Dr. Frank Till Superintendent of Schools HEALTH EDUCATION IN MIDDLE SCHOOLS: ONE COURSE VERSUS INTEGRATION EVALUATION REPORT

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1 Dr. Frank Till Superintendent of Schools HEALTH EDUCATION IN MIDDLE SCHOOLS: ONE COURSE VERSUS INTEGRATION EVALUATION REPORT The School Board of Broward County, Florida Carmen Varela-Russo Associate Superintendent Technology, Strategic Planning and Accountability Dr. Katherine Blasik Director, Research and Evaluation Dr. Cary Sutton Director, Research Services Lois Wexler, Chairperson Darla L. Carter, Vice Chairperson Carole L. Andrews Judie S. Budnick Paul D. Eichner, Esq. Stephanie Arma Kraft, Esq. Miriam M. Oiliphant Dr. Robert D. Parks Diana Wasserman September, 1999 Prepared by: Dr. William F. Younkin, Educational Instruction Systems Niveen Iskandar, Research Specialist, Research & Evaluation

2 HEALTH EDUCATION IN MIDDLE SCHOOLS: ONE COURSE VERSUS INTEGRATION EVALUATION REPORT Table of Contents I. EXECUTIVE SUMMARY i II. INTRODUCTION Background 2 Formation of Research Groups 4 Health Test Development 4 Cost Impact 4 Purpose of the Evaluation Report 4 III. EVALUATION METHOD 5 IV. RESULTS Psychometric Properties of the Test 5 Data Analysis 8 Differences Between Waivered and Non-waivered Schools 11 Outlier Schools 12 Evaluation Question Results 13 V. SUMMARY AND RECOMMENDATIONS Summary 13 Recommendations 14 VI. REFERENCES 14 VII. APPENDIX A 15 VIII. APPENDIX B 17 IX. APPENDIX C 19 X. APPENDIX D 20

3 HEALTH EDUCATION IN MIDDLE SCHOOLS: ONE COURSE VERSUS INTEGRATION EVALUATION REPORT List of Tables and Figures Table 1. Middle Schools By Health Curriculum and School Year 3 Table 2. Coefficient Alpha By Race, Gender, FRL, LEP, ESE, and DOP Status 6 Table 3. Table 4. Mean and Standard Deviation (SD) of Health Test Score By Race, Gender, FRL, LEP, ESE, and DOP Status 9 Correlations Between Health Test Scores, Demographic Variables, GPA, and Stanford Achievement Test, Eighth Edition (SAT8) 10 Table 5. Regression Model Statistics 11 Table 6. Mean and Standard Deviation for Residual Scores of Waivered and Non-Waivered Schools 12 Table 7. Outlier Schools 13 Figure 1. Distribution of Student Scores on the Health Test 7 Figure 2. Distribution of Item Difficulty Values on the Health Test 8

4 HEALTH EDUCATION IN MIDDLE SCHOOLS: ONE COURSE VERSUS INTEGRATION EVALUATION REPORT The evaluation reports on the findings and recommendations resulting from the administration of a Health Test to a sample of seventh grade students in each middle school. After statistically adjusting for initial differences between the two comparison groups, the evaluation finds that there is no significant difference in performance between students attending schools that offer and provide a health unit course on the wheel and schools that have integrated health education into other subject areas. Study findings also identified five schools whose results were higher than the normal range of variation, and four schools whose results were lower than the normal range. Introduction There has been considerable concern raised in the literature regarding the knowledge and behavior of contemporary youth regarding health issues. Griesemar (1993), summarizing recent research, concludes that Urban adolescent youth are particularly at risk of developing lifestyles that are not conducive to good health (p. 60). In a discussion of the trends in health education, Davis (1996) concludes that any curriculum in the future must have clearly articulated standards with assessment as an integral part. There are few studies reported in the literature that have investigated the relative merits of a stand-alone health course compared to an integrated approach. The one recent study, by Sondag, Curry, and Thomas (1997), reported on the requirement by the State of Montana that individual school districts combine learner outcomes for health and physical education under the umbrella term Health enhancement. The study surveyed the schools to investigate the degree of integration and topic coverage in Mr. Turano s Third Period Class at Sunrise Middle School the schools. Their report revealed minimum support for Health enhancement in theory or practice (p. 111) and concluded that the state must establish more well-defined standards and learner outcomes to ensure greater consistency regarding health education content and the amount of class time devoted to health education activities (p. 110). Background 1

