Section 3: Overview and Exam Framework
Health EC–12 (157)

Exam Overview

Table outlining the test format, number of questions, time, and passing score.
Exam Name Health EC–12
Exam Code 157
Time 5 hours
Number of Questions 100 selected-response questions
Format Computer-administered test (CAT)

The TExES Health EC–12 (157) exam is designed to assess whether an examinee has the requisite knowledge and skills that an entry-level educator in this field in Texas public schools must possess. The 100 selected-response questions are based on the Health EC–12 exam framework and cover grades EC–12. The exam may contain questions that do not count toward the score. Your final scaled score will be based only on scored questions.

The Standards

Standard I

The health teacher applies knowledge of both the relationship between health and behavior and the factors influencing health and health behavior.

Standard II

The health teacher communicates concepts and purposes of health education.

Standard III

The health teacher plans and implements effective school health instruction and integrates health instruction with other content areas.

Standard IV

The health teacher evaluates the effects of school health instruction.

Domains and Competencies

Table outlining test content subject weighting by domain.
Domain Domain Title Approx. Percentage of Exam Standards Assessed
I Personal Health 26% Health EC–12: I, III
II Healthy Interpersonal Relationships 20% Health EC–12: I
III Community and Environmental Health and Safety 20% Health EC–12: I, III
IV Health-Related Skills and Resources 20% Health EC–12: I
V The School Health Education Program 14% Health EC–12: I–IV

Pie chart of approximate test weighting outlined in the table above.

The content covered by this exam is organized into broad areas of content called domains. Each domain covers one or more of the educator standards for this field. Within each domain, the content is further defined by a set of competencies. Each competency is composed of two major parts:

Domain I—Personal Health

Competency 001—The teacher understands human body systems and the processes of human growth and development.

The beginning teacher:

  1. Demonstrates an understanding of the structures, functions and interactions of body systems and of factors (e.g., heredity, environment, behavior) that influence the functioning of body systems.
  2. Analyzes the roles of various body systems in maintaining health and knows strategies for maintaining the healthy status of body systems.
  3. Demonstrates knowledge of typical patterns and processes of human growth and development, including physical, cognitive and emotional development and understands individual variation in rates and patterns of development.
  4. Analyzes factors affecting growth and development and knows personal health behaviors (e.g., nutrition, exercise, sleep) required to maintain health throughout the life cycle.
  5. Demonstrates knowledge of physical and emotional changes associated with puberty and how these changes may affect personal health.
  6. Identifies practices that promote or impede development of a healthy embryo and fetus (e.g., prenatal care; proper nutrition; use of alcohol, tobacco or other drugs; exposure to disease).
Competency 002—The teacher understands nutrition, exercise and physical fitness and their role in maintaining and enhancing health.

The beginning teacher:

  1. Identifies types of nutrients, their sources in food and their uses in the body (e.g., the importance of calcium for bone growth, iron for red blood cells and vitamin A for vision).
  2. Demonstrates knowledge of scientifically proven principles of nutrition, the components of a balanced diet and how to apply these principles of nutrition to ensure a balanced diet.
  3. Analyzes healthy and unhealthy dietary practices, including eating disorders and fad diets, and ways in which diet influences personal health.
  4. Applies skills and strategies for reading, interpreting and evaluating nutritional information (e.g., food pyramids, food labels, promotional claims) and for using this information to make healthy food choices.
  5. Applies knowledge of factors that influence nutritional and caloric requirements (e.g., age, activity level, pregnancy) and factors that influence food choices (e.g., cultural background, family eating patterns, advertising, peer behaviors).
  6. Demonstrates knowledge of skills and motivational strategies for making healthy food choices and for planning a healthy diet.
  7. Analyzes relationships between dieting, exercising and maintaining a healthy weight.
  8. Demonstrates knowledge of the components of fitness (e.g., cardiovascular fitness, flexibility, muscle strength) and methods for assessing fitness.
  9. Identifies types of exercise and analyzes the effects of exercise on different body systems (e.g., cardiovascular, musculoskeletal).
  10. Demonstrates an understanding of the health benefits of physical activity throughout the life span, including weight control, and strategies for maintaining and improving fitness.
  11. Identifies strategies for developing and following a personal health plan that stresses good nutrition, exercise and appropriate body weight.
Competency 003—The teacher understands how diseases and disorders affect health.

