Project – Integrating Public Health Education into Christian Religious Studies Curriculum: Implications for Students’ Health Behaviour in Secondary Schools

CHAPTER ONE

INTRODUCTION

1.1 Background of the Study

Education plays a pivotal role in shaping the knowledge, attitudes, values, and behaviours of young people, making it one of the most effective platforms for promoting healthy lifestyles and preventing disease. Secondary school students are at a critical stage of physical, psychological, emotional, moral, and social development, during which lifelong health behaviours are established. During adolescence, individuals become increasingly exposed to health-related challenges such as substance abuse, unhealthy dietary habits, poor personal hygiene, mental health problems, sexually transmitted infections, teenage pregnancy, environmental health risks, and communicable diseases. Consequently, integrating public health education into the school curriculum has become a global priority aimed at equipping learners with the knowledge and life skills necessary for making informed health decisions. The World Health Organization (WHO, 2024) maintains that health education is a fundamental strategy for disease prevention and health promotion because it empowers individuals and communities to adopt healthier behaviours.

Public health education refers to the organized process of providing individuals with knowledge, attitudes, competencies, and practical skills required to maintain personal and community health through disease prevention, health promotion, environmental sanitation, nutrition, reproductive health education, mental health awareness, substance abuse prevention, and healthy lifestyle practices. Unlike clinical medicine, which focuses primarily on treating illness, public health emphasizes prevention, behavioural modification, and community participation in improving health outcomes (Schneider, 2020). The increasing prevalence of preventable diseases among adolescents has reinforced the need for schools to strengthen health education initiatives that address both physical and psychosocial dimensions of health.

Globally, educational systems have increasingly recognized that effective health promotion extends beyond science and physical education into the broader curriculum. The WHO and UNESCO jointly advocate the Health Promoting Schools (HPS) framework, which encourages schools to integrate health concepts across different subjects while creating supportive learning environments that foster healthy behaviours (WHO & UNESCO, 2021). This integrated approach recognizes that students acquire health-related values not only through formal health lessons but also through moral education, counselling services, school policies, peer interactions, and extracurricular activities.

UNESCO (2023) emphasizes that quality education should prepare learners not only for academic success but also for healthy living, responsible citizenship, and sustainable development. Sustainable Development Goal (SDG) 3 seeks to ensure healthy lives and promote well-being for all at all ages, while SDG 4 aims to provide inclusive and equitable quality education. These two goals are closely interconnected because education enhances health literacy, while healthy students are more likely to achieve better educational outcomes (United Nations, 2015).

In Nigeria, adolescent health remains a significant public health concern despite various government interventions. The country continues to face challenges such as communicable diseases, malaria, poor sanitation, malnutrition, drug abuse, sexual and reproductive health problems, mental health disorders, and increasing cases of non-communicable diseases associated with unhealthy lifestyles. According to the Federal Ministry of Health (2022), many of these health problems are preventable through effective health education and behavioural change interventions targeted at young people. Schools therefore remain strategic institutions for developing health-conscious citizens capable of making informed decisions concerning their well-being.

The Nigerian educational system recognizes the importance of promoting values that support healthy living. Although health-related concepts are included in subjects such as Basic Science, Physical and Health Education, Biology, Home Economics, and Civic Education, there is increasing recognition that moral and religious education can also contribute significantly to shaping positive health behaviours. Christian Religious Studies (CRS), one of the core subjects offered in many Nigerian secondary schools, provides a unique opportunity for integrating public health education because its objectives extend beyond biblical knowledge to include moral formation, character development, ethical decision-making, responsible citizenship, and respect for the sanctity of human life (Nigerian Educational Research and Development Council [NERDC], 2013).

