and generate positive perceptions about protective behaviors and negative perceptions about risk behaviors.

-An effective curriculum provides instructional strategies and learning experiences to help students accurately assess the level of risk-taking behavior among their peers (for example, how many of their peers use illegal drugs), correct misperceptions of peer and social norms, emphasizes the value of good health, and reinforces health-enhancing attitudes and beliefs.

-An effective curriculum provides opportunities for students to validate positive health-promoting beliefs, intentions, and behaviors. It provides opportunities for students to assess their vulnerability to health problems, actual risk of engaging in harmful health behaviors, and exposure to unhealthy situations.

-An effective curriculum provides opportunities for students to analyze personal and social pressures to engage in risky behaviors, such as media influence, peer pressure, and social barriers.

-An effective curriculum builds essential skills — including communication, refusal, assessing accuracy of information, decision-making, planning and goal-setting, self-control, and self-management — that enable students to build their personal confidence, deal with social pressures, and avoid or reduce risk behaviors.

For each skill, students are guided through a series of developmental steps:

Discussing the importance of the skill, its relevance, and relationship to other learned skills.
Presenting steps for developing the skill.
Modeling the skill.
Practicing and rehearsing the skill using real-life scenarios.
Providing feedback and reinforcement.

-An effective curriculum provides accurate, reliable, and credible information for usable purposes so students can assess risk, clarify attitudes and beliefs, correct misperceptions about social norms, identify ways to avoid or minimize risky situations, examine internal and external influences, make behaviorally relevant decisions, and build personal and social competence. A curriculum that provides information for the sole purpose of improving knowledge of factual information will not change behavior.

-An effective curriculum includes instructional strategies and learning experiences that are student-centered, interactive, and experiential (for example, group discussions, cooperative learning, problem solving, role playing, and peer-led activities). Learning experiences correspond with students' cognitive and emotional development, help them personalize information, and maintain their interest and motivation while accommodating diverse capabilities and learning styles. Instructional strategies and learning experiences include methods for

Addressing key health-related concepts.
Encouraging creative expression.
Sharing personal thoughts, feelings, and opinions.
Thoughtfully considering new arguments.
Developing critical thinking skills.

-An effective curriculum addresses students' needs, interests, concerns, developmental and emotional maturity levels, experiences, and current knowledge and skill levels. Learning is relevant and applicable to students' daily lives. Concepts and skills are covered in a logical sequence.

-An effective curriculum has materials that are free of culturally biased information but includes information, activities, and examples that are inclusive of diverse cultures and lifestyles (such as gender, race, ethnicity, religion, age, physical/mental ability, appearance, and sexual orientation). Strategies promote values, attitudes, and behaviors that acknowledge the cultural diversity of students; optimize relevance to students from multiple cultures in the school community; strengthen students' skills necessary to engage in intercultural interactions; and build on the cultural resources of families and communities.

-An effective curriculum provides enough time to promote understanding of key health concepts and practice skills. Behavior change requires an intensive and sustained effort. A short-term or "one shot" curriculum, delivered for a few hours at one grade level, is generally insufficient to support the adoption and maintenance of healthy behaviors.

-An effective curriculum builds on previously learned concepts and skills and provides opportunities to reinforce health-promoting skills across health topics and grade levels. This can include incorporating more than one practice application of a skill, adding "skill booster" sessions at subsequent grade levels, or integrating skill application opportunities in other academic areas. A curriculum that addresses age-appropriate determinants of behavior across grade levels and reinforces and builds on learning is more likely to achieve longer-lasting results.

-An effective curriculum links students to other influential persons who affirm and reinforce health-promoting norms, attitudes, values, beliefs, and behaviors. Instructional strategies build on protective factors that promote healthy behaviors and enable students to avoid or reduce health risk behaviors by engaging peers, parents, families, and other positive adult role models in student learning.

-An effective curriculum is implemented by teachers who have a personal interest in promoting positive health behaviors, believe in what they are teaching, are knowledgeable about the curriculum content, and are comfortable and skilled in implementing expected instructional strategies. Ongoing professional development and training is critical for helping teachers implement a new curriculum or implement strategies that require new skills in teaching or assessment.
Beans and peas are the mature forms of legumes. They include kidney beans, pinto beans, black beans, lima beans, black-eyed peas, garbanzo beans (chickpeas), split peas and lentils. They are available in dry, canned, and frozen forms. These foods are excellent sources of plant protein, and also provide other nutrients such as iron and zinc. They are similar to meats, poultry, and fish in their contribution of these nutrients. Therefore, they are considered part of the Protein Foods Group. Many people consider beans and peas as vegetarian alternatives for meat. However, they are also considered part of the Vegetable Group because they are excellent sources of dietary fiber and nutrients such as folate and potassium. These nutrients, which are often low in the diet of many Americans, are also found in other vegetables.

