Running with Partici-Patrick: Integrating HIV/AIDS Education with DPA and Character Education in Ontario Schools

In the early 1980s, in Kapuskasing, Ont., seven-year-old Patrick Fortin contracted HIV, along with many other viruses, through blood transfusions needed to treat hemophilia. Patrick died on November 8, 2001, at the age of 23, having lived more than 15 years with HIV and AIDS.

Patrick’s wish was for a world with no AIDS. The Fortin family carried on Patrick’s legacy by creating Patrick4Life, a community-based program that strives to eliminate HIV and AIDS through educating others about the disease using a variety of platforms including the schoolbased component, Partici-Patrick (see patrick4life.org for greater details and a full account of Patrick’s legacy). Partici- Patrick is currently being implemented in English and French in four school boards in the near north of Ontario. There is every reason to believe that the components of Partici-Patrick are transferrable to other jurisdictions in Canada and beyond. Health education curricula, as well as character-education initiatives and efforts to increase children’s physical activity contain very similar objectives. In many cases, have congruent specific learning expectations regardless of the governing body responsible for education. Patrick’s story is not unique to the near north of Ontario but, rather, is echoed in many places throughout the world. Furthermore there is a lack of other community-based programming throughout Canada.

Partici-Patrick aims to link the real-life story of Patrick with the character traits he displayed during his experiences with HIV/AIDS.Partici-Patrick aims to link the real-life story of Patrick with the character traits he displayed during his experiences with HIV/AIDS.

The program could also fill a significant need in places where it is not yet implemented. According to the Canadian AIDS Society (2010) community programs are instrumental in HIV/AIDS education in schools, however only Patrick4Life was mentioned as a specific example of a program that has had a community impact.

Teaching sensitive topics such as sexual health education while staying up-to-date on current information has presented teachers with difficulties and discomfort for many years (Canadian AIDS Society, n.d.). In addition to managing such sensitive topics in the classroom, teachers are faced with a variety of other challenges related to current initiatives offered by provincial education mandates. In some cases, mandated initiatives take up large amounts of teachers’ available time with students, making the implementation of new programs problematic. One major initiative is the mandated minutes of daily physical activity (DPA) that teachers across Canada need to incorporate into their day (Alberta Education, 2006; British Columbia Ministry of Education, 2011; Ontario Ministry of Education, 2005a). In addition to DPA, schools often require teachers to focus on the issues of self-esteem and self-efficacy, and these are often the focus of many school goals and improvement plans. Teachers have become overwhelmed with these add-on components to the curriculum (Patton 2012). To ensure that Partici-Patrick does not place more pressure on teachers and administrators, Partici-Patrick aims to integrate Ontario Ministry of Education mandates and curriculum expectations while empowering teachers and students with lesson plans on virtues, values, and healthy lifestyle approaches, and addressing the sensitive topic of HIV and AIDS education. Again, due to the congruency of curricula across Canada, there is potential to easily adapt the components to other jurisdictions (Canadian AIDS Society, n.d.).

This article will provide a rationale, background information and literature pertinent to the Partici-Patrick program as well as a thorough description of the program components. Furthermore, this article features current research efforts that measure and describe the effectiveness of the program for students, teachers, administrators and parents who have participated in Partici-Patrick. The commentary and results presented here are pertinent to classroom teachers attempting to implement many of the components found in Partici-Patrick. In addition, those stakeholders responsible for the adoption of programs, whether they are individual schools or entire school boards, should be interested in the components and the transferability of this program.

Rationale for Partici-Patrick

According to the Canadian AIDS society (n.d.), the majority of provinces and territories in Canada provide content and learning outcomes related to HIV and AIDS. Although inconsistencies exist between provinces the necessity to educate students remains. Because Partici-Patrick is an Ontario-based program, the rationale is specific to this context, but it can be further applied across Canada. Partici- Patrick aims to address a number of recent initiatives promoted by the Ontario Ministry of Education for implementation in elementary schools. These include:

• Ontario Physical and Health Education: Interim (2010), with promised updated guidelines regarding sexual health education;
• The Healthy Schools (2009) program which addresses DPA and is a response to the need to foster healthier lifestyles in youth;
• Finding common ground: Character development in Ontario schools (2008) which assists in the implementation of values/virtues education;
• Ontario education, excellence for all: Developing partners in Education (2005b) which is striving for a new relationship among all interest groups that make up the publicly funded education sector.