The Senior Secondary Christian Religious Studies curriculum developed by NERDC emphasizes values such as honesty, discipline, love, compassion, self-control, obedience, service, forgiveness, integrity, and responsible living. These values influence many health-related behaviours because they encourage students to avoid practices that may endanger their physical, emotional, or social well-being. For instance, biblical teachings that discourage drunkenness, sexual immorality, violence, dishonesty, and substance abuse align closely with contemporary public health objectives aimed at preventing risky behaviours among adolescents.

Christian theology views the human body as sacred and worthy of protection. The Apostle Paul teaches that the body is the temple of the Holy Spirit (1 Corinthians 6:19–20), implying that believers have a moral responsibility to maintain healthy lifestyles and avoid behaviours that damage physical or mental health. Similarly, biblical teachings encourage cleanliness (Leviticus 11), compassion toward the sick (Matthew 25:35–40), moderation (Philippians 4:5), and stewardship of God’s creation, all of which possess practical implications for public health education.

These biblical principles correspond remarkably with modern health promotion strategies that advocate personal hygiene, healthy nutrition, disease prevention, environmental sanitation, emotional well-being, and responsible interpersonal relationships. Integrating public health education into Christian Religious Studies therefore enables students to appreciate healthy living not merely as scientific knowledge but also as a moral and spiritual responsibility grounded in their religious beliefs.

Health behaviour refers to the actions, practices, and decisions individuals undertake that influence their health status either positively or negatively. Such behaviours include handwashing, healthy eating, physical activity, vaccination acceptance, environmental sanitation, avoidance of harmful substances, stress management, regular medical check-ups, responsible sexual behaviour, and compliance with disease prevention measures. According to Glanz, Rimer, and Viswanath (2015), health behaviour is influenced by multiple interacting factors including knowledge, beliefs, attitudes, cultural values, social norms, religious convictions, environmental conditions, and educational experiences.

Research consistently demonstrates that knowledge alone is insufficient to produce sustained behavioural change. Individuals may possess adequate knowledge regarding healthy practices yet fail to translate such knowledge into everyday behaviour due to peer pressure, inadequate motivation, poor value systems, misinformation, or social influences. Consequently, health education programmes that integrate moral reasoning and value formation often achieve more sustainable behavioural outcomes than programmes focusing exclusively on factual information (Nutbeam & Lloyd, 2021).

Christian Religious Studies provides opportunities for value-based discussions that encourage students to evaluate contemporary health issues from biblical and ethical perspectives. Classroom discussions on topics such as alcohol abuse, drug addiction, sexual purity, HIV/AIDS stigma, mental health, environmental responsibility, and care for vulnerable populations enable students to connect religious values with practical health decisions. Such integration supports holistic education by addressing the cognitive, affective, behavioural, moral, and spiritual dimensions of learning.

Beyond classroom instruction, integrating public health concepts into CRS may enhance students’ understanding of contemporary health challenges. For example, lessons on compassion can be linked with caring for persons living with chronic illnesses, stewardship can be related to environmental sanitation, self-control can be associated with substance abuse prevention, while teachings on love and responsibility can reinforce reproductive health education and violence prevention.

The COVID-19 pandemic further demonstrated the importance of health literacy among adolescents. During the pandemic, schools became important channels for educating learners on hand hygiene, respiratory etiquette, vaccination, social distancing, mental health, misinformation, and community responsibility. UNESCO (2021) observed that education systems capable of integrating health messages across different subjects were more effective in reinforcing preventive behaviours among students.

Within Lagos State, adolescents face unique public health challenges associated with rapid urbanization, environmental pollution, overcrowding, increasing technology use, sedentary lifestyles, stress, unhealthy dietary practices, and exposure to substance abuse. Secondary schools therefore require innovative approaches that combine scientific knowledge with ethical and moral education to promote sustainable healthy behaviours.

The Lagos State Government has continued to invest in school health programmes through collaborations with the Ministries of Health and Education. Nevertheless, studies continue to report varying levels of health literacy, hygiene practices, reproductive health knowledge, and mental health awareness among adolescents in urban secondary schools (Federal Ministry of Health, 2022). This situation suggests that existing approaches may require strengthening through interdisciplinary curriculum integration.