Because of their high nutrient content, consuming beans and peas is recommended for everyone, including people who also eat meat, poultry, and fish regularly. The USDA Food Patterns classify beans and peas as a subgroup of the Vegetable Group. The USDA Food Patterns also indicate that beans and peas may be counted as part of the Protein Foods Group. Individuals can count beans and peas as either a vegetable or a protein food.

Green peas, green lima beans, and green (string) beans are not considered to be part of the beans and peas subgroup. Green peas and green lima beans are similar to other starchy vegetables and are grouped with them. Green beans are grouped with other vegetables such as onions, lettuce, celery, and cabbage because their nutrient content is similar to those foods.
The Dietary Guidelines' Key Recommendations for healthy eating patterns should be applied in their entirety, given the interconnected relationship that each dietary component can have with others.

Consume a healthy eating pattern that accounts for all foods and beverages within an appropriate calorie level.

A healthy eating pattern includes:[1]

A variety of vegetables from all of the subgroups—dark green, red and orange, legumes (beans and peas), starchy, and other
Fruits, especially whole fruits
Grains, at least half of which are whole grains
Fat-free or low-fat dairy, including milk, yogurt, cheese, and/or fortified soy beverages
A variety of protein foods, including seafood, lean meats and poultry, eggs, legumes (beans and peas), and nuts, seeds, and soy products
A healthy eating pattern limits:

Saturated fats and trans fats, added sugars, and sodium
Key Recommendations that are quantitative are provided for several components of the diet that should be limited. These components are of particular public health concern in the United States, and the specified limits can help individuals achieve healthy eating patterns within calorie limits:

Consume less than 10 percent of calories per day from added sugars[2]
Consume less than 10 percent of calories per day from saturated fats[3]
Consume less than 2,300 milligrams (mg) per day of sodium[4]
If alcohol is consumed, it should be consumed in moderation—up to one drink per day for women and up to two drinks per day for men—and only by adults of legal drinking age.[5]
In tandem with the recommendations above, Americans of all ages—children, adolescents, adults, and older adults—should meet the Physical Activity Guidelines for Americans to help promote health and reduce the risk of chronic disease. Americans should aim to achieve and maintain a healthy body weight. The relationship between diet and physical activity contributes to calorie balance and managing body weight. As such, the Dietary Guidelines includes a Key Recommendation to

Meet the Physical Activity Guidelines for Americans.[6]
Several terms are used to operationalize the principles and recommendations of the 2015-2020 Dietary Guidelines. These terms are essential to understanding the concepts discussed herein:

Eating pattern—The combination of foods and beverages that constitute an individual's complete dietary intake over time. Often referred to as a "dietary pattern," an eating pattern may describe a customary way of eating or a combination of foods recommended for consumption. Specific examples include USDA Food Patterns and the Dietary Approaches to Stop Hypertension (DASH) Eating Plan.

Nutrient dense—A characteristic of foods and beverages that provide vitamins, minerals, and other substances that contribute to adequate nutrient intakes or may have positive health effects, with little or no solid fats and added sugars, refined starches, and sodium. Ideally, these foods and beverages also are in forms that retain naturally occurring components, such as dietary fiber. All vegetables, fruits, whole grains, seafood, eggs, beans and peas, unsalted nuts and seeds, fat-free and low-fat dairy products, and lean meats and poultry—when prepared with little or no added solid fats, sugars, refined starches, and sodium—are nutrient-dense foods. These foods contribute to meeting food group recommendations within calorie and sodium limits. The term "nutrient dense" indicates the nutrients and other beneficial substances in a food have not been "diluted" by the addition of calories from added solid fats, sugars, or refined starches, or by the solid fats naturally present in the food.

Variety—A diverse assortment of foods and beverages across and within all food groups and subgroups selected to fulfill the recommended amounts without exceeding the limits for calories and other dietary components. For example, in the vegetables food group, selecting a variety of foods could be accomplished over the course of a week by choosing from all subgroups, including dark green, red and orange, legumes (beans and peas), starchy, and other vegetables.
As children grow into teenagers, it becomes more challenging for parents to know what they are thinking and feeling. When do the normal ups and downs of adolescence become something to worry about?

It's important to learn about the factors that can put a teen at risk for suicide. Spend some time reading these ten ways you can help prevent a tragedy from occurring. The more you know, the better you'll be prepared for understanding what can put your child at risk.

1. Don't let your teen's depression or anxiety snowball.
Maybe your child is merely having a bad day, but maybe it's something more if this mood has been going on for a couple of weeks.

Fact: 9 in 10 teens who take their own lives were previously diagnosed with a psychiatric or mental health condition or disorder—more than half of them with a mood disorder such as depression or anxiety.
Depressed people often retreat into themselves, when secretly they're crying out to be rescued. Many times they're too embarrassed to reveal their unhappiness to others, including Mom and Dad. Boys in particular may try to hide their emotions, in the misguided belief that displaying the feeling is a fifty-foot-high neon sign of weakness.

Let's not wait for children or youth to come to us with their problems or concerns. Knock on the door, park yourself on the bed, and say, "You seem sad. Would you like to talk about it? Maybe I can help."

