Missouri 2020 School Health Profiles Report

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The report presents findings from a weighted survey of lead health education teachers in Missouri schools regarding health education courses from grades 6 to 12. It includes data on the number of required health education courses, schools requiring two or more health education courses, courses taught per grade level, handling failed courses, and materials provided to health education teachers.


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  1. MISSOURI 2020 School Health Profiles Report Weighted Lead Health Education Teacher Survey Results 1. Percentage of schools in which students take the following number of required health education courses in grades 6 through 12. a. 0 courses 1.2 10.0 0.0 5.0 b. 1 course 45.8 16.3 45.3 32.0 22.4 c. 2 courses 26.0 26.0 24.8 10.3 d. 3 courses 29.5 19.9 21.2 20.3 e. 4 or more courses 18.2 8.8 17.0 0 20 40 60 80 100 High Schools Middle Schools Junior/Senior High Schools All Schools Page 1 of 77

  2. MISSOURI 2020 School Health Profiles Report Weighted Lead Health Education Teacher Survey Results 1N. Percentage of all schools that require students to take two or more health education courses. 53.0 73.7 54.7 63.0 0 20 40 60 80 100 High Schools Middle Schools Junior/Senior High Schools All Schools Page 2 of 77

  3. MISSOURI 2020 School Health Profiles Report Weighted Lead Health Education Teacher Survey Results 2. Percentage of schools that taught a required health education course in each of the following grades.* NA a. Sixth grade 58.6 NA 58.1 NA 80.6 b. Seventh grade 66.6 77.1 NA 81.9 c. Eighth grade 64.4 77.4 0 20 40 60 80 100 High Schools Middle Schools Junior/Senior High Schools All Schools *Among schools with students in that grade. NA = Not available Page 3 of 77

  4. MISSOURI 2020 School Health Profiles Report Weighted Lead Health Education Teacher Survey Results 2. Percentage of schools that taught a required health education course in each of the following grades.* d. Ninth grade 83.0 NA 72.4 79.2 45.6 e. Tenth grade NA 44.5 45.1 24.6 f. Eleventh grade NA 29.5 26.4 25.7 g. Twelfth grade NA 23.7 25.0 0 20 40 60 80 100 High Schools Middle Schools Junior/Senior High Schools All Schools *Among schools with students in that grade. NA = Not available Page 4 of 77

  5. MISSOURI 2020 School Health Profiles Report Weighted Lead Health Education Teacher Survey Results 3. Percentage of schools that require students who fail a required health education course to repeat it.* 98.5 34.9 97.2 69.3 0 20 40 60 80 100 High Schools Middle Schools Junior/Senior High Schools All Schools *Among schools in which students take one or more required health education courses in any of grades 6 through 12. Page 5 of 77

  6. MISSOURI 2020 School Health Profiles Report Weighted Lead Health Education Teacher Survey Results 4. Percentage of schools in which those who teach health education are provided with each of the following materials.* a. Goals, objectives, and expected outcomes for health education 92.7 87.7 91.8 90.2 74.7 b. A chart describing the annual scope and sequence of instruction for health education 68.3 72.6 71.3 83.3 c. Plans for how to assess student performance in health education 73.1 68.9 75.5 85.4 d. A written health education curriculum 82.5 72.8 81.4 0 20 40 60 80 100 High Schools Middle Schools Junior/Senior High Schools All Schools *Among schools that teach health education. Respondents that answered NA are excluded. Page 6 of 77

  7. MISSOURI 2020 School Health Profiles Report Weighted Lead Health Education Teacher Survey Results 5. Percentage of schools in which the health education curriculum addresses each of the following skills. a. Comprehending concepts related to health promotion and disease prevention to enhance health 96.4 89.4 96.1 93.1 95.4 b. Analyzing the influence of family, peers, culture, media, technology, and other factors on health behaviors 89.2 96.1 92.7 91.8 c. Accessing valid information and products and services to enhance health 81.7 96.1 88.1 96.4 d. Using interpersonal communication skills to enhance health and avoid or reduce health risks 87.4 96.1 92.3 0 20 40 60 80 100 High Schools Middle Schools Junior/Senior High Schools All Schools Page 7 of 77

  8. MISSOURI 2020 School Health Profiles Report Weighted Lead Health Education Teacher Survey Results 5. Percentage of schools in which the health education curriculum addresses each of the following skills. e. Using decision-making skills to enhance health 96.4 90.0 96.1 93.4 93.1 f. Using goal-setting skills to enhance health 90.1 96.1 92.3 96.4 g. Practicing health-enhancing behaviors to avoid or reduce risks 89.1 96.1 93.0 91.6 h. Advocating for personal, family, and community health 85.3 96.1 89.6 0 20 40 60 80 100 High Schools Middle Schools Junior/Senior High Schools All Schools Page 8 of 77