Curriculum integration refers to the deliberate combination of concepts from different disciplines to provide learners with comprehensive understanding of complex societal issues. Drake and Reid (2020) argue that integrated curricula enhance meaningful learning because students recognize connections between academic subjects and real-life experiences. Public health issues are inherently multidisciplinary and therefore benefit from integration across science, social studies, civic education, religious education, and counselling programmes.

Integrating public health education into Christian Religious Studies may also support national educational objectives by promoting responsible citizenship, peaceful coexistence, respect for human dignity, social responsibility, and community participation in health promotion. Students who internalize these values are more likely to influence their families and communities positively through healthy practices.

Although several studies have investigated the effectiveness of health education programmes, relatively few have specifically examined the integration of public health education within Christian Religious Studies curricula. Existing Nigerian studies predominantly focus on CRS and moral development, academic performance, character formation, or value acquisition, while studies on public health education concentrate largely on science education, reproductive health, HIV/AIDS awareness, or school health services. Consequently, empirical evidence regarding the educational implications of integrating public health education into Christian Religious Studies remains limited, particularly within Nigerian secondary schools.

Furthermore, little is known about how such integration influences students’ health behaviour in contemporary urban settings where adolescents face multiple behavioural and environmental health risks. Given the increasing emphasis on holistic education, preventive healthcare, and sustainable development, there is a need to investigate whether embedding public health education within Christian Religious Studies can enhance students’ health-related knowledge, attitudes, values, and behaviours.

Against this background, this study examines the integration of public health education into the Christian Religious Studies curriculum and its implications for students’ health behaviour in secondary schools. It seeks to contribute empirical evidence that may guide curriculum planners, educators, policymakers, school administrators, counsellors, public health practitioners, and religious educators in developing more effective strategies for promoting healthy behaviours among adolescents.

1.2 Statement of the Problem

Health behaviour among adolescents has become a growing concern worldwide because many preventable diseases and unhealthy lifestyles originate during the secondary school years. Adolescence is a developmental stage characterized by increased curiosity, experimentation, peer influence, and identity formation. During this period, students often make decisions regarding personal hygiene, nutrition, substance use, sexual behaviour, mental health management, physical activity, and environmental sanitation that may have long-term consequences for their health. Despite continuous public health campaigns and school-based interventions, many secondary school students continue to engage in behaviours that expose them to avoidable health risks. The World Health Organization (2024) notes that a substantial proportion of premature adult illnesses are linked to unhealthy behaviours established during adolescence, underscoring the need for effective school-based health promotion strategies.

In Nigeria, public health challenges among adolescents remain significant. Reports by the Federal Ministry of Health (2022) and the United Nations Children’s Fund (UNICEF, 2023) indicate persistent concerns relating to poor personal hygiene, unhealthy dietary practices, inadequate physical activity, substance abuse, teenage pregnancy, sexually transmitted infections, mental health disorders, environmental sanitation, and low health literacy among young people. Although governments, schools, faith-based organizations, and non-governmental organizations have implemented numerous awareness programmes, evidence suggests that many adolescents still lack the knowledge, attitudes, and behavioural competencies required for maintaining healthy lifestyles.

Secondary schools have traditionally addressed health education through subjects such as Basic Science, Biology, Physical and Health Education, Home Economics, and Civic Education. While these subjects provide important scientific knowledge about health, they may not adequately address the moral, ethical, spiritual, and value-based dimensions that influence students’ behavioural choices. Research in health promotion consistently demonstrates that knowledge alone rarely guarantees behavioural change because individuals’ decisions are also shaped by their beliefs, values, attitudes, religious convictions, family influences, and social environment (Glanz, Rimer, & Viswanath, 2015). Consequently, there is increasing recognition that effective health education should integrate cognitive learning with moral and value formation.

