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AOHS Global Health

Lesson 10Behavioral Risk Factors

In this lesson, students learn about high-risk behaviors and associated health outcomes. They learn about health determinants that are linked to risky behaviors. By developing concept maps, they analyze the links between high-risk behaviors and injury and disease. In preparation for their culminating project, they write an argument about pressing health issues related to nutritional, environmental, or behavioral risk factors.

Advance Preparation In Class Period 4, each student will need access to a computer for Internet research. In Class

Period 5, each student will also need word processing software. In this lesson, students are placed in groups of four to begin work on their culminating project. Put

some thought into grouping students according to their skills and work styles as well as to the topics they’ve chosen, so that all groups are likely to succeed with their project.

This lesson is expected to take 5 class periods.

Lesson FrameworkLearning ObjectivesEach student will:

Identify the high-risk behaviors that have the biggest impact on global health Describe the general relationship between risky behavior and disease, and explain how a risky

behavior can impact an entire population* Evaluate how health determinants can influence individual high-risk behaviors Explain the ways that risky behaviors increase risk for a particular disease and identify the health

determinants that come into play Evaluate all aspects of global health issues that merit attention and determine which issue

deserves resources to be the next global initiative*This is one of the 16 key learning objectives assessed by the NAFTrack Certification end-of-course exam for this course.

Copyright © 2012–2016 NAF. All rights reserved.

AOHS Global Health Lesson 10 Behavioral Risk Factors

Academic Standards The relevant Common Core State Standards are too extensive to list here but are an important basis for this lesson. For details, please refer to the separate document “Correlations to the Common Core Standards” (available in the Course Planning Tools section of the course materials).

Practice speaking and active listening skills (National Health Science Standards 2015, Standard 2.15)

Discuss religious and cultural values as they impact healthcare (such as: ethnicity, race, religion, gender) (National Health Science Standards 2015, Standard 6.21)

Describe strategies for prevention of disease (National Health Science Standards 2015, Standard 9.12)

Determine the academic subject matter, in addition to high school graduation requirements, necessary for pursuing a health science career (Common Career Technical Core 2012, HL 1)

AssessmentAssessment Product Means of Assessment

Concept map that shows links between a risky behavior and injuries and diseases (Student Resource 10.4)

Assessment Criteria: Concept Map (Teacher Resource 10.3)

Notes on behavioral risk factors (Student Resource 10.5)

Assessment Criteria: Behavioral Risk Factors in Global Health (Teacher Resource 10.4)

Brief argument about an important issue related to environmental, nutritional, or behavioral risk factors (Student Resource 10.6)

Assessment Criteria: Pressing Health Issue Argument (Teacher Resource 10.5)

Prerequisites Knowledge about nutritional and environmental risk factors Knowledge of scope of health determinants Knowledge about substance abuse

Instructional Materials Teacher Resources

Teacher Resource 10.1, Presentation and Notes: Risky Behaviors and Health Outcomes (includes separate PowerPoint file)

Teacher Resource 10.2, Answer Key: Vignettes on Health Determinants and Risky Behaviors Teacher Resource 10.3, Assessment Criteria: Concept Map Teacher Resource 10.4, Assessment Criteria: Behavioral Risk Factors in Global Health

Copyright © 2012–2016 NAF. All rights reserved. 2


Teacher Resource 10.5, Assessment Criteria: Pressing Health Issue Argument Teacher Resource 10.6, Key Vocabulary: Behavioral Risk Factors Teacher Resource 10.7, Bibliography: Behavioral Risk Factors

Student Resources Student Resource 10.1, Note Taking: Risky Behaviors and Health Outcomes Student Resource 10.2, Reading: Risky Behaviors and Health Outcomes Student Resource 10.3, Vignettes: Health Determinants and Risky Behaviors Student Resource 10.4, Assignment: Concept Map Student Resource 10.5, Notes: Behavioral Risk Factors Student Resource 10.6, Writing Assignment: Pressing Health Issue Argument

Equipment and Supplies LCD projector and computer for PowerPoint presentation Computers with Internet access and word processing software (one for each student) Whiteboard, blackboard, or flip chart Sticky notes (about 10 per student) Basic art supplies to make a concept map, such as markers, scissors, glue, rulers, and recycled

magazines

Lesson StepsStep Min. Activity

CLASS PERIOD 1

1 10 Correlations: Risky Behavior and Health OutcomesThis activity introduces students to the concept of risky behaviors and activates students’ prior knowledge to identify health outcomes of risky behaviors.