  9. MISSOURI 2020 School Health Profiles Report Weighted Lead Health Education Teacher Survey Results 6. Percentage of schools in which those who teach sexual health education are provided with each of the following materials.* 83.3 a. An approved health education scope and sequence that includes learning objectives, outcomes, and content to guide sexual health education instruction 71.2 78.5 76.9 78.3 74.9 b. A written health education curriculum that includes objectives and content addressing sexual health education 66.6 74.3 66.5 56.9 c. Teacher pacing guides for sexual health education (i.e., schedules that regulate a teacher s pace of the unit or curriculum) 47.6 58.2 0 20 40 60 80 100 High Schools Middle Schools Junior/Senior High Schools All Schools *Among schools that teach sexual health education. Page 9 of 77

  10. MISSOURI 2020 School Health Profiles Report Weighted Lead Health Education Teacher Survey Results 6. Percentage of schools in which those who teach sexual health education are provided with each of the following materials.* 80.6 d. Teaching resources (e.g., lesson plans, handouts) to support sexual health education instruction 77.3 71.4 77.2 84.7 80.4 e. Strategies that are age-appropriate, relevant, and actively engage students in learning 76.7 81.1 82.3 76.1 f. Methods to assess student knowledge and skills related to sexual health education 72.2 77.4 0 20 40 60 80 100 High Schools Middle Schools Junior/Senior High Schools All Schools *Among schools that teach sexual health education. Page 10 of 77

  11. MISSOURI 2020 School Health Profiles Report Weighted Lead Health Education Teacher Survey Results 7. Percentage of schools that provide curricula or supplementary materials that include HIV, STD, or pregnancy prevention information that is relevant to lesbian, gay, bisexual, transgender, and questioning youth. 61.5 40.8 34.4 46.5 0 20 40 60 80 100 High Schools Middle Schools Junior/Senior High Schools All Schools Page 11 of 77

  12. MISSOURI 2020 School Health Profiles Report Weighted Lead Health Education Teacher Survey Results 8. Percentage of schools in which health education instruction is required for students in any of grades 6 through 12. 98.9 92.7 100.0 96.3 0 20 40 60 80 100 High Schools Middle Schools Junior/Senior High Schools All Schools Page 12 of 77

  13. MISSOURI 2020 School Health Profiles Report Weighted Lead Health Education Teacher Survey Results 9. Percentage of schools in which teachers tried to increase student knowledge on each of the following topics in a required course in any of grades 6 through 12 during the current school year. a. Alcohol- or other drug-use prevention 98.9 91.6 100.0 95.7 b. Asthma 71.7 72.3 75.6 72.8 96.6 c. Chronic disease prevention (e.g., diabetes, obesity prevention) 90.0 96.1 93.4 98.9 d. Emotional and mental health 89.0 97.9 94.1 62.1 e. Epilepsy or seizure disorder 50.6 63.3 57.1 0 20 40 60 80 100 High Schools Middle Schools Junior/Senior High Schools All Schools Page 13 of 77

  14. MISSOURI 2020 School Health Profiles Report Weighted Lead Health Education Teacher Survey Results 9. Percentage of schools in which teachers tried to increase student knowledge on each of the following topics in a required course in any of grades 6 through 12 during the current school year. f. Food allergies 82.4 74.5 89.8 80.3 g. Foodborne illness prevention 87.1 74.7 94.0 82.8 96.6 h. Human immunodeficiency virus (HIV) prevention 84.2 95.7 90.9 83.0 i. Human sexuality 66.1 80.4 75.0 95.6 j. Infectious disease prevention (e.g., influenza [flu] prevention) 87.1 93.9 91.3 0 20 40 60 80 100 High Schools Middle Schools Junior/Senior High Schools All Schools Page 14 of 77

  15. MISSOURI 2020 School Health Profiles Report Weighted Lead Health Education Teacher Survey Results 9. Percentage of schools in which teachers tried to increase student knowledge on each of the following topics in a required course in any of grades 6 through 12 during the current school year. k. Injury prevention and safety 95.4 89.8 100.0 93.7 l. Nutrition and dietary behavior 100.0 96.1 100.0 98.2 98.9 m. Physical activity and fitness 98.4 100.0 98.9 95.3 n. Pregnancy prevention 73.3 95.7 85.6 96.8 o. Sexually transmitted disease (STD) prevention 81.4 95.7 89.7 0 20 40 60 80 100 High Schools Middle Schools Junior/Senior High Schools All Schools Page 15 of 77

