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The Pennsylvania State College The Graduate School Department of Health and Physical Education

An Analysis of Certain Factors Related to the Health Knowledge and Health Habits of College Freshmen Women

A dissertation by John W* Mas ley

Submitted in partial fulfillment of the requirements for the degree of Doctor of Education August 1950 Approved:



7.ffSV r


In Charge, professional essIona1 f Preparation t and Research _



_ _______ ___

Professor of Physical Education

■7 -c* Professor of Educational Research



yslcal Education Professor of Psychology

ACKNOWLEDGMENTS This study has teen guided by a committee which has been helpful, and gratitude is expressed for the efforts of Dr. Arthur P. Davis, Dr. Hugh M. Davison, Dr. Arthur L. Harnett, Dr. Edward B. van Ormer, and Dr. Lloyd M. Jones, its chairman. To Professor Marie Haidt, in Charge, Required Health and Physical Education, for Women, The Pennsylvania State College, appreciation is expressed for permission to admin­ ister tests to students in the required hygiene courses. Further acknowledgment must be made to Miss Anne Jesnak, Miss Ruth E. Leonard, Miss Ruth E. McFeeter, and particularly Miss Preda A. Phillips, instructors in the required hygiene courses for women, The Pennsylvania State College, for their assistance in administering several tests in this study. Thanks must also be given to Dr. Robert G. Bernreuter, Director of the Psycho-Educationa1 Clinic, and Martin L. Zeigler, Special Graduate Assistant, The Pennsylvania State College, for data obtained from that office. And finally, to my wife, June L. Mas ley, sincere ap­ preciation and thanks are expressed for her constant inspira­ tion, assistance and loyalty, without which much of the per­ sonal value of this study would have been lost. J.W.M. 3*3



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


Statement of the problem and definition



of t e r m s .......................................


REVIEW OF RELATED S T U D I E S ......................




Studies on



Studies on



Studies on



. . . .




THE MEASURES U S E D ................................


The Personal I n v e n t o r y ........................


Socio-economic status of family



Home e n v i r o n m e n t ............................


Parental attitude toward health



Community health e n v i r o n m e n t ...............


School health environment



School health instruction program Units of


health in the school program . . .

The number of semester periods of health

. .

52 53 55

The number of periods per week of health i n s t r u c t i o n ...............................



PAGE The Pennsylvania State College Academic Aptitude Examination ........................


The Bernreuter Personality Inventory .........


The Strong Vocational InterestBlank ..........




Kilander Health Knowledge Test ...............


The reliability and validity of the measures .


Johns Health Practice Inventory

The Personal Inventory ......................


The Pennsylvania State College Academic Aptitude Examination ......................


Bernreuter Personality Inventory ...........


The Strong Vocational Interest Blank . . . .


Johns Health Practice Inventory



Kilander Health Knowledge Test . . . . . . .


S u m m a r y .................................... IV.



79 .


The s u b j e c t s ...............................


P r o c e d u r e ..................................


S u m m a r y ....................................




Characteristics of the d a t a ..............


Correlation of the several factors


Multiple r e l a t i o n s h i p s ..................... Analysis of individual factors The school health program

. .

99 106








SUMMARY OP THE FINDINGS AND IMPLICATIONS OP THE S T U D Y ......................................


F i n d i n g s ........................................


I m p l i c a t i o n s ...................................

15 0

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


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



PAGE Item Correlations of the Socio-Economic Status Section of The Personal Inventory . .


Item Correlations of the Home Environment Section of The Personal Inventory





Item Correlations of the Parental Attitude Toward Health Section of The Personal I n v e n t o r y ...................................



Item Correlations of the Community Health Environment Section of The Personal Inventory




Item Correlations of the School Health Environment Section of The Personal I n v e n t o r y ........... .......................


Item Correlations of the Health Instruction Program Section of The Personal Inventory




Reliability Coefficients of Various Sections of The Personal I n v e n t o r y .................



Distribution of Subjects According to Age

. .

65 84

Means, Standard Deviations and Ranges of Variables Used in S t u d y ...................


vli table



Comparison of Health Habits Scores Made by Two Groups of College W o m e n .............


Comparison of Health Knowledge Scores Made by Two Groups of College F r e s h m e n .........



Intercorrelations Between Variables


98 100

Coefficient of Multiple Correlation Between Five Selected Factors and Health Habits S c o r e s .......................................



Coefficient of Multiple Correlation Between Five Selected Factors and Health Knowledge S c o r e s .................



Zero Order and Multiple Correlations Involv­ ing Health Habits and Health Knowledge


. . .


Means and Standard Deviations of Health Habits, Health Knowledge and Scholastic Aptitude Scores for Subjects Having Similar Likes and Dislikes..................



Significance of Differences Between Means of Scores Made by the Health and NonHealth Occupation Groups




Significance of Differences Between Means of Health Habits Scores Made by Subjects With Varying Occupational Interests

. . . .



PAGE Significance of Differences Between Keans of Scores Made by the Technical and NonTechnical Curriculum Groups




Significance of Differences Between Means of Scores Made by Groups Answering Yes \V

and No to Questions Regarding Health Occupation of Parent ........................... XXI.


Means and Standard Deviations of Health Habits, Health Knowledge and Scholastic Aptitude Scores for Subjects Having Different Backgrounds of School Health Education




Significance of Differences Between Means Made by Groups With Varying Backgrounds of School Health Education ...................



Means and Standard Deviations of Health Habits, Health Knowledge and Scholastic Aptitude Scores for Subjects Having or Not Having Certain Subject Matter Areas in Secondary School




Significance of Differences Between Means of Scores Made by Subjects Who Had. and Those Who Did Not Have Certain Courses in High S c h o o l ..............................



PAGE Significance of Differences Between Means of Scores Made "by Subjects Who Had and Those Who Did Hot Have Certain Course Combinations in High S c h o o l .................



Means and Standard Deviations of Scores Made by Subjects Having Different Patterns of Course Background in Secondary School


. . .


Significance of Differences Between Means Made by .Subjects With Varying Patterns of Course Background



CHAPTER I INTRODUCTION TO TEE PROBLEM There seems to be general agreement among health educators that health education should be directed toward improvement of individual and community health; the promo­ tion of satisfactory understanding, attitudes and behavior; and instruction In recognized good health practices.


health education is primarily a continuous process of pro­ viding learning experiences for individuals and groups In which facts and principles are applied for the purpose of Influencing behavior, attitudes and knowledge to the end that better Individual, community and world health will result. It Is at once obvious that the attainment of these ends Is dependent upon a number of factors in the home, school and community.

Behavior, attitudes and understanding

are modified by the economic status of the family, the ed­ ucation of the individual, the social mores of the group, as well as many other factors of which the personality and intelligence of the Individual are not the least important considerations.