Christian Religious Studies occupies a unique position within the Nigerian secondary school curriculum because its primary objective extends beyond religious instruction to include character formation, ethical reasoning, responsible citizenship, respect for human dignity, discipline, compassion, honesty, self-control, and service to society (NERDC, 2013). These values are closely related to behaviours that promote physical, mental, emotional, and social well-being. Biblical teachings concerning stewardship of the body, avoidance of harmful substances, sexual responsibility, love for neighbours, care for the vulnerable, environmental responsibility, and healthy interpersonal relationships align with many contemporary public health principles. However, these connections are often presented only from theological or moral perspectives without deliberately linking them to public health education and preventive health practices.

Another challenge is that public health education and Christian Religious Studies are frequently taught as separate and unrelated areas of learning. Consequently, students may acquire scientific knowledge about diseases and healthy living in one subject while receiving moral and spiritual instruction in another without recognizing the complementary relationship between the two. This fragmented approach may reduce opportunities for students to develop holistic understanding of health that combines knowledge, values, attitudes, and behaviour. Integrating public health concepts into Christian Religious Studies could reinforce healthy behaviours by presenting them as both scientific necessities and moral responsibilities.

Furthermore, contemporary adolescents face emerging public health challenges that extend beyond communicable diseases. Issues such as depression, anxiety, cyberbullying, internet addiction, substance misuse, poor dietary habits, sedentary lifestyles, environmental pollution, misinformation about health, and inadequate emotional resilience require educational approaches that develop not only knowledge but also ethical judgement, self-control, empathy, resilience, and responsible decision-making. Christian Religious Studies provides opportunities for discussing these issues within ethical and biblical frameworks, yet there is limited empirical evidence regarding the effectiveness of such integration in influencing students’ health behaviour.

Despite the recognized importance of school-based health promotion, existing literature reveals that most Nigerian studies on Christian Religious Studies have concentrated on moral development, character formation, discipline, academic performance, value acquisition, and spiritual growth. Likewise, studies on public health education have primarily examined reproductive health education, HIV/AIDS awareness, school health services, nutrition education, and sanitation practices. Very few studies have investigated the integration of public health education into the Christian Religious Studies curriculum and its implications for students’ health behaviour in secondary schools. This represents an important gap in educational and public health research.

The problem is further compounded by the limited availability of empirical data that can guide curriculum developers, educational policymakers, school administrators, Christian Religious Studies teachers, and public health practitioners on how religious education can be utilized as a complementary strategy for promoting healthy behaviours among adolescents. Without such evidence, opportunities to strengthen school-based health promotion through interdisciplinary curriculum integration may remain underutilized.

In addition, the Nigerian Educational Research and Development Council advocates values-based education that promotes responsible citizenship, moral development, and national unity. However, there is little documented evidence indicating the extent to which Christian Religious Studies currently incorporates public health themes such as disease prevention, mental health awareness, environmental sanitation, nutrition, substance abuse prevention, reproductive health responsibility, and healthy lifestyle practices. The absence of structured integration may limit students’ ability to appreciate health not merely as a biological concept but as a moral obligation that reflects responsible stewardship of self and society.

Therefore, the central problem of this study is the insufficient empirical understanding of how integrating public health education into the Christian Religious Studies curriculum may influence students’ health behaviour in secondary schools. Addressing this gap is necessary to provide evidence-based recommendations that will improve curriculum development, teaching practices, school health programmes, and educational policies aimed at promoting healthier lifestyles among adolescents.

1.3 Aim of the Study

The main aim of this study is to examine the implications of integrating public health education into the Christian Religious Studies curriculum on students’ health behaviour in secondary schools.