To begin, write the following list on the board:

Sitting around too much (being sedentary) Not wearing a seat belt Having unprotected sex



Step Min. Activity

Ask students to tell a partner what they think the items have in common, and then have students share their responses with the class.

Explain that this list describes risky behaviors. Tell students that high-risk behaviors potentially threaten the health of the person who manifests the behavior, and they can threaten the health of others.

Then refer students to Student Resource 10.1, Note Taking: Risky Behaviors and Health Outcomes. Have students work in pairs to complete the second column, where they write down what they know about how a behavior affects health outcomes. Ask students to read the directions, and then answer their questions. Explain that as they watch a presentation in the next activity, they will complete the What I Learned column of the chart.

After pairs complete their work, ask them to share different examples they wrote as health outcomes. Take a minute to reinforce the difference between a health behavior and a health outcome. Make sure students understand that bad eating habits, for example, should always be classified as a behavior and not as an outcome. Obesity, on the other hand, is always an outcome and never a behavior.

2 30 Presentation: Risky Behaviors and Health OutcomesThis activity provides students with a more in-depth understanding of diseases and injuries that can be attributed to high-risk behaviors. It also develops students’ listening and note-taking skills.

To prepare, make notes to guide class discussion using Teacher Resource 10.1, Presentation Notes: Risky Behaviors and Health Outcomes. Have Teacher Resource 10.1, Presentation: Risky Behaviors and Health Outcomes (separate PowerPoint file), ready to show as a full-screen slideshow using an LCD projector.

Refer students to Student Resource 10.1, Note Taking: Risky Behaviors and Health Outcomes. Remind them that as they watch the presentation, they should take notes by filling in the third column of their chart.

Present the slideshow. Use the notes you prepared previously and the questions on the slides to encourage class discussion.

This presentation is duplicated as Student Resource 10.2, Reading: Risky Behaviors and Health Outcomes. If an LCD projector is unavailable, students can read the presentation, answer the discussion questions in their notebook, and discuss their answers as a class. This student resource is also useful for review.

After the presentation, divide the class into pairs and have them compare their notes for completeness and accuracy. Then have the pairs report out as a class to answer any outstanding questions or misunderstandings. If time allows, ask students to add information about India and sub-Saharan Africa to their regional reference maps. If time is running short, tell students to add information to their regional reference maps for homework.

To conclude, summarize that finding solutions to problems associated with risky behavior involves helping people change their behavior.

3 10 Vignettes: Health Determinants and Risky Behaviors



Step Min. Activity

This activity helps students activate prior knowledge about health determinants that are linked to risky behaviors.

To begin, ask student volunteers to recall what a health determinant is. If students struggle to remember, offer this way of putting it: a health determinant is one of many things that determine your health—it’s a factor that affects how healthy you are. Then refer students to Student Resource 10.3, Vignettes: Health Determinants and Risky Behaviors. Tell students to use what they know about health determinants to complete the resource. Ask students to read the instructions, and then answer their questions.

Explain that students should complete the resource for homework and come to class prepared to review it.

CLASS PERIOD 2

4 15 Homework Review: Health Determinants and Risky Behavior VignettesStudents solidify their understanding of the relationship between health determinants and risky behaviors as they review their homework.

Call on different volunteers to offer their answers for each vignette. Encourage students with different answers to explain their reasoning. Take this opportunity to clear up misunderstandings and to point out that a range of answers can be accurate. Use Teacher Resource 10.2, Answer Key: Vignettes on Health Determinants and Risky Behaviors, to help guide the discussion.

You may wish to gauge student understanding by assessing this assignment on a credit/no-credit basis.