Attainment of the aims of health education

must therefore be considered with full recognition of the

2 many forces which tend to distract from and minimize the desired result. Teaching boys and girls in such a way that desirable health outcomes will result,

is the responsibility of the

home, school and community with parents, teachers, school administrators and community health specialists sharing in the task.

Considerable research in the methods of teaching

has indicated those techniques and procedures which, when applied by a teacher, produce the maximum attainment of health objectivesj

however, much remains to be done to

investigate the extent to which those techniques and pro­ cedures assist the teacher.

On the other hand there is

little evidence relative to the contributory effect on health education outcomes of such factors as socio-economic status, environment, parental attitude, amount and quality of health instruction in school, intelligence, personality and voca­ tional interests of the individual.

It is with these latter

considerations that this study has been concerned. The purpose of this study was to Investigate certain socio-economic, environmental and educational factors In the home, school and community in relation to certain health education outcomes among college women.

It was felt that

an investigation encompassing these general areas would tend to focus attention upon the aims of health education and serve as an evaluative device in appraising the role of the home, school and community.

Consideration of these

3 contributory factors also indirectly served to appraise educational instrumentalities such as teachers, methods and curricula, thus furthering the realization of the aims of health education.

In addition, an investigation of this

type provided a measure of the degree to which these aims were attained and the relative effectiveness of the home, school and community in the educative process. The educational value of an Investigation of this type lies In a re-appraisal of the role of the school, In relation to the home and community, in the total educative process.

It tends to focus closer attention upon the cur­

riculum and other educational processes used in achieving the educational aims.

It provides an opportunity to re­

evaluate the philosophy, objectives and purposes of the school health program in light of the modifying conditions of home and community environment, as well as the intellectual and personality differences of the pupil.

This study can serve,

as a guide In future planning of currlculums which are d e ­ signed to serve best the needs of the pupil, by indicating more clearly the modifying effect which the school has had upon the individual. Statement of the problem and definition of terms. Specifically this study has determined the relationships which existed between certain socio-economic, environmental, and educational factors In the home, school and community, and health knowledge and health habits possessed by 473

4 freshmen women at The Pennsylvania State College,


of these relationships has indicated the respective roles which the school, community and home have played in the total health education of the individual. Of necessity, certain limitations had to he recognized in this study.

To insure a measurement of the effect of the

elementary and secondary school health education program upon health habits and health knowledge, college freshmen were used as subjects to reduce any modification of habits or knowledge by the required college hygiene program.

Since The

Pennsylvania State College admitted only women to the State College campus in the 1949-50 freshman class, no men were considered in this investigation.^

The fact that admission

requirements were relatively high also tended to act as a selective factor.

Thus the scope of the investigation was

limited, the sample being relatively homogeneous. The specific factors considered were limited in num­ ber because of the defined limits of the problem as well as by available means of measurement.

Those factors which were

considered were defined as folloY/3: 1. Socio-economic status referred to the cultural, economic and aesthetic level of the family as exemplified by the presence of certain objective elements in the home. 2. Home environment was a description of the individ­ u a l ’s home and family and included parent-to-parent rela­ tionships and parent-to-child relationships. Mother men and women were admitted as Pennsylvania State College freshmen to co-operating colleges.

5 3. Parental attitude toward health was defined as the expressed feeling of the parents, through overt actions, In matters dealing with personal and community health prob­ lems . 4. Community health environment was a description of the community In which the individual resided in terms of available health services, community awareness of health problems and positive action taken to promote good health. The community was defined as the place where the individual normally attended church and school, shopped, and sought recreation;

it was not determined solely on the basis of

resIdence. 5. School health environment was descriptive of the secondary school In terms of overt expressions of health­ ful school living.

This Included consideration of a whole­

some environment, organization of a healthful school day and establishment of teacher-pupil relationships designed to provide favorable conditions under which the healthful development of pupil and teacher could take place. 6. School health Instruction program referred to the tangible evidence of organized effort to direct pupil’s learning experiences toward the development of favorable health knowledge, attitudes and habits.

Integrated teaching

as well as the teaching in the health education classes was considered. 7. Units of health in the school program was defined

6 as the scope of the health Instruction program in terms of specific units taught.

Units of health presented, in the

health education class as well as those integrated in other classes were considered. 8. The number of periods per week in which the stu­ dents* health education classes met in high school defined the health education course in terms of relative concentra­ tion. 9. The number of semester periods of health instruc­ tion which the student had in high school was descriptive of the amount of instruction received in health education classes.

No attempt was made to evaluate the quality of

instruction b y the quantity which was measured. 10. The students* scholastic aptitude referred to the higher mental processes and special mental abilities considered useful in predicting success in college. 11. The students' personality was a measure of three aspects of adjustment; neurotic tendency, self-sufficiency and dominance-submission. 12. Vocational interests of the student was described by their likes and dislikes in occupations, school subjects, amusements, activities and peculiarities of people. 13. Students* amount

h e a l t h kn o wl e dg e was d e fi n ed as the

of s pe c if i c h e a l t h i n f o r ma t io n p o ss e ss e d b y the



14. Students' health habits were descriptive of the

health practices of the individual as measured "by informa­ tion furnished relative to the incidence of performing cer­ tain acts of a healthful nature. The above mentioned factors were considered indiv­ idually and in relationship to one another to investigate their influence upon health knowledge and health habits. Since these factors operated in a complex fashion to affect health knowledge and health habits, a cross section consid­ eration of these complex factors had to be used to evaluate the various aspects of the home, school and community in the total health education of the individual.

Attempt was

made to differentiate the influence of these various con­ tributory factors by investigating each separately.


this investigation certain factors appeared as dominant forces in the determination of health education outcomes. No attempt was made to control the many subtle in­ fluences of the factors herein considered.

For this reason

comparison of control and experimental groups was abandoned Therefore,

in order to compare groups which were alike in

one factor but different in another,

it was necessary to

reduce all factors to a quantitative basis and apply a b i o ­ metric form of analysis.

This permitted interpretation of

the contributory effect of each of the various factors con­ sidered . Strang has said that, 11in general, the most useful research in health education will be that which deals with

8 the complex outcomes or a total situation; with the detailed. processes by which certain results in healthful living are 2


. . . ."

This implied detailed consideration

of a large number of factors in a relatively large sample for the purpose of ascertaining the relative influence of each the total situation. Before a proper evaluation of the relative worth of various practices in school health education could by made, the effect of many factors had to be accounted for.


should be pointed out that this investigation was directed toward ascertaining the extent to which the several factors influenced health habits and health knowledge of college freshmen women, and did not include an evaluation of the quality of teaching in the health education the schools.

programs in

Specific applications to these health educa­

tion programs were not presented; however, knowledge of the forces which affect health education outcomes would make, evaluation of school health education more practical and realistic.


