Inclusive Practices in Health Education
GUIDANCE DOCUMENT
Inclusive Practices in Health Education
Acknowledgements
SHAPE America extends its appreciation to the many professionals who reviewed this document and contributed to its development, including the members of the Inclusive Practices in Health Education Task Force listed below:
Samuel Burns, Fargo School District, ND
Mari Jones, Health Educator, KY
Mary Malam, DREAM Technical Academy, MN
Angie Miyashiro, Health Educator, HI
Jongho Moon, Montclair State University, NJ
Tracy Stefano, K-12 Supervisor of Health & PE, East Hartford Public Schools, CT
Audra VanRaden, Community High School District 218, IL
Tara Whitney (co-chair), Montgomery County School District, MD
Kathleen Vogt, Arlington Central School District, NY
Emily Zien (co-chair), Tumwater Middle School, Beaverton, OR
Copyright © 2024 by SHAPE America | All rights reserved.
PO Box 225
Annapolis Junction, MD 20701
800-213-9527
SHAPE America – Society of Health and Physical Educators serves as the voice for 200,000+ health and physical education professionals across the United States The organization’s extensive community includes a diverse membership of health and physical educators, as well as advocates, supporters, and 50+ state affiliate organizations
Since its founding in 1885, the organization has defined excellence in school-based health education and physical education For decades, SHAPE America’s National Physical Education Standards have served as the foundation for well-designed physical education programs across the country, just as the SHAPE America National Health Education Standards serve as the foundation for effective skills-based health education Together, these national standards provide a comprehensive framework for educators to deliver high-quality instruction and make a positive difference in the health and well-being of every preK-12 student
Find additional resources at shapeamerica org
RATIONALE
Inclusive Practices in Health Education Task Force Rationale: To provide strategies and practices that promote a student-centered learning environment and to create resources for preK-12 educators and HETE programs that aid in supporting educators to make their health education space one that values each student in the room.
“As educators, we can develop lesson plans and instructional experiences that (1) consider the experiences and realities of our students belonging to multiple social and cultural identities, while (2) including acknowledgement and critical examination of power and inequality, and (3) incorporating individual and social contexts (peers, school, home, and community) as fluid and dynamic.”
(Grant & Boddy, 2025).
INTRODUCTION
In the evolving landscape of health education, the shift toward a student-centered learning environment is paramount. This approach emphasizes the importance of creating educational spaces that are inclusive and respectful of each student’s unique background and experiences.
The core of this strategy involves the development and implementation of inclusive practices and resources tailored for preK-12 educators and health and physical education teacher education (HETE) programs. These resources aim to empower educators to transform their health education spaces into nurturing environments that value and support every student.
The foundation of this approach rests on a shared definition of inclusion:
“The active, intentional, and ongoing engagement with diversity, including intentional policies and practices that promote the full participation and sense of [safety and] belonging of every person.” (CommonHealth Action).
This definition underscores the commitment to an educational setting where every individual feels valued, safe and engaged.
Central to this educational supplement is the understanding and application of inclusive practices’ six key competencies, which include:
1. Cultural Competency and Responsiveness: Central to creating an inclusive learning environment is the ability of educators to be culturally competent and responsive. This involves recognizing and integrating diverse cultural perspectives into health education. According to Geneva Gay’s conceptualization of culturally responsive teaching, it focuses on using the cultural traits, experiences and perspectives of ethnically diverse students as conduits for more effective teaching.
2. Accessibility: Ensuring that health education is accessible to all students is crucial. This means creating learning materials and environments that are easily understandable and usable by students with varying abilities and backgrounds.
3. Language Considerations: Adhering to the Health Equity Guiding Principles for Inclusive Communication is essential. It is about ensuring that health education is delivered in a language and manner that is inclusive and respectful of all students, taking into account the diverse linguistic backgrounds in the classroom.
4. Safe Environments: The establishment of safe and supportive environments is fundamental to effective health education. Following the CDC’s guidelines on “Safe and Supportive Environments: Classroom Management,” educators are encouraged to create spaces where students feel secure and respected, fostering a conducive learning atmosphere.
5. Community Connections: Strengthening community connections is key to a holistic health education approach. The CDC highlights the importance of school connectedness in its report, “School Connectedness Helps Students Thrive,” noting that students who feel connected at school are less likely to engage in health-risk behaviors.
6. Advocacy: Empowering educators to advocate for specific student populations or needs is vital. This involves utilizing resources like the Youth Risk Behavior Surveillance System’s (YRBSS) data to identify and address the unique health challenges and requirements of different student groups.