2. Listen—even when your teen is not talking.
Not all, but most kids who are thinking about suicide (this is called suicidal ideation) tip off their troubled state of mind through troubled behaviors and actions. Studies have found that one trait common to families affected by a son's or daughter's suicide is poor communication between parents and child. However, there are usually three or more issues or factors going on all at once in a child's life at the time when he or she is thinking about taking his or her life.

These include but are not limited to:
Major loss (i.e., break up or death)
Substance use
Peer or social pressure
Access to weapons
Public humiliation
Severe chronic pain
Chronic medical condition
Family history of suicide
If your instinct tells you that a teenager might be a danger to himself, heed your instincts and don't allow him to be left alone. In this situation, it is better to overreact than to underreact. See How to Communicate With and Listen to Your Teen.

3. Never shrug off threats of suicide as typical teenage melodrama.
Any written or verbal statement of "I want to die" or "I don't care anymore" should be treated seriously. Often, children who attempt suicide had been telling their parents repeatedly that they intended to kill themselves. Most research supports that people who openly threaten suicide don't really intend to take their own lives; and that the threat is a desperate plea for help. While that is true much of the time, what mother or father would want to risk being wrong?

Any of these other red flags warrants your immediate attention and action by seeking professional help right away:
"Nothing matters."
"I wonder how many people would come to my funeral?"
"Sometimes I wish I could just go to sleep and never wake up."
"Everyone would be better off without me."
"You won't have to worry about me much longer."
When a teenager starts dropping comments like the ones above or comes right out and admits to feeling suicidal, try not to react with shock ("What are you, crazy?!") or scorn ("That's a ridiculous thing to say!"). Above all, don't tell him or her, "You don't mean that!." Be willing to listen nonjudgmentally to what he or she is really saying, which is: "I need your love and attention because I'm in tremendous pain, and I can't seem to stop it on my own."

To see your child so troubled is hard for any parent. Nevertheless, the immediate focus has to be on consoling; you'll tend to your feelings later. In a calm voice, you might say, "I see. You must really, really be hurting inside."​

4. Seek professional help right away.
If your teenager's behavior has you concerned, don't wait to contact your pediatrician. Contact a local mental health provider who works with children to have your child or youth evaluated as soon as possible so that your son or daughter can start therapy or counseling if he or she is not in danger of self-harm. However, call your local mental health crisis support team or go to your local emergency room if you think your child is actively suicidal and in danger of self-harm.

5. Share your feelings.
Let your teen know he or she is not alone and that everyone feels sad or depressed or anxious now and then, including moms and dads. Without minimizing his anguish, be reassuring that these bad times won't last forever. Things truly will get better and you will help get your child through counseling and other treatment to help make things better for him or her..

6. Encourage your teen not isolate himself or herself from family and friends.
It's usually better to be around other people than to be alone. But don't push if he says no.

7. Recommend exercise.
Physical activity as simple as walking or as vigorous as pumping iron can put the brakes on mild to moderate depression.

There are several theories why:
Working out causes a gland in the brain to release endorphins, a substance believed to improve mood and ease pain. Endorphins also lower the amount of cortisol in the circulation. Cortisol, a hormone, has been linked to depression.
Exercise distracts people from their problems and makes them feel better about themselves.
Experts recommend working out for thirty to forty minutes a day, two to five times per week.
Any form of exercise will do; what matters most is that children and youth enjoy the activity and continue to do it on a regular basis.
8. Urge your teen not to demand too much of himself or herself.
Until therapy begins to take effect, this is probably not the time to assume responsibilities that could prove overwhelming. Suggest that he or she divide large tasks into smaller, more manageable ones whenever possible and participate in favorite, low-stress activities. The goal is to rebuild confidence and self-esteem.

9. Remind your teen who is undergoing treatment not to expect immediate results.
Talk therapy and/or medication usually take time to improve mood. Your child shouldn't become discouraged if he or she doesn't feel better right away.

10. If you keep guns at home, store them safely or move all firearms elsewhere until the crisis has passed.
Fact: Suicide by firearm among American youth topped a 12-year high in 2013, with most of the deaths involving a gun belonging to a family member, according to a report from the Brady Center to Prevent Gun Violence. Any of these deaths may have been prevented if a gun wasn't available.
If you suspect your child might be suicidal, it is extremely important to keep all firearms, alcohol, and medications under lock and key.
Thousands of teens commit suicide each year in the United States. In fact, suicide is the third leading cause of death for 15- to 24-year-olds.

Suicide does not just happen. Studies show that at least 90% of teens who kill themselves have some type of mental health problem, such as depression, anxiety, drug or alcohol abuse, or a behavior problem. They may also have problems at school or with friends or family, or a combination of all these things. Some teens may have been victims of sexual or physical abuse. Others may be struggling with issues related to sexual identity. Usually they have had problems for some time.

Most teens do not spend a long time planning to kill themselves. They may have thought about it or tried it in the past but only decide to do it after an event that produces feelings of failure or loss, such as getting in trouble, having an argument, breaking up with a partner, or receiving a bad grade on a test.