  16. MISSOURI 2020 School Health Profiles Report Weighted Lead Health Education Teacher Survey Results 9. Percentage of schools in which teachers tried to increase student knowledge on each of the following topics in a required course in any of grades 6 through 12 during the current school year. 96.9 p. Suicide prevention 84.8 90.0 89.8 98.9 92.1 q. Tobacco-use prevention 100.0 96.0 96.2 93.1 r. Violence prevention (e.g., bullying, fighting, dating violence prevention) 96.0 94.7 0 20 40 60 80 100 High Schools Middle Schools Junior/Senior High Schools All Schools Page 16 of 77

  17. MISSOURI 2020 School Health Profiles Report Weighted Lead Health Education Teacher Survey Results 10. Percentage of schools in which teachers taught each of the following tobacco-use prevention topics in a required course for students in any of grades 6 through 12 during the current school year. a. Identifying tobacco products and the harmful substances they contain 97.6 88.4 100.0 93.9 b. Identifying short- and long-term health consequences of tobacco product use 97.6 90.6 100.0 94.9 92.8 c. Identifying social, economic, and cosmetic consequences of tobacco product use 81.8 87.7 86.7 96.3 d. Understanding the addictive nature of nicotine 89.0 98.0 93.3 87.2 e. Effects of nicotine on the adolescent brain 82.5 91.9 86.0 0 20 40 60 80 100 High Schools Middle Schools Junior/Senior High Schools All Schools Page 17 of 77

  18. MISSOURI 2020 School Health Profiles Report Weighted Lead Health Education Teacher Survey Results 10. Percentage of schools in which teachers taught each of the following tobacco-use prevention topics in a required course for students in any of grades 6 through 12 during the current school year. f. Effects of tobacco product use on athletic performance 87.3 83.2 85.6 85.1 g. Effects of second-hand smoke and benefits of a smoke-free environment 92.6 85.9 93.9 89.7 95.3 h. Understanding the social influences on tobacco product use, including media, family, peers, and culture 88.1 97.9 92.5 95.3 i. Identifying reasons why students do and do not use tobacco products 88.8 97.9 92.9 76.9 j. Making accurate assessments of how many peers use tobacco products 74.0 82.2 76.7 0 20 40 60 80 100 High Schools Middle Schools Junior/Senior High Schools All Schools Page 18 of 77

  19. MISSOURI 2020 School Health Profiles Report Weighted Lead Health Education Teacher Survey Results 10. Percentage of schools in which teachers taught each of the following tobacco-use prevention topics in a required course for students in any of grades 6 through 12 during the current school year. k. Using interpersonal communication skills to avoid tobacco product use (e.g., refusal skills, assertiveness) 94.3 87.4 91.8 90.6 l. Using goal-setting and decision-making skills related to not using tobacco products 85.6 82.6 84.1 83.9 86.0 m. Finding valid information and services related to tobacco-use prevention and cessation 77.2 82.0 81.1 86.0 n. Supporting others who abstain from or want to quit using tobacco products 70.2 86.0 78.7 92.6 o. Identifying harmful effects of tobacco product use on fetal development 73.9 89.7 83.3 0 20 40 60 80 100 High Schools Middle Schools Junior/Senior High Schools All Schools Page 19 of 77

  20. MISSOURI 2020 School Health Profiles Report Weighted Lead Health Education Teacher Survey Results 10. Percentage of schools in which teachers taught each of the following tobacco-use prevention topics in a required course for students in any of grades 6 through 12 during the current school year. p. Relationship between using tobacco products and alcohol or other drugs 91.8 83.6 92.0 88.0 84.5 q. How addiction to tobacco products can be treated 73.7 83.9 79.4 91.8 r. Understanding school policies and community laws related to the sale and use of tobacco products 84.9 86.1 87.4 71.3 s. Benefits of tobacco product cessation programs 61.6 66.3 65.8 0 20 40 60 80 100 High Schools Middle Schools Junior/Senior High Schools All Schools Page 20 of 77

  21. MISSOURI 2020 School Health Profiles Report Weighted Lead Health Education Teacher Survey Results 10N. Percentage of schools that taught all 19 tobacco-use prevention topics during the current school year.* 51.0 48.4 52.3 50.1 0 20 40 60 80 100 High Schools Middle Schools Junior/Senior High Schools All Schools *Responses to question 10 a through s all are "yes." Page 21 of 77