Explain that you’ve been talking about risky behaviors; but the other side of the coin is behaviors that protect a person from engaging in risky behavior. Ask students to call out some ideas on what these might be. Flesh out their suggestions with some of the following:

Positive relationship with parents Positive relationships with other adults Community service or volunteering for an hour a week Solid boundaries for behavior at home and school, with realistic consequences Doing something creative every week Being on a team or doing something physically active regularly Reading for pleasure Feeling good about the future

Professionals call these protective factors. Teens who have these in their lives are less likely to engage in risky behaviors and more likely to grow up into caring, healthy, responsible adults.

5 35 Concept Map: Risky BehaviorsStudents discover that concept maps are a means of showing how a risky behavior can



Step Min. Activity

lead to injury or disease. The activity also focuses on the following college and career skill:

Demonstrating teamwork and collaboration

Assign students to groups of three. Then refer them to Student Resource 10.4, Assignment: Concept Map. Direct their attention to the sample concept map on the second page. Explain that a concept map is used to communicate ideas about a complex subject. Ask the groups to spend a few moments studying the example.

Write the questions listed below on the board. Use the questions to help students understand the purpose of a concept map. Ask students to discuss their responses as a group, and then have groups share their responses with the class:

What is the broad topic of the concept map? Why do you think the creator of the map put some information in boxes with dotted

borders and some information in boxes with broken line borders? What do the dotted lines between boxes show? What is the most interesting or creative aspect of the map?

Once students have a general understanding of the purpose and function of a concept map, tell them that they will be creating a concept map that shows how a risky behavior can lead to injury or disease. Ask students to read the instructions and assessment criteria, and then answer any questions. Emphasize that students should let their creativity be their guide but that they should also focus on making sure that the relationship between the elements on their map is clear and accurate. Also, tell them that they can let their classmates’ work serve as inspiration, but their work should be original and unique. Then provide students with various materials that they can use to create their maps, such as chart paper, markers, recycled magazines, scissors, and rulers.

Consider having students create concept maps using an online brainstorming tool like SpiderScribe (www.spiderscribe.net) or MindMeister (www.mindmeister.com).

At the end of the activity, tell students that they will have 20 minutes in the next class period to complete their concept maps.

CLASS PERIOD 3

6 20 Concept Map: Risky Behaviors (Continued)In this activity, students complete their concept maps.

Have students assemble in their groups and get right to work completing their concept maps. Remind them to make sure that their map meets or exceeds the assessment criteria. Circulate to answer questions as students work.

When students complete their maps, have them post them around the room in preparation for a gallery walk.

7 10 Gallery Walk: Concept Maps


http://www.mindmeister.com/

http://www.spiderscribe.net/


Step Min. Activity

Students provide each other with feedback on their concept maps.

Point out that the ability to recognize how different parts of a broad concept fit together is an important professional skill that is especially useful for problem solving. Explain that in this gallery walk, they will study their peers’ concept maps and look for elements or relationships that might help to solve a problem.

Pass out sticky notes, about 9 or 10 per student, and instruct students to view at least three of the maps in the room. Write the following questions on the board, and ask students to respond to the questions on sticky notes for each map they view:

What relationship or element do you see that gives a new clue about a way to decrease this risky behavior? Try to find something you haven’t thought about before.

How could the relationship between the elements on the map be even clearer?

Tell students they can turn their map in for assessment, or they can make improvements to their map based on their peers’ feedback and turn it in at the beginning of the next class period. Use Teacher Resource 10.3, Assessment Criteria: Concept Map, to assess students’ work.

You may wish to have students vote on three maps that will be displayed in a public area at school, such as the library, media center, or cafeteria.

8 15 Note Taking: Behavioral Risk FactorsThis activity allows students to review what they’ve learned in this lesson and evaluate which behavioral health issues are the most pressing.

Ask students to look at Student Resource 10.5, Notes: Behavioral Risk Factors. Its format will be familiar by now, since they have filled out a similar chart on environmental and nutritional issues. Remind students that the objective is to look through all of their resources from this lesson and fill in the chart with behavioral issues that they feel are worthy of consideration for their culminating project. Ask students to take note of the assessment criteria at the end of the resource, and answer any questions.

Tell students to complete their chart for homework. They will need to use it in the next class period.