Why do most teens kill themselves?
Most teens who kill themselves have a mood disorder (bipolar disorder or depression). A mood disorder is an illness of the brain. A mood disorder can come on suddenly or can be present on and off for most of a teen's life. A teen with a mood disorder may be in one mood for weeks or months or may flip rapidly from one feeling to another.

Teens with bipolar disorder, also called manic depression, may change between mania (angry or very happy), depression (sad or crabby), and euthymia (normal mood). Some teens have more mania, some have more depression, and some seem normal much of the time. Mania and depression can happen at the same time. This is called a mixed state.

Teens in a manic or a mixed state may:
Strongly overreact when things do not go their way
Become hyper, agitated, or aggressive
Be overwhelmed with thoughts or feelings
Sleep less
Talk a lot more
Act in impulsive or dangerous ways
Feel they can do things they really can't
Spend money they do not have or give things away
Insist on unrealistic plans for themselves or others
Teens with depression may:
Feel sad, down, or irritable, or not feel like doing things
Have a change in sleeping or eating habits
Feel guilty, worthless, or hopeless
Have less energy, or have more difficulty paying attention
Feel lonely, get easily upset, or talk about wanting to be dead
Lose interest in things they used to enjoy
Mood disorders can be treated. Ask your teen's doctor about treatment resources. Recent declines in teen suicide may be due to an increase in early detection, evaluation, and effective treatment of mood disorders.
For Educators
Educators are often the first to notice mental health problems. Here are some ways you can help students and their families.

What Educators Should Know
You should know:

The warning signs for mental health problems.
Whom to turn to, such as the principal, school nurse, school psychiatrist or psychologist, or school social worker, if you have questions or concerns about a student's behavior.
How to access crisis support and other mental health services.
What Educators Should Look For in Student Behavior
Consult with a school counselor, nurse, or administrator and the student's parents if you observe one or more of the following behaviors:

Feeling very sad or withdrawn for more than two weeks
Seriously trying to harm oneself, or making plans to do so
Sudden overwhelming fear for no reason, sometimes with a racing heart or fast breathing
Involvement in many fights or desire to badly hurt others
Severe out-of-control behavior that can hurt oneself or others
Not eating, throwing up, or using laxatives to make oneself lose weight
Intense worries or fears that get in the way of daily activities
Extreme difficulty concentrating or staying still that puts the student in physical danger or causes problems in the classroom
Repeated use of drugs or alcohol
Severe mood swings that cause problems in relationships
Drastic changes in the student's behavior or personality
What Educators Can Do in Classrooms and Schools
You can support the mental health of all students in your classroom and school, not just individual students who may exhibit behavioral issues. Consider the following actions:

Educate staff, parents, and students on symptoms of and help for mental health problems
Promote social and emotional competency and build resilience
Help ensure a positive, safe school environment
Teach and reinforce positive behaviors and decision-making
Encourage helping others
Encourage good physical health
Help ensure access to school-based mental health supports
Developing Effective School Mental Health Programs
Efforts to care for the emotional wellbeing of children and youth can extend beyond the classroom and into the entire school. School-based mental health programs can focus on promoting mental wellness, preventing mental health problems, and providing treatment.

Effective programs:

Promote the healthy social and emotional development of all children and youth
Recognize when young people are at risk for or are experiencing mental health problems
Identify how to intervene early and appropriately when there are problems
Learn More about Ways to Support Your Students and Their Families
Find how to assess mental health needs in your school and develop and implement a school-based mental health program exit disclaimer icon.
Find tips for talking to children and youth after a disaster or traumatic event (PDF - 796 KB).
Registered National Association of School Nurses exit disclaimer icon can learn about their role in providing behavioral health services in schools exit disclaimer icon through an online continuing education program.
Bullying occurs at all developmental levels,
including adulthood.

Bullying includes intentional acts of
aggressive behaviors that are characterized by
an imbalance of power or strength.

Researchers agree that the definition of
bullying includes:

Attacks or intimidation with the intention of causing
fear, distress, or harm

A real or perceived imbalance of power between the
bully and the victim

Repeated attacks or intimidation between the same
children over time

Approximately 160,000 students are absent
from school each day because of the fear of
being bullied.

Bullying can take many forms


hitting, kicking, etc.


name calling, threatening, etc.

Social or relational

spreading rumors,
gossip, etc.


Many schools underestimate the prevalence
and consequences of bullying, which is
reflected in the following attitudes:






Key stakeholders in the school community
must join together to reduce the effects of
school bullying.

Important actions a teacher can take to
promote a culture of respect in their
school include:

Avoid consistent "student or school" problem
saturated conversation with other teachers

Be connected to as many teachers in the school as
possible (avoiding exclusionary cliques)

Remain reflective about the purpose of conversation
with other adults about professional challenges and
whether the intention is to momentarily vent or solve
a problem

Foster appreciation on a regular basis by "catching
others being successful" or having special days or
Definition: Childhood drowning and near-drowning can occur in a number of settings -- pools, hot tubs, beaches, lakes, bathtubs, and buckets. Activities such as boating, jet skiing, water skiing, sailing, and surfing are also associated with water-related injuries and fatalities. Most drowning incidents happen when a child falls into a pool or is left alone in the bathtub. It can take only a couple of seconds for a child to drown, and drowning typically occurs when a child is left unattended or during a brief lapse in supervision.