1.4 Objectives of the Study

The specific objectives are to:

1. examine the extent to which public health education is integrated into the Christian Religious Studies curriculum in secondary schools;
2. determine students’ level of awareness of public health concepts acquired through Christian Religious Studies;
3. examine the influence of integrating public health education into Christian Religious Studies on students’ health behaviour;
4. identify the perceived benefits of integrating public health education into Christian Religious Studies for promoting healthy lifestyles among secondary school students; and
5. identify the challenges affecting the effective integration of public health education into the Christian Religious Studies curriculum in secondary schools.

1.5 Research Questions

The following research questions will guide the study:

1. To what extent is public health education integrated into the Christian Religious Studies curriculum in secondary schools?
2. What is the level of students’ awareness of public health concepts acquired through Christian Religious Studies?
3. What influence does integrating public health education into Christian Religious Studies have on students’ health behaviour?
4. What are the perceived benefits of integrating public health education into Christian Religious Studies for promoting healthy lifestyles among secondary school students?
5. What challenges affect the effective integration of public health education into the Christian Religious Studies curriculum in secondary schools?

1.6 Research Hypothesis

The following null hypothesis will be tested at the 0.05 level of significance:

H₀₁: There is no significant influence of integrating public health education into the Christian Religious Studies curriculum on students’ health behaviour in secondary schools.

1.7 Significance of the Study

The findings of this study will be of immense theoretical and practical importance to curriculum developers, Christian Religious Studies teachers, students, school counsellors, educational administrators, policymakers, public health practitioners, researchers, parents, and faith-based organizations. The study is expected to contribute to educational practice by demonstrating how integrating public health education into Christian Religious Studies can promote healthier behaviours among secondary school students.

The study will benefit curriculum developers, particularly the Nigerian Educational Research and Development Council (NERDC), by providing empirical evidence on the need to strengthen the Christian Religious Studies curriculum through the inclusion of structured public health concepts. The findings may assist curriculum planners in reviewing existing curriculum contents to incorporate relevant themes such as personal hygiene, disease prevention, mental health awareness, environmental sanitation, nutrition, substance abuse prevention, reproductive health responsibility, and healthy lifestyle education within biblical and moral contexts. Such integration will contribute to achieving the broader educational objective of producing morally upright and health-conscious citizens.

The findings will also be valuable to Christian Religious Studies teachers, as they will gain a better understanding of how biblical teachings can be linked with contemporary public health issues during classroom instruction. Teachers will become more equipped to adopt interdisciplinary teaching approaches that combine scriptural principles with practical health education. This will improve students’ understanding of the relationship between Christian moral values and responsible health behaviours while making CRS lessons more relevant to everyday life.

Students are expected to benefit significantly from the study because integrating public health education into Christian Religious Studies may improve their knowledge, attitudes, values, and behaviours concerning healthy living. Through exposure to health-related biblical teachings, students may develop stronger commitments to personal hygiene, healthy nutrition, disease prevention, environmental cleanliness, emotional well-being, substance abuse avoidance, sexual responsibility, and positive interpersonal relationships. Ultimately, this may contribute to improved academic performance, better quality of life, and healthier adulthood.

The study will provide useful information for school guidance counsellors by highlighting the complementary relationship between religious education and school health programmes. Counsellors may use the findings to design more holistic intervention programmes that combine counselling strategies with moral and spiritual education to address behavioural challenges such as drug abuse, bullying, depression, peer pressure, unhealthy relationships, and risky lifestyle choices among adolescents.

School administrators will equally benefit from the study because the findings may provide evidence supporting stronger collaboration between Christian Religious Studies teachers, health educators, school counsellors, and administrators in implementing comprehensive school health programmes. Such collaboration may improve school policies relating to health promotion, student welfare, sanitation, disease prevention, and behavioural management.

The study will be useful to educational policymakers, including the Federal Ministry of Education, State Ministries of Education, and education quality assurance agencies. The findings may inform policy decisions regarding interdisciplinary curriculum implementation, teacher training programmes, and school-based health promotion initiatives. Policymakers may also utilize the findings in designing educational reforms that emphasize holistic learner development by integrating moral education with public health promotion.

