HECAT FAQs

The Health Education Curriculum Analysis Tool (HECAT) is an assessment tool for examining school health education curricula. The HECAT can help school districts conduct a clear, complete, and consistent analysis of health education curricula based on the National Health Education Standards and CDC’s Characteristics of Effective Health Education Curricula. The HECAT results can help schools select or develop appropriate and effective health education curricula and improve the delivery of health education. The HECAT is customizable to meet local community needs and conform to the curriculum requirements of the state or school district.

The purpose of the HECAT is to provide state, regional and local education agencies with a common set of tools to assist with the selection or development of health education curricula. The HECAT contains guidance, analysis tools, scoring rubrics, and resources for carrying out a clear, complete, and consistent examination of health education curricula. The HECAT results can help schools select or develop appropriate and effective health education curricula, strengthen the delivery of health education, and improve the ability of health educators to influence healthy behaviors and healthy outcomes among school-age youth. The HECAT is customizable to meet local community needs and conform to the curriculum requirements of a state or school district. HECAT modules address the following curricula:

• Alcohol and Other Drugs
• Food and Nutrition
• Healthy Eating
• Mental and Emotional Health
• Personal Health and Wellness
• Physical Activity
• Safety
• Sexual Health
• Tobacco
• Violence Prevention
• Comprehensive Health Education

The HECAT is designed to be used by state, regional and local education agency staff and others responsible for selecting, supervising, developing or using health education curricula in schools. For example,

1. Curriculum committees or educators at school districts, schools, or community-based organizations that work with schools can use the HECAT, in conjunction with the state standards and health education frameworks or other locally determined requirements, to
   • Develop new or improved courses of study, frameworks, learning objectives, or curricula
   • Guide the selection of curricula available for purchase
   • Examine curricula currently in use
2. State or regional educational agency staff can use the HECAT to inform the development or review of
   • State health education standards or frameworks
   • Recommendations for conducting state or local curriculum review
   • State-recommended health education curricula
3. Developers of nationally disseminated and packaged curricula, such as nongovernmental organizations and for-profit curriculum development companies, can use the HECAT to design health education curricula that best meet the needs of schools and the young people they serve.
4. Institutions of higher education teacher preparation programs can use the HECAT to improve their students’ understanding of health education, curriculum analysis, and development of instructional skills.

The HECAT includes all the needed guidance and appraisal tools for carrying out a thorough and systematic assessment of a health education curriculum. Information, materials, processes and tools are included in the chapters, appendices, and glossary. The HECAT includes

• Essential background information and instructions for using the HECAT to review and improve locally developed curriculum.
• Guidance for using HECAT to develop a scope and sequence for health education.
• Templates to record important descriptive information about a curriculum for use in the curriculum review process.
• Preliminary curriculum considerations, such as accuracy, acceptability, feasibility, and affordability analyses.
• Curriculum fundamentals, such as teacher materials, culturally responsive and inclusive approaches, instructional design, and instructional strategies and materials.
• Customizable templates for state or local use.
• Specific health-topic knowledge and skills analyses.

No. The HECAT is not required as a condition for receiving funding from CDC or any other federal agency. CDC developed the HECAT to help improve health education curriculum selection and development. Its use is entirely voluntary.

The HECAT is available free of charge. You can select either the interactive, customizable online tool or the downloadable, print version.  Both are available on CDC’s Healthy Youth website.

The last time CDC updated the HECAT was 2011, with publication in 2012. Over the last decade, new evidence has emerged describing characteristics of primary prevention curricula and programing, delivered through a variety of settings including schools, to address topics impacting children and adolescent health. The 2021 updated literature on antecedents of adolescent risk and protective factors, behaviors, and behavior change.

Collectively, studies suggest well-designed, well-delivered school-based health interventions and programs can enable students to prevent disease and injury. A health education curriculum is the primary means through which schools deliver health education. HECAT provides practical guidance for schools and school districts using health education as a critical component of a coordinated approach to improving the health of all students.

The systematic process for conducting an analysis of health education curricula using HECAT has not changed with recent updates. Chapter 1, General Instructions provides the essential background information and instructions for conducting a health education curriculum review.