Magnitude of the Problem: According to Safe Kids, in 2008:

Approximately 745 children aged 14 and under drowned.
Drowning is the third leading cause of unintentional injury fatalities among youth ages 14 and under.
Boys are twice as likely to drown as girls.
Children ages 4 and under account for 65% of drowning deaths.
African-Americans are at higher risk for drowning -- African-American children age 5-9 are 3 times more likely to drown in swimming pools than Caucasian children.

Prevention: Laws and regulations enacted to address water safety often concentrate on swimming pool regulations and personal flotation device mandates. For example, the Virginia Graeme Baker Act requires anti-entrapment drain covers on pools and spas. According to the National Conference of State Legislators, at least 12 states have laws related to swimming pool safety, which may include: certified lifeguards on duty, fences, alarms, safety covers, light fixture requirements, and safe spa and pool drain standards.

Environmental protections (e.g., isolation pool fences and lifeguards) can protect children and youth from drowning. Other strategies include teaching children proper techniques for survival swimming; communicating to parents and caregivers the importance of closely supervising children who are engaged in water activities; emphasizing the necessity of wearing life jackets while boating; educating individuals about avoiding alcohol while participating in water activities; and providing training in cardiopulmonary resuscitation (CPR).
Definition: Residential fires can be caused by cooking, heating, smoking, gasoline, or candles.

Magnitude of the Problem: Lighted tobacco products (mainly cigarettes) are the leading cause of residential fire fatalities while cooking equipment is the leading cause of residential fire injuries.

According to the CDC, fires and burns are the third leading cause of unintentional injury fatalities in the U.S.

According to Safe Kids USA:

Approximately 366 children 14 or under died due to fire and burn injuries in 2008.
Nearly 90,000 children 14 or under sustained nonfatal fire or burn injuries in 2009.
Scalds are the most common cause of burn-related hospitalizations for young children. Contact burns are more common with older children.
20% of all burn cases in the U.S. are for children ages 4 and under.
In 2010, children ages 5-9 had the most firework injuries. Children ages 10-14 had the second highest rate of firework injuries (per capita).

Prevention: Personal fire safety depends upon:

safe storage of matches, lighters, and gasoline
smoking outdoors and using fire safe cigarettes
not leaving stoves, grills, or burning candles unattended
performing proper maintenance on furnaces, fireplaces, chimneys, and wood stoves
installing smoke detectors and changing batteries annually; and
developing and practicing a fire evacuation plan.

Injury prevention initiatives aimed at keeping people safe from fires and burn-related injury and death include fire alarm give-aways; fire alarm safety checks; and regulations mandating fire safe cigarettes, child-resistant safety lighters, and smoke alarms in homes.
Definition: Firearm injuries are injuries that occur because a firearm has been discharged. They can be fatal or nonfatal, intentional or unintentional, and include homicides, assaults, suicides, suicide attempts, and accidental shootings.

Magnitude of the Problem: Homicides and suicides constitute the majority of fatal firearm injuries. In 2010, 67.5% of the 9,960 victims of homicide were killed with firearms (UNODC (link is external)). Those who most frequently die from firearm injuries are between the ages of 10 and 24. When compared with 17 other high-income countries, firearm homicide rates for youth ages 15-24 in the U.S. are 35.7 times higher; firearm suicides are 8 times higher for children 5-14 years old, and their death rates from unintentional firearm injuries are 10 times higher (American Academy of Pediatrics, 2012). Firearm-Related Injuries Affecting the Pediatric Population. Pediatrics. 130(5). Of the 4,828 youth homicides in 2010, 82.8% were committed with firearms.

Firearms are often used in suicide attempts, and while other means, such as pill ingestion are more common, attempts made with firearms are much more lethal. In 2011, 52% of the 19,766 completed suicides were committed with guns.

An additional 851 individuals died in 2011 due to accidents involving a firearm. (National Vital Statistics Reports Volume 61, Number 6 October 10, 2012 (link is external)).

Firearms are widely available in the U.S. "There are at least 875 million firearms in the world today of which... over a third [are held] by civilians in the United States" (Violence Prevention, The Evidence: Guns, Knives and Pesticides: reducing access to lethal means (link is external).)

Prevention: Reducing firearm-related fatalities and injuries requires comprehensive prevention strategies. The World Health Organization and other international bodies have identified several prevention strategies for targeting and reducing armed violence. They include: reducing access to firearms; safe storage and use of firearms; law enforcement and criminal justice interventions; improving parenting skills and caregiver relationships; youth development; "academic enrichment and mentoring programs; reducing access to and harmful use of alcohol; environmental and urban design; disrupting illegal drug markets, and reducing inequalities."
Definition: The CDC defines poison as any substance that is harmful to your body when ingested, inhaled, injected, or absorbed through the skin.