CULTURAL COMPETENCY AND
RESPONSIVENESS
Central to creating an inclusive learning environment is the ability of educators to be culturally competent and responsive. This involves recognizing and integrating diverse cultural perspectives into health education. Recommendations include:
• Establish relationships with students and provide opportunities for students to share their cultural backgrounds, with a focus on identity and health.
• Cultivate respect for and validate diverse perspectives on health and well-being.
• Provide opportunities to explore a wide variety of health-enhancing behaviors.
• Understand and acknowledge that stigmas and biases impact people’s concept of health.
• Use culturally diverse case studies and examples that reflect the backgrounds of the students.
• Identify and validate the complexities and multitudes of various social groups (socioeconomic status, genders, cultural background, family makeup, abilities and sexual orientation) and how these impact an individual’s decision-making
• Offer examples that feature visually diverse examples of people and situations (e.g., race, language, gender, sexuality, ability, social status) when talking about what influences a variety of “health behaviors.”
• Recognize health-based disparities due to socioeconomic and social determinants of health.
• Be aware of cultural expression in everyday life (e.g., food choices, hygiene).
o Differences in cultural norms
o Cultural self-awareness
o Historical trauma associated with public health and health care systems
• Incorporate students’ customs, characteristics, experience and perspectives as a way to connect to classroom instruction.
• Consistently include topics and gender identities that are culturally relevant and affirming for LGBTQIA+ youth.
• Use materials that reflect a wide range of identities and backgrounds
Skills-Based Standards Examples
Health promotion concepts:
• Integrate diverse health practices into curriculum
Analyzing influences:
• Allow students to reflect on how their biographical, cultural, religious, geographic and social upbringing influences their health behaviors.
o Explore how family background and culture impact various health decisions (e.g., nutrition, how to decide to become sexually active, accessing mental healthcare, deciding to get vaccines)
• Examine “influences” and “health behaviors” as socially designed constructs and discuss how the “ideals” of health and well-being are shaped by social and cultural narratives.
Accessing information and services:
• Be mindful of cultural norms and practices when discussing information-seeking behaviors. Some people may prefer individualistic approaches while others prefer a more collaborative effort.
• Acknowledge a wide spectrum of health-promoting products and services
Interpersonal communication:
• Allow students to practice using the skill of communication in situations that might be uncomfortable (e.g., refusal skills, compromise, making a decision against a social norm).
Decision-making:
• Explore how implicit bias and discrimination play a role in preconceived notions of “good decisions” and “bad decisions ”
• Allow a safe space for students to engage in discussion determining a “healthy decision” from an “unhealthy decision” using ideologies from varying perspectives
Goal-setting:
• Allow for multiple perspectives of what constitutes a meaningful goal
• Provide a wide array of examples of types of goals people set (e.g., academic, hobby, personal development, health and fitness, family)
• Provide examples of notable diverse role models who have shared the highs and lows of their journey to success.
Self-management (practicing health promotion):
• Validate and explore varying perspectives on what it means to “enhance health” vs. “reduce health risks ”
Advocacy:
• Provide opportunities for students to research cultural health practices that have led to positive community health outcomes.
• Examine how cultural norms and values influence health advocacy in different cultures and communities.
ACCESSIBILITY
Ensuring that health education is accessible to all students is crucial. This means creating learning materials and environments that are easily understandable and usable by students with varying abilities and backgrounds. Recommendations include:
• Supply materials that are suitable for students of all ability levels (physical, cognitive and emotional) as well as English language learners:
o Word walls, visuals, posters, anchor charts
o Assistive technology
o Speech-to-text
• Allow students to demonstrate their learning through a variety of mediums, such as text, images, audio, and video.
• Recognize common barriers to healthcare accessibility in your community, including socioeconomic status and social determinants of health.
o Acknowledge and teach about health disparities.
• Present content through a variety of modalities, such as text, images, audio and video to aid vocabulary acquisition and comprehension of the skill.
Skills-Based Standards Examples
Health promotion concepts:
• Provide age- and developmentally appropriate health content (i.e., consider the cognitive level of your students).
Accessing information and services:
• Recognize common barriers to healthcare accessibility in your community, including socioeconomic status and social determinants of health.
Decision-making:
• Provide access to a decision-making model that reflects your students’ ability levels.
Goal-setting:
• Create accessible templates for students to have access to track progress on their goal
Advocacy:
• Discuss ways to advocate for equity in health care accessibility (e.g., uninsured or minimal insurance coverage).
LANGUAGE CONSIDERATIONS
Adhering to the Health Equity Guiding Principles for Inclusive Communication is essential. It is about ensuring that health education is delivered in a language and manner that is inclusive and respectful of all students, taking into account the diverse linguistic backgrounds in the classroom. Recommendations include:
• Present content through a variety of mediums, such as text, images, audio and video to aid vocabulary acquisition and comprehension of health-enhancing concepts.