5 In Broward County Public Schools (BCPS), health education for grade six consists of 45 days of instruction which, in keeping with Florida Statute , includes but may not be limited to the following topics: Substance Abuse Prevention and Mental and Emotional Health Family Life/Human Sexuality and Abstinence HIV/AIDS and STDs Nutrition Injury Prevention and Safety Personal Health Prevention and Control of Disease Consumer, Community and Environmental Health Health instruction in grades seven and eight consists of 20 days of instruction covering the following topics: Substance Abuse Prevention and Mental and Emotional Health, Family Life/Human Sexuality and Abstinence, HIV/AIDS and STD s, and Nutrition. Instruction in grades seven and eight is integrated into other courses and occurs primarily in science courses. All Health instruction for grade seven and eight students throughout the district is integrated. Instruction for grade six students, however, is provided either through a 45 day class on an enrichment wheel or it is integrated into other subject areas. Wheel courses occur only at the middle school level and basically provide a final grade for the course for one 45 day marking period the entire course is provided during one 45 day marking period. Enrichment Health wheel courses possess a separate State Course Code Number on the student database. Integrated Health instructional approaches, on the other hand, do not result in similar coursework codes compared to schools that use the wheel. Course numbers at these schools are recorded for only the primary course and do not specify a Health course on the student s academic record. Nineteen middle schools during the school year integrated Health instruction for grade six students into science, physical education, social studies, language arts, reading, mathematics, social skills, peer counseling, art, band, and other curriculum areas. In these schools, Health has been replaced on the "wheel" with conflict mediation, study skills, social skills, music, and a variety of other courses. At the same point in time many school staffs were voting on integrating Heath and considering a formal waiver for grade six students, some teachers were already integrating Health into their discipline even though other members of their department at the school were not supportive of the integration concept. The non-supporters of Health integration felt an additional burden is placed upon teachers to teach material from two disciplines at the same time with separate sets of Sunshine State Standards. School staffs opting to integrate Health into other subject areas were originally required to submit a formal waiver request to the district. This process began in the school year. The sites implementing waivers wrote individual waiver plans to document the manner in which the content was to be integrated. As shown in Table 1, seven middle schools submitted waiver requests in Health 2

6 waivers were submitted by nine middle schools for the school year, including five renewal waivers and four new waivers. Two of the schools did not renew their waiver from the previous school year. Beginning with the school year, school staffs were no longer required to submit a formal waiver to integrate Health into other curriculum areas. An informal survey was used to document the schools integrating Health for students during the and school years. The number of schools that self-reported the integration of health education into other curriculum areas totaled 15 schools in and 19 schools in Table 1 Middle Schools Integrating Health into Other Curriculum Areas by School Year School Year School Apollo Attucks X X X X Bair Coral Springs X X Crystal Lake X X Dandy, William X Deerfield Beach X Driftwood X Forest Glen Indian Ridge Lauderdale Lakes X X X X Lauderhill X X Margate X X McNicol X X X New River X Nova X Olsen X X X X Parkway X X X Perry X X X X X Pines Pioneer X Plantation X X X X Pompano Beach X X X X Ramblewood Rickards X Sawgrass Springs Seminole X Silver Lakes X X Silver Trail Sunrise X X X X X Tequesta Trace X X Westpine Young, Walter C. X X X Note: An X in a column means that the school integrated health into other subjects rather than having a health unit on the wheel. 1 This year served to form research groups. 3