Sexual Health Education in Canada

Sexual health education is an important component for the promotion of health and wellbeing in students. Developing and implementing school-based programs is essential to providing students with information regarding sexual health education (Sex Information and Education Council of Canada [SIECCAN], 2009). According to the SIECCAN (2009), sexual health education covers many topics from positive relationships and family planning to issues such as sexually transmitted diseases and teenage pregnancy. Families, educators, health professionals, governments and communities as a whole need to share the responsibility in providing students with an effective and valuable sexual health program.

The Public Health Agency of Canada (PHAC, 2009) reports that since 1985, a cumulative total of 69,844 positive HIV tests were reported through December 31, 2009. Furthermore, In 2009, 2,417 HIV cases were reported; an 8.3% decrease since 2008 (2,636). From 1995 to 2000 there was a steady decrease in the number of reported cases until the year 2000, followed by an increase in 2001 and 2002, where it has remained fairly stable over the last eight years. (PHAC, 2009, para. 3) In 2008, approximately 65,000 people were living with HIV and AIDS in Canada. Twenty-six per cent were unaware of their infection.

In 2008, there were between 2,300 and 4,300 new cases of HIV in Canada (Public Health Agency of Canada, 2009, para. 2). Each year in Ontario, more than 1,000 people are diagnosed with HIV, and more are infected but not yet diagnosed (Remis, Swantee and Liu, 2009). Although HIV/AIDS diagnoses are nationally decreasing, there are still more than 2,000 new case reports each year (Public Health Agency of Canada 2012). Given the ongoing spread of HIV and other sexually transmitted infections, the question is no longer whether HIV and AIDS education should be taught in schools, but rather, at what age and how to ensure the greatest impact.

Sexual health education appears to have a greater impact when it happens early in a student’s life (i.e., before children become sexually active) (Appleton, Christenson, and Furlong, 2008). Other factors come into play, as well. According to a study coordinated by the Council of Ministers of Education, the sexual health and behaviour of adolescents is influenced by a number of socio-demographic variables, including coping skills, self-esteem and attachment to their school. However, between 1989 and 2003, both the coping skills and self esteem of Canadian youth dropped (Boyce, Doherty, Fortin, & MacKinnon, 2003). Key national and provincial strategy documents including Leading Together: Canada Takes Action on HIV/AIDS (2005–2010) and the Ontario Advisory Committee on HIV/ AIDS (OACHA Strategy, 2010) identified youth education as a priority and stressed the need to re-engage schools and develop effective interventions. 

Partici-Patrick was created to address the issues of promoting sound education about HIV/AIDS while incorporating self-esteem initiatives using values and virtues learning, daily phyiscal activity and school and community engagement practices (patrick4life.org).

Daily Physical Activity

The Ministry of Education in Ontario, in mandating daily physical activity, requires that students have a minimum of 20 minutes of moderate to vigorous physical activity each day at school. The benefits of DPA are well recognized in promoting a healthy lifestyle in youth and will be described in the review of relevant literature. The Healthy Schools: Daily physical activity in schools (2005) resource guide, written by the Ontario Ministry of Education, advocates that “Daily physical activity is critical not only to improving student achievement but also to making publicly funded schools healthy places to learn” (p.1). They also provide guidelines for school boards and recommend that boards select staff who can coordinate and provide support while implementing DPA to ensure that all students have the opportunity to participate.

According to the Ontario Ministry of Education (2011b), students do not engage in sufficient amounts of physical activity. This in turn leads to potential health issues including the development of heart disease, type 2 diabetes, hypertension, stroke and potentially some cancers. Physical activity provides many positive benefits including physical, mental and social well-being and it has long been understood that physical activity has wide-reaching and long lasting benefits including an increase in self-esteem and self-concept, a decrease in anxiety and stress, improved academic performance, an increase in positive attitudes and school climate, and a decrease in the number of students who engage in smoking, drugs and alcohol consumption (MacKenzie, 1972; De Marco & Sydney, 1989; Stephens & Craig, 1990; Canadian Fitness and Lifestyle Institute, 1993; Shephard, 1996; Ontario Ministry of Education, 2011b). Physical activity is important to develop students’ physical literacy as well as improve academic performance. Patton (2012), while gaining an understanding of teachers’ perspectives of the DPA program in Ontario, found that the majority of respondents in his study “did not have enough time to plan DPA on a regular basis” (p. 20) and that more than half of the 145 teacher participants in the survey “rarely or never had been given grade-appropriate activity ideas” (p. 20).

