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A STUDY OF THE HEALTH KNOWLEDGE, ATTITUDES, STATUS, AND PRACTICE OF HIGH SCHOOL PUPILS

A Dissertation Presented to the Faculty of the School of Education University of Southern California

In Partial Fulfillment of the Requirements for the Degree Doctor of Education

by Gerv/in Neher April 194B

UMi Number: DP25697

All rights reserved INFORMATION TO ALL USERS The quality of this reproduction is dependent upon the quality of the copy submitted. In the unlikely event that the author did not send a complete manuscript and there are missing pages, these will be noted. Also, if material had to be removed, a note will indicate the deletion.

Dissertation Publishing

UMI DP25697 Published by ProQuest LLC (2014). Copyright in the Dissertation held by the Author. Microform Edition © ProQuest LLC. All rights reserved. This work is protected against unauthorized copying under Title 17, United States Code

ProGuesf ProQuest LLC. 789 East Eisenhower Parkway P.O. Box 1346 Ann Arbor, Ml 48106- 1346

‘- f x

Yu 3? 5

T7m dissertation, written under the direction of the Chairman of the candidate’s Guidance Committee and approved by a ll members of the Committeej has been presented to and accepted by the Faculty of the School of Education in p a rtia l fulfillm ent of the requirements fo r the degree of D octor of Education. .........

Guidance Com m ittee

D. V/elty Lefever Chairm an

C. C. Crawford

0. R. Hull

K. K. Thompson

Louis P. Thorpe

TABLE OF CONTENTS

CHAPTER I.

II.

PAGE

THE P R O B L E M ....................................

1

Nature and purpose of the s t u d y .............

1

Definitions of terms u s e d ...................

4

Importance of the p r o b l e m ...................

8

Limitations of the investigation.............

11

Organization of the s t u d y ...................

13

REVIEW OF THE L I T E R A T U R E ........................

15

Related investigations . .....................

15

Investigations of health information, status, and p r a c t i c e ..................... Investigations of a t t i t u d e s ............ .

22

Literature on measurement of attitudes . . . .

25

The validity of attitude scales

...........

The method of equal-appearing intervals III.

15

. .

METHOD OF P R O C E D U R E ............................

25 50 35

Outline of procedure

.......................

35

Details of procedure

.............

. . . . .

36

.........

36

Pupil groups i n v o l v e d ......................

44

Further classification of the pupils . . . .

51

Methods employed in comparing groups . . . .

53

Grade levels and schools involved

iii CHAPTER IV.

PAGE

■ CONSTRUCTION AND VALIDATION OF THE MEASURING I N S T R U M E N T .........................

56

Nature and preparation of the health practice and status questionnaire

........

57

Nature and preparation of the health knowledge t e s t ..............................

62

Nature and preparation of the attitude scale

................................

81

Reliability and validity of the measuring i n s t r u m e n t .................. ................ V.

92

ANALYSIS OF THE STATED HEALTH PRACTICE AND HEALTH STATUS OF HIGH SCHOOL P U P I L S .........

100

Comparisons between schools

102

.................

Comparisons between grade levels

....

. .

112

Comparisons between age-groups ..............

116

Comparisons between the sexes

123

...............

Comparisons on the basis of coursee n r o l l m e n t ..................................

123

Comparisons on the basis of occupation of f a t h e r .................................. Comparisons on the basis

ofr a c e ............

Correlations between intelligence and health status and between intelligence and health practice .

................................

126 132

iv CHAPTER

PAGE Responses to specific health status q u e s t i o n s ..............................

158

Responses to specific health practice q u e s t i o n s ................................

140

Responses to specific health practice questions according to r a c e ................

145

Summary of chapter . ...................... VI.

150

ANALYSIS OF THE HEALTH KNOWLEDGE OF HIGH SCHOOL P U P I L S .................................

156

Comparisons between schools

157

..................

Comparisons between grade levels ........

.

161

Comparisons between age-groups ................

163

Comparisons between the s e x e s ................

168

Comparisons on the basis of coursee n r o l l m e n t ...........................

1

Comparisons on the basis of occupation of f a t h e r ...................................

178

Comparisons on the basis of r a c e ..............

174

Comparison of pupil groups on the basis of public health information

.......

178

Comparisons of pupil groups on the basis of first aid i n f o r m a t i o n .................

183

Comparison of pupil groups on the basis of information about prevention of disease

.