• Use materials that are suitable for students with a variety of language competencies, particularly English language learners.
o Word walls, visuals, posters, anchor charts
• Consider students who may not be strong in their own language and how that can impact their ability to comprehend concepts.
• Avoid stereotypes and biases.
• Use gender-neutral language.
• Use current vocabulary.
• Present information to students and families in native languages.
• Collaborate with school staff around accommodating language learners.
• Educate to help understand disease does not have a language barrier.
• Provide an opportunity for high quality health education to everyone
Skills-Based Standards Examples
Accessing information and services:
• Encourage students to identify information, products and services that are offered in multiple languages.
• Promote local services based off of language
• Provide tools to access reliable resources
Interpersonal communication:
• Consider the impact of language variations when teaching and learning about how to communicate in a healthy way.
• Offer opportunities for students to learn how to communicate with people who do not speak the same language as them.
Decision-making:
• Provide the resources necessary for students to be able to understand the skill of decision-making regardless of their native language
Goal-setting:
• Offer vocabulary in multiple languages that meet the criteria for goal-setting.
Self-management (practicing health promotion):
• Consider how language variations may limit students’ ability to avoid health risks.
• Consider students who may not be strong in their own language and how that can impact their ability to reduce health risks
Advocacy:
• Encourage bilingual or multilingual health advocacy campaigns.
• Highlight the role of language in effective health communication and advocacy.
SAFE ENVIRONMENTS
The establishment of safe and supportive environments is fundamental to effective health education. Following the CDC’s guidelines on “Safe and Supportive Environments: Classroom Management,” educators are encouraged to create spaces where students feel secure and respected, fostering a conducive learning atmosphere. Recommendations include:
• Make known one’s own pronouns and then encourage the use of appropriate pronouns/preferred names. Provide the option for students to share pronouns and preferred names in confidence.
• Employ strategies that help everyone know everyone’s name and insist on proper pronunciation.
• Establish clear guidelines for respectful communication and confidentiality.
• Address bullying or stigma related to health issues promptly and effectively.
• Learn about significant aspects of young people’s backgrounds with a focus on identity and health.
• Use materials that reflect a variety of cultures and perspectives
• Have awareness of different student health needs
• Provide welcoming, inclusive and safe environments that allow students to trust and respect one another
• Use scenarios that are “pronoun neutral, using they or them instead of using only binary terms like she and he. ” (Grant & Boddy, 2025).
• “Develop equitable calling-on practices where each student has an opportunity to share rather than just the student who always raises their hand or the student you call on to “call out” because you think they are not paying attention.” (Grant & Boddy, 2025).
• “Create a partnership and class environment where all voices are valued and all students feel seen and heard to share their cultural assets with the class even if they are not the predominant narrative in that school community ” (Grant & Boddy, 2025).
Skills-Based Standards Examples
Accessing information and services:
• Provide a safe place where students can access sensitive information without being threatened or bullied
• Take time to understand your students to create an environment that provides the resources that are necessary to their needs.
• Create an environment that encourages students to recognize and access reliable information.
Interpersonal communication:
• Teach refusal skills and why they are important.
• Educate students on cultural differences in body language and other nuances related to respectful communication
Decision-making:
• Create a classroom climate that allows students to explore the impact of one’s own values and morals on various decision-making scenarios
• Allow students to share varying perspectives on making decisions and how culture, upbringing, identity, etc., play a role in defining a “health-enhancing decision.”
• Cultivate mutual respect between students and their peers around the understanding that one person’s “healthy decision” may be different from another’s.
Goal-setting:
• Practice non-judgmental attitudes regarding aspirations and goals.
• Promote collaborative goal-setting activities where students can work together to identify shared goals.
Self-management (practicing health promotion):
• Consider how the school environment provided can promote or deter students from health-enhancing behaviors.
• Consider students’ regular environments outside of school that do not promote healthenhancing behaviors.
Advocacy:
• Address bullying or stigma related to health issues promptly and effectively.
• Provide opportunities for students to connect health advocacy to their lived experiences.
COMMUNITY CONNECTIONS
Strengthening community connections is key to a holistic health education approach. The CDC highlights the importance of school connectedness in its report, “School Connectedness Helps Students Thrive,” noting that students who feel connected at school are less likely to engage in health-risk behaviors. Recommendations include:
• Get to know the individual young people in your classroom.
• Explore ways to build connections with community members through guest speakers or field trips.
• Provide opportunities for students to explore health resources and support that is available in their community.
• Connect with available community resources, facilities and services in your community.
• Consider health care or health services that are available to your community members for free or at a reduced fee (sliding scale discount) for people without health insurance.
