PURPOSE: The purpose of this study was to determine how the performance-based shift and revision of 2001 Guidelines for AAHE/NCATE Review of Initial Level Programs for Health Education Teacher influenced: 1) content and process of selected school health teacher education programs (TEPs) in public institutions of higher education (IHEs) in Illinois. A secondary purpose was to provide school health TEPs with an assessment tool that could: 1) demonstrate that implemented programs appropriately reflect AAHE/NCATE Program Standards; and 2) provide means of communicating program assessment and successes to program administrators, health education practitioners, and teacher educators. SIGNIFICANCE: Results of data collected could assist IHEs and TEPs in understanding and identifying strengths and weaknesses of the process of program design and systemic assessment within the context of educational reform and the revision of program standards vis a vis AAHE/NCATE Program Standards. School health TEPs also will be challenged to communicate programmatic changes and successes to the field of health education and teacher preparation. Results from continued administration of the survey designed for this study could provide continued evaluation of the reform process and an assessment tool that communicates program strengths and weaknesses to program administrators, health education practitioners, and teacher educators. PROCEDURES: This research study used a descriptive research design. Employing three different procedures for data collection, qualitative methods were used. Data was accumulated through document analyses and e-mail interviews. Sources of data for document analyses included program reports most recently submitted for review to AAHE/NCATE by TEPs at selected public institutions of higher education (IHEs) and most recent syllabi from core courses in health education teacher preparation. E-mail interviews with professional education faculty, most often school health teacher education program coordinators, filled gaps identified via document analyses. FINDINGS: This study found that implementing new Standards was realized by modifying and/or adding content, eliminating projects or tasks, as opposed to adding them, and developing and adding new courses to the program. In general, after considering findings from the document analyses, content and performance-based project changes were evident among all IHEs. When analyzing documents by Standard and Key Element, however, significant differences existed between Standards, Key Elements, and IHEs. CONCLUSIONS: Findings for e-mail interviews were categorized into one of four stages including conceptualization, developmental, implementation, and evaluation. Variations existed regarding the particulars of addressing departmental progression and systemic change; the evolutionary process, however, to varying degrees, still was visible in participating IHEs.