  22. MISSOURI 2020 School Health Profiles Report Weighted Lead Health Education Teacher Survey Results 11. Percentage of schools in which teachers taught about the following tobacco products in a required course for students in any of grades 6 through 12 during the current school year. a. Cigarettes 94.1 89.2 100.0 93.0 b. Smokeless tobacco (e.g., chewing tobacco, snuff, dip, snus, dissolvable tobacco) 92.9 85.5 100.0 91.0 77.9 c. Cigars, little cigars, or cigarillos 68.2 86.0 75.1 68.8 d. Pipes 58.6 82.0 66.8 94.0 e. Electronic vapor products (e.g., e- cigarettes, vapes, vape pens, e-hookahs, mods, or brands such as JUUL) 89.8 100.0 93.3 0 20 40 60 80 100 High Schools Middle Schools Junior/Senior High Schools All Schools Page 22 of 77

  23. MISSOURI 2020 School Health Profiles Report Weighted Lead Health Education Teacher Survey Results 12. Percentage of schools in which teachers taught each of the following alcohol- and other drug-use prevention topics in a required course for students in any of grades 6 through 12 during the current school year. a. Differences between proper use and abuse of over-the-counter medicines and prescription medicines 94.1 79.3 91.9 86.8 b. Harmful short- and long-term physical, psychological, and social effects of using alcohol and other drugs 96.4 89.9 100.0 94.1 95.1 c. Situations that lead to the use of alcohol and other drugs 88.2 94.0 91.7 77.3 d. Alcohol and other drug use as an unhealthy way to manage weight 62.8 77.9 70.8 97.6 e. Identifying reasons why individuals choose to use or not to use alcohol and other drugs 86.7 92.3 91.5 0 20 40 60 80 100 High Schools Middle Schools Junior/Senior High Schools All Schools Page 23 of 77

  24. MISSOURI 2020 School Health Profiles Report Weighted Lead Health Education Teacher Survey Results 12. Percentage of schools in which teachers taught each of the following alcohol- and other drug-use prevention topics in a required course for students in any of grades 6 through 12 during the current school year. f. Using interpersonal communication skills to avoid alcohol and other drug use (e.g., refusal skills, assertiveness) 98.9 89.1 96.0 93.8 93.3 g. Supporting others who abstain from or want to quit using alcohol and other drugs 79.4 90.3 86.3 98.9 h. Understanding the social influences on alcohol and other drug use, including media, family, peers, and culture 87.4 97.9 93.4 90.8 i. How to persuade and support others to be alcohol and other drug free 84.2 91.9 88.0 0 20 40 60 80 100 High Schools Middle Schools Junior/Senior High Schools All Schools Page 24 of 77

  25. MISSOURI 2020 School Health Profiles Report Weighted Lead Health Education Teacher Survey Results 13. Percentage of schools in which teachers taught each of the following sexual health topics in a required course in any of grades 6, 7, or 8 during the current school year. a. How HIV and other STDs are transmitted NA 73.2 38.7 64.7 b. Health consequences of HIV, other STDs, and pregnancy NA 72.4 45.2 65.7 NA c. The benefits of being sexually abstinent 77.8 46.9 69.9 NA d. How to access valid and reliable health information, products, and services related to HIV, other STDs, and pregnancy 63.7 45.4 59.2 NA e. The influences of family, peers, media, technology and other factors on sexual risk behaviors 72.0 48.3 66.1 0 20 40 60 80 100 High Schools Middle Schools Junior/Senior High Schools All Schools NA = Not available Page 25 of 77

  26. MISSOURI 2020 School Health Profiles Report Weighted Lead Health Education Teacher Survey Results 13. Percentage of schools in which teachers taught each of the following sexual health topics in a required course in any of grades 6, 7, or 8 during the current school year. f. Communication and negotiation skills related to eliminating or reducing risk for HIV, other STDs, and pregnancy NA 65.1 55.0 62.7 g. Goal-setting and decision-making skills related to eliminating or reducing risk for HIV, other STDs, and pregnancy NA 61.6 45.2 57.6 NA h. Influencing and supporting others to avoid or reduce sexual risk behaviors 68.1 46.8 63.0 NA i. Efficacy of condoms, that is, how well condoms work and do not work 46.1 23.4 40.8 NA j. The importance of using condoms consistently and correctly 37.2 22.5 33.7 0 20 40 60 80 100 High Schools Middle Schools Junior/Senior High Schools All Schools NA = Not available Page 26 of 77

