Youth Perspectives of School-Based Health Education: Findings from a US Youth-Led Nationwide Qualitative Survey.

Objective: While most primary and secondary school students in the USA participate in school-based health education to promote a healthy lifestyle, adolescents and young adults continue to engage in risk-related behaviour. National guidelines encourage youth inclusion when developing health curricula, but there is minimal evidence of youth voice in current education programmes. High school student co-researchers designed a qualitative survey to gather youth perspectives on health education and guide improvements to future curriculum development. Method: The 5-question survey was sent to 791 14-to-24-year-olds in the USA using a weekly text message poll. The research team and youth co-researchers conducted an iterative thematic analysis of text message responses. Participant demographics were described and differences between responders and non-responders were tested using Wilcoxon rank sum tests, Chi-squared tests, and Fisher's exact tests. Results: 506 participants responded to all 5 survey questions (response rate 64%). Thematic analysis resulted in three final themes with young people 1) feeling that the school-based health education they received was insubstantial, 2) wanting their school-based health education to be inclusive; and 3) wanting school-based health education to be taught by dedicated and trained educators. Conclusion: While youth want to improve their understanding of mental, sexual, and physical health to establish healthier habits, current limitations in school-based health education result in many young people feeling excluded and without practical or relevant guidance. Our findings support the need to reform health education so as to comprehensively address youth's diverse and evolving needs.