Ruth Strang, "Health Education,’1 Encyclopedia of Educational Research, Revised Edition, 19501 pi 537.

CHAPTER II REVIEW OF RELATED STUDIES An abundance of published material was found relative to health, health education, and health education outcomes as they applied to the home, school and community.


most of the literature In the area of health was found to be based not upon careful research, but rather upon opinions of the leaders in that field.

The apparent emphasis has

been toward rationalization rather than research and this condition has drawn comments from several sources.

In r e ­

viewing recent research activity in health education, Rugen'*' contended that current emphasis in health education was on the clarification of the basic concepts and objectives of health education and of their realization in practice. Furthermore, she stated that, "research in the area of health O

education has continued to emphasize descriptive studies.11 In a similar vein, Strang wrote, "opinions about health education are far more prevalent than facts, and discussion

■^iabel E. Rugen, "Health Education," Review of Ed­ ucational Research, 19:427, December, 1949. 2 Ibid., p. 432.

10 and description than research.” In general, the research in health education has been directed toward the evaluation of outcomes in terms of pupil achievement and a study of factors affecting these outcomes. These evaluative procedures have followed three general patterns:

(1) study of the effects of health education

at a particular stage of development, determined standards,

judged against pre­

(2) contrast between two periods in

the developmental process, and (5) contrast between control and experimental groups. Studies on health habits.

An early attempt to eval­

uate certain aspects of the health education program was made by the Research Division of the American Child Health Association.^

In a health survey of eighty-six typical

cities in the United States, that association considered the "hygiene of the school child1' from several points of view; namely, the health education program, the physical education program, the physical examination, control of disease, sanitation of school buildings, and responsibility for school health supervision.

Of particular interest was

the investigation of the health habits of 35,349 fifth grade

^Ruth Strang, "Health Education," Encyclopedia of Educations 1 Research, Revised Edition, 1950, p. 529. ^George Truman Palmer, director, A Health Survey of 86 Gitiea (Research Division of the American Child HeaitKAssociatlon, Hew York: American Child Health Association, 1925), pp. 144-197.

11 students aimed at ascertaining some of the results of the health education program in the school,

By means of group

interviews, where a surveyor read aloud the several questions and gave the children time to answer, information was se­ cured relative to habits of sleep, dietary and play.


several schools tested were ranked according to the chil­ dren's habits and compared subjectively on the basis of their health education programs.

It was concluded from that in­

vestigation, that the school program proved effective in developing desirable health habits. Upon examining the problem of the influence of the school in improving health habits, Wood and Lerrigo® reported a study carried out in the lower east side of New York City which resulted in marked improvement in children's diets and their sleeping habits during the course of a school year in which they had a health education program.


those results, it was suggested that even though the home may have had a greater share In the Improvement of health habits, the power of the school was frequently underestimated. The Sub-committee on the Function of Home Activities In the Education of the Child, of the White House Conference

^Thomas D. Wood and Marlon Olive Lerrigo, Health Behavior (Bloomington, Illinois: Public School Publishing Company, 1927), pp. 22-24.

12 on Child Health and. Protection^ reported several interesting findings relative to health habits of children.

Prom data

secured on 7,513 children of varying socio-economic back­ grounds it was apparent that some relationship existed b e ­ tween economic status and specific health habits.

In the

matter of sleeping, eating, bathing and brushing of the teeth, children whose parents were principally of the lower socio-economic classes showed poorer habits than those from higher economic levels.

However, when health habits were

considered in relation to general health of the child, no relationship was apparent and similarly children of low economic groups had no more Illness than had the higher Income groups. In 1936, Hardy and Hoefer7 reported a study involving 409 boys and girls who had been divided Into control and experimental groups on the basis of an Intensive four year course In health education consisting of regular classroom Instruction.

The differences between groups were evaluated

with respect to a number of factors, one of which was im­ provement of dietary practices and sleeping habits.


6E. W. Burgess, chairman. The Adolescent in the Fam­ ily (Report of the Sub-committee on the Function of Home Activities in the Education of the Child, White House Con­ ference on Child Health and Protection, New York: D. Apple­ ton -Century Company, 1934), pp. 179-191. 7 Martha Crumptcn Hardy and Carolyn H. Hoefer, Healthy Growth (Chicago; The University of Chicago Press, 1936), pp:~S'5-73.

13 the critical ratio to express the significance of difference between groups after the period of instruction, several significant differences were reported.

Further analysis

was made by equating two groups on the basis of age, socio­ economic backgrounds, and physical condition, and determining the significance of differences.

In the second instance

a greater number of significant differences were reported, leading to the Implication that health habits of children may also be related to the income of the family as well as the health instruction received in school. Q Grout, reported on a six year study in Cattaraugus County, New York, which attempted to determine the effect­ iveness of the health program in terms of improvement of behavior and understanding at the elementary level.


of one- and two-teacher schools, which had organized school and community health programs, were measured in 1932 and again in 1936.

When the gains were analyzed it was found

that health practices were significantly better in 1936 than they had been In 1932, with evidence of improvement most striking in the upper grade levels.

In addition, the 1S36

results were compared with a control group which differed only in not having had an organized health program.

In this

case It was also found that the 1936 results were signifi-


Ruth E. Grout, "Appraising A School Health Education Program,” American Journa1 of Public Hea1th, 30;797-805, J u l y , 194TXI

14 cantly better.

In spite of these findings, Grout made this

statement, ’’the practices, however, were largely associated with home living, and home influence is known to be great in respect to home (health) habits More recently a study involving 15,480 students in Massachusetts was undertaken to determine their health prac­ tices, knowledge, attitudes and interests in relation to the type of community from which they came, the economic status of their family, their age, and their sex.


worth, Latimer and T u r n e r ^ reported that the quality of health practice, as measured by a HWhat do you do?" question­ naire, remained constant throughout the high school period, showed no difference between types of communities and was consistently better in girls than in boys. N e h e r ’s ^

study of 2,415 junior and senior high school

pupils indicated that pupils of higher Intelligence and relatively high socio-economic levels scored above others in the factors of health knowledge, status, attitvides and practices as measured by the High School Health Inventory.

^Ibid . , p. 800. b a r r e n H. Southworth, Jean V. Latimer and Clair E. Turner, "A Study of the Health Practices, Knowledge, Atti­ tudes and Interests of Senior High School Pupils,” Research Quarterly of the American Association for Health, Physical Education and Recreation, 15:118-136, May, 1944. •^Gerwin Neher, ’'Health In High Schools." Journa 1 of School Health, 13:95-99, -^pril, 1943.