The findings will also contribute to the work of public health professionals and health promotion agencies by demonstrating how schools and religious education can serve as effective channels for promoting preventive healthcare. Public health practitioners may identify opportunities for collaborating with schools in delivering health campaigns, awareness programmes, vaccination education, mental health initiatives, nutrition education, and environmental sanitation campaigns using existing religious education structures.

Parents and guardians may benefit from the findings because they will appreciate the importance of reinforcing at home the healthy values taught through Christian Religious Studies. This collaboration between schools and families may strengthen adolescents’ commitment to positive health behaviours and responsible decision-making.

Faith-based organizations and churches will equally find the study useful because it demonstrates how Christian teachings can contribute meaningfully to addressing contemporary public health challenges. Religious leaders may utilize the findings in designing youth development programmes that integrate biblical teachings with practical health education, thereby strengthening community-based health promotion.

From an academic perspective, this study will contribute to the growing body of literature on interdisciplinary curriculum integration, religious education, health promotion, and adolescent behavioural development. It will fill an existing gap in Nigerian educational research by providing empirical evidence on the implications of integrating public health education into Christian Religious Studies. Future researchers will find the study valuable as reference material for further investigations into religion, education, health literacy, adolescent development, and curriculum innovation.

Finally, the study contributes to the achievement of the United Nations Sustainable Development Goals, particularly SDG 3 (Good Health and Well-being) and SDG 4 (Quality Education) by promoting educational approaches that simultaneously improve health literacy, moral development, and responsible citizenship among young people (United Nations, 2015).

1.8 Scope of the Study

This study focuses on the integration of public health education into the Christian Religious Studies curriculum and its implications for students’ health behaviour in secondary schools.

Geographically, the study will be limited to selected secondary schools within the chosen study area (to be specified by the researcher).

Content-wise, the study will examine:

• the extent to which public health education is integrated into the Christian Religious Studies curriculum;
• students’ awareness of public health concepts learned through Christian Religious Studies;
• the influence of curriculum integration on students’ health behaviour;
• the perceived benefits of integrating public health education into Christian Religious Studies; and
• the challenges affecting effective curriculum integration.

The independent variable is the integration of public health education into Christian Religious Studies, while the dependent variable is students’ health behaviour.

The study will involve Senior Secondary School (SS I–SS III) students and Christian Religious Studies teachers because they constitute the primary participants directly involved in curriculum implementation and learning.

1.9 Operational Definition of Terms

Christian Religious Studies (CRS):
A school subject that teaches biblical knowledge, Christian doctrines, moral values, ethical principles, and responsible living with the aim of developing students’ spiritual, moral, and social character.

Curriculum Integration:
The systematic incorporation of concepts, skills, values, and learning experiences from one discipline into another to enhance meaningful learning and real-life application.

Public Health Education:
An organized educational process that equips individuals with knowledge, attitudes, values, and skills necessary for preventing diseases, promoting healthy lifestyles, improving environmental sanitation, maintaining mental well-being, and enhancing community health.

Health Behaviour:
The actions, habits, attitudes, and lifestyle practices adopted by individuals that influence their physical, mental, emotional, and social health either positively or negatively.

Secondary School Students:
Learners enrolled in Senior Secondary School classes (SS I–SS III) who are studying Christian Religious Studies in selected secondary schools.

Health Awareness:
The level of knowledge, understanding, attitudes, and consciousness individuals possess regarding disease prevention, healthy living, personal hygiene, nutrition, environmental sanitation, mental health, and other health-related issues.

Implication:
The likely effect, consequence, or outcome resulting from integrating public health education into the Christian Religious Studies curriculum on students’ health behaviour.

Project – Integrating Public Health Education into Christian Religious Studies Curriculum: Implications for Students’ Health Behaviour in Secondary Schools