187

V

CHAPTER

PAGE Comparison of pupil groups on the' basis of information about proper health habits

* .

191

Comparison of pupil groups on the basis of diet i n f o r m a t i o n ..................... .

195

Comparison of pupil groups' on the basis of mental hygiene i n f o r m a t i o n .......... . .

200

Correlation between health knowledge and i n t e l l i g e n c e ......................... Summary of the c h a p t e r .............. VII.

204 206

ANALYSIS OF THE HEALTH ATTITUDES OF HIGH SCHOOL PUPILS ................................

210

Comparisons between schools .................

213

. ........

217

............

217

Comparisons between the sexes ..............

221

Comparisons between grade levels Comparisons between age-groups

Comparisons on the basis of coursee n r o l l m e n t ................................

224

Comparisons on the basis of occupation of f a t h e r .................................. Comparisons on the basis of r a c e ...........

224 227

Results of the attitude scale on certain specific health practices .................

229

Comparison of attitudes of pupils and attitudes of health authorities ...........

232

vi CHAPTER

PAGE Correlation between health attitude and i n t e l l i g e n c e .............. Summary of the chapter

Till.

. . .

236 . ......... •

COMPARISONS BETWEEN THE FOUR HEALTH FACTORS

236 241

. .

Correlation between stated health status and stated health practice. . . . . . . .

241

Correlation between stated health practice and health k n o w l e d g e .................

243

Correlation between stated health practice and health attitude

...............

245

Correlation between health knowledge and health a t t i t u d e ................. ..........

247

Correlation between health knowledge and stated health status

.....................

249

Correlation between health attitude and stated health status

.....................

249

Comparison of change in health status, practice, knowledge, and attitude by grade level

.......................

252

Further comparison between health attitude and stated health practice.... ............ Summary of the c h a p t e r ................. IX.

256 258

SUMMARY AN 7) C O N C L U S I O N S ............. ..........

261

Summary of the problem and procedure . . . .

261

vii CHAPTER

IX.

SAGE Summary of the c h a p t e r .......................

S58

SUMMARY AND C O N C L U S I O N S ............ ...........

261

Summary of the problem andp r o c e d u r e ..........

261

Summary of the findings withrespect to stated health status andhealth practice . .

262

Summary of the findings with respect to health knowledge

.....................

265

Summary of the findings with respect to health attitude

. . .

...................

267

Summary of the comparisons between the four health factors ..............................

269

C o n c l u s i o n s ..................................

270

R e c o m m e n d a t i o n s ..........

276

B I B L I O G R A P H Y ......................................

278

A P P E N D I X ...............................................

285

...............

286

Directions to the E x a m i n e r .............. ...........

291

High School Health Inventory .......................

294

Directions for Scaling Statements

LIST OF TABLES TABLE

PAGE

I.

Grade Distribution of Pupils by S c h o o l s ...........38

II. III. IV.

Distribution of Hacial Groups by Schools

Distribution of Occupational Groups by Schools

. 41

. . . . . .

42

Race Distribution of Pupils by Grades and Mean Intelligence Quotients of Each Grade Group

VI.

40

Distribution of Intelligence Quotients by Schools . . . .

V.

. . . .

. . 45

Grade Distribution of Races Expressed in Per C e n t ......................................... 47

VII.

Distribution of Intelligence Quotients by Racial G r o u p s .....................

VIII.

Age Distribution of Pupils by Sex Showing Mean Intelligence Quotient of Each Age-Group . . . .

IX.

49

50

Statements of Opinion on Health Practices Showing Scale Values and Q-values for Each Statement in the Final Attitude Scale . . . . .

X.

90

Statements of Opinion on Health Practices Showing Seale Values and Q-values for Each Statement in the Alternate Form of the Attitude S c a l e ...........................

XI.

91

Summary of Reliability Data, Correlations, Probable Errors, and Median Scores of the Preliminary and Final Form of the Inventory . .

94

TABLE XII. XIII.

PAGE Health Status Scores by Schools ...............

i03

Critical Ratios of the Comparisons between Means of Health Status Scores by Schools

. .

104

XIV.- Health Practice Scores by Schools . . ........... 105 XV.

Critical Ratios of the Comparisons between Means of Health Practice Scores by Schools

XVI. XVII. XVIII.

Health Status Scores by Grades

.

. . ......... 113

Health Practice Scores by Grades

.............