15 He also reported that pupils whose fathers were in profes­ sional and managerial occupations ranked consistently higher in those health factors, thus giving rise to the observation that the background of the child contributed to his present standing with respect to several health factors. Thus, the evidence related to health practices and the acquisition of health habits appeared to be conflicting in some instances.

The majority of studies reported, h o w­

ever, appeared to have indicated there was an improvement in the health habits of pupils following a period of health instruction.

Similarly, the majority of studies had indi­

cated that some relationships existed between health prac­ tices and socio-economic levels.

The extent to which the

factor of health instruction in the school is related to socio-economic status and the relative influence of each on health habits has not been reported in the literature and may have accounted for the apparently conflicting evi­ dence . Since the formation of habits was dependent upon factors of environment and factors which influenced the individual’s surroundings, as well as the individual’s own attitudes and understandings, a more comprehensive knowledge of those factors was sought.

Several studies have reported

relationships between those factors and various aspects of health habits.

The Sub-committee on the Function of

Home Activities in the Education of the Child of the White

16 House Conference on Child Health and P r o t e c t I a n f o u n d a relationship between health habits and personality;


child with a well balanced personality exhibiting more desirable health habits.

Similarly, Powell

found a relation­

ship significantly larger than zero between health practices and personality adjustment.

Through use of the Johns Health

Practice Inventory and the Bell Adjustment Inventory, a d ­ ministered to 141 entering college freshmen women at Sam Houston ^tate College, a correlation coefficient of .20 14 was obtained. Turner reported low correlations between health habits of an Individual and his I.

, with similarly

low correlations between health habits scores and scores made on health knowledge tests. Studies on health knowledge.

Studies Involving health

education outcomes In terms of knowledge and information were also reported In the literature.

As with the studies

reported in the area of health habits, those in health know­ ledge dealt with the influences of the school and environ-

^ B u r g e s s , _op. c l t . , pp. 186-187. ■^Virginia Margaret Powell, "An Analysis of Relation­ ships Existent Between Current Health Practices, Personal and Social Adjustment, and Physical Performance," (unpub­ lished D octo r’s dissertation, New York University, New York, 1946), p. 77. ■^Clair E. Turner, "Significant Findings of the Mass­ achusetts High School Study and Their Implications for Health Education Programs," Journa1 of School Health, 13;9-17, January, 1943.

17 ment In affecting an increased amount of health Information possessed by the individual.

Other relationships with the

factor of health knowledge were reported and were included in the survey of literature. One of the earlier studies reported by Franzen


indicated that the influence of cultural status and economic rating of the family was small in the development of health knowledge In the individual, while those same factors played a much greater role In the development of a recognition of health necessities and awareness of health codes.


found that the Intelligence of the individual, as measured by the McCall Multi-Menta1 Seale, exerted b y far the great­ est force In health knowledge, and a significant Influence in health awareness. "I

Hardy and Hoefer


reported a significant difference

between a control group and an experimental group on the basis of scores made on the Gates-Strang Hea1th Knowledge T est.

The test was administered to the two groups follow­

ing an intensive four year course of health education taken by the experimental group only, and the significance of the difference between the two groups was reported as a critical

■^Raymond Pranzen, Influence of Social and Economic Factors on the Health of the School Child ("School Health Research Monographs, No. IV, New Yorks American Child Health Association, 1932), pp. 58-67. 1 Pt

Hardy and Hoefer, op. c i t ., pp. 73-74.

18 ratio of 5.59.

They made the observation that, following

the health instruction program, the experimental group was better grounded, in health knowledge than were the children of like ages in the control group.

The authors maintained,

however, that it was impossible to cay that the increased knowledge was due to special health instruction as the e x ­ perimental group came from homes in which the parents were better educated. A portion of the Regent's Inquiry into the Character and Cost of Public Education in the State of New York dealt with the school health program.

In evaluating the vast quan17 titles of data collected, Winslow found that there were

significant relationships between the actual health know­ ledge acquired by pupils and the quality of the health in­ struction programs in the school.

Twenty-one school systems

were used in that study, the quality of health instruction being graded on the basis of field observations with regard to the apparent efficiency of the program of health instruc­ tion.

In the same study, a correlation of .55 was reported

between results on a health awareness test and the quality of health instruction, and .33 between the same test and scores made on the Otis test of general intellectual ability.

■^C.-E. A. Vl/ins low, The School Health Program (The Regent's Inquiry into the Character and Cost of Public E d ­ ucation in the State of New York, New York; The McGraw-H:Lll Book Company, Inc., 1938), pp. 46-50.

19 Two studies reported in 1935 indicated no differences in health knowledge between groups which had varying types of health instruction.

Studying 502 college freshmen who 1ft came from different parts of Iowa, Rooks divided them into four groups on the basis of the type of health Instruction which they had In high school.

The groups were: "specific

health course," "specific health course supplemented with special speakers," "special speakers alone," "no health Instruction."

The mean scores of each group on a health

knowledge test were reported along with the standard devi­ ation.

The differences between means were so small and. the

variability within groups so large that It precluded any significant differences in knowledge scores on the basis of the type of health instruction programs In the high school. Jones 19 compared health knowledge and health Instruc­ tion at the sixth grade level.

He found no significant

difference in health knowledge as measured by the Gates Strang Health Knowledge Test between a sample of 207 pupils from rural schools and 205 pupils from urban schools. did, however, find a slight


advantage in favor of the urban

-^Roland Rooks, "The College Freshman's Knowledge of and Interest in Personal Hygiene," Research Quarterly of the American Phys ica1 Education Ass oc iatlon Supplament, 6:51-80, October, 1935. ■^Joseph H. Jones, "A Comparison of Health Knowledge and Health Instruction at the Sixth Grade Level in Certain Rural and Urban Schools," Research Quarterly of the American Physical Education Association, 5T55-60, May, 1935.

20 schools over the rural schools In the matter of quality of health instruction which led to the implication that the amount of health knowledge is not materially effected by the quality of instruction. In a study by Neher


it was found that higher scores

on a health knowledge test were made by students of high intelligence and relatively high socio-economic levels as measured by the occupational pursuits of the father.


addition it was indicated that girls* scores were signifi­ cantly higher than boys*; both in health knowledge and in health attitudes. and Turner


On the other hand, Southworth, Latimer,

have reported no differences in health know­

ledge between boys and girls or between groups of students coming from various types of communities.

They did, how­

ever, report a slight Improvement in the amount of health knowledge from grade to grade; the high school seniors had a higher mean score than either the sophomores or juniors. A more recent study seemed to indicate the Influence of both intelligence and environment in the acquisition of health knowledge.




administered the Haggerty

op. c lt ., pp. 95-99.