7 Formation of Research Groups For the purposes of this study, the 15 schools that opted to integrate Health during the school year will be considered Waivered Schools. The remaining schools served as a comparison sample and were termed Non-Waivered Schools. Because the Health Test was administered during February of the school year to seventh graders, the students tested attended either waivered or non-waivered schools during the school year as sixth graders and received different methods of health instruction. Health Test Development During the school year, local educators developed a health assessment designed to measure middle school students knowledge of health issues. At the request of BCPS administrators and teachers, a locally-developed criterion-referenced test was piloted to assist with waiver evaluation and potential accountability for mastery of standards. Upon completion of the pilot testing, the Department of Health Education Services decided to investigate the availability of nationally-normed testing in this area. The Health Education Assessment Project of the Council of Chief State School Officers, State Collaborative on Assessment and Student Standards (CCSSO-SCASS) was asked to assist in test development. This project assists states in developing needed student standards and related assessments, and works with other states with similar needs. The test was piloted in the district during the school year with a random sample of grade seven students from all middle schools. Cost Impact There is no financial impact to the district of the health waiver program, the source of funds is the HIV/AIDS Comprehensive Health grant. The licensing costs of the items comprising the Health Test are included in membership in the SCASS, held by Broward County Public Schools ($18,000 per year). Costs associated with testing expenses totaled $2,632, which included printing costs and the purchase of SCANTRON answer sheets. Purpose of the Evaluation Report The purpose of this evaluation effort is to determine whether the Health Test is an effective psychometric instrument and to use it to examine the differences in the amount of learning regarding health issues, as demonstrated by scores on the Health Test, in schools that integrate Health into other curriculum areas (waivered) and those that do not (non-waivered). This evaluation is also intended to determine if any schools demonstrated performance on the Health Test above or below the normal range. In particular, the study was designed to answer the following evaluation questions: 1. Is the Health Test an effective psychometric instrument to evaluate knowledge regarding health issues? 2. Are there any differences on Health Test scores between the waivered and non-waivered schools? 4

8 3. Are there any schools whose students perform unusually above or below the mean in comparison to similar schools? Evaluation Method The Health Test was administered during the week of February 23, 1999 to four randomly selected English classes in each middle school. This test was administered using standard answer sheets that included student numbers and school codes. The answer sheets were scanned and provided to the evaluator in machine readable form, along with demographic and test score data for each student. A total of 525 students (17%) who either turned in answer sheets with no responses or presented multiple responses to questions were excluded from the analysis. Psychometric Properties of the Test Results In order for a testing instrument to be useful for making decisions, it must be reliable and valid. Reliability refers to the stability of the testing results and relates to the amount of random error introduced by the test itself. Reliability, therefore, refers to the consistency of the measuring instrument. Reliability is measured by obtaining an estimate of the consistency of results that would be obtained if the instrument could be administered twice to the same set of participants. A reliability coefficient of 1.0 would indicate that each administration resulted in the same value, whereas a reliability of 0.0 would indicate that the results of the two administrations had a random relationship to each other. Because it is often not practical or even possible to administer a test twice to the same participants, a measure of internal consistency is utilized to estimate the reliability of a test. One of the most common of these estimates is known as Coefficient Alpha. This procedure was applied to the Health Test. The results for the overall sample and for demographic subgroups are presented in Table 2. 5

9 Table 2 Coefficient Alpha By Race, Gender, FRL, LEP, ESE, and DOP Status Group Coefficient Alpha n Overall ,030 Race Black ,056 Hispanic White ,415 Other Gender Male ,512 Female ,518 Free/Reduced Lunch (FRL) FRL ,149 Non-FRL ,881 Limited English Proficient (LEP) LEP Non-LEP ,883 Exceptional Student Education (ESE) ESE Non-ESE ,716 Drop Out Prevention (DOP) DOP Non-DOP ,767 These coefficients, ranging from 0.91 to 0.94, indicate that the test as a whole is measuring one attribute (presumably health knowledge) and introduces a relatively small random error component into the measurement process. In conclusion, the Health Test demonstrates a high degree of reliability. Validity is an indication of how well the instrument measures the variable it is claimed to measure (i.e., Is this test a valid measure of health knowledge or is it measuring something else?). One type of validity, construct validity, refers to the degree to which the instrument measures the attribute that it is intended to measure. This is the type of validity that was assessed in relation to the Health Test. The Health Test consists of a set of 73 items selected from the Elementary Assessment Form developed by the Health Education Project of the CCSSO-SCASS. The CCSSO-SCASS contracted with Harcourt Brace Educational Measurement who went through an extensive process of engaging national experts in health education in developing a set of topics to be tested. Next, item developers, also health education experts, developed items for the test. Following an extensive field-testing process, 89 items were chosen for the original instrument (Harcourt Brace Educational Measurement, 1996). 6