Character Education

Character education is intended to address the cognitive development of students while also promoting positive character development. Curriculum Services Canada (2006) states that the purpose of character education is to promote a “civil, just, and democratic society” (para. 1). The success of character education is a shared responsibility necessitating a partnership between families, schools and the community as a whole (Curriculum Services Canada, 2006).

The opportunities outlined by the Ontario Ministry of Education for the facilitation of character education include “a deliberate focus on character development in board and school plans with specific alignment with other ministry expectations; for example, Safe Schools, Student Success and other initiatives” (Ontario Ministry of Education, 2011, para. 5). Character education in schools provides students with opportunities to learn about diverse and controversial issues and experiences. The goal of character education is to cultivate students in ways that encourage them to be responsible for how they conduct themselves; specifically their thoughts, feelings and actions in response to these dynamic and controversial issues and experiences (Ontario Ministry of Education, 2008). When there is the expectation to teach sensitive topics such as those related to sexual health and character development, while also focusing on values and virtues, it is important to understand the preparation of teachers and the education they experience. Partici- Patrick aims to link the real-life story of Patrick with the character traits he displayed during his experiences with HIV/AIDS.

School and Community Engagement

Merging community and school has been a topic of interest since 1952, when Edwards proposed that communities are centres where people develop the problemsolving skills they require throughout life. (Edwards, 1952). This thought carries over to present-day mandates: “Good schools are better where there is a stronger connection with parents as part of the learning community” (Ontario Ministry of Education, 2005c, p. 2). The Ontario Parental Involvement Policy (Ontario Ministry of Education, 2005b) notes “the main thrust is an onus on decision-makers to create the conditions for parents’ engagement in their children’s education to take place by way of the right environment, supports and attitudes” (Ontario Ministry of Education, 2005c, p. 1).

Description of Partici-Patrick

This description focuses on Partici-Patrick as a program which aims to enrich teacher and student resources and provide the opportunity to integrate HIV and AIDS education, DPA, and values and virtues education with other subject areas. One of the benefits of Partici-Patrick which will be further explained is that the program is not viewed as an additional curriculum item, but rather, as a program that provides the opportunity to use existing curriculum documents to provide a complementary experience while meeting the mandates of the Ontario Ministry of Education initiatives previously discussed. In addition to describing the teacher and student resources available in this program, as well as the various links this program has with current educational initiatives, this section will discuss the culminating activity for the Partici-Patrick program: the Day of Champions.

Teacher and Student Resources

A key component to successful implementation of Partici-Patrick is the teacher resource binder (Patrick4Life, 2013). This binder provides suggestions for teachers regarding the integration of concepts across a number of academic disciplines for particular grades. Currently, there are newly revamped (2013) integrated curriculum activity suggestions for grades 4, 5 and 6 with a team of eight teachers working on the development of a learning continuum for full implementation of the program for students in kindergarten through to grade 8. The team ensures consistency across grades and helps to build and restructure activities so that repetition does not occur as students advance through the program. Furthermore, the binder includes a children’s book titled Patrick’s Wish, which provides a biographical account of Patrick’s life written from his younger sister, Lyanne’s perspective, as a child. There is also a logbook in which students write entries about their own physical activity and learning on a daily basis. In an effort to provide a comprehensive understanding, the teacher binder and student logbook integrate HIV and AIDS education, DPA, and values and virtues learning for students and teachers.

HIV and AIDS Education

HIV and AIDS education is woven into all components of the Partici-Patrick program, including the resource package given to teachers. With respect to knowledge of HIV and AIDS, the teaching binder includes quizzes, facts about HIV and AIDS, suggested student activities and ideas, along with links to children’s literature and a review of related literature for teachers. The intent is that teachers will integrate these components of Partici- Patrick into their daily teaching along with reinforcing the program’s values and virtues during daily physical activity. These activities are directly related to Patrick’s story and encourage integration with the Ontario language curriculum. Opportunities for further curricular links are also available in the resource binder.