^Isouthworth, Latimer and Turner, _op. clt., pp. 118136. ^ H a r r i s o n G. Gough, "The Relationship of Socio-Ec­ onomic Status to Personality Inventory and Achievement Test Scores,” Journal of Educational Psychology, 37:527-540, December, 1946.

21 DeIta II Inte 11 lgence Te a t , the American Home Seale, a meas­ ure of home environment, and the Orleans-Sealy Health Informatlon Teat to 127 sixth grade children.


of .35 and .58 between the information test and the envi­ ronment and intelligence measures respectively were reported. Holding statistically constant the influence of the intel­ ligence, the partial correlation between health information and environment was

.22, which led to the conclusion that

students ceding from homes of higher socio-economic sta tus appeared to be superior in health information. Using 145 college students of whom thirty-eight were 23 women, Kraiss found women slightly better informed on matters of food, nutrition and digestion while men were noticably better informed on sex information.

With total

score on a health knowledge test as a criterion, however, there were no differences between men and women.


no differences were found between groups of students coming from rural areas where health instruction was recognized as weak and those coming from urban areas whose health pro­ grams were considered to be better. Other relationships with health knowledge which have been reported in separate studies included those by Loy and

^ H e l e n Blair Kraiss, "A Study of the Health Knowl­ edge of Freshmen at Catawba College Salisbury, North C ar­ olina," (unpublished Master’s thesis, The Pennsylvania State College, State College, 1947), p. 33.

22 Husband,




and Neher.


Loy and Husband found some

evidence that choice of curriculum in college was related to the health knowledge of 1002 Kansas State College stu­ dents, as measured by a revised Forsythe-Rugen test.


found that college divisions In order of highest average scores on the test were veterinary medicine, home economics, general sciences, agriculture, and engineering.

They also

reported negligible differences between male and female stu­ dents.

Considering the factors of health knowledge, health

habits, and intelligence, Turner reported the highest cor­ relation between knowledge and intelligence, the lower b e ­ tween habits and intelligence, and habits and knowledge. Similarly, Neher found only slight positive correlations between health knowledge and practices of junior and senior high school pupils. The studies relating to health knowledge report some conflicting evidence; however, they seemed to denote a marked relationship between an individuals Intelligence and meas­ ures of health Information.

With respect to the quality

of the school health instruction program, there seemed to

2^David T. Loy and M. W. Husband, "A Health Knowledge Survey,” Research Quarterly of the American Association for Health, Physical Education anl Recreation, 10:53-36, May,




25 Turner, _op. c i t . , pp. 9-17. 2 ®Gerwin Neher, "What High School Students Know, Think, and Do About Health," The Physical Educator, 3:78-79, January, 1943.

23 be some doubt as to the precise influence it had on health knowledge;

several studies reported measurable differences,

others indicated little or none. appeared to be important.

The effect of environment

While several studies reported

low correlations between this factor and health knowledge, when interpreted in light of those studies reporting more significant association,

these relationships had the effect

of indicating the influence of environment in the acquisi­ tion of health information.

Differences between sexes were

reported in knowledge of specific areas of health informa­ tion . Studies on health status.

Ideally, the health status

of the individual pupil was the ultimate outcome of all health education programs, since a prime objective Is the develop­ ment of individual, community and racial health.


measures of health have been correlated with a number of factors indicating certain relationships.

These interpreted

in terms of the school health program had far reaching im­ plications . In the study by Pranzen,

p *7

socio-economic forces

were studied in relation to certain measures of health sta­ tus, such as condition of the teeth and mouth, occurence of pediculosis, amount of subcutaneous tissue Irrespective of skeletal structure, and arm girth irrespective of skel-

27Franzen, op. c i t ., pp. 69-83.

24 etal build.

Data indicated marked influence of the socio­

economic factor on some aspects of health, principally the adequacy of subcutaneous tissue, with relatively lesser in­ fluence in the matter of occurence of pediculosis, and con­ dition of the teeth and mouth.

In light of this, Franzen

stated that, "procedures in a school health program may be evaluated only in terms of measures where allowance has been 20 made for socio-economic opportunity0" Approaching the subject from a different point of view, Sydenstricker


investigated variations among individ­

uals with respect to mortality, morbidity and physical im­ pairment.

He made use of acturarial statistics from many

sources and concluded, on the basis of the evidence presented, that differences in heredity and environment accounted for those variations among individuals.

Such environmental

factors as occupational status, dietary habits, and economic status were held as important factors which Influenced the health of individuals. Turner^^ concluded, from a study of ninety-five chil­ dren who did not gain weight over a three-month period, that the "non-gainers" were inferior in a combination of

28 Ibld., p. 83. 2^Edgar Sydenstricker, Hea1th and Environment York; McGraw-Hill Book Company, Inc., 1§33), 2l7pp.


^ C l a i r E. Turner, "Growth and Health," Education, 54:215-218, December, 1933.

25 dietary and other health habits, giving some evidence of a positive relationship between physical growth and health habits. Strang and Smiley


reported studies which showed

boys and girls from poor homes were smaller in many respects than those who came from homes of superior social and eco­ nomic status.

It was also indicated that men attending

private schools such as Princeton, Yale and Stanford were taller and heavier than those attending state universities who in turn exceeded those in municipal colleges. students, likewise showed similar differences.


They con­

cluded, however, that the evidence relative to the effect of economic conditions on growth was not conclusive as the problem is complicated by factors of both environment and heredity. Using data from the Office of Statistical Investig­ ations, United States Public Health Service, Perrott and 32 Collins found that, in a sample of 20,283 Individuals from 4,421 families, there was a higher incidence of dis­ abling illness among Individuals in lower income classes

^ R u t h M. Strang and Dean P. Smiley, The Role of the Teacher in Health Education (Hew York; The Macmillan Company, 1942), p . 124. St.J. Perrott and Selwyn D. Collins, "Sickness Among the ’Depression P oor’," American Journal of Public Health, 24:101-107, February, 1934.

26 than among those with higher incomes.

Similarly, Menden­

hall,53 who used data of the Federal Security Agency, So­ cial Security Administration, showed that in general the amount of money spent for needed medical care varied accord­ ing to the size of income of the family and as a consequence the wealthier groups had fewer days of disabling illness than groups of lower economic status. 34 Hardy and Hoefer revealed noticable improvement in specific types of physical condition as well as general health during the progress of an extensive program of health education.

It was found that those children who had the

broadest contacts with the program made marked improvement while those whose contacts were limited showed little gain. 7/hen the factors of socio-economic background, age and size of the individual were held constant by equating groups, they found gains, attributable to participation in a health education program, in rate of growth, anthropometric devel­ opment, and muscular strength.