9 5 Homework: Narrowing the Project ChoicesStudents look at the project options they have accumulated and narrow them down in preparation for choosing one.

For homework, tell students to look at the environmental, nutritional, and behavioral issues they have written down as possibilities for their culminating project. Tell them to narrow their choices down to three, and to write these down on a piece of paper. Explain that you will use their choices to help you form project groups in the next class period.

CLASS PERIOD 4



Step Min. Activity

10 10 Notes Review: Behavioral Risk FactorsStudents compare the notes they took on behavioral risk factors.

Prior to class, decide which factors (in addition to an interest in the same or similar global health issues) are most important for choosing project groups in which students will work well together. Also decide if it matters whether more than one group winds up choosing the same issue or if you want each group to work on a different one.

As students come into class, collect their papers with their top three project choices. Make sure their names are on the papers.

Place students in groups of four. Ask them to share which issues they chose for Student Resource 10.5, Notes: Behavioral Risk Factors. Then tell them to discuss the following prompts:

In our community, I think the risky behaviors that are a problem are…. If I were a health professional in our community, interventions I’d try in order to

decrease these risky behaviors are….

As students are talking in their groups, look through their project choices. Combine these with the other factors you have considered and choose project groups.

Collect and assess Student Resource 10.5, Notes: Behavioral Risk Factors using Teacher Resource 10.4, Assessment Criteria: Behavioral Risk Factors in Global Health. Return Student Resource 10.5 to the students as soon as possible, so that they can refer to it as they work on their culminating project as needed.

11 15 Culminating Project Work: Choosing an IssueStudents learn who their project group mates are and work together to finalize their choice of issue for their culminating project. This activity focuses on the following college and career skills:

Working effectively with a diversity of individuals and perspectives Demonstrating adaptability and flexibility

Organize students into their project groups. Note that one factor in choosing these groups is the similarity of their top three project choices. Their first task as a group is to choose one issue to work on together for their culminating project. Explain that professionals are often required to relinquish their top choices in order to move forward with group consensus, and many students today will need to be flexible and agree on a topic that was not their favorite. The ability to adapt to a new priority and work just as hard on it as if it were their top choice is a great experience that will serve them well.

Tell students to follow this procedure to make their choices:

Group members pitch their favorite issue to the group. Group members ask questions and carefully consider each suggestion. Group members take a vote.

Circulate among groups as they work through the process of making a choice, guiding and encouraging students to be open and willing to go with the majority. If there is a tie, students can undergo the procedure again or ask you for guidance on making the final decision.



Step Min. Activity

Once groups have made their choices (which should take about 5–10 minutes), ask each group to tell you their decision and write these on the board. Decide whether you want to ensure that each group works on a different issue or if some overlap is acceptable.

12 25 Culminating Project Work: Pressing Health Issue Written ArgumentStudents produce a written argument about a pressing health issue attributed to an environmental, nutritional, or behavioral risk factor. This activity also focuses on the following college and career skill:

Thinking critically and systemically to solve difficult problems Demonstrating the ability to write effectively

Refer students to Student Resource 10.6, Writing Assignment: Pressing Health Issue Argument. Ask students to read the instructions, including the assessment criteria, and then answer any questions.

Have students read the example argument in their project group and write down their ideas about whether the argument meets each of the assessment criteria. Then assign one of the assessment criteria to each group, and ask them to share with the class why they think the example argument does or does not meet the assessment criterion assigned to them. Make sure they give specific examples of how the argument measures up to the assessment criterion.

Before students begin, emphasize that their argument should be persuasive—meaning that they are expressing a belief or a point of view that they want others to share.

If students have Internet access, another option is to have them use a cloud-based application like Google Docs to upload, edit, and review documents as a group. This will be especially useful when students are working on their argument for homework.

Then have students get to work. Circulate as students work and answer any questions they have about their argument.

At the end of the class period, let students know that they will have 40 minutes in the next class period to finish writing their argument. Tell them that they should complete any remaining research they need to bolster their argument for homework.

CLASS PERIOD 5

13 40 Culminating Project Work: Pressing Health Issue Written Argument (Continued)In this activity, students write the rough and final draft of their argument.