• Understand barriers and limitations in regard to geographic diversity (i.e., what is accessible based on geography)
• Connect with community areas that will provide access for all students and respect who they are, their culture, and their lifestyle.
Skills-Based Standards Examples
Accessing information and services:
• Provide resources for students to access and use outside of the classroom to communicate their needs (i.e. how to find a mental health professional, where to go for STI/pregnancy testing, where to go if you are a victim or know somebody who is a victim of domestic violence).
• Offer guidance on accessing affordable or free resources.
• Focus on the surrounding areas of your population.
• Be aware of local laws and regulations.
• Collaborate with community health organizations for educational resources or events.
Decision-making:
• Offer various resources in the community that students can access when they need assistance making healthy decisions.
• Encourage students to talk with trusted adults when navigating the decision-making process for various health behaviors
Goal-setting:
• Encourage students to share their goals with trusted adults.
• Students can interview adults in their life to learn more about the process that worked for a goal they have set and achieved in the past.
• Facilitate a larger-scale school goal challenge (e.g., monthly health-enhancing behavior goals)
Self-management (practicing health promotion):
• Promoting allyship for those who are still learning health-enhancing behaviors
Advocacy:
• Encourage students to collaborate with local health organizations for advocacy projects.
• Guide students on how to identify community health needs and how to address them.
• Promote projects that involve family and community participation in health advocacy.
ADVOCACY
Empowering educators to advocate for specific student populations or needs is vital. This involves utilizing resources like the Youth Risk Behavior Surveillance System’s (YRBSS) data to identify and address the unique health challenges and requirements of different student groups. Recommendations include:
• Identify needs and necessary supports for LGBTQIA+ students
• Identify platforms and forums for voicing student health concerns.
• Recognize the effects of discrimination and marginalization on one’s personal health and the health of others.
• Seek out resources for understanding diverse student health needs
• Encourage critical thinking about how to improve health policies or practices in schools and communities
• Use YRBS data to discuss and address prevalent health issues among youth.
Skills-Based Standards Examples
Accessing information and services:
• Share resources that can be used for specific student populations or student needs
• Provide lists of local community agencies for assistance with bills, food, heating, pregnancy, and shelter
• Provide access to resources that are relevant to various student populations (with regard to race, culture, socioeconomic status, gender identity, sexual orientation, etc.), which can be used in the decision-making process
Decision-Making:
● Build an understanding that when students make the best decision for themselves, they are advocating for their own health.
● Provide examples of decision-making scenarios that are relevant to students from varying backgrounds
Advocacy:
• Access resources that allow educators to advocate for specific student populations or student needs
• Provide instructional opportunities for students to develop communication skills to be able to advocate for the health of themselves and others
• Build a supportive network for health education advocacy
EXTERNAL RESOURCES
• Inclusive Images (CDC)
• Developing Inclusive Communications (CDC)
• Person-First Language (CDC)
• Principles of Community Engagement (CDC)
• Investing in Student Health: The Importance of Partnerships (CDC)
• Family-School-Community Partnerships (National Center on Safe Supportive Learning Environments)
• American Psychological Association (APA) Inclusive Language Guide
• Rethinking Cultural Competence: Shifting to Cultural Humility
• School Connectedness Helps Students Thrive (CDC)
• Youth Risk Behavior Surveillance System Data (CDC)
Learn about your own cultural assumptions and values and how it informs your work:
• Health Education Teacher Coaching Form (CDC)
• LGBTQ Inclusivity in Schools: A Self-Assessment Tool (CDC)
• Personal Self-Assessment of Anti-Bias Behavior (Anti-Defamation League)
• Harvard Implicit Bias (Harvard University)
• Critical Reflection Questions (SHAPE America)
• Weight Bias Quiz
• Culturally Responsive Checklist (Cairn Guidance)
Professional development:
• Gender Spectrum: Principles of Gender-Inclusive Puberty and Health Education
• Advocates for Youth: Building Cultural Responsiveness: A Toolkit for Youth-Service Professionals
• Advocates for Youth: Steps for Working Effectively With Young People From a Variety of Backgrounds
• Human Rights Campaign: Supporting and Caring for Our Gender Expansive Youth
• Trevor Project: Guide to Being an Ally to Transgender and Nonbinary Young People
• Learning for Justice: Critical Practices for Anti-Bias Education
• GLSEN: Ready, Set, Respect: Elementary Toolkit
REFERENCES
Grant, C. D., & Boddy, T. E. (2025). Intersectionality in Health Education. Human Kinetics.
Suggested Citation:
SHAPE America – Society of Health and Physical Educators (2024). Inclusive Practices in Health Education [Guidance Document]. Annapolis Junction, MD: Author