On the same basis they found

no differences between control and experimental groups in condition of teeth and scores made on a battery of physical achievement tests . Thus, the literature in the area of health status

^ J a m e s E. Mendenhall, "Health and Living Standards," Progresslve Education, 26:132-136, March, 1949. 5^Hardy and Hoefer, op. c l t ., pp. 32-121.

tended to indicate a strong positive relationship between the health of individuals and their socio-economic back­ grounds.

While environment, considered in its broadest

sense, also had a positive relationship to health, this relationship was so small as to make the accurate determina­ tion of the health of an individual difficult, differenti­ ated as they are by heredity.

There was some indication

that a school health program directed toward improvement of the general health of pupils does contribute to pupil health.

CHAPTER III THE MEASURES USED This study investigated the relationships which ex­ isted between certain socio-economic, environmental and educational factors in the home, school and community and the health knowledge and health habits possessed by enter­ ing freshmen women at The Pennsylvania State College.


measure these factors, a number of different instruments was used which included a personal Inventory blank and sev­ eral standardized tests. A personal inventory blank was constructed to meas­ ure the factors of socio-economic status of family, home environment, parental attitude toward health, community health environment, school health environment, school health in­ struction program, units of health taught in the school program, number of periods per week In which the student had health instruction in secondary school, and the number of semester periods of health* included;

The standardized forms used

(1) The Pennsylvania State College Academic A p ­

titude Examination, (2) Bernreuter Personality Inventory, (3) Strong Vocational Interest Blank, (4) Johns Health Prac­ tice Inventory, and (5) Kllander Health Knowledge Test.

29 The validity and reliability of each of these instruments were considered and reported in this study. I.


The construction of the personal inventory blank was accomplished with the aid of a number of guiding prin­ ciples.

The factors to be measured were situational In

nature, e.g.* external to and relatively independent of the subject.

Under this circumstance, Horst has pointed out

that the factors, "must always be understood In the way they are defined by the individual himself.”^

He has further

indicated that consistency of responses can be improved through the elimination of the difficulty which people have 2 in deciding upon a correct answer to a question. The use of questions which could be answered on the basis of inform­ ation possessed b y the individual being tested and readily definable by him was an important criterion for selecting Items for the Inventory.

Factual Information relative to

the home, school and community which required little or no personal Interpretation was therefore sought in all questions. The primary concern of this Investigation was the determination of relationships which existed between the

•^•Paul H. Horst, and others, The Prediction of Per­ sonal Adjustment (New Yorkj Social ‘Science ResearcH“Council,

i$4i), p. is: 2 Ibid., p. 95.

30 several factors.

Measurement of these factors, of necessity

had to be made In quantitative terms, which Ideally should be in a continuum.

This principle was followed In construct

Ing the Inventory to permit ease of manipulation. The Instrument was to be administered to college freshmen women.

The type of question and sampling range

of the Inventory were considered carefully In light of the sample.

The language of the questions was adjusted to the

ability of college freshmen, the type of question was con­ sistent with those used in other standardized forms which the student had used, and the questions represented as wide a sampling range as possible. A final principle considered was the length of the inventory.

Since the Instrument was to be administered in

a single class period of fifty minutes, the number of ques­ tions and the length of each had to be taken into account. The amount of explanatory material and oral direction also had to be kept to a minimum. Within the limitations mentioned, an inventory con­ sisting of seven sections and ninety-one separate Items was constructed.

It was based upon items used in previous

investigations in the several areas.

A thorough search of

the literature in these areas produced statements which dealt with socio-economic, environmental, and educational factors In the home, school and community which were used as devices to measure the relative degree of each factor

31 possessed by each subject.

Each of the Items was carefully

analyzed for the purpose of determining what elements were involved and retained or discarded on the basis of agree­ ment in the literature relative to its validity as a meas­ ure . A total of 102 items were thus obtained and submitted to six members of the graduate faculty of The Pennsylvania State College for criticism as to clarity, adequacy and con­ tent.

In addition, those persons reviewing the inventory

considered each Items plausibility, appropriateness and validity as well as correctness of English usage and for­ mat.

The suggestions thus received were incorporated in

the inventory preparatory to a preliminary tryout. Preliminary inventories containing 102 Items were distributed to fifty-three students in the sophomore, junior and senior classes at The Pennsylvania State College.


the trial administration, students were instructed to re­ spond to each item and to check any statement or direction which was not absolutely clear.

After completing the in­

ventory the various ambiguities were discussed, the students commenting on how they had interpreted the question and offering suggestions as to how the item might be clarified. The results of the trial Inventory were analyzed and sub­ sequent revisions made on this basis as well as on the sug­ gestions of the students. Socio-economic status of family.

When defined as

32 the cultural, economic and aesthetic level of the family, socio-economic status can best be evaluated on the basis of a large number of selected indexes.

A single index such

as the occupation of the father, income of the family and the possession of such single items as a telephone, automo­ bile or a washing machine are definitely inadequate as they fail to distinguish one level from another on the basis of the one factor.

To be able to measure the various levels

of socio-economic status, an adequate coverage of those factors affecting this status must be considered. Many methods of using multiple measures of a number of factors have been devised. measures, Kerr

In a critical review of these

discussed two more common procedures used,

the individual home-call scale and the group measures of home environment.

Speaking of these, he said, "Leahy’s

Minnesota Home Status Index is probably the best individualtype home environment scale developed to date

• • • ,"^

while the "most outstanding among the objective group scales developed during the last two decades is the Sims* Score 5 Card . . . ." These scales together with The American

3W. A. Kerr, "The Measurement of Home Environment and Its Relationship With Certain Other Variables," Purdue University Division of Educational Reference, Studies in

5 ig E i'ir~EducarE'Ioin',~'~HoT~4’5',' 4

L oc . c i t .

^Kerr, c>js. c i t ., p. 10.


35 6


Home Scale and. more recent work reported by Cattell and 8 Gough served as a basis for the construction of Part I of The Persona 1 Inventory. The original scale was composed of eighteen items, many of which were multiple in nature.

For example, item

number seven in both the original and final scale asked the subject to "Underline the following items which are in your home. Telephone."

Bathtub; Furnace in basement; Fireplace; Thus, in the eighteen items of the original

scale, the subjects indicated a response to forty-eight separate questions concerning various factors related to the socio-economic status of their families. Determination of those items to be retained in the final scale was made on the basis of an item analysis of each item, correlating each item in Section I with the to­ tal score made on Section I.

By eliminating those items

which showed low correlation coefficients the internal con­ sistency of the scale was increased. The items in Section I of The Persona1 Inventory were scored by giving one point for possession of a described

6 Ibid. , pp. 7-43. *7

Raymond B. Cattell, "The Concept of Social Status," The Journa1 of Social Psychology, 15:293-308, May, 1942. % a r r i s o n G. Gough, "A Short Social Status Inventory," The Journal of Educational Psychology, 40:52-56, January,


34 . item and zero for non-possession.

