Abstract
Background. In recent years, a textbook titled Health and Hygiene has been introduced into the 12th-grade curriculum in Iran. The current research has examined the necessary revisions to the 12th-grade health and hygiene curriculum based on teachers' and students' perceptions.
Methods. This study employs a qualitative approach and conventional content analysis to examine the perceptions of female teachers and students. Based on this, in 2022, perceptions of 22 teachers and 19 12th-grade students in the provinces of West Azerbaijan and East Azerbaijan were investigated through semi-structured interviews. Participants were selected using purposive sampling. To verify the trustworthiness of the research information, the reliability criterion was applied, using two review methods by 12 participants and a review by four non-participating experts. For data analysis, Graneheim & Lundman’s strategy has been used.
Results. From data analysis, 174 codes, three themes, and 26 sub-themes were obtained. The themes extracted from the research are: the need to align the curriculum with different academic fields; the inappropriateness of the 12th grade; the need to adjust the grade levels of the curriculum; and the need to revise the curriculum's goals and content.
Conclusion. The 12th-grade health and hygiene curriculum requires fundamental revisions; such revisions can increase its likelihood of achieving its goals.
Extended Abstract
Background
Promoting students’ health is one of the most significant approaches in education. According to the emphases outlined in the Fundamental Reform Document of Education in Iran, one of the joint programs mandated for implementation by the Ministry of Health and Medical Education and the Ministry of Education is the development of health literacy among students. One of the most effective strategies for promoting student health is to focus on self-care and its principles, tailored to students' physical and psychological development.
Since, considering the various human, social, and cultural contexts of health education, the conventional content analysis method can describe the lived experiences of teachers and students in greater depth, this study seeks to explain the necessary revisions to the 12th-grade health and wellness curriculum based on the perceptions of female students and female teachers of this curriculum.
Methods
This study aims to identify necessary revisions to the 12th-grade health and hygiene curriculum based on the lived experiences of female students and female teachers. The research employs a qualitative approach and uses a descriptive phenomenological method to analyze participants’ lived experiences. Conducted in 2022, the sampling was purposive and employed a combination of maximum variation and snowball sampling techniques, guided by specific inclusion criteria.
Maximum variation sampling was used to recruit individuals from diverse backgrounds, and snowball sampling was used when participant referrals were necessary. The inclusion criteria for students were as follows: (a) being a 12th-grade student, (b) having completed all schooling in urban public schools, (c) having a normal socioeconomic and cultural family background, and (d) residing in either East Azerbaijan or West Azerbaijan provinces. Based on these criteria, the lived experiences of 19 students concerning puberty and hygiene education were explored through semi-structured interviews. A total of 19 individual interviews were conducted.
For teacher participants, the inclusion criteria were: (a) having taught the "Health and Hygiene" course since 2018, (b) holding an academic degree in health or biological sciences, and (c) having at least five years of teaching experience in secondary education. Student interviews ranged from 27 to 50 minutes (average 34 minutes), whereas teacher interviews ranged from 20 to 55 minutes (average 28 minutes). Interviews were conducted until data saturation was reached. Sample interview questions included: “How did you experience the Health and Hygiene curriculum?” “What pleasant or unpleasant experiences have you had with it?”, and “Please describe your own experiences.” Each interview was analyzed using Colaizzi’s method. To ensure the study’s trustworthiness, Lincoln and Guba’s criteria—including credibility, transferability, dependability, and confirmability—were applied. Participant validation (12 individuals) and expert review (4 professors in educational psychology, health education, and social medicine) were used to enhance credibility.
Results
Demographic self-reports revealed that 9 of the student participants were from East Azerbaijan and 10 from West Azerbaijan. Of these, five were in the mathematics stream, 7 in the natural sciences, and 7 in the humanities. Among the teachers, 10 were from East Azerbaijan and 12 from West Azerbaijan. From data analysis, 174 codes, three main themes, and 26 sub-themes were extracted. The main themes included: the necessity of curriculum differentiation by academic stream; the inappropriateness of 12th grade for this subject and the need to change the grade level; and the need to revise the curriculum's goals and content. Findings suggest that the Health and Hygiene curriculum should be revised to adopt a holistic approach that integrates the local community, the school, and students. Efforts to better integrate health and education sectors should become a social priority, acknowledging the interdependence of learning and health. Such integration not only supports healthy students but also contributes to the development of effective and healthy schools. Health research institutes have identified the integration of health literacy into curricula from kindergarten through grade 12 as a remedy for the current confusion in the educational system and as a critical pathway to improving public health literacy. This integration can improve public health, strengthen dialogue among school authorities, health officials, teachers, parents, and students, and engage learners in health matters within both formal and informal educational settings.
Conclusion
In interpreting the findings, one notable reason for curriculum revision is the centralized nature of curriculum planning in Iran. Studies and existing evidence from general and secondary education curricula indicate a highly centralized system in which uniform curricula are designed for all students, often lack specificity regarding the skills and knowledge students should acquire, and limit the influence of teachers and students. A key limitation of this study is its focus solely on the 12th-grade textbook-based Health and Hygiene curriculum, thereby excluding other health-related curricula. Based on the findings, it is recommended that this curriculum be revised to align its delivery across educational stages, disciplines, and grade levels, and that it reconsider both its goals and content.
Practical Implications of Research
The findings of this study can inform necessary revisions to the secondary school health curriculum in order to enhance student health and strengthen the effectiveness of health education programs in schools.