The beginning teacher:

  1. Demonstrates knowledge of types and characteristics of communicable diseases and noncommunicable diseases.
  2. Demonstrates knowledge of types of pathogens (e.g., viruses, bacteria, fungi) that cause communicable disease, how they cause disease and how they are transmitted.
  3. Analyzes risk factors for contracting common communicable diseases.
  4. Demonstrates an understanding of methods for treating different types of communicable diseases (e.g., viral, bacterial) and preventive measures (e.g., washing hands, avoiding stress, quarantine, vaccination) that limit the spread of communicable disease.
  5. Recognizes causes of common noncommunicable diseases (e.g., asthma, diabetes, cancer, heart disease) and analyzes risk factors for contracting these diseases (e.g., heredity, smoking, sedentary lifestyle).
  6. Demonstrates knowledge of methods for early detection of noncommunicable diseases (e.g., genetic counseling, Pap smear) and for preventing noncommunicable diseases (e.g., exercising, losing weight, reducing air pollution).
  7. Demonstrates an understanding of immune system responses to disease (e.g., fever, antibody formation, asthma).
  8. Analyzes the effects of environmental factors on health and disease.
  9. Analyzes the influence of laws and policies on disease prevention and health-related issues.
Competency 004—The teacher understands mental and emotional health and factors that influence mental and emotional health.

The beginning teacher:

  1. Analyzes interrelationships among physical, mental, emotional and social health (e.g., child abuse and neglect, substance abuse).
  2. Demonstrates knowledge of how emotional health needs change throughout the life span (e.g., emotional attachment, decision making, life and death issues).
  3. Analyzes factors (e.g., heredity, personal experience, environmental factors) that affect mental and emotional health.
  4. Identifies types, causes and symptoms of mental and emotional health disorders (e.g., anxiety, depression, eating disorders, suicidal tendencies) and methods for obtaining assistance for mental and emotional problems.
  5. Applies knowledge of causes of stress (e.g., family, social situations, academic pressure), effects of stress on individual and family health and strategies for coping with and managing stress (e.g., counseling, exercise).
  6. Demonstrates an understanding of strategies for managing anxiety and grief, preventing suicides and maintaining good mental and emotional health.


Domain II—Healthy Interpersonal Relationships

Competency 005—The teacher understands family relationships and their significance for health.

The beginning teacher:

  1. Demonstrates knowledge of diverse family structures and factors that influence relationships within families.
  2. Applies strategies that demonstrate an understanding of individual roles and responsibilities within a family and of behaviors that show consideration and respect for self and other family members (e.g., expressing needs and wants appropriately, practicing self-control).
  3. Applies knowledge of strategies for promoting healthy interactions among family members (e.g., building trust, expressing affection, setting limits).
  4. Analyzes ways in which family relationships and family problems (e.g., abuse, divorce, death) can influence an individual’s emotional, physical and mental health.
  5. Analyzes the nature, causes and consequences of conflict in families.
  6. Identifies strategies for coping with unhealthy behaviors in the family (e.g., abuse, alcoholism, neglect) and knows how to seek help in dealing with family problems.
Competency 006—The teacher understands interpersonal relationships and healthy ways of interacting with others and avoiding conflict.

The beginning teacher:

  1. Analyzes characteristics of healthy and unhealthy friendships and other interpersonal relationships.
  2. Demonstrates an understanding of skills and strategies for building and maintaining healthy interpersonal relationships.
  3. Analyzes peer relationships, the role of peers and peer pressure in influencing behavior and health and healthy/positive strategies for responding to peer pressure.
  4. Demonstrates an understanding of characteristics of groups and social support networks, group dynamics and the health consequences of various types of group interactions.
  5. Knows the role of social and communication skills (e.g., showing tolerance, empathy, consideration and respect; responding appropriately to criticism; using listening skills; discussing problems; using conflict resolution skills) in building and maintaining healthy interpersonal relationships.
  6. Analyzes the use of various communication strategies (e.g., assertiveness, refusal skills) in situations involving interpersonal interactions.
  7. Applies knowledge of steps and procedures for mediating and resolving conflict.
  8. Demonstrates knowledge of strategies for avoiding unsafe situations and for responding to negative behaviors exhibited by others (e.g., bullying, ridicule, harassment).
Competency 007—The teacher understands human sexuality and its significance for health.

The beginning teacher:

  1. Demonstrates knowledge of potential consequences of sexual activity (e.g., pregnancy, sexually transmitted diseases) and the benefits of abstaining from sexual activity outside of a committed relationship.
  2. Analyzes factors that influence decisions about sexual activity (e.g., peer pressure, personal values, media messages) and strategies for making responsible decisions about sexual activity.
  3. Demonstrates knowledge of appropriate ways to express affection in a caring relationship and strategies for refusing sexual advances.
  4. Analyzes roles and responsibilities of individuals involved in dating relationships.
  5. Identifies the legal and ethical implications of unacceptable behaviors (e.g., sexual harassment, acquaintance rape, statutory rape, sexual abuse).
  6. Demonstrates an understanding of sexually transmitted diseases (e.g., chlamydia, gonorrhea, HIV) and methods for preventing the spread of these diseases.
  7. Demonstrates an understanding of the types, characteristics, effectiveness, advantages and disadvantages of various methods of contraception.