Updates to CDC’s HECAT serve to strengthen the existing research-based guidance for schools selecting, developing, or revising health education curricula. Incorporating information research, curriculum best practices, and key knowledge and skills expectations addressed within a single- or multi-topic health curriculum remain important for helping all students practice, adopt, and maintain health-enhancing behaviors.

No. HECAT 2021 includes the same 10 health topic areas found in previous versions; but does include one updated module title. These health-related topics have been identified by CDC to contribute to child and adolescent health.

• Alcohol and Other Drugs
• Food and Nutrition (formerly Healthy Eating)
• Mental and Emotional Health
• Personal Health and Wellness
• Physical Activity
• Safety
• Sexual Health
• Tobacco
• Violence Prevention
• Comprehensive Health Education

Using the HECAT can

• Help ensure a complete, thorough, and consistent review of a health education curriculum.
• Help clarify what should be included in a health education curriculum.
• Help ensure that the curriculum is aligned with research-based practices, the National Health Education Standards, and CDC’s Characteristics of an Effective Health Education Curriculum.
• Help identify instructional strategies that improve teaching and student learning.
• Inform your selection of a high-quality curriculum that is affordable and feasible to implement in your schools.
• Inform the development of a scope and sequence for health education.
• Provide sound and defensible justification for curriculum decisions to parents, school board members, and other people interested in health education in your community or state.

The HECAT can help ensure that your current health education curriculum selection or development process is systematic, consistent, and thorough and reflects current research and practice, which will strengthen your own curriculum selection or development processes.

Many school districts and schools do not have a systematic method for selecting health education curricula.  It can vary considerably, often driven by preferences of influential school board members, vocal parents, community activists, a small group of school staff, a single curriculum coordinator, or a salesperson from a commercial curriculum developer.  Selection should be guided by data, evidence, established priorities, state laws and regulations, and a systematic process that engages the whole community.

Considering this, the HECAT lays out a systematic process using established standards and clearly identified behavioral outcomes. Analysis solicits a broad range of expertise from the school and community and provides uniform criteria for assessing curricula in order to select, revise, or develop effective and desirable curricula that respond to variability in priorities.

To use the HECAT

• Print a copy of HECAT from cdc.gov/healthyyouth/HECAT or create a HECAT Online account
• Read the entire HECAT to become familiar with its contents and how it can meet your curriculum analysis, development, or selection needs. If using HECAT Online, read the HECAT User Guide found in the Help section.
• Review the Overview and Chapter 1, General Instructions. Chapter 1 provides the essential background information and instructions for conducting a health education curriculum review. Then, read all remaining chapters, follow the steps from Chapter 1 to review the curriculum, and complete the forms to finalize the HECAT.

No. The review of curricula using the HECAT should be conducted by a team — an individual should not do it alone.  A health education curriculum review team, working together, should complete the HECAT. This process may be conducted in-person or using HECAT Online, which allows for the creation of online curriculum review teams.

Yes. Some chapters and sections of the HECAT can be completed by one person, who then provides information to other review committee members. For example, Chapter 2, General Curriculum Information, captures general descriptive information needed to understand and review any health education curriculum and to make a final curriculum selection. One person who is very familiar with the curriculum, usually the curriculum coordinator, can complete the General Curriculum Information and provide the results to other review committee team members.

It is not advisable, however, to assign one person to review sections that would benefit from multiple perspectives and expertise. For example, acceptability of a curriculum typically varies within a community. It is critical that multiple reviewers complete the Acceptability Analysis together to ensure that the Acceptability Score reflects community perspectives, rather than only one individual’s point of view.

No. The health education curriculum review team also should include parents and other people from the community at-large. A suggested list of team members is provided in Chapter 1, General Instructions. All members should be stakeholders with an investment in the health and education needs and interests of the students in your school district or school.

No. But it is important that the most knowledgeable person(s) complete each section of the HECAT. The curriculum review team must have a broad range of expertise, and each of the team members should review only the HECAT components for which he or she is most qualified. For example, parents are invaluable in completing the Acceptability Analysis and, perhaps, less able to review the Skill Application. Chapter 1 in the HECAT provides a list of the persons who might be appropriate to serve on the curriculum review team and who have the expertise needed to complete some or all of the HECAT.

Even though it is not necessary for all team members to complete all sections of the HECAT, all members should receive the results of the entire HECAT analysis prior to making curriculum recommendations.  Chapter 1 of the HECAT provides guidance for using the HECAT results to make curriculum recommendations.