  27. MISSOURI 2020 School Health Profiles Report Weighted Lead Health Education Teacher Survey Results 13. Percentage of schools in which teachers taught each of the following sexual health topics in a required course in any of grades 6, 7, or 8 during the current school year. k. How to obtain condoms NA 22.9 16.0 21.2 l. How to correctly use a condom NA 16.5 16.0 16.4 NA m. Methods of contraception other than condoms 45.3 25.8 40.6 NA n. The importance of using a condom at the same time as another form of contraception to prevent both STDs and pregnancy 39.2 26.0 36.0 NA o. How to create and sustain healthy and respectful relationships 75.4 61.3 71.8 0 20 40 60 80 100 High Schools Middle Schools Junior/Senior High Schools All Schools NA = Not available Page 27 of 77

  28. MISSOURI 2020 School Health Profiles Report Weighted Lead Health Education Teacher Survey Results 13. Percentage of schools in which teachers taught each of the following sexual health topics in a required course in any of grades 6, 7, or 8 during the current school year. p. The importance of limiting the number of sexual partners NA 60.6 42.1 56.1 NA q. Preventive care (such as screenings and immunizations) that is necessary to maintain reproductive and sexual health 64.3 35.5 57.3 NA r. How to communicate sexual consent between partners 53.0 32.3 48.0 NA s. Recognizing and responding to sexual victimization and violence 56.4 39.0 52.1 0 20 40 60 80 100 High Schools Middle Schools Junior/Senior High Schools All Schools NA = Not available Page 28 of 77

  29. MISSOURI 2020 School Health Profiles Report Weighted Lead Health Education Teacher Survey Results 13. Percentage of schools in which teachers taught each of the following sexual health topics in a required course in any of grades 6, 7, or 8 during the current school year. NA t. Diversity of sexual orientations and gender identities 31.6 19.2 28.6 NA 40.6 u. How gender roles and stereotypes affect goals, decision making, and relationships 35.4 39.3 NA 75.8 v. The relationship between alcohol and other drug use and sexual risk behaviors 58.3 71.4 0 20 40 60 80 100 High Schools Middle Schools Junior/Senior High Schools All Schools NA = Not available Page 29 of 77

  30. MISSOURI 2020 School Health Profiles Report Weighted Lead Health Education Teacher Survey Results 13. Percentage of schools in which teachers taught each of the following sexual health topics in a required course in any of grades 9, 10, 11, or 12 during the current school year. a. How HIV and other STDs are transmitted 93.9 NA 93.0 93.6 b. Health consequences of HIV, other STDs, and pregnancy 92.3 NA 93.0 92.6 93.7 c. The benefits of being sexually abstinent NA 90.7 92.6 88.8 d. How to access valid and reliable health information, products, and services related to HIV, other STDs, and pregnancy NA 86.4 87.9 95.0 e. The influences of family, peers, media, technology and other factors on sexual risk behaviors NA 97.6 96.0 0 20 40 60 80 100 High Schools Middle Schools Junior/Senior High Schools All Schools NA = Not available Page 30 of 77

  31. MISSOURI 2020 School Health Profiles Report Weighted Lead Health Education Teacher Survey Results 13. Percentage of schools in which teachers taught each of the following sexual health topics in a required course in any of grades 9, 10, 11, or 12 during the current school year. f. Communication and negotiation skills related to eliminating or reducing risk for HIV, other STDs, and pregnancy 87.4 NA 90.9 88.8 g. Goal-setting and decision-making skills related to eliminating or reducing risk for HIV, other STDs, and pregnancy 88.3 NA 84.4 86.8 89.6 h. Influencing and supporting others to avoid or reduce sexual risk behaviors NA 83.9 87.5 79.9 i. Efficacy of condoms, that is, how well condoms work and do not work NA 72.9 77.2 72.7 j. The importance of using condoms consistently and correctly NA 66.8 70.4 0 20 40 60 80 100 High Schools Middle Schools Junior/Senior High Schools All Schools NA = Not available Page 31 of 77

  32. MISSOURI 2020 School Health Profiles Report Weighted Lead Health Education Teacher Survey Results 13. Percentage of schools in which teachers taught each of the following sexual health topics in a required course in any of grades 9, 10, 11, or 12 during the current school year. k. How to obtain condoms 52.8 NA 53.5 53.1 l. How to correctly use a condom 46.0 NA 40.2 43.7 75.0 m. Methods of contraception other than condoms NA 73.3 74.4 77.9 n. The importance of using a condom at the same time as another form of contraception to prevent both STDs and pregnancy NA 73.3 76.1 93.6 o. How to create and sustain healthy and respectful relationships NA 93.0 93.4 0 20 40 60 80 100 High Schools Middle Schools Junior/Senior High Schools All Schools NA = Not available Page 32 of 77