Domain III—Community and Environmental Health and Safety

Competency 008—The teacher understands methods and procedures for promoting safety, preventing accidents and responding to emergencies.

The beginning teacher:

  1. Demonstrates knowledge of hazards to health and safety in the home, school and community.
  2. Knows basic safety rules and procedures for reducing hazards, avoiding unintentional injuries and preventing injuries in various situations (e.g., driving an automobile, bicycling, swimming).
  3. Identifies personal behaviors that increase the risk of injury (e.g., fatigue, risk taking, use of alcohol and other drugs) and recognizes the importance of personal responsibility in preventing injury.
  4. Relates different types of safe and unsafe behavior to positive and negative health effects throughout the life span.
  5. Knows strategies for recognizing and avoiding potentially dangerous situations and for preventing and responding to different types of violence (e.g., dating violence, gang violence, hate crimes).
  6. Demonstrates knowledge of home safety and emergency response plans, their components and their benefits.
  7. Demonstrates knowledge of principles and procedures related to safety, unintentional-injury prevention and response to emergencies, including first aid procedures (e.g., CPR, conscious choking technique).
Competency 009—The teacher understands the use and abuse of alcohol, tobacco and other drugs, including prescription drugs, and the effects of alcohol, tobacco and other drugs on health.

The beginning teacher:

  1. Identifies types of legal and illegal drugs (e.g., alcohol, tobacco, steroids, stimulants, depressants, narcotics, hallucinogens, herbal supplements, over-the-counter medications), their characteristics and laws related to their use.
  2. Analyzes short-term and long-term effects (e.g., physical, psychological, social) of the use and abuse of alcohol, tobacco and other legal and illegal drugs, including effects on individuals with given characteristics (e.g., pregnant women, adolescents).
  3. Demonstrates knowledge of different types of addiction (e.g., physical, psychological) and factors contributing to chemical dependency on and addiction to alcohol, tobacco and other drugs.
  4. Analyzes factors in the home, school and community that can influence an individual’s use and abuse of alcohol, tobacco and other legal and illegal drugs.
  5. Applies knowledge of strategies for preventing the use and abuse of alcohol, tobacco and other legal and illegal drugs and of strategies for promoting individual responsible drug use (e.g., designated driver programs).
  6. Knows methods of intervention and treatments for abuse of alcohol, tobacco and other drugs and age-appropriate strategies for dealing with another person’s substance abuse.
  7. Demonstrates knowledge of how the use and abuse of alcohol, tobacco and other drugs may lead to health and safety problems (e.g., unplanned pregnancies, motor vehicle crashes or injuries, drownings).
  8. Analyzes the role of assertiveness, refusal skills and peer pressure in decision making and problem solving related to the use of alcohol, tobacco and other legal and illegal drugs.
  9. Applies knowledge of types of school-based and community-based efforts to address health-risk behaviors related to the use and abuse of alcohol, tobacco and other legal and illegal drugs and strategies for promoting student participation in such efforts.
Competency 010—The teacher understands issues and factors related to community and environmental health.

The beginning teacher:

  1. Demonstrates knowledge of community health care agencies, programs and services and their roles and responsibilities (e.g., primary, preventive and emergency care).
  2. Analyzes community and national health care needs and goals and demonstrates knowledge of health-related social, political and economic issues (e.g., organ donation, rising medical costs, uninsured and underinsured families).
  3. Analyzes individual factors (e.g., socioeconomic status, cultural background, age, attitudes) and societal factors (e.g., economic trends, government policies) that influence the cost, availability, accessibility and use of health care for different individuals and communities.
  4. Demonstrates an understanding of community health problems (e.g., poor nutrition, violence, unplanned pregnancy), their causes (e.g., poverty, inadequate access to health care) and strategies for addressing them (e.g., violence-prevention awareness, drug-abuse prevention and treatment programs).
  5. Analyzes the influence of various factors (e.g., media messages, technological advances) on individual and community health.
  6. Demonstrates knowledge of major types of health-related laws, regulations and policies (e.g., mandatory vaccinations, workplace safety regulations) and their effects on community health.
  7. Demonstrates knowledge of environmental problems (e.g., air and water pollution, noise, overcrowding, hazardous waste), their causes and their effects on individual, community and world health.
  8. Identifies strategies for reducing environmental hazards (e.g., water purification, emission control, waste management) and analyzes ways in which protecting the environment promotes individual, community and world health.
  9. Demonstrates an understanding of ways in which individuals can contribute to improving community and environmental health (e.g., advocacy, volunteerism).


Domain IV—Health-Related Skills and Resources

Competency 011—The teacher understands the use of decision-making and other skills in making informed choices that influence health.