It is important to select review team members who have the necessary expertise to complete the HECAT. Chapter 1 provides a list of persons who should be considered on your review team for completing specific parts of the HECAT. For the Accuracy Analysis, for example, you should use persons who have research expertise (e.g., a university researcher), scientific expertise in the content area under review (e.g., a dietician for the topic “healthy eating”), and expertise in instructional delivery (e.g., a certified health educator or curriculum director). You should identify these experts prior to beginning the curriculum review. If desired, you can limit their assignments to cover only the parts of the HECAT for which they have expertise.

No. It is often helpful to talk with the curriculum developers in order to thoroughly complete Chapter 2, General Curriculum Information. You might also want to invite them to showcase their curricular materials (e.g., scope and sequence, charts showing alignment with the National Health Education Standards) before you begin your review. However, curriculum developers should not be included in the analysis or scoring process, nor should they be allowed to unduly influence review members’ analyses. Most developers of commercially packaged curricula have a primary interest in marketing their products.

It is not necessary, but all categories and items can be useful for selecting or developing a curriculum. You can determine which items in the HECAT are useful and important to include in your curriculum analysis and in the selection or development process. You also have the choice of determining how you want to use the HECAT items in your review process. For example, to make initial decisions and shorten the list of curricula to be seriously considered, some curriculum review teams have used Chapter 2, General Curriculum Information to collect general descriptive information about the curriculum; Chapter 4, Preliminary Curriculum Considerations, to determine curriculum accuracy, acceptability, feasibility, and affordability; and Chapter 5, Curriculum Fundamentals, to appraise the learning objectives, culturally responsive and inclusive approaches, teacher materials, curriculum design, instructional strategies and materials, promotion of norms that value positive health behaviors, and promotion of skills that reinforce positive health behaviors of a health education curriculum. The remainder of the HECAT (i.e., Chapter 6, Overview of Modules to appraise specific health-topic curricula) is then used to review the curricula under serious consideration.

Pilot reviews of individual topic curricula, using the HECAT, have taken from 4 to 16 hours per curriculum. No pilot reviews have been done to determine time needed to review a comprehensive health education curriculum. The time required for any curriculum review will depend on several factors, including

• The overall length of the HECAT you decide to use for curriculum analysis.
• Each reviewer’s understanding of health education and relevant health topics.
• Each reviewer’s familiarity with the HECAT.
• Each reviewer’s familiarity with the curriculum being reviewed.
• The breadth and scope of the curriculum under review. For example, a multi-grade curriculum will require more time than a single-grade curriculum and a comprehensive curriculum will require more time than a single-topic curriculum.
• The amount of curriculum materials. For example, more time will be required for a curriculum that includes multiple parts, such as videos, workbooks, and separate guides for teachers, than will a single-package curriculum with no extra materials.
• The orderliness of a curriculum. For example, more time will be required for a curriculum that is disorganized, fragmented, or incomplete than one that is well organized.
• The extent to which curriculum materials are easily available for all reviewers. For example, the process will take longer if the reviewers have to share the curriculum materials than if they each have their own complete package of materials.
• Single topic vs. comprehensive curriculum. The analysis of a comprehensive health education curriculum, using the CHE modules, requires significant time and attention. There are more knowledge and skill expectations to be analyzed in a comprehensive curriculum than in a single topic curriculum. A comprehensive health education curriculum requires a greater depth of analysis of multiple topics compared to a single topic curriculum. It also requires an additional breadth of analysis across topics and grade groups not necessary in the analysis of a single topic curriculum.

The HECAT requires sufficient time to prepare for and complete the analysis. Typically, a curriculum review will not be completed in one session. Separate sessions might be necessary to prepare your team to use the HECAT, determine local performance benchmarks, shorten the list of curricula that might be acceptable for complete analysis, and conduct the complete analysis on the remaining curricula. You should also allow time for your team to review curriculum analysis scores and reach a consensus on curriculum recommendations. Chapter 1 of the HECAT provides guidance for coordinating and organizing your curriculum review and helps you determine the time you need to complete your curriculum review and selection process.