Health Status Scores by Age ...................

XIX.

Health Practice Scores by A g e ............... 119

XX.

Health Status Scores by S e x ..................124

XXI.

Health Practice Scores by S e x ............... 125

XXII.

.............

.............

XXVII. XXVIII.

128

130

Health Practice Scores According to Father’s Occupation . . . .

XXVI.

127

Health Status Scores According to Father’s O c c u p a t i o n .............................

XXV.

118

Health Practice Scores of 12th Grade Pupils According to Course-Enrollment

XXIV.

114

Health Status Scores of 12th Grade Pupils According to Course-Enrollment

XXIII.

106

.................

Health Status Scores According to Race

. . . .

Health Practice Scores According to Race

. . .

131 133 134

Correlation between Intelligence Quotient and Health Status Score .

................... 136

X

TABLE

PAGE

XXIX.

Correlation between Intelligence Quotient and Health Practice Score

XXX.

.................

137

Distribution of Responses to Health Status Questionnaire .......................

XXXX.

139

Distribution of Responses to Health Practice Questionnaire .....................

XXXII.

142

Responses to Health Practice Questionnaire of an Unselected Group of Mexican, Negro,, and White Boys from the 9th Grade Matched for Age and Intelligence Q u o t i e n t ........... 147

XXXIII. XXXIV.

Health Knowledge Scores

by Schools ...........

158

Critical Ratios of the Comparisons between Means of Health Knowledge Scores by Schools

159

XXXV.

Health Knowledge Scores

by Grades

...........

162

XXXVI.

Health Knowledge Scores

by Age ...............

165

XXXVII.

Health Knowledge Scores

by Sex ...............

169

XXXVIII.

Health Knowledge Scores

of 12th Grade Pupils

According to Course-Enrollment ............. XXXIX.

Health Knowledge Scores According to Father's Occupation

XL. XLI.

171

.......................

Health Knowledge Scores According to Race

173

. .

175

Scores on Public Health Information According to Grade, Sex, Course, Occupation and R a c e ................... ..

.

180

xi TABLE

PAGE

XXII.

Critical Patios on Public Health. Information According to Grade, Sex, Gourse, Occupa­ tion and R a c e ...................

XXIII.

182

Scores on First Aid Information According to Grade, Sex, Course, Occupation and Race

XLIV.

184

Critical Ratios on First Aid Information According to Grade, Sex, Course, Occupa­ tion and R a c e ..........................

XLV.

186

Scores on Information about Prevention of Disease According to Grade, Sex, Course, Occupation and R a c e ....................

XXVI.

188

Critical Ratios on Information about Preven­ tion of Disease According to Grade, Sex, Course, Occupation-and R a c e ...........

XXVII.

190

Scores on Information about Proper Health Habits According to Grade, Sex, Course, Occupation and R a c e ....................

XXVIII.

192

Critical Ratios on Information about Proper Health Habits According to Grade, Sex, Course, Occupation and R a c e ...........

XXIX.

Scores on Diet Information According to Grade, Sex, Course, Occupation

L.

194

and Race . .

196

Critical Ratios on Diet Information According to Grade, Sex, Course, Occupation, Race . .

198

xii TABLE LI.

PAGE Scores on Mental Hygiene Information Accord­ ing to Grade, Sex, Course, Occupation, Race

-LII.

. 201

Critical Ratios on Mental Hygiene Information According to Grade, Sex, Course, Occupation and R a c e ......................................... 203

LIII.

Correlation between Intelligence Quotient and Health Knowledge S c o r e .......................... 205

LIV.

Health Attitude

Scores by Schools

.............

LV.

Critical Ratios

of the Comparisons between

Means of Health Attitude Scores by Schools . . ...............

214

215

LVI.

Health

Attitude Scores by Grade

LVII.

Health

Attitude Scores by Age ' .................... 222

LVIII.

Health

Attitude Scores by Sex

LIX.

Health

Attitude Scores of 12th Grade Pupils

..................

218

223

According to Course-Enrollment.............. LX.

225

Health Attitude Scores According to Father*s O c c u p a t i o n ....................................... 226

LXI.

Health Attitude

Scores According to Race . . . .

228

LXII.

Attitude Scores

toward Certain Health Practices

230

LXIII.

Comparison between Attitudes of Pupils and Attitudes of Health Authorities toward Certain Health Practices.... ...................

LXIV.

