Development and Evaluation of Integrated Diabetes Curricula for Teaching Gene by Environment Concepts to High School Health and Biology Students.

The authors designed an integrated type 2 diabetes (T2D) curricula to model real-world complexity for high school biology and health students, highlighting interactions between genetic, biologic, environmental, and social factors, and modeling prevention and intervention activities. We evaluated the curriculum with two samples of students (888 historical comparison [no exposure] and 2,122 intervention students [received the T2D curricula]). Students completed pre-post assessments that were analyzed for knowledge gains and changes in self-efficacy to engage in healthy behaviors. Correct posttest answers in the intervention group increased by 24% versus 1% (biology) and 3% (health) of comparison students (p < .001); mean (sd) self-efficacy scores increased for biology [3.2 (25.2)] and health [1.5 (7.2), both p < .0001)]. COVID-19 prompted mandatory online teaching starting in March 2020 resulting in more health (65%) than biology students (47%, p < .001) doing the curriculum in virtual/hybrid classrooms, yet posttest knowledge gains were similar for these students learning in class or online (p = .47). Students' "take-home" messages mentioned the importance of prevention (64%), physiological mechanisms for developing T2D (54%), and environmental factors (17%). The curricula successfully delivered cross-disciplinary content without placing undue burden on teachers to create and sustain integrated learning systems.