The theory and practice of behaviour change in the school context

There is a large volume of teaching material on health education which provides factual information. Although facts are important, other factors are also involved in bringing about attitude and behaviour change. Taking the teaching of a difficult subject, that of "responsible sexual behaviour" to lower ability pupils aged 14-15 years, the author describes her approach which involves (a) the use of humour to remove defences; (b) the use of games to hold interest and promote involvement, the objective being to lead to serious discussion of sex before marriage, the use of contraception, abortion, adolescent-parent relationships, etc.; and (c) the use of self-assessment to determine individual contributions to the lesson and the impact of the teaching. The author then reviews current theories of attitude and behaviour change. "Health education", she says, "aims to immunize teenagers against pressures by exposure to them in small doses, as with measles. We need further to undermine harmful pressures and create new positive ones." This is no easy task for teachers, involving as it does individual motivation as well as the long-term modification of social norms. Hence the importance of adequate basic and in-service training to help teachers think in behavioural terms rather than in terms of imparting knowledge and to use tested methods of attitude and behaviour change.