233

Correlation between Intelligence Quotient and Health Attitude Scores

...

237

xiii TABLE LXV.

PAGE Correlation between Health Status Score and Health Practice S c o r e .................

LXVI*

Correlation between Health Practice Score and Health Knowledge Score

LXVII.

. . . . . . . . . .

,250

Correlation between Health Status Score and Health Attitude Score .........................

LXXI.

248

Correlation between Health Knowledge Score and Health Status Score .....................

LXX.

246

Correlation between Health Knowledge Score and Health Attitude S c o r e .....................

LXIX.

244

Correlation between Health Practice Score and Health Attitude Score .....................

LXVIII.

242

251

Comparison of Stated Health Practices and the Corresponding Health Attitudes in Terms of Modal R e s p o n s e s .....................

257

LIST OF FIGURES FIGURE 1.

PAGE

Change in Health Status by Grade in Terms of Standard Scores . ..............

2.

Change in Health Practice by Grade in Terms of Standard Scores . . . . . . . . .

3.

.............

.

.

219

Change in Health Attitude by Age in Terms of Standard S c o r e s ................ ...............

9.

167

Change in Health Attitude by Grade in Terms of Standard S c o r e s ...........................

8.

164

Change in Health Knowledge by Age in Terms of Standard S c o r e s .......... .................

7.

122

Change in Health Knowledge by Grade in Terms of Standard S c o r e s ............................

6.

120

Change in Health Practice by Age in Terras of Standard Scores ................................

■5.

117

Change in Health Status by Age in Terms of Standard S c o r e s ...........

4.

115

220

Change in Health Status, Practice, Attitude, and Knowledge in Terms of

Standard Scores .........

253

CHAPTER I THE PROBLEM Educators have long recognized the importance of health as a fundamental objective of education.

From an

educational standpoint health should be thought of primarily in terms of behavior rather than as a condition.

The aim of

health education is to aid in the development of healthful behavior in pupils.

Such behavior is revealed through daily

habits or practices, the expression of desirable attitudes, and the grasp of a body of scientific knowledge which will give a basis for intelligent self-direction.

The instruc­

tional program in the school should be so organized that it will make its contribution to the development of a scien­ tific, wholesome, intelligent attitude concerning individual and community health and to the shaping of behavior in ac­ cordance with recognized scientific knowledge. Nature and purpose of the study.

This study was an

investigation of the health knowledge, attitudes, and stated behavior of high school pupils.

More specifically, the pur­

pose of the study was to measure the amount of health in­ formation or knowledge possessed by these pupils; to deter­ mine the nature of their attitudes toward certain health practices; to obtain responses indicating the nature of

2 their health practices and health status; and .to discover the implications these findings had for the school health program.

The study investigated the changes and differences

to be found between different groups of secondary school pu­ pils classified according to age, gra. cit., pp. 64-67.

24 that used in the present investigation in the construction of an attitude scale.

Bues applied his generalized attitude

scale to four groups.of college students, members of a fra­ ternity, a sorority, the Young Women’s Christian Association, and a Sunday School to determine differences in attitude toward petting and drinking liquor.

He found statistically

significant differences between the means in the attitude scores of fraternity men and sorority women on the practices of petting and drinking; of Young Women’s Christian Associa­ tion and Sunday School members on the practice of drinking. He claimed that these differences indicated validity for his scale, because the differences as measured by the scale were in the direction of attitude differences normally expected from these groups. Three other studies-*-0 employing the same type of scale claimed validity for their instrument on the basis of high correlation between the scale findings and the recog­ nized social commitments of the various groups.

In each

_

Ida B. Kelley, "The Construction and Evaluation of a Scale to Measure Attitudes toward Any Institution,” Studies in Higher Education XXVT. op . jcit., pp. 18-36. H. H. Grice, "The Construction and Validation of a Generalized Scale to Measure Attitudes toward Defined Groups,” Studies in Higher Education XXVI, ibid., pp. 37-46. Floyd 0. Miller, "The Validation of a Generalized Attitudes Scaling Technique,” Studies in Higher Education XXVI, ibid., pp. 98-109.

25 study the groups measured were known to differ in the par­ ticular attitude under observance.

The difference was indi­

cated likewise by the attitude scale.