10 The School Board of Broward County (SBBC) Department of Health Education Services matched these items to the Sunshine State Standards and selected 73 items to be included in the district s Health Test. This development process insured that the measuring instrument measures health knowledge as defined by national experts and the Sunshine State Standards. Thus, it can be concluded that the instrument has a high degree of construct validity. Other factors of interest in evaluating a measuring instrument are the distribution of scores, the distribution of item difficulty values, and the item discrimination values. As shown in Figure 1, the distribution of student scores is symmetrical and nearly normal or bell-shaped. The overall mean is (54% correct) and the standard deviation is Number of Students Total Correct Figure 1. Distribution of student scores on the Health Test. Item difficulty refers to the percentage of students who correctly responded to an item. In general, a test item is considered to be a good discriminator if 55% of the students answer it correctly (this maximizes the reliability of the test). The distribution of item difficulty values on the Health Test is displayed in Figure 2 and presented by item, race and gender in Appendix A. The item difficulty values are approximately normally distributed and center close to indicating that, on average, 50% of the students responded correctly to an item. The values range from 0.28 to Thus, there is a good range of item difficulties to accommodate the knowledge level of most of the students tested. When the range of item difficulties includes both easy and difficult items, yet the average for item difficulty approximates.55, reliability is maximized and the items potentially could measure differences in achievement for students of differing abilities. 7

11 30 Number of Items Difficulty Figure 2. Distribution of item difficulty values on the Health Test. Item discrimination refers to the relationship between the correctness of the response to a particular item and the total test score. Item discrimination is reported as a biserial correlation between item score and total test score. A negative item discrimination score indicates an item that is misleading (i.e., for the total test score high scoring students tend to get it wrong) and an insignificant item discrimination indicates an item that only adds random variance to the total score. The item discrimination values for the Health Test are presented by item, race and gender in Appendix B. Overall, the item discrimination values range from 0.18 to All of the item discrimination values (both overall and for subgroups) are positive and significant (except for the race category of Other where the sample sizes are too low). These values indicate that all of the items contribute positively to the total score and that none of the items are useless or misleading. In conclusion, the Health Test appears to have excellent psychometric properties and is well-suited for the purpose of this study. Data Analysis The overall average score on the Health Test is approximately 39 items correct on the 73 item test. These data are presented in Table 3 and are disaggregated by demographic variables. Means for each of the subgroups, except non-lep, non-ese and non-dop, are significantly different from the overall mean. A breakdown of results by school and race is presented in Appendix C and by school, and other demographic variables in Appendix D. 8

12 Table 3 Mean and Standard Deviation (SD) of Health Test Score by Race, Gender, FRL, LEP, ESE, and DOP Status Group M SD n Overall ,030 Race Black ,056 Hispanic White ,415 Other Gender Female ,518 Male ,512 Free/Reduced Lunch (FRL) FRL ,149 Non-FRL ,881 Limited English Proficiency (LEP) LEP Non-LEP ,883 Exceptional Student Education (ESE) ESE Non-ESE ,716 Drop Out Prevention (DOP) Educational Alternative Disciplinary Non-DOP ,767 Because the disaggregated data for the groups in Table 3 were not randomly selected, it was not appropriate to compare them directly. There are many sources of variation that are not related to the grouping variables (i.e., the type of health curriculum, school). The main source of this variation is the difference among student populations in terms of demographics and incoming ability (e.g., GPA, test scores). Although not influenced by the curricular structure of the school, these factors may influence scores on the Health Test. Table 4 presents the correlations between these factors and the scores on the Health Test. The determination of the relationship between the qualitative factors (e.g., race) and Health test score was accomplished by using dummy variables. Dummy variables represent categories of the qualitative variable (e.g., White) and are coded as 1 or 0, representing whether or not the subject fits that category. There are dummy variables for all categories of the original demographic variable, except for gender which can be coded by only one variable (Male) with 1=male and 0=female. 9

13 Table 4 Correlations Between Health Test Scores, Demographic Variables, GPA, and Stanford Achievement Test, Eighth Edition (SAT8) Demographic Variables r Ability Variables r Race GPA 0.51 Black Math Applications NCE Hispanic White Male Total Math NCE FRL LEP Reading Comprehension NCE ESE DOP 0.20 Total Reading NCE Basic Total NCE Notes: Demographic variables were coded as dummy variables. All of the correlations are significant (p<0.05) except Hispanic. A correlation for the 1996 Basic Total NCE was not computed due to the small sample size. To appropriately determine the effect of the curriculum and school variables, it was necessary to ruleout as many alternative explanations of the observed differences as possible. A statistical technique known as multiple regression was used to remove variation that is not related to the type of curriculum or type of school. A mathematical model was constructed, utilizing the best combination of previous test scores and demographic data, to predict Health Test scores. The model development utilized a technique known as stepwise regression to select the optimal set of predictor variables that would result in an effective and efficient model. The goal was to develop a prediction model that contained the least number of predictor variables (efficient) that could explain the maximum amount of variation in the criterion (effective). The criterion variable was the total score on the Health Test. The model developed is summarized in Table 5. 10