No. The HECAT provides knowledge and skill expectations deemed appropriate for grade groups (pre-K–2; 3–5; 6–8; 9–12). It does not identify the individual grade at which these might be most appropriate. State boards of education, local school boards, school district administrators, or curriculum coordinators determine curriculum priorities and curriculum requirements for all relevant health education topics, including the grades at which specific concepts and skills should be addressed. The HECAT can inform priorities and decisions about grade-level requirements. However, the HECAT is most useful in determining which commercially packaged curriculum best aligns with established requirements or what should be included in a locally developed curriculum to better meet these requirements. You can rearrange the HECAT knowledge and skill expectations if their current placement does not match your local requirements.

No. The HECAT does not assess research findings related to a particular curriculum’s effectiveness. Instead, it measures the extent to which a curriculum incorporates effective practices. The HECAT is based on CDC’s Characteristics of Effective Health Education Curricula and National Health Education Standards. The HECAT does include questions that ask whether or not the curriculum under review is included on federal lists that identify research-based, effective curricula.

Various federal agencies have identified youth-related programs considered to be worthy of recommendation based on a review of research evidence. Identification by these agencies should augment, not replace, your use of the HECAT to determine the best health education curriculum for your school and community.

Yes. However, you should follow your own thorough process to develop your health education framework and scope-and-sequence that reflect the needs of your students and the interests and priorities of others in your school community. The HECAT provides valuable information to assist you in the scope-and-sequence or framework development process. The HECAT articulates the National Health Education Standards, identifies the expected outcomes (Healthy Behavior Outcomes) of a topic-specific or comprehensive health education curriculum, and identifies the essential knowledge and skill expectations that are directly related to each topic by grade group. This information can help expedite the development of a health education scope-and-sequence or health education framework. More information about using the HECAT to design a scope-and-sequence for health education can be found in Appendix 5.

A textbook is not typically considered a complete health education curriculum. The HECAT is designed to analyze an entire curriculum, including all the resources, such as textbooks that will be used with the curriculum. We do not recommend that you use the HECAT to analyze a single resource, such as a textbook, independent of the curriculum in which it will be used, because it will require a more extensive review than would normally be necessary for such a single resource.

We recognize that schools and school districts might use a separate review process to select a textbook that will become part of an existing health education curriculum. The HECAT can help you consider what to include in a separate textbook review process. Guidance for considering how the HECAT can be useful in the review of health education resource materials, such as a textbook, is provided in Appendix 2.

The HECAT is designed to support analysis of many health education curricula, some that might focus on health outcomes related to a single topic (e.g. violence prevention) and some that address a comprehensive set of health outcomes across multiple health topics. You can choose the module(s) that best matches your needs and the focus of the curriculum under review. If a curriculum clearly focuses on a single topic, such as violence prevention, use the module that addresses that topic. If a curriculum focuses on outcomes related to only two or three topics and it is clear that the curriculum is intentionally limited only to those topics (e.g., only nutrition and physical activity; or only mental and emotional health, sexual health, and violence prevention), use the two or three topic-specific modules that address these topics. If a curriculum addresses numerous health problems, issues, or topics; focuses on more than one grade level; and includes a wide range of learning activities to address multiple health outcomes, use the comprehensive health education curriculum module.

The comprehensive health education module includes the knowledge and skill expectations that are found in each of the health topic modules. The comprehensive module also enables you to analyze knowledge and skill expectations across topic areas and allows you to score these as an integrated whole rather than merely a collection of individual topics.

Yes. CDC recognizes that school curricula are typically selected at the local level and must meet local school and community needs and conform to state or school district curriculum requirements. You are encouraged to review the HECAT items before analyzing curricula and, if necessary, add, delete, or revise items to meet local needs and curriculum requirements. You can also shorten the HECAT. Ultimately, its length and content should reflect what you want to analyze. In making revisions, you should remember that the items included in the HECAT were developed through a rigorous process guided by research evidence and expert opinion on the types of information and learning experiences that help young people adopt and maintain health-enhancing behaviors. Revisions that significantly change the content or length of the HECAT could diminish the value the HECAT brings to your curriculum analysis, selection, or development process.

CDC’s HECAT Online is an interactive website that allows users to customize the HECAT to meet local needs and curriculum requirements.