Kelley found also a

correlation of .98 between her generalized scale and Thur­ stons’s Attitude Scale toward Communism, and a correlation of .83 between her scale and the Thurstone-Wang Attitude Scale toward Sunday Observance. , Orice found a correlation of .98 between his generalized scale and Thurstone’s Atti­ tude Scale toward the Negro.

These high correlations with

reliable outside criteria indicated evidence for the validity of the generalized scale. II.

LITERATURE ON MEASUREMENT OF ATTITUDES

The validity of attitude scales.

Controversy regard­

ing the measurement of attitudes centers around the question of validity of the scales available.

That attitudes should

be studied and measured is generally agreed upon by all authorities.

Sherman11 and Bain12 stated the position of

those who would doubt the validity of these scales by point­ ing out that the real question involved is whether the re­ sponses on the scale actually indicate a disposition to act

11

Mandel Sherman, "Theories and Measurement of Atti­ tude," Child Developmentt 3:15-88, March, 1932. 12 Read Bain, "Theory and Measurement of Attitudes and Opinions,” Psychological Bulletin, 27:357-59, May, 1930.

26 in a given way and whether there is a discrepancy between verbal and actual behavior. It must be admitted from the start that attitude scales do not measure behavior.

However, the question in­

volved was not whether these scales measure behavior, but whether they measure attitude.

From the definition used in

this study an attitude is a disposition, tendency, or readi­ ness to act in a given way.

The extent to which expressed

attitudes and behavior, in a given situation, are in agree­ ment has not been established.

One of the problems of this

investigation was to determine t h e .correlation between ver­ balized attitudes and stated practices as they relate to health. S h e r m a n ^ admitted that the examiner may obtain a true picture of an opinion, although he maintained that this opin­ ion may not be a true opinion and that it has no necessary relation to the subject’s attitude.

Sherman based his con­

tention on the premise that an attitude or opinion does not measure behavior, a premise with which nearly all authorities find themselves in agreement.

The position taken in the

present study was that attitudes expressed verbally, through opinions which can be measured, indicate only mental dispo­ sitions or tendencies to act in general ways in specific

13

Sherman, o p . cit., p. 24.

27 situations. That the disagreement between attitudes measured by scales and true attitudes is not so great as certain critics suspect is indicated in a study by Stouffer-^ who compared attitudes as measured by a Thurstone scale with attitudes as revealed by case history study. that a correlation of test scores

His investigation revealed of 238 individuals with

the composite ratings of four judges interpreting case his­ tories as to attitude toward prohibition laws was .81 which became .86 when corrected for attenuation.

The conditions

under which Stoufferfs investigation was made were precise and his findings should indicate a satisfactory degree of validity.

Case history study is not an infallible guide to

true attitude nor to overt behavior, but when carefully ob­ tained and expertly interpreted it serves as a useful indi­ cator of probable attitude and overt behavior.

These find­

ings seemed to indicate a satisfactory degree of validity for the measurement of attitudes by the Thurstone method. A further study which pointed to the comparative validity of applying psycho-physical scaling methods in measuring atti­ tudes is that of AckerlylS w ho compared attitude scales with _

.

S. A. Stouffer, "Experimental Comparison of Statis tical and Case History Technique of Attitude Research," Amer­ ican Sociological Society Publication, 25:154-156, 1931. 15 Lois A. Aokerly, "A Study of the Transferable Elements in Interviews with Parents," Journal of Experimental Education, 5:137-164, December, 1936.

28 the interview method.

She reported that attitude scales can

he substituted for the personal interview without much greater error than that which arises in interviews by spe­ cially trained workers. It is logical to assume that an expressed opinion is as accurate an index of attitude as is behavior.

In other

words, an opinion expressed or endorsed under conditions favorable to sincerity will likely reflect a true attitude as nearly as overt behavior under similar conditions. Neither opinion nor behavior is an infallible guide.

Murphy

and Murphy-1-6 took a practical viewpoint in the matter when they stated that in everyday life a m a n ’s sincere agreement or disagreement with a strongly stated opinion about reli­ gion, Chinese, Communism, or other attitude object is re­ garded as a significant part of his behavior.

There seemed

to be no reason, they concluded, ’’why this behavior should suddenly become non-significant when it is made the subject of careful inquiry.nU Allport^-8 pointed out that one of the major accom­ plishments of social psychology during the past ten years

16 Gardner Murphy and L. B. Murphy, Experimental So­ cial Psychoiogy (New York:Harper and Brothers,1931), p. 626. E o c . cit. Gordon Allport, "Attitudes,” Handbook of Social Psychology, Carl Murchison, editor (Worcester: Clark Univer­ sity P re s s , 1935), p. 832.