Magnitude of the Problem:

According to the CDC,
In 2009, 76% of the 41,592 poisoning deaths in the U.S. were unintentional, and 8% were of undetermined intent
In 2009, 14% of the 41,592 poisoning deaths in the U.S. were intentional; the majority were suicides
In 2008, 91% of unintentional and undetermined poisoning deaths were caused by drugs (this includes prescription medication)
An estimated 71,000 children 18 years or younger went to the ED each year due to medication poisonings between 2004 and 2005; over 80% were due to unsupervised children finding and taking medications.
According to the Health Resources and Services Administration's Poison Help project, 51% of poisoning exposures occur in children under age 6

Prevention: Poison Control Centers can be valuable resources in helping to prevent poisonings in communities. They can also be cost saving services for states, according to the Health Resources and Services Administration (HRSA) for every dollar spent on Poison Control Center services, $7 is saved in medical spending. Raising awareness about poison prevention resources can be done through National Poison Prevention Week, which occurs every March. National organizations like the Home Safety Council and the American Association of Poison Control Centers can provide educational materials to help individuals understand common poisons found in the home, and steps to take to reduce risks and help keep children safe.
Definition: Sporting activities can improve both the physical and mental health of children, teaching them to work with other children and improving their coordination and confidence. Safety precautions and equipment can be instrumental in preventing or lessening injuries from sporting activities. The environment in which sports are played also has an impact on injury risks. Organized sports take place at schools, public parks, or recreation centers. More casual sports activities take place in backyards, streets, or neighborhood courts.

Magnitude of the Problem: According to Safe Kids:

Each year, over 38 million children and adolescents participate in some sports in the U.S.
Over 3.5 million children under the age of fifteen receive medical treatment due to sports injuries.
62% of injuries from organized sports occur during practice, not games. According to a national survey, 27% of parents don't always take the same safety precautions during practice as in games.
The most common cause of sports-related death is traumatic brain injury; sports and recreation account for one out of five TBIs in children.
Sprains (usually ankle) are the most common sports-related injury in children.

Prevention: The environment children play in (e.g., heat, protective ground surface, properly maintained equipment); proper safety equipment (e.g., helmets, padding); supervision; physical check-ups; and regular hydration are just a few of the factors that should be considered to prevent injuries to children while they are playing sports. In addition, assuring that children are in age- and ability-appropriate activities can help prevent stress-related mental health issues.
Definition: Traumatic Brain Injury (TBI) is caused by a blow or jolt to the head which disrupts normal brain function or by a foreign object penetrating the skull. Studies have found thatthe four most common causes of TBIs are falls, motor vehicle and traffic accidents, struck by/against events, and assaults (Centers for Disease Control and Prevention's Traumatic Brain Injury in the United States: Emergency Department Visits, Hospitalizations and Deaths 2002-2006 webpage).

Magnitude of the Problem: The CDC estimates that in the U.S. around 1.7 million people sustain a TBI every year. TBI is a contributing factor in almost one third of all injury deaths. In addition:

Each year nearly half a million (473,947) children between the ages of 0 and 14 are treated in emergency departments for TBI-related injuries;
TBIs are most commonly sustained by children between the ages of 0 and 4, adolescents between the ages of 15 and 19, and adults age 65 and over; and
TBI rates are higher for boys than girls.

Prevention: Strategies for preventing TBIs include:

Ensuring that new parents receive education on the prevention of Shaken Baby Syndrome;
Installing safety gates on stairs and guards on windows to prevent falls by young children;
Practicing proper traffic safety, such as wearing a seatbelt and using child safety seats or booster seats for children;
Providing a soft landing surface below playground equipment;
Using appropriate protective equipment while engaging in sports (e.g., wearing a helmet while bicycling or snowboarding);
Providing training to coaches and officials so that they can take steps to prevent sport-related TBIs and can recognize TBIs and respond appropriately when these injuries do occur; and
Educating parents and young athletes so that they understand the risks and recognize the signs and symptoms of sport-related TBIs.
Definition: Unsafe sleep environments for infants can lead to suffocation, strangulation, or entrapment (National Institute of Child Health and Human Development's Safe Sleep for Your Baby: Reduce the Risk of Sudden Infant Death Syndrome webpage). The sudden death of an infant under one year of age that does not have an immediately obvious cause is referred to as a Sudden Unexpected Infant Death (SUID). Some cases of SUID are due to Sudden Infant Death Syndrome (SIDS), a term which is applied when no cause of death can be determined even after rigorous investigation (Centers for Disease Control and Prevention SUID/SIDS webpage).

Magnitude of the Problem: Over 4,500 infants die from SUID/SIDS every year in the U.S. (CDC).