  33. MISSOURI 2020 School Health Profiles Report Weighted Lead Health Education Teacher Survey Results 13. Percentage of schools in which teachers taught each of the following sexual health topics in a required course in any of grades 9, 10, 11, or 12 during the current school year. p. The importance of limiting the number of sexual partners 87.1 NA 86.4 86.8 89.7 q. Preventive care (such as screenings and immunizations) that is necessary to maintain reproductive and sexual health NA 77.3 84.9 76.4 r. How to communicate sexual consent between partners NA 79.5 77.6 80.5 s. Recognizing and responding to sexual victimization and violence NA 78.6 79.7 0 20 40 60 80 100 High Schools Middle Schools Junior/Senior High Schools All Schools NA = Not available Page 33 of 77

  34. MISSOURI 2020 School Health Profiles Report Weighted Lead Health Education Teacher Survey Results 13. Percentage of schools in which teachers taught each of the following sexual health topics in a required course in any of grades 9, 10, 11, or 12 during the current school year. 59.8 t. Diversity of sexual orientations and gender identities NA 52.2 56.8 67.4 NA u. How gender roles and stereotypes affect goals, decision making, and relationships 69.0 68.0 95.0 NA v. The relationship between alcohol and other drug use and sexual risk behaviors 92.9 94.2 0 20 40 60 80 100 High Schools Middle Schools Junior/Senior High Schools All Schools NA = Not available Page 34 of 77

  35. MISSOURI 2020 School Health Profiles Report Weighted Lead Health Education Teacher Survey Results 13N_1. Percentage of schools that taught all 22 sexual health topics in any of grades 6, 7, or 8 during the current school year.* NA 10.7 12.4 11.1 0 20 40 60 80 100 High Schools Middle Schools Junior/Senior High Schools All Schools *Responses to question 13 a through v all are "yes." NA = Not available Page 35 of 77

  36. MISSOURI 2020 School Health Profiles Report Weighted Lead Health Education Teacher Survey Results 13N_2. Percentage of schools that taught all 22 sexual health topics in any of grades 9, 10, 11, or 12 during the current school year.* 30.3 NA 29.0 29.8 0 20 40 60 80 100 High Schools Middle Schools Junior/Senior High Schools All Schools *Responses to question 13 a through v all are "yes." NA = Not available Page 36 of 77

  37. MISSOURI 2020 School Health Profiles Report Weighted Lead Health Education Teacher Survey Results 14. Percentage of schools in which teachers assess the ability of students to do each of the following in a required course for students in any of grades 6, 7, or 8 during the current school year. a. Comprehend concepts important to prevent HIV, other STDs, and pregnancy NA 66.6 41.3 60.8 NA b. Analyze the influence of family, peers, culture, media, technology, and other factors on sexual risk behaviors 63.2 46.7 59.3 NA c. Access valid information, products, and services to prevent HIV, other STDs, and pregnancy 55.4 40.2 51.8 NA d. Use interpersonal communication skills to avoid or reduce sexual risk behaviors 66.8 53.6 63.7 0 20 40 60 80 100 High Schools Middle Schools Junior/Senior High Schools All Schools NA = Not available Page 37 of 77

  38. MISSOURI 2020 School Health Profiles Report Weighted Lead Health Education Teacher Survey Results 14. Percentage of schools in which teachers assess the ability of students to do each of the following in a required course for students in any of grades 6, 7, or 8 during the current school year. NA e. Use decision-making skills to prevent HIV, other STDs, and pregnancy 66.5 50.2 62.7 NA 66.9 f. Set personal goals that enhance health, take steps to achieve these goals, and monitor progress in achieving them 56.9 64.6 NA 59.4 g. Influence and support others to avoid or reduce sexual risk behaviors 50.2 57.2 0 20 40 60 80 100 High Schools Middle Schools Junior/Senior High Schools All Schools NA = Not available Page 38 of 77