29 has been the success achieved in the field of attitude meas­ urement.

He offered the following limitations which must be

kept in mind by any investigator: 1.

Only attitudes that .are common can be measured.

2.

The findings of attitude scales should be regarded

as rough approximations of the true attitudes of the indi­ vidual. 3.

The individual possesses contradictory and change­

able attitudes, and hence a scale may show the mental set only at the time of measurement; this may be only a partial pioture of his attitude. 4.

Rationalization and deception often occur.

This

is especially true when the subjects are studied in relation to their moral or social life.^-9 The general question of attitude measurement, as it applied to the present investigation, might be resolved by pointing out the following assumptions recognized in the application and interpretation of the scale administered: 1.

Attitudes were considered as verbalized attitudes

determined by endorsement of certain opinions showing favor or disfavor toward certain common health practices. 2.

The opinion endorsed was assumed to be the sin­

cere expression of the attitude of the respondent at the

19 L o c . cit.

30 time the scale was presented. 3.

The large number of cases involved in the inves­

tigation tended to cancel out error which might enter because of partial or changeable attitude dispositions. 4.

Rationalization and deception were assumed to be

absent as important factors because of the immaturity of the respondents, the favorable conditions for sincerity under which the test was given, and the large number of cases involved. 5.

Attitude scores were interpreted as rough approx­

imations and were used to indicate general trends, growth, or change for a large number,of cases. 6.

It is important to measure attitudes expressed by

opinion, even though they may be considered as verbalizations merely indicating tendencies to act in certain ways. The method of equal-appearing intervals.

Many author­

ities agree that the application of the method of equalappearing intervals in constructing attitude scales is the most refined method available at this time.

Thurstone2^

first applied this psychophysical, method to the measurement of attitude, although he gave credit to Cattell for the

L. L. Thurstone and E. J. Chave, The Measurement of Attitude (Chicago: The University of Chicago Press, 1929), pp. 1-96.

31

original extension of this psychophysical method to social stimuli.21

Allport referred to this application as f,the

most significant event in the history of the measurement of attitudes."22

Guilford23 recommended the use of the equal-

appearing interval method for attitude scale construction in his chapter under that name.

Other writers who have done

considerable research and who consider the Thurstone tech­ nique the best so far devised are Bain24: and

N e l s o n . 25

To apply psychophysical methods to attitude measure­ ment, Allport stated that . . . it is necessary first to conceive of an atti­ tude as a degree of effect for or against an object or a value with which the scale is concerned. If this assumption is granted, it becomes possible to study the degree of favor or disfavor which each subject in a population has toward certain objects or values, such as church, war, moving pictures, government o w n e r s h i p . 26 Kirkpatrick spoke of these objects or values as qual­ itative variables.

He defined a qualitative variable as "a

Ibid., p. 2. 22

Allport, o p . cit.. p. 830.

23

I. P. Guilford, Psychometric Methods McGraw Hill Book Company; 1936), pp. 143-165. 24 Bain, p£. cit.. p. 363. 25 Erland Nelson, tfAttitudes," Journal of General Psychology. 21:427, October, 1939. 26 Allport, 0£. cit., p. 830.

(New York:

32

numerical expression of a classification, in terms of de­ gree. ”27

This makes the measurement of attitude a type .of

rating or rating-measurement. An attitude is expressed, therefore, by a numerical classification in terms of degree rather than amount.

The

variables on the scale measure qualitative variables ex­ pressing degree relationship.

Thus, pupil A is more cooper­

ative than pupil B, but less so than pupil C.

Or, as in the

case of the present health attitude scale, a certain health practice is held to be more or less favorable to a person’s emotional reaction.

This more-or-less degree can be ex*

pressed by descriptive adjectives which may be favorable, very favorable, unfavorable, neutral, etc.

Instead of

adjectives, numerical ratings or classifications are given to certain statements which are verbal expressions of one’s attitude.

These classifications are in terms of degree.

The method of scaling these statements is based upon the psychophysical theorem that equally often observed differ­ ences are equal.

This is usually referred to as the method

of equal-appearing intervals.

The method involves collecting

a large number of affective statements,

sorting them into

equally-spaced categories or successive intervals by a large

27 Clifford Kirkpatrick, ’’Assumptions and Methods in Attitude Measurement,” American Sociological Review, 1:81, February, 1936.