The topics used in the HECAT reflect the health issues that CDC considers to be important for children and adolescents. These topics may not match those used by other organizations or curriculum developers or the terminology used in your state, school district, or school. You should review the HECAT to find health topic modules that most complement your curriculum requirements and terminology. You can change the terminology and content of the modules to best meet your needs. If you do not find a match within a single module, it might be necessary to select items from multiple modules and design a new HECAT topic module to meet your needs.

There are many possible resources available to assist you with your health education and curriculum planning.  First, contact the school health education consultant or coordinated school health program director in your state education or state health agency. Although the state consultant or director might not be able to assist you directly, he or she can refer or link you to state resource centers and other experts, including

• Instructional staff from local or state university health education teacher preparation programs.
• State-based professional health education organizations.
• Knowledgeable health educators employed in other school districts.
• Reputable consultants with expertise in health education curricula.

Many school health educators are members of national professional associations that represent school health educators, including

• American School Health Association.
• Society for Public Health Education.
• Society of State Directors of Health, Physical Education, and Recreation.
• SHAPE America.

The national officers in these organizations can help answer questions and link you to knowledgeable members who might be available to provide more direct assistance.  You can direct your questions regarding health education or HECAT to CDC at the following e-mail address: cdcinfo@cdc.gov or phone 1-800-CDC-INFO. CDC-funded recipients can contact their Program Consultant to discuss how to best use the HECAT.

CDC provides support for HECAT trainings through a series of instructional videos on core training tools, including HECAT. For more information on e-learning videos.

No. In order to determine reliability of HECAT analysis and analysis processes and items and inform improvements, CDC conducted pilot reviews of a limited number of commercial curricula. No curriculum names were documented, and scores were not retained after improvements were incorporated into the HECAT.

CDC does not conduct systematic reviews of curricula using the HECAT; does not retain or disseminate HECAT curriculum scores from others who have used the HECAT; and does not endorse HECAT-based curriculum analysis scores distributed by other organizations or companies.

HECAT Online is a free, interactive tool that allows you to work collaboratively in teams to complete projects related to curriculum analyses, comparing strengths and weaknesses of multiple curricula, and developing a scope and sequence for health education.

Digitizing the HECAT into an interactive, web-based application can improve accessibility and usability by school health education researchers and practitioners in the field.

No. Content that appears in the HECAT Online is the same as the downloadable PDFs that  is on CDC’s web page.

HECAT Online uses the same systematic steps and processes for conducting a curriculum analyses found in Chapters 1 through 6 of the print/PDF version; however, organization of modules and system-generated forms (e.g., curriculum score cards) may be displayed differently in HECAT Online to ensure better function in a user-friendly, interactive application. Detailed guidance for how to use HECAT Online can be found in the HECAT User Guide.

Once you are ready to begin using the HECAT Online, you will need to register, and then log in. Once logged in for the first time, create a team.Note that if you received an email invitation to join a HECAT team, you will automatically be assigned to that team, although you can be on multiple teams. The next step is to create or select a project (e.g., Curriculum Analysis or Scope and Sequence) and get started.

HECAT is available on CDC’s Healthy Youth website. You can register to use HECAT Online for free at https://hecatonline.cdc.gov/#/

The HECAT was developed in response to requests from state education agencies and local school districts for a tool that would help them select or develop appropriate health education curriculum materials.  The HECAT is limited to this specific purpose.  CDC recognizes that high-quality health education also includes

• A documented, planned, and sequential program of health instruction for students from kindergarten through grade 12.
• Adequate time devoted for health instruction.
• Appropriately certified health education teachers and professional development to improve delivery of health education.
• Health education classroom management.
• Administrative, parent, and community support for school health education.

The School Health Index (SHI) is a school-level self-assessment and planning guide that addresses many of these aspects and will enable you to

• Identify the strengths and weaknesses of your school’s policies and programs for promoting health and safety, including school health education.
• Develop an action plan for improving overall health education.
• Involve faculty, staff, parents, students, and the community in improving school health policies, programs, and services.

More information about the School Health Index is available at www.cdc.gov/healthyyouth/SHI.

Yes, you may save your responses and return to complete the HECAT at your convenience. HECAT Online does not need to be completed all at one time.

No. CDC does not ask that schools report their scores. The HECAT is a self-assessment process, and the data are not meant to be reported to outside agencies or used for the purposes of comparison.