  39. MISSOURI 2020 School Health Profiles Report Weighted Lead Health Education Teacher Survey Results 14. Percentage of schools in which teachers assess the ability of students to do each of the following in a required course for students in any of grades 9, 10, 11, or 12 during the current school year. a. Comprehend concepts important to prevent HIV, other STDs, and pregnancy 92.8 NA 82.3 88.7 90.0 b. Analyze the influence of family, peers, culture, media, technology, and other factors on sexual risk behaviors NA 91.0 90.4 82.8 c. Access valid information, products, and services to prevent HIV, other STDs, and pregnancy NA 80.1 81.8 88.2 d. Use interpersonal communication skills to avoid or reduce sexual risk behaviors NA 86.8 87.6 0 20 40 60 80 100 High Schools Middle Schools Junior/Senior High Schools All Schools NA = Not available Page 39 of 77

  40. MISSOURI 2020 School Health Profiles Report Weighted Lead Health Education Teacher Survey Results 14. Percentage of schools in which teachers assess the ability of students to do each of the following in a required course for students in any of grades 9, 10, 11, or 12 during the current school year. 85.1 e. Use decision-making skills to prevent HIV, other STDs, and pregnancy NA 84.5 84.9 83.5 NA f. Set personal goals that enhance health, take steps to achieve these goals, and monitor progress in achieving them 86.7 84.7 84.3 NA g. Influence and support others to avoid or reduce sexual risk behaviors 75.8 81.0 0 20 40 60 80 100 High Schools Middle Schools Junior/Senior High Schools All Schools NA = Not available Page 40 of 77

  41. MISSOURI 2020 School Health Profiles Report Weighted Lead Health Education Teacher Survey Results 15. Percentage of schools in which teachers provided students with the opportunity to practice the following skills in a required course for students in any of grades 6 through 12 during the current school year. 77.6 a. Communication, decision-making, goal- setting, or refusal skills related to sexual health (e.g., through role playing) 54.0 78.2 66.8 86.5 58.6 b. Analyzing the influence of family, media, and culture on sexual health 85.8 73.5 79.2 51.0 c. Accessing valid sexual health information, products, and services 70.2 64.3 0 20 40 60 80 100 High Schools Middle Schools Junior/Senior High Schools All Schools Page 41 of 77

  42. MISSOURI 2020 School Health Profiles Report Weighted Lead Health Education Teacher Survey Results 16. Percentage of schools in which teachers implemented the following inclusive practices when providing sexual health education in a required course for students in grades 6 through 12 during the current school year.* a. Encouraged use of gender-neutral pronouns such as they/them during instruction to recognize gender diversity among students 42.4 26.7 35.6 33.8 b. Provided positive examples of lesbian, gay, bisexual, or transgender (LGBT) people and same-sex relationships 38.3 28.2 29.2 31.9 88.0 c. Encouraged students to respect others sexual and gender identities 66.2 82.6 76.8 44.6 d. Provided students with information about LGBT resources within the school (e.g., counseling services, student support groups like Gay/Straight Alliances or Genders and Sexualities Alliances) 28.4 29.3 34.1 25.9 e. Identified additional LGBT resources available in the community or online 19.8 17.5 21.5 0 20 40 60 80 100 High Schools Middle Schools Junior/Senior High Schools All Schools *Among schools that teach sexual health education. Page 42 of 77

  43. MISSOURI 2020 School Health Profiles Report Weighted Lead Health Education Teacher Survey Results 17. Percentage of schools in which teachers taught each of the following nutrition and dietary behavior topics in a required course for students in any of grades 6 through 12 during the current school year. a. Benefits of healthy eating 98.9 95.3 100.0 97.5 b. Benefits of drinking plenty of water 98.9 95.3 100.0 97.5 95.6 c. Benefits of eating breakfast every day 89.6 97.9 93.3 94.3 d. Food guidance using the current Dietary Guidelines for Americans (e.g., MyPlate) 92.0 100.0 94.4 98.9 e. Using food labels 90.2 98.0 94.7 0 20 40 60 80 100 High Schools Middle Schools Junior/Senior High Schools All Schools Page 43 of 77

  44. MISSOURI 2020 School Health Profiles Report Weighted Lead Health Education Teacher Survey Results 17. Percentage of schools in which teachers taught each of the following nutrition and dietary behavior topics in a required course for students in any of grades 6 through 12 during the current school year. f. Differentiating between nutritious and non-nutritious beverages 98.9 90.5 97.9 94.8 g. Balancing food intake and physical activity 98.9 94.4 100.0 97.1 98.9 h. Eating more fruits, vegetables, and whole grain products 92.7 100.0 96.3 97.6 i. Choosing foods and snacks that are low in solid fat (i.e., saturated and trans fat) 88.7 100.0 94.0 98.9 j. Choosing foods, snacks, and beverages that are low in added sugars 90.4 100.0 95.2 0 20 40 60 80 100 High Schools Middle Schools Junior/Senior High Schools All Schools Page 44 of 77