There seemed to be suf­

ficient evidence in defense of this method of scoring. Q Kerr on a preliminary test of his American Home Scale given to 1300 high school seniors found no significant dif­ ferences between the unit-zero method of scoring and a dif­ ferential method based on weights given to items according to their cultural, economic or environmental value, or a sigma method which weighted items according to their infre­ quency of possession. Adkins,^

in discussing weighting of test items,

maintained that when an item is analyzed either through item analysis or subjective judgement, the best alternative is determined and assigned a weight of unity, while others are assigned a zero weight.

R i c h a r d s o n ^ has pointed out

that differential weights were not likely to prove useful for most tests.

When a set of items was weighted in two

ways, one using differential weights, the other using weights of unity, the correlation between the two sets approached unity as the number of positively correlated measures in­ creased.

Also if these two sets of positive weights were

themselves positively correlated, the effect of differential 9 Kerr, _op. c l t ., p. 15. ^°Dorothy G . Adkins, and others, Construction and Analysis of Achievement Tests (Washington D. G.s 0. S. Government Printing Office, 1947), p. 190. ^"blorst, op. c it., pp. 398-401.

35 weighting tended to disappear. Table I shows the correlation coefficients between each item and the total score made on Section I in the pre­ liminary test.

The method employed to compute the correla12

tions was suggested by Engelhart,

and was a modified tet-

rachoric r found by using an abac.

The criterion variable

was dichotomized at the median as were the multiple item responses. Examination of Table I revealed that items 12 and 16 had low correlations,

.19 and .20 respectively.


12 asked, "Are either of your parents members of a parentteacher organization?” , while Item 16 queried, IfDoes either your mother or father play a musical instrument?”


items were eliminated from the final scale on the basis of their lack of relationship with the factor which Section I was measuring.

Items 5, 6, 10, 13, and 14 showed relatively

high item correlations.

These items, with the exception

of number 10, were multiple items and as such were expected to show a high relationship due to their greater contribu­ tion to the total score of the section.

Item 10 asked the

subject to indicate whether their families employed servants. Five persons answered in the affirmative; scores in this section.

all had high total

In final form Section I contained

■^Max D. Engelhart, ”How Teachers Can Improve Their Tests,” Chicago Schools Journa1 , 25:16-24, September-December, 1943.



Item number 1 2 3 4 5 6 7 8 9

Item correlation

Item number

Item correlation

.30 .32 .32 .40 .78 .73 .50 .35 .59

10 11 12 13 14 15 16 17 18

.75 .68 .19 .72 .75 .47 .20 .41 .47

37 sixteen items which required response to forty-six separate questions.

The final form of the inventory can be found

in the Appendix. Home environment.

This section of The Personal In­

ventory was designed to measure the home environment of the subject in terms of intra-family relationships.


relationships were of the nature of parent-to-parent and child-to-parent.

That is to say, an attempt was made to

measure major sources of satisfaction and discontent with­ in the family, how various members of the family feel and act toward one another, ana the child's adjustment within the framework pattern of the family.

To measure such r e ­

lationships, adequate coverage of overt expressions of fam­ ily behavior had to be made.

Difficulty at' once arose from

the traditional feeling of privacy regarding family affairs and made this factor not readily measurable. Several noteworthy attempts have been made to quan13 tify the concept of home environment. Myers undertook the construction of a questionnaire designed to measure var­ ious factors in the home environment of junior-senior high school students, using as a basis replies to questions about the pupils' home and family.

Two of the six sections in

^ T h e o d o r e R. Myers, Intra-Family Relationships and Pupil Adjustment (Teachers Collegia Columbia University ContributIons to Education No. 651, New York: Bureau of Publications Teachers College, Columbia University, 1935), pp. 1-115.

38 Myers * Intra-Family Quest!onnalre dealt with relationships between parents, and parent-child relations.

A similar

attempt to evaluate home environment was reported by McCall in his Educational Background Questionnaire.


He attempted

to measure certain social and personal relationships between the child and parents in a section called "You and Your Parents."

A recent effort in the direction of evaluating 15 home environment was made by Havighurst and Taba with the construction of the PR (Family Relationships) Questionnaire. They had found it impractical to secure data on family r e ­ lationships by studying overt behavior within the family and resorted to less direct measures.

The items in their

questionnaire were determined by an "operational definition of affectional family relationships," questions being form­ ulated covering various areas which had been outlined. They concluded that the instrument could not measure all of the factors of the home situation, but that the responses presented a reasonably valid picture of family relations which exist within the home.

The several scales discussed

above served as a basis in the construction of Section II of The Persona 1 Inventory.

14William A. McCall, Measurement Macmillan Company, 1939), pp. 228-246.

(New Yorks The

■^Robert J. Havighurst and Hilda Taba, Adolescent Character and Personality (New York: John Wiley and Sons, Inc., 194977”P P • 233-242.

59 In original form Section II contained twenty-one items, several of which were of the multiple type.

In all,

the twenty-one items represented a total of 52 separate ques­ tions relating to the several aspects of home environment. This section was scored in a similar manner to that of Sec­ tion I, one point was given to the best alternative to each question while no points were given to the others.


method of scoring seemed defensible in light of the method in which the items were originally selected and in further item analysis. Table II shows the correlation coefficients between each Item and the total score in Section II made on the preliminary test.

Examination of this table revealed throe

Items whose correlations were either low or In a negative direction.

These items were number 2, ”As a child, did a

nurse maid or governess take care of you rather than your mother or sister?” number 4, "How many years have you attended school where you lived away from home?’1 and number 9, uHow often do your parents permit you to make your own decisions and decide Important things for yourself?”

The r's for

these three Items were .20, -.50, and .00 respectively. Study of the responses to Item 4 indicated a posi­ tive relationship between home environment and attending school away from home, as the Item was scored by giving the greatest weight to an answer indicating the Individual had' never gone away to school.

Item 9 which had an r of .00



Item number 1 2 3 4 5 6 7 8 9 10 11

Item correlation o39 .20 .23 -.50 .38 .81 .40 .50 .00 .80 .65

Item number

Item correlation

12 13 14 15 16 17 18 19 20 21

.30 .35 .43 .79 .70 .90 .50 .49 .21 .77

41 received, similar responses from all subjects and was there­ fore non-discriminatory.

Items which exhibited high posi­

tive correlations were all multiple In nature and were ex­ pected to yield these high relationships.

Eliminating items

2, 4, and 9 produced a scale of eighteen Items with 46 sepa­ rate responses.