33

number of judges and tabulating and arranging from this sort­ ing according to scale values into a psychological continuum. The intervals between the selected statements are equal ac­ cording as they appear so to the judges, and represent equal shifts of opinion along the single continuum.

The assumption

is that endorsement of such statements may be taken as an index of the individual’s attitude as measured on a psycho­ logical continuum— favorable to unfavorable— defined by the scaling process.

The score values for each statement are de­

termined by combining the judgments of all the judges who have arranged the statements according to their discriminable differences. Remmers modified the Thurstone technique by collecting statements toward a group or class of objects. general procedure of scaling was followed.

The same

Remmers described

the difference as follows: The essential difference from the method de­ veloped by Thurstone lies in the assumption that an attitude toward any one of a large group or class of objects can validly be measured on a single scale. . . . An object in this sense is any affec­ tive stimulus to which an individual may react. It may range, therefore, from a very concrete phenom­ enon to the most abstract idea possible. . . Based on this assumption, then, the search for affective statements will concern itself with such statements as will validly and unambiguously apply to any num­ ber of such a large class of objects.28

28

H. H. Remmers, editor, "Studies in Attitudes,” Studies in Higher Education X X V I . Bulletin of Purdue University, VoT7 XXXV, N o . 4, December, 1934, p. 9.

Nelson*^ pointed out that the Remmers’ generalized scales yield reliabilities fully as high as the scales con­ structed definitely for a specific issue by the more labor­ ious (Thurstone) method.

Dunlap and Kroll30 compared the

Peterson-Thurstone War Attitude Scale with the KelleyRemmers Generalized Attitude Scale for Any Institution, ad ­ ministered to determine attitude toward war.

They found

that the Kelley-Remmers generalized scale applied to atti­ tude toward war was more reliable than the Peterson-Thur­ stone Scale when administered to high school boys.

The

studies by Bues, Kelley, Grice, and Miller, described ear­ lier in this chapter, furnished further evidence for the validity and reliability of the generalized attitude scales and the method of equal-appearing intervals.

29

Nelson, op. cit.. p. 419.

30 lack W. Dunlap and Abraham Kroll, "Observations on the Methodology in Attitude Scales,” Journal of Social Psychology. 10:475-487, November, 1939.

CHAPTER III METHOD OF PROCEDURE In the previous chapters the nature and purpose of the investigation with explanations of the terms and con­ cepts used and of certain limitations of the method and materials of the study were indicated.

Authorities were

cited showing various viewpoints with regard to the validity of attitude scales and their construction and authoritative justification given for utilization of the type of scale employed in the present study.

Finally, a review of studies

involving certain of the same techniques and problems was presented.

In the present chapter is a description of the

procedure followed and the pupils involved in this investi­ gation. I. 'OUTLINE OF PROCEDURE The problem of this investigation was to determine the amount of health information, the nature of the health attitudes, and the nature of the stated health practice and status of high school pupils.

To measure these factors a

health inventory was constructed and called a High School Health Inventory.

Its construction and validation are de­

scribed in Chapter IV. This Health Inventory was administered to 2,415 jun­ ior and senior high school pupils, all of whom were in the

ninth, tenth, eleventh, and twelfth grades.

The pupils were

enrolled in six junior and seven senior and six-year high schools.

The inventory was given in all schools during

April or early in May.

On the basis of the results of this

inventory were determined the data presented in this report of the study.

All pupils took the same inventory, making

the investigation a cross-sectional study.

The schools par­

ticipating were representative of various economic and social levels, as the next section indicates, and it was assumed that the various groups compared were a representative samp­ ling of the pupil-population in the Los Angeles schools. All responses on the Health Inventory were entered on a machine-scoring answer sheet.

Intelligence quotients were

provided by each school for all but a few of the pupils par­ ticipating.

All of the data were transferred to Hollerith

cards to facilitate tabulating. II.

DETAILS OF PROCEDURE

Grade levels and schools involved.

Pupils taking the

High School Health Inventory were all classified as A9, A10, All, or A12.

This division was employed so that there would

be equal time-intervals between each of the grade-groups compared.

Hereafter these groups are designated simply as

ninth, tenth, eleventh, and twelfth grade-groups.

The in­

ventory was administered in science, social living or

physical education classes according to the convenience of the particular school.