  45. MISSOURI 2020 School Health Profiles Report Weighted Lead Health Education Teacher Survey Results 17. Percentage of schools in which teachers taught each of the following nutrition and dietary behavior topics in a required course for students in any of grades 6 through 12 during the current school year. k. Choosing foods and snacks that are low in sodium 97.9 88.7 100.0 94.1 l. Eating a variety of foods that are high in calcium 95.4 88.7 97.9 92.8 94.1 m. Eating a variety of foods that are high in iron 86.3 97.9 91.3 93.1 n. Food safety 85.4 95.9 90.2 96.4 o. Preparing healthy meals and snacks 90.5 98.0 94.0 0 20 40 60 80 100 High Schools Middle Schools Junior/Senior High Schools All Schools Page 45 of 77

  46. MISSOURI 2020 School Health Profiles Report Weighted Lead Health Education Teacher Survey Results 17. Percentage of schools in which teachers taught each of the following nutrition and dietary behavior topics in a required course for students in any of grades 6 through 12 during the current school year. p. Risks of unhealthy weight control practices 98.9 87.8 98.0 93.6 95.4 q. Accepting body size differences 86.1 96.0 91.2 97.9 r. Signs, symptoms, and treatment for eating disorders 80.8 98.0 90.1 98.9 s. Relationship between diet and chronic diseases 83.6 95.9 91.2 0 20 40 60 80 100 High Schools Middle Schools Junior/Senior High Schools All Schools Page 46 of 77

  47. MISSOURI 2020 School Health Profiles Report Weighted Lead Health Education Teacher Survey Results 17. Percentage of schools in which teachers taught each of the following nutrition and dietary behavior topics in a required course for students in any of grades 6 through 12 during the current school year. 88.3 t. Assessing body mass index (BMI) 73.6 85.7 81.0 97.9 87.6 u. The influence of the media on dietary behaviors 100.0 93.6 83.1 68.6 v. Food production, including how food is grown, harvested, processed, packaged, and transported 81.6 76.1 0 20 40 60 80 100 High Schools Middle Schools Junior/Senior High Schools All Schools Page 47 of 77

  48. MISSOURI 2020 School Health Profiles Report Weighted Lead Health Education Teacher Survey Results 17N. Percentage of schools that taught all 22 nutrition and dietary behavior topics during the current school year.* 72.2 58.1 69.3 65.1 0 20 40 60 80 100 High Schools Middle Schools Junior/Senior High Schools All Schools *Responses to question 17 a through v all are yes. Page 48 of 77

  49. MISSOURI 2020 School Health Profiles Report Weighted Lead Health Education Teacher Survey Results 18. Percentage of schools in which teachers taught each of the following physical activity topics in a required course for students in any of grades 6 through 12 during the current school year. a. Short-term and long-term benefits of physical activity, including reducing the risks for chronic disease 96.6 97.5 98.0 97.3 b. Mental and social benefits of physical activity 96.6 96.6 100.0 97.3 95.1 c. Health-related fitness (i.e., cardiorespiratory endurance, muscular endurance, muscular strength, flexibility, and body composition) 98.4 96.1 96.8 91.6 d. Phases of a workout (i.e., warm-up, workout, and cool down) 97.7 94.1 94.9 95.1 e. Recommended amounts and types of moderate, vigorous, muscle- strengthening, and bone-strengthening physical activity 96.1 92.1 95.0 0 20 40 60 80 100 High Schools Middle Schools Junior/Senior High Schools All Schools Page 49 of 77

  50. MISSOURI 2020 School Health Profiles Report Weighted Lead Health Education Teacher Survey Results 18. Percentage of schools in which teachers taught each of the following physical activity topics in a required course for students in any of grades 6 through 12 during the current school year. f. Decreasing sedentary activities (e.g., television viewing, using video games) 94.1 98.4 98.0 96.9 g. Preventing injury during physical activity 95.1 97.5 94.1 96.0 87.3 h. Weather-related safety (e.g., avoiding heat stroke, hypothermia, and sunburn while physically active) 90.6 96.0 90.6 91.8 i. Dangers of using performance-enhancing drugs (e.g., steroids) 81.9 94.1 87.7 95.3 j. Increasing daily physical activity 98.4 94.1 96.4 0 20 40 60 80 100 High Schools Middle Schools Junior/Senior High Schools All Schools Page 50 of 77

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