This is the leading cause of mortality among infants between one and twelve months (CDC).
It is the third leading cause of death among all infants (CDC).
Most of these deaths occur between two and four months of age (NICHD).
African American babies are more than twice as likely to die from SUID/SIDS as Caucasian babies (NICHD).
American Indian/Alaskan Native babies are almost three times as likely to die from SUID/SIDS as Caucasian babies (NICHD).

Prevention: It is possible to reduce the risk of SUID/SIDS. Some safe sleep tips from the American Academy of Pediatrics' website include:

Always place a baby to sleep on his or her back;
Place a baby to sleep on a firm surface which is free of soft objects and loose bedding that could trap, strangle, or suffocate the baby;
A baby should sleep in the same room as his or her parents, but not in the same bed;
Babies should always have their own sleep space to reduce the risk of strangulation or suffocation;
Keep babies away from smoke and those who are smoking;
Offer a baby a pacifier at bedtime and naptime; and,
Do not let a baby overheat.
Definition: Off-road vehicles (ORVs) are any three-or four-wheeled vehicle that has a motor and is designed for riding on unpaved surfaces. Examples of ORVs include All-Terrain Vehicles (ATVs), snowmobiles, jet skis, and motor bikes.

Magnitude of the Problem: According to the U.S. Consumer Product Safety Commission:

55 children under the age of 16 died in 2010 as a result of ATV-related injuries, representing 17% of all ATV-related deaths.
47% of these child deaths occurred in children younger than 12
An estimated 14,100 children under age 12 were injured in ATV-related incidents in 2010. This accounts for 12% of all ATV-related injuries.

According to the American Academy of Pediatrics:

In 1997, 12,600 people were injured as a result of snowmobiles
18% were children under 14 years of age
48% were ages 15-24
43% of pediatric snowmobile-related injuries occurred on private property where snowmobile use restrictions do not apply

Prevention: Some States have passed laws related to ATVs and youth, such as mandating the use of safety equipment; safety education courses; and minimum operator age requirements. Other prevention strategies include educating parents and youth about the skills needed to operate an ATV, the importance of supervision based on developmental skill level, personal protective equipment, having an ATV that is appropriate to the size of the operator, and the dangers of having passengers on ATVs.

Few States have enacted snowmobile-related age restrictions or helmet laws. Children as young as 8 years old may legally operate a snowmobile in some States. Age restrictions, graduated licensing, and safety education courses would also be an appropriate intervention to preventing snowmobile related injuries and fatalities in children and youth.

Drowning Prevention courses can be useful for teaching safety skills for jet skiers and preventing injury.
For alcohol and illicit drug abuse, visit our Underage Drinking & Illicit Drug Abuse injury topic page.

Definition: The misuse and abuse of prescription medications involves obtaining and taking these drugs without a prescription and for a nonmedical purpose. Teens and young adults are at risk of abusing prescription medications because they are widely available, free or inexpensive, and falsely believed to be safer than illicit drugs.

Magnitude of the Problem: Prescription drug use increased sharply from 1997 to 2007, and the abuse of these drugs is now the U.S.'s fastest growing drug problem (Executive Office of the President, Epidemic: Responding to America's Prescription Drug Abuse Crisis, 2011).

The 2011 Youth Risk Behavior Surveillance questionnaire found that almost 21% of high school students reported taking a prescription drug without a prescription at least once in their lifetime.
According to the Archives of Internal Medicine (2011;171(11):1034-1036),more than three-quarters of youth and young adults ages 18-25 received painkillers only from nonmedical sources compared with 52% of those older than age 50.
More teens abuse prescription drugs than cocaine, heroin, and methamphetamine (National Council on Alcoholism and Drug Dependence's Prescription Drugs webpage).

Prevention: Strategies to reduce prescription medication abuse among youth include:

Educating parents and caregivers about the importance of keeping prescription medications locked up;
Encouraging parents and caregivers to talk with teens about the dangers of misusing and abusing prescription drugs and over-the-counter medications;
Educating the public about how to properly dispose of old or unneeded medications;
Training health care providers to screen patients for past or current substance use and to monitor patients' use of prescribed medications; and
Understanding the role of prescription drug monitoring programs (PDMPs) in reducing prescription medication misuse/abuse and working with PDMPs to increase their effectiveness.
Definition: Intimate partner violence (IPV) is abuse that occurs between two people in a close relationship. The term "intimate partner" includes current and former spouses and dating partners. IPV exists along a continuum from a single episode of violence to ongoing battering. The longer intimate partner abuse goes on, the more serious the effects on the victim.

Magnitude of the Problem: According to the CDC,

In 2007, intimate partner violence resulted in 2,340 deaths.
70 percent of those who died were women, and 30% were men.
IPV cost the U.S. an estimated $5.8 billion in 1995 and $8.3 billion in 2003.
Almost 3 out of 10 women and 1 out of ten men have experienced IPV in the U.S.