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15 Table 5 Regression Model Statistics Variable B SE B ß R 2 Constant Reading Comprehension NCE GPA Male Black FRL The unstandardized coefficients, B, indicate the absolute contribution to the predicted score of that variable. For example, for each point rise in GPA, the predicted score goes up 3.1 points. For the dummy variables (Male, Black, FRL), these coefficients represent the mean difference between subjects with that value of the qualitative variable and those with the remaining values independent of the other variables present. For example, Blacks score, on average, 2.35 points below others (i.e., Whites, Hispanics, and Others) after adjusting for differences in test scores, GPA, gender, and FRL status. The standardized coefficients, ß, give the relative contribution of that variable to the prediction model -- the greater the standardized coefficient, the greater the contribution of that variable to the model. In this case, reading scores, with a coefficient of 0.53, provide the single best contribution to our ability to predict Health Test scores. The R 2 value for the overall model (0.51) indicates the amount of variance in Health Test scores that the model is able to predict. Therefore, this model was able to account for approximately half (51%) of the variation in student scores, with Reading Comprehension explaining most of this variability (46%). A predicted score was then computed for each student based on this model and this predicted score was subtracted from the student s actual score. These differences (or residual scores) represent the amount of knowledge gained by the student above or below that which would be expected given his or her incoming attributes. These differences are thus due to variables that were not included in the model. It is assumed that these variables are primarily school specific. In particular, it is assumed that quality of the health curriculum represents most of the remaining differences. These residual values were then used to test the evaluation questions. Due to the fact that seventh grade students were tested and the health courses are given in the sixth grade, only students who attended the same school in and were included in the following analyses. Differences Between Waivered and Non-Waivered Schools To determine whether students in waivered schools performed differently on the Health Test than those in non-waivered schools, residual scores were used to calculate a mean score for each type of school. As shown in Table 6, there is no statistically significant difference between waivered and non-waivered 12

16 schools after adjusting for initial differences. The small difference observed (0.34 points) can be attributed to random sampling and measurement variation. Table 6 Mean and Standard Deviation for Residual Scores of Waivered and Non-Waivered Schools Group n M SD Waivered 1, Non-Waivered 1, Note: t=0.79, p>0.05. Outlier Schools Within any type of distribution, there exists some degree of random variation. Most processes follow a normal, bell-shaped distribution that has a mean equal to 0 and a standard deviation equal to 1.0. A standard deviation indicates how far a score is from the mean. To determine whether a particular school is an outlier (i.e., unusually above or below the average), it is necessary to determine whether that school demonstrates a performance that is outside the normal range in comparison to other similar schools (i.e., waivered or non-waivered). In a normal distribution, 98% of the scores typically fall within three standard deviations of the mean. Thus, schools that have a mean score on the Health Test that falls more than three standard deviations away from the mean (either above or below the mean) would be considered outliers. For the residual data, it is expected that schools that randomly differ from each other will have a mean of 0.0. These mean residuals and corresponding SD s were calculated separately for each school. Schools whose mean residual score fell at a distance of more than three SD s away from 0.0 were identified as being outliers. These schools and their supporting statistics are shown in Table 7. As can be seen, five schools (four non-waivered and one waivered) scored unusually high on the Health Test. In contrast, four schools (two non-waivered and two waivered) scored unusually low on the Health Test. It is interesting to note that both waivered and non-waivered schools appear in both the unusually high and unusually low groups. 13

17 Table 7 Outlier Schools Residual School Group Mean SD Distance From 0.0 Unusually High Dandy, William NW Ramblewood NW Bair NW Silver Trail NW Young, Walter C. W Unusually Low Westpine NW Lauderdale Lakes W Parkway W Nova NW Notes: W = Waivered NW = Non-waivered. Distance from 0.0 was calculated by Mean/SD. Evaluation Question Results 1. Is the Health Test an effective psychometric instrument to evaluate knowledge regarding health issues? Yes. Both in terms of reliability and validity the Health Test demonstrated excellent measurement properties. 2. Are there any differences on Health Test scores between the waivered and non-waivered schools? There is no statistically significant difference between the waivered and non-waivered schools after adjusting for initial differences among students. 3. Are there any schools whose students perform unusually above or below the mean in comparison to similar schools? Nine schools were identified as outliers -- students averaged more than three standard errors away from the mean for similar schools. Of these, five schools performed unusually high and four schools performed unusually low. Summary Summary And Recommendations The Health Test appears to have excellent psychometric properties and was well-suited for the purpose of this study. 14