Daily Physical Activity

Partici-Patrick spans the course of 10 weeks each school year and currently begins in April. It requires that students are active each day of the program by running or walking 1 km or completing alternative and equivalent exercise. The total running distance or accumulated exercise by each student at the end of 10 weeks is equivalent to 40 km. With this running distance added to the culminating activity (a 2.2 km run on the Day of Champions described below), students complete their own marathon of 42.2 km by the end of the program each year. This achievement is logged in their logbook to showcase the physical activity progress each student has made throughout the 10 weeks.

Character Education Through Values/Virtues

Each week of the program is connected to a value/virtue associated with Patrick’s story. These values/virtues include courage, thankfulness, acceptance, excellence, self-discipline, unity, humility, compassion, enthusiasm and determination. The suggested curricular links reinforce each value/virtue and are listed in the student 10-week logbooks and family activity calendars.

Day of Champions

The Partici-Patrick program culminates with the Day of Champions where all participating students (currently, approximately 2,000 students per year) from the four participating school boards come together in a park in North Bay, Ont. for a day of activity and celebration. The focal point of the day is the 2.2 km run that completes the students’ marathons. Students receive tee-shirts upon arrival at the Day of Champions and medals upon completion of the run. In addition to the group run, students have an opportunity to participate in a variety of interactive activities that emphasize the values/virtues of Partici-Patrick while providing valuable information about HIV and AIDS. The Day of Champions brings together various participants from the community such as representatives from municipal, provincial and federal levels of government, and the Aboriginal community, who each address the audience.

Research Summary

In 2011, a mixed-methodology research study was undertaken to determine the efficacy of Partici-Patrick. This study hypothesized that Partici-Patrick, an integrated, age-appropriate, developmentally appropriate, values- and activity-based approach to HIV and AIDS awareness and education for students in grades 3 to 8 would have a positive impact on students’ knowledge, attitudes and behaviours regarding HIV and AIDS.

Participants

The participants in this study were selected from 18 schools from the Near North District School Board, the Nipissing-Parry Sound Catholic District School Board, Le Conseil scolaire public du Nord-Est de l’Ontario, and Conseil scolaire catholique Franco-Nord in Ontario. Figure 1 shows the participants from the student, teacher, parent and administrator populations from this study.

Methodology

Students were asked to complete a 42- item online survey that measured whether or not their participation in Partici- Patrick had an effect on each or any of the following:

• a Knowledge of HIV and AIDS
• b Attitudes toward HIV and AIDS
• c Engagement in school
• d Participation in daily physical activity (DPA)
• e Development of positive virtues and values in students

​Random sampling was employed for these student surveys. All survey responses were analyzed for central tendencies and all interview responses were applied to an organizational framework (SWOT) for further analysis. In addition to seeking student responses, parents and principals were interviewed and teachers completed an online survey as well as an interview if selected, upon receiving an invitation through their school board email list. Purposeful sampling was applied in selecting teachers, administrators and parents from each school board. Individual interviews were conducted with parents and administrators, while focus groups and individual interviews were conducted with teachers, as determined by their availability. The interview questions were loosely categorized into program strengths, weaknesses, opportunities and threats (SWOT).

Quantitative Data Analysis

Demographic variables were examined in terms of frequencies to identify the basic parameters of participants. To identify the differences between students and teachers who participated and those who did not participate in Partici-Patrick in 2011, a one-way analysis of variance (ANOVA) was used. Descriptive statistics were analyzed to determine where the differences lie between groups, in terms of means. Finally, cross-tabulations were used to compare the two groups in terms of percentages across significant questions.

Qualitative Data Analysis

The SWOT categorization provided a framework for the analysis of the transcripts based upon the perspective from each interest group (Johnson, Scholes & Sexty, 1989). The investigators sorted through the transcribed interview and focus group data to find supporting excerpts to accompany the high-frequency and, if necessary, low-frequency responses (Gay & Airasian, 2003).

Results and Findings

Overall, significant quantitative findings were noted at the 0.01 level for 39 of 42 items on the five different categories of the student survey. These results provide overwhelming support in all areas for the students’ perceived benefits to taking part in in Partici-Patrick. The findings in the qualitative component of this research were congruent with the findings in the quantitative component. In particular, there was ample anecdotal evidence from all stakeholders to support increased HIV and AIDS knowledge, daily physical activity, positive character development, and school and community engagement of students who participated in Partici-Patrick. These activities led to increased discourse between students, parents and teachers while also promoting a sense of pride in students’ achievements in school-related activities.