Social living and physical education

were required in all the participating schools, while science was required as a separate or a fused course in all junior high schools and for at least one year in all hut one senior high school.

It made no practical difference, therefore, in

which class a pupil took the test.

All of the junior high

schools offered health instruction to all ninth grade pupils either in science or in physical education.

The senior and

six-year high schools varied somewhat in their offering of health instruction.

All, however, included health instruc­

tion as part of the common course of study either,-in science or physical education during one or all of the three years. Table I shows the number of pupils from each grade . and school who were involved in this study.

All of the jun­

ior high schools administered the inventory in at least three classes.

Including pupils in the two six-year high

schools, 1,139, or 47.2 per cent, were in the A9 grade.

In

the seven senior and six-year high schools participating, there were 512 pupils (21.2 per cent). in the A10 grade; 412 (17 per cent): in the All grade; and 352 (14.6 per cent) in the A12 grade.

The total number of completed papers from

which the data of the study were taken was 2,415; nearly one hundred test sheets were eliminated because of incomplete data appearing on them.

This elimination was caused through

38 TABLE X GRADE DISTRIBUTION OF PUPILS BY SCHOOLS

School

9th

Number Pupils in Grade 10th llth

12th

Total

A

157

157

B

134

134

C

139

139

D

145

145

E

287

287

F

195

195

G

37

54

73

164

H

165

172

1

338

I

73

21

52

146

J

152

74

117

343

30

33

85

55

84

K

22

L

29 60

56

61

21

198

Total

1139

512

412

352

2415

Per cent

47.2

21.2

17.0

14.6

100.0

M

39 lack of time, absence the second day of the testing, or failure to follow instructions. The thirteen schools participating in the study were: Junior high schools

Senior high schools

Audubon

Dorsey

Bancroft.

Eagle Rock (6-year)

Edison

Hollywood

Gompers

J efferson

McKinley

Jordan (6-year)

Stevenson

Narbonne (6-year) North Hollywood

These schools were located in representative sections of Los Angeles.

Their pupils came from homes representing

various racial groups, as shown in Table II, and various types of social and economic levels, as indicated in Table III which shows the distribution of occupational groups by schools.

Furthermore, these pupils had a wide range of m e n ­

tal ability, their average intelligence quotient being one hundred.

Table IT shows a distribution of intelligence

quotient scores by schools. Four of the schools, E, F, J, and K, administered the health inventory to pupils over half of whom were Mexican, Negro, or Oriental.

These four schools were located in the

southeastern and extreme eastern sections of the city near industrial areas where the population was very cosmopolitan

40 TABLE II DISTRIBUTION OF RACIAL GROUPS BY SCHOOLS

Race School

Not Given

Total

White

0

157

0

157

0

2

131

1

134

8

1

0

126

4

139

D

1

0

4

137

3

145

E

27

211

2

42

5

287

F

49

2

7

115

22

195

G

1

4

4

155

0

164

H

1

0

0

335

2

338

I

2

1

3

137

3

146

J

60

198

35

42

8

343

K

28

27

5

22

3

85

L

1

1

12

68

2

84

M

1

0

3

192

2

198

Total

179

445

77

1659

55

2415

Per cent

7.4

18.4

3.2

68.7

2.3

100

.Mexican

Negro

A

0

0

B

0

C

Oriental

TABLE III DISTRIBUTION OF OCCUPATIONAL GROUPS BY SCHOOLS

Occupation School

Profes­ sional

Mana­ gerial

Clerical

18 14 1 1 8 1 15 15. 0 4 1 0 22

35 26 9 3 11 5 27 36 0 14 3 7 35

37 27 11 4 16 10 18 43 0 17 3 12 34

27 23 58 16 27 19 22 31 0 20 11 13 38

100

211

232

Per cent 8.5

16.9

18 •6

A B C D E F a H I I K L M Total

Un­ skilled

Not given

Total

11 4 23 4 40 13 9 9 0 23 8 25 13

8 3 11 6 76 12 1 1 0 52 17 14 17

21 37 26 111 109 135 , 72 203 146 213 42 13 39

157 134 139 145 287 195 164 338 146 343 85 84 198

305

182

218

1167

2415

24.4

14.6

17.0

Skilled

Semi­ skilled

100.0

TABLE I? DISTRIBUTION OF INTELLIGENCE QUOTIENTS BY SCHOOLS