18 There was no statistically significant difference between the waivered and non-waivered schools after adjusting for initial differences among students. These results reveal that, as indicated in the literature, the more important issue may be the school s understanding of and focus on standards (in particular the Sunshine State Standards), rather than the chosen method of curriculum delivery (e.g., stand alone vs. integrated). A total of nine schools were identified as outliers -- demonstrating unusually high or unusually low student performance. The schools whose students performed unusually high were William Dandy, Ramblewood, Bair, Silver Trail and Walter C. Young. The schools whose students performed unusually low were Westpine, Lauderdale Lakes, Parkway and Nova. The identification of schools whose performance was above the normal range should provide models of curricular implementation in the health area for the improvement of other schools. The schools that performed below the normal range should be provided assistance in improving their delivery of health curriculum. Recommendations 1. Continue to use the Health Test to monitor the performance of schools in educating students regarding health issues and refine the categories of curricular approaches to health education that are currently in place. 2. Investigate the schools that were identified as outliers to learn from those that performed unusually high and assist those that performed unusually low, thereby ensuring that all schools meet the Sunshine State Standards. References Davis, M. G. (1996). Health, physical recreation, and dance: Where are they going? NASSP Bulletin 80 (581), Griesemer. B. A. (1993). Developing healthy adolescents. NASSP Bulletin, 77 (557), Harcourt Brace Educational Measurement (1996, October). CCSSO SCASS Health Education Project (Technical Report). San Antonio, Texas. Sondag, K. A., Curry, L. A., & Thomas, M. (1997). Integrating physical and health education into one course: Is it working in Montana? Physical Educator, 52(2),

19 Appendix A Item Difficulties By Race and Gender Race Gender Item Black Hispanic White Other Female Male Overall

20 Race Gender Item Black Hispanic White Other Female Male Overall

21 Appendix B Item Discrimination Values By Race and Gender Race Gender Item Black Hispanic White Other Female Male Overall

22 Race Gender Item Black Hispanic White Other Female Male Overall

23 Appendix C Raw Score Means by School, Race and Gender Race Gender School Black Hispanic White Other Female Male Overall Apollo Attucks Bair Coral Springs Crystal Lake Dandy, William Deerfield Beach Driftwood Forest Glen Indian Ridge Lauderdale Lakes Lauderhill Margate McNicol New River Nova Olsen Parkway Perry Pines Pioneer Plantation Pompano Beach Ramblewood Rickards Sawgrass Springs Seminole Silver Lake Silver Trail Sunrise Tequesta Trace Westpine Young, Walter C Note: Blanks indicate that there were not sufficient students in that subgroup to compute a mean. These raw scores are heavily influenced by demographic and ability characteristics of the students and cannot be utilized to make any judgments about the relative quality of health education at these specific 20

24 schools. Selected samples of students from each school were obtained for the purpose of comparing waivered vs. non-waivered schools, not individual schools. School Appendix D Raw Score Means by School, FRL, ESE, LEP, and DOP FRL ESE LEP DOP Non- Non- Non- Non- FRL FRL ESE ESE LEP LEP DOP DOP Apollo Attucks Bair Coral Springs Crystal Lake Dandy, William Deerfield Beach Driftwood Forest Glen Indian Ridge Lauderdale Lakes Lauderhill Margate McNicol New River Nova Olsen Parkway Perry Pines Pioneer Plantation Pompano Beach Ramblewood Rickards Sawgrass Springs Seminole Silver Lake Silver Trail Sunrise Tequesta Trace Westpine

25 Young, Walter C Note: Blanks indicate that there were not sufficient students in that subgroup to compute a mean. Selected samples of students from each school were obtained for the purpose of comparing waivered vs. non-waivered schools, not individual schools or groups. These raw scores are heavily influenced by demographic and ability characteristics of the students and cannot be utilized to make any judgments about the relative quality of health education at the schools. 22