All ETDs from UAB

Advisory Committee Chair

Retta R Evans

Advisory Committee Members

Loucrecia W Collins

Marcia R O'Neal

Angelia M Paschal

Sandra K Sims

Document Type


Date of Award


Degree Name by School

Doctor of Philosophy (PhD) School of Education


The elementary classroom offers a potentially favorable setting to impact student health. However, research indicates that elementary health education (EHE) is frequently omitted or haphazardly delivered. Traditional efforts in educational change have had limited success and lack a theoretical foundation. The purpose of this study was to investigate the organizational readiness of a public school district in Alabama for the delivery of 60 minutes of weekly EHE using constructs of the Transtheoretical Model (TTM). This study was intended to identify the stage of readiness, decisional balance, self-efficacy, the extent to which the school district was engaging in behaviors that may facilitate teacher progression through the Stages of Change (SOC), and to inform the development of a stage-matched intervention for EHE. Development of the Elementary Health Education District Assessment Tool (EHE-DAT) included a pilot, and the instrument was found to be reliable and valid through qualitative and quantitative review. Data was collected at an Alabama school district’s inservice at the beginning of the school year. Inservice was a mandatory time for the district faculty and administrators to meet together prior to the first day of student arrival. A total of 161 school district faculty and administrators completed the EHE-DAT. A majority of the participants were female, white, and regular classroom teachers. Data analysis included descriptive statistics, analysis of variance (ANOVA), and Kruskal-Wallis H tests. Results indicated that the school district is not fulfilling the state requirements for EHE. Most of the respondents were classified in the two earliest stages of readiness for EHE: Precontemplation and Contemplation. Self-efficacy, beliefs, and practices were significantly correlated with EHE readiness. The current study enhanced understanding applicable to improving health education policy and practice. It contributed to the limited research in addressing the integration of TTM theory, change processes of schools, and readiness for EHE.

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