Teen dating violence is a significant component of IPV. 9.8% of high school students reported that they had been purposely physically hurt by a dating partner in the past year (CDC - 2009 YRBS). A survey of adult victims of dating violence found that nearly 1 in 5 women and nearly 1 in 7 men first experienced partner violence between the ages of 11 and 17 (CDC - 2012 National Intimate Partner and Sexual Violence Survey). For more information and resources, visit our Teen Dating Violence injury topic page.

Prevention: The reduction of intimate partner violence relies upon identifying and addressing risk factors and developing programs to maintain and encourage healthy and safe relationships. To prevent teen dating violence, for example, responsible adults can mentor youth and model nonviolent dating relationships. Schools can implement policies to address potential dangers; provide training to parents, teachers, and administrators; and establish an advisory team from the community. Schools may also provide discussion groups for students and develop school safety plans.
Definition: Teen dating violence is a pattern of controlling behavior exhibited towards one teenager by another in a dating relationship. There are three major types of teen dating violence:

Physical abuse - hitting, punching, slapping, shoving, kicking
Emotional abuse - threats, name calling, screaming, yelling, ridiculing, spreading rumors, isolation, intimidation, stalking, and, more recently, using technology to harass or intimidate by texting, calling, and/or bullying or monitoring via social networking sites
Sexual abuse - unwanted touching or kissing, forced or coerced engagement in sexual acts

Magnitude of the Problem: According to the Centers for Disease Control and Prevention (CDC), 9% of high school students reported that they had been purposely physically hurt by a dating partner in the past year (CDC - 2011 Youth Risk Behavior Surveillance questionnaire). A survey of adult victims of dating violence found that nearly 1 in 5 women and nearly 1 in 7 men first experienced partner violence between the ages of 11 and 17 (CDC, 2012 National Intimate Partner and Sexual Violence Survey).

Prevention: Close to half of adolescents between the ages of 11 and 14 have dated (Liz Claiborne, Inc./Teen Research Unlimited, Tween and Teen Dating Violence and Abuse Study, 2008). Since dating relationships begin in early adolescence, prevention programs must start with this age group in order to be effective in deterring teen dating violence. Although more research is needed, Safe Dates, the Youth Relationships Project, the 4th R curriculum, the Ending Violence curriculum, and the Shifting Boundaries program are all promising practices for increasing awareness of the risks and consequences of dating violence and/or reducing teen dating violence behavior.
Definition: Youth violence can be violence either against or committed by a child or adolescent. Violent crimes include child abuse and neglect, rape, murder, and nonfatal assault. Bullying and school violence are also considered subsets of youth violence.

Magnitude of the Problem: According to the CDC,

In 2007, 5,764 young people ages 10 to 24 were murdered--an average of 16 each day. Of these victims, 84% were killed with firearms.
For young people ages 10-24, homicide is the second leading cause of death.
In 2008, more than 656,000 young people ages 10 to 24 were treated in emergency departments for injuries sustained due to violence.
Among 10 to 24 year olds, homicide is the leading cause of death for African Americans, the second leading cause of death for Hispanics, and the third leading cause of death for American Indians, Alaskan Natives, and Asian/Pacific Islanders

Prevention: Factors that may protect some youth from violence include: connectedness to family or other adults; ability to discuss problems with parents; the perception that parental expectations for school performance are high; frequent shared activities with parents; youth involvement in social activities; commitment to school; and the consistent presence of parent during at least one of the following: when awakening, when arriving home from school, during evening mealtimes, and when going to bed.

A number of measures may indirectly affect the factors that contribute to youth violence. Programs that address community deterioration (improving areas for children to play and providing supervised activities); alcohol abuse; gun safety; non violence coping skills; and economic issues can also help to prevent youth violence.

Domestic violence and child abuse often occur in the same family. Children who witness violence between parents are at risk of serious mental health and other problems. Domestic violence prevention and abuse services can help break the cycle of violence for children.
Enhance protective factors and
reverse/reduce risk factors
Address all forms of drug abuse, alone
or in combination
Address the type of drug abuse problem
in the local community, target
modifiable risk factors, and strengthen
identified risk factors
Address risks specific to populations or
audience characteristics
Family-based prevention programs
Enhance family bonding and
relationships and include parenting
Provide practice in developing,
discussing, and enforcing family
policies on substance abuse
Train in drug education and
School prevention programs should:
Be designed to intervene as early as
preschool to address risk factors
Target improving academic and socialemotional
learning for elementary age
students to address risk factors, with focus
on the following skills:
Emotional awareness
Social problem-solving
Academic support, especially in reading
Middle and high school prevention
programs should increase academic
and social competence with the
following skills:
Study habits and academic support
Peer relationships
Self-efficacy and assertiveness
Drug resistance
Reinforcement of anti-drug attitudes
Strengthening of personal commitments
against drug abuse
Community prevention programs
Focus on key transition points, such
as transition to middle school
Combine two or more programs, such
as family-based and school-based
programs, to be more effective
Present consistent, community-wide
messages in various settings
When delivering prevention programs:
Retain core elements of research-based
Be long-term with repeated interventions
Include teacher training on good classroom
Employ interactive techniques that allow for
active involvement in learning