Assemble students in their project groups. Have each group designate one person to collect everyone’s research into one document and then share this complete set of research with the group members (if the research hasn’t already been collected via Google docs or a similar application).

Next, groups should decide which member is responsible for writing the rough draft of different sections of the argument. Circulate around the room, ensuring that each group has divided up responsibilities and written down who is in charge of writing each



Step Min. Activity

section.

Assign each student to a computer with word processing software. Then students should use their research to write the rough draft of their section of the argument. When they have completed their drafts, one member of the group acts as the editor and puts each section into one complete draft. All group members read this draft, noting areas that need revision. Remind students to keep an eye out for issues as noted in Student Resource 10.6. The editor should make revisions with input from the group, and all group members should review the final draft of their argument before submitting it. Assess the arguments using Teacher Resource 10.5, Assessment Criteria: Pressing Health Issue Argument. When you return them, remind students to keep their assessed argument in their project portfolio.

To conclude, remind students that the work they have done on their argument prepares them for working on their culminating project slideshow.

14 10 Final Reflection: High-Risk Behavior and Health OutcomesThe purpose of this activity is for students to reflect on risky behavior and health outcomes in their own lives.

Write the following prompts on the board:

One potentially risky behavior I have is…. Based on what I now know about risky behavior, I might consider changing….Ask students to complete the statements in their notebook. Tell them that they will not be required to share what they wrote.After students have finished writing, ask volunteers to share their statements, if they feel comfortable doing so.Then conclude by pointing out that students can use what they know about risky behavior to help them make healthy lifestyle choices now and in the future.

ExtensionsContent Enrichment

Have students assess what risky behaviors are most prevalent in their communities. Instruct students to design surveys that they will use to collect data about risky behavior in their communities. Students should cover a range of risky behaviors—from texting while driving to unsafe sex—on their surveys. Then work with students to develop a plan to have community members fill out surveys anonymously. Once students have collected data, work with them to use charts and graphs to organize and then draw conclusions from their data.

Remind students that experts believe that there are certain measures that can be taken to curb high-risk drinking, such as prohibiting the sale of alcohol at certain times of day or prohibiting drinking in public places, like sports events. Explain that some people feel, though, that measures like these infringe on people’s personal freedom and rights. Have students participate in an organized debate about the issue.



Explain that since the AIDS epidemic began, public awareness about the consequences of risky sexual behavior has risen dramatically in the United States and elsewhere. Have students conduct and film interviews with their parents, grandparents, or other older adults whom they are close to about what life was like before AIDS. They may wish to ask them questions about how they first learned about the disease, if the epidemic changed the behavior of people they knew, and the difference they see in the awareness of young people compared with people’s awareness in their generation. Then instruct students to edit the interviews into five- to eight-minute videos to share with the class.

Expand the Final Reflection activity into a longer journal assignment. Ask students to journal how they do with their own risky behaviors every day for a week. At the end of the week, ask students to reread their previous entries and respond to the following questions:o What about the behavior was risky?o Why did I participate in the risky behavior?o How could I change my behavior?o Why would changing my behavior be hard?

STEM Integration Math: Have students examine a few case studies that illustrate how statistics show or don’t show

correlation. Help students understand the basic statistical math that establishes correlation. Technology: Create and use an online discussion forum on the topic of risky behavior at your

school. Alternatively, start an online discussion forum where students contribute to a descriptive list of protective assets. The forum can be hosted on your class or school website using an application like Moodle, or use a host service such as Boardhost.

Additional Cross-Curricular Ideas English Language Arts: Have students write persuasive essays that argue in support of a certain

solution to obesity. Students may choose to write solutions such as restricting the sale of high-fat food, mandatory physical activity during the work day, or increased use of medications that help control weight. Students can choose a solution that they have learned about or a solution that is their own idea.

History: Have students research and develop either a physical or online exhibition that explains the history of traffic laws in their state. Their exhibit should also include information about current, or persistent, road-safety problems that still need to be addressed. You may wish for students to view this online exhibit about the history of traffic laws in Indiana to get ideas for their project: http://www.in.gov/judiciary/citc/museum/traffic/index.html.


http://www.in.gov/judiciary/citc/museum/traffic/index.html

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