The beginning teacher:

  1. Analyzes the multiple influences (e.g., beliefs, knowledge, skills, attitudes, peers, role models) on health decisions and behaviors.
  2. Applies knowledge of steps and procedures for using decision-making and problem-solving skills in various health-related contexts.
  3. Demonstrates an understanding of risk assessment and ways to reduce health risks and enhance and maintain health.
  4. Applies knowledge of how to use planning and goal-setting, decision-making and problem-solving skills and procedures to enhance personal, family and community health.
  5. Recognizes the importance of seeking advice and guidance from others (e.g., health care professionals, family members) in making decisions about personal health.
  6. Recognizes benefits of and procedures for developing personal plans for maintaining and enhancing health.
Competency 012—The teacher understands sources of health-related information and strategies for accessing, evaluating and using health-related information.

The beginning teacher:

  1. Demonstrates knowledge of sources of valid health-related information (e.g., health professionals, government agencies, private nonprofit agencies, Internet resources) and how to access and use different types of health-related information.
  2. Applies knowledge of strategies for researching health-related information and products and for synthesizing information from various sources to make informed health decisions.
  3. Distinguishes between valid and invalid sources of health information.
  4. Applies critical-thinking skills to evaluate the validity of health information and recognizes fraud and quackery.
  5. Evaluates health-related advertising/marketing claims about health care services and products and knows how such claims may influence behavior.
  6. Knows how to use health information to make decisions about health services, products and behaviors.
Competency 013—The teacher demonstrates knowledge of health-related products and services and the skills and strategies needed to be an informed consumer of health-related products and services.

The beginning teacher:

  1. Demonstrates an understanding of the characteristics and roles of different types of health care delivery systems (e.g., hospitals, clinics) and health care professionals.
  2. Identifies health maintenance activities (e.g., regular medical and dental checkups) and their benefits.
  3. Analyzes how specific factors (e.g., cultural background, socioeconomic status, access to information) influence the selection and use of health care services and products.
  4. Demonstrates knowledge of advertising/marketing techniques used in health product and health service promotion and applies skills for determining whether advertising claims are accurate, misleading, or deceptive.
  5. Applies knowledge of skills and criteria for evaluating and selecting health-related treatments, products, providers and services.
  6. Demonstrates knowledge of local, state and federal laws, regulations and agencies related to consumer health and how they protect consumers of health care products and services.


Domain V—The School Health Education Program

Competency 014—The teacher knows how to plan, implement and evaluate a school health education program and understands the role of the school health educator.

The beginning teacher:

  1. Demonstrates knowledge of a coordinated school health model and the role of the teacher within a coordinated school health education program.
  2. Analyzes the interdependence of health education and other components of a coordinated school health program.
  3. Applies knowledge of procedures for planning and implementing a school health education program and for involving others (e.g., faculty, administrators, health care professionals) in planning, implementing and supporting the program.
  4. Demonstrates awareness of the need to use procedures that are compatible with school policy when implementing curricula.
  5. Knows the role of local health advisory councils in the implementation of health education, including the role of a School Health Advisory Council (SHAC) as mandated by the Texas Education Code.
  6. Applies knowledge of factors and procedures involved in planning an effective school health education program that involves parents/guardians and takes into consideration local culture, needs and interests.
  7. Applies knowledge of strategies for communicating the importance of health education to students, parents/guardians and the community and for being an advocate for health-related issues in the school and the community.
  8. Demonstrates an understanding of the role of the health education teacher as a source of health-related information within the school community.
  9. Applies procedures for evaluating the school health education program and for making program modifications based on evaluation results.
Competency 015—The teacher knows how to plan and implement effective school health instruction.

The beginning teacher:

  1. Demonstrates an understanding of the major content areas of health instruction (e.g., community health, nutrition, mental health, sexuality education) and the purposes and components of a scope and sequence plan for school health instruction.
  2. Knows how to integrate the school health education curriculum with other content areas (e.g., language arts, science, social studies).
  3. Applies knowledge of strategies for planning health instruction that reflects the abilities, needs, interests, developmental levels and cultural backgrounds of all students.
  4. Demonstrates knowledge of strategies for effectively implementing and integrating a school health education curriculum.
  5. Demonstrates knowledge of accurate and age-appropriate sources of information about health and knows how to incorporate appropriate resources and materials into school health instruction.
  6. Analyzes factors that shape students’ patterns of health behavior (e.g., knowledge, skills, attitudes) and knows effective strategies for helping students learn skills for health maintenance and apply this knowledge in their daily lives.
  7. Knows how to help students develop and apply skills for locating, reading, comprehending and retaining content-related information from a range of texts and technologies.
  8. Applies strategies for addressing sensitive or controversial health issues appropriately and in ways that are compatible with state and school policies.
  9. Understands the importance of modeling positive health behaviors and knows how to use communication skills and strategies effectively in health education contexts.
  10. Demonstrates knowledge of criteria and methods for evaluating student learning about health and for applying student assessment results to enhance health instruction.

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