Participant Responses: Teachers

Teachers identified the ability to easily integrate program components into a number of subject areas as a major strength of Partici-Patrick. In particular, there was repeated mention of Partici-Patrick not being an “add on” to the already demanding curriculum, but rather, a way to incorporate daily physical activity, and health and character education. With respect to opportunities, teachers identified how the discussion regarding HIV and AIDS led to further discussions related to building empathy in students and enhancing students’ knowledge of global issues.

Participant Responses: Administrators

As with other stakeholders, administrators identified the strengths of Partici-Patrick to be increased knowledge of HIV and AIDS, increased discourse among students regarding an understanding of their own and others’ situations, increased importance given to DPA, and increased school engagement. Partici-Patrick also allows for an increased engagement with the community through various forms of outreach; something administrators also identified as a strength of the program. Administrators recognized the need to have a “champion teacher” to lead the Partici-Patrick program in each school. Essentially, a champion teacher would be charged with the responsibility of fully implementing Partici- Patrick and liaising between the school and Patrick4Life to ensure that a complete and cohesive program was delivered. The lack of such a position could act as a weakness and a threat with regards to program cohesiveness and consistency. Where a champion teacher was in place, there appeared to be a seamless implementation of the program.

Participant Responses: Parents

Parents identified the increased knowledge of HIV and AIDS— both for their children and themselves—as a major strength of Partici-Patrick. In addition, some recognized the increased importance their children placed on physical activity and the determination to finish the marathon run. Parents also identified the increased engagement with school through their participation in the Day of Champions as a positive aspect of the program. Some of the parents included, as a weakness, the lack of consistency between teachers in their approaches to teaching the components of the program. Since the time that this study was conducted, efforts have been put in place by the educators responsible for curriculum development at Partici-Patrick to promote such consistency through program review and restructuring.

Recommendations

• Four key recommendations were made as a result of this research and have already been acted upon. These were:
• An enhancement of teacher training efforts with inclusion of a champion teacher and board consultant
• An enhancement of teaching resources and the development of grade-specific curricular connections
• The development of an educational component to more actively involve parents and community stakeholders
• Further exploration of the opportunity for program expansion.

These recommendations have already been acted upon in the following ways:

• Partici-Patrick has developed a more extensive teacher training process with an annual inservice session for approximately 30 teachers. This inservice takes place in conjunction with the local school boards and teacher release times are covered by funding from Patrck4Life.
• There has been an enhancement of the teacher resource binder to include more suggestions for integrating key concepts associated with Partici-Patrick into the regular school curriculum. In addition, there has been a conscious effort to develop a continuum of learning across grades. Curriculum links for grades 3 through 8 have been finalized. Further expansion to kindergarten and grades 1 and 2 is underway for the current academic year (See http://www. p4l.ca/ online-teacher-resources).
• Partici-Patrick, and by extension, Partick 4Life, has made substantial efforts to expand community programming to include educational stakeholders and will support the further development of leadership opportunities for secondary school students through their youth4 youth ambassadorship program. The program has also enhanced outreach to parents with the development of the Partici-Patrick 10-week Family Activity Calendar that provides a synopsis of the program complete with a schedule of events, lists of values andvirtues, and suggested activities for families to complete to complement those introduced in school.
• Partici-Patrick has been expanded to two First Nation communities in Northern Ontario, which was one of the program’s initial goals. There are plans are underway for this academic year.

Conclusions

Partici-Patrick provides a unique approach to many key initiatives recently introduced in Ontario schools. It explores many critical issues facing youth and it provides youth with the tools to assist in the development of healthy lifestyles. These critical issues include sexual health, daily physical activity, character education through virtues and values education development, and the integration and engagement of parents and the wider community in the schooling process. Based on findings from this research study, participants noted that linking HIV/AIDS education with personal fitness encourages students to develop positive attitudes towards health and their bodies as well as values such as acceptance, helping others, self-discipline and determination, which are key to promoting sexual health. Partici-Patrick is maintained by dedicated and passionate leaders in the near north area of Ontario so that students can have an enhanced and beneficial educational experience related to HIV/AIDS education, physical activity, and values and virtues. Because of the immediate benefits that participating students are displaying, such as compassion for others, enthusiasm for continuing in the quest to complete their marathon, and increased engagement in school, stakeholders have recognized the need to continue efforts to create a place for Partici- Patrick in all schools across Canada.

References