Section II in final form appears in the

Appendix. Parenta1 attitude toward hea1t h .

Section III of The

Persona1 Inventory was designed to measure parental attitude toward health through evaluation of overt expressions in matters dealing with individual, family and community health lfi problems. Byrd has developed a scale to measure health attitudes of high school and college students, while The 17 Hea1th Awareness Test included an evaluation of health a t ­ titudes of pupils, grades 7-9.

However, neither measured the

attitudes of parents toward health.

In an unpublished study

by the Committee on the Evaluation of Commercial Advertis18 ing appointed b y the Public Health Education Section of the American Public Health Association, an attempt was 1^0. B. Byrd, Health Attitudes Scale (Stanford Un­ iversity: Stanford University Press, 1941), 7pp. T7Raymond H. Pranzen, Mayhew Derryberry, and William A. McCall, Health Awareness Test (New York: Bureau of Pub­ lications, 0 olumbia University, 1946), 8pp. 18 Edna M. Kech, chairman, "Committee on the Evalua­ tion of Commercial Advertising," (unpublished committee r e ­ port, Committee on the Evaluation of Commercial Advertising, Public Health Education Section of the American Public Health Association, (1948)), pp. 1-23.

42 made to quantify the family's attitude toward health through measurement of specific actions taken by the family relative to health.

While the latter study employed the interview

technique, the questions used on the Interview schedule were such as to lend themselves, with modification, to a question­ naire type of study. sonal Inventory

The items in Section III of The Per­

were therefore based quite largely upon

materials covered in the Committee's report. Fifteen items were included in the original draft of the third part of the Inventory.

These fifteen Items

represented a total of 37 possible responses due to several multiple Items which were Included.

Items in this section

were also scored on the basis of one point for the best alternative to each response and no points for the others. The correlation coefficients which were computed on a basis of an Item analysis in the preliminary test ap­ pear in Table III.

These represent the correlations between

individual items on the scale and the total score on Section III of the Inventory.

Item 3, which had an Item correla­

tion of .80, seemed to be the strongest indicator of the parental attitude toward health on the basis of frequency of regular check ups by a physician.

Item analysis also

revealed that three Items had either low or negative rela­ tionships with the total score.

They werej number 1, ’’Does

your family have a family physician to whom they turn for advice on health problems?" n u m b e r 6, "When you were given


table: h i


Item number 1 2 3 4 5 6 7 8

Item correlation

Item numb er

Item correlation

.13 .32 .80 .61 .46 .08 .51 .48

9 10 11 12 13 14 15

.49 .62 .30 .69 -.01 .60 .20

44 health examinations in elementary of secondary school, was either one of your parents present for* these examinations?11 and number 13, "Do members of your family take vitamin cap­ sules to supplement their diet?”

The respective correlation

coefficients were ,13, .08, and -.01.

Item 13, which had

a correlation coefficient nearly equal to zero, had approx­ imately an oven distribution of responses, not discriminatory on the basis of the factor which Section III as a whole was measuring.

Eliminating these three items resulted In a final

form of twelve Items with 34 possible responses. Community health environment.

Evaluating the com­

munity health environment of specific communities has long been a problem considered by leaders in both public and school health.

Considerable progress has been made toward evalu­

ating thi3 particular factor.

In general, community health

environment included the concept of community action to guard and improve the health of Its inhabitants.

This d e f ­

inition included a consideration of services provided, reg­ ulations enforced and attitudes taken by the community in recognizing and solving community health problems.


only the prevention and cure of disease, but the positive attainment and preservation of health for the entire com­ munity was within the concept of community health environ­ ment . Among the numerous attempts to evaluate community health environment, the works of Colcord and Goodykoontz


were frequently referred to in the literature.



presented 208 separate items relative to the provision for health care which should be considered in evaluating the health environment of the community; in addition* she listed twenty-eight items for consideration in the distribution of health care.

These items were broken down into various

sub-sections which included: environment,

(1) the community as a health

(2) indexes of community health,

for health services and medical care, to special groups,

(3) facilities

(4) health services

(5) aids in planning the community's

health program, (6) informing the public about health, (7) cost of medical care, (9) free medical care.

(8) voluntary payment plans, and Pn Goodykoontz outlined eleven areas

for investigation and discussion which served as a basis for evaluating the health environment of the community. Ideally, community health environment can best be measured b y a detailed survey of facilities, health depart­ ment regulations and practices within the respective com­ munity.

In this study, where the relative influence of this

factor and other factors was sought In relation to certain

19 Joanna C. Colcord, Your Community Its Provlsion for Health, Education, Safety, and Welfare ("New York: R u s ­ sell Sage Foundation, 1941), Chapters Vli£ and IX. 20

Bess Goodykoontz, Know Your Community, Federal Security Agency, U. S. Office of EducatIon, Know Your School Series, Leaflet No. 57 (Washington D. C.: United States Government Printing Office, 1941), pp. 20-23.


health education outcomes,

it was felt that it would he best

to seek information which was possessed by the individual being tested in order to get a more accurate measure of the influence of the community health environment upon the health education outcome.

The soundness of this approach had been

discussed on page 29.

With this consideration in mind,

the lists of Colcord and Goodykoontz were studied and those items of information representitive of the comnunity health environment, which would normally be expected to be pos­ sessed by the individuals being tested were selected as a basis for items in Section IV of The Personal Inventory. The original draft of Section IV was made up of seven­ teen items with a total of 51 separate responses which dealt with various aspects of community health.

The directions

for Section IV defined the community in terms of the place where certain functions such as going to school and church, shopping and seeking recreation were performed.

The unit-

zero method, described above, was used In scoring this sec­ tion.

An analysis of items in Section IV showed three which

had low coefficients of correlation when correlated with the total score of the section.

Those items were two, five, and

eight with correlation coefficients of .00, .16, and respectively,

(see Table IV).


All respondents answered

yes to Item 2 resulting in no measurable relationship. Items 9 and 10 were multiple

Items and their correlation

coefficients were expected to be high.



Item number 1 2 3 4 5 6 7 8 9

Item correlation

Item number

Item correlation

.60 .00 .70 .20 .16 .23 .22 .07 .95

10 11 12 13 14 15 16 17

.90 .80 .40 .78 .71 .50 .60 .70


On the basis of the low item correlations, the fol­ lowing items were not included in the final scale: "Does your community have a modern up to date water supply?" "Does your community have a truck which makes regular col­ lections to pick up garbage, ashes and rubbish?" and "Are there outdoor privies in your community?"

Eliminating these

left a scale of fourteen items with a total of 28 possible responses which appear in the Appendix.

Further improve­

ment over the original draft was made in the final scale by directing the respondents to answer for the specific community in which they had lived the longest period of time.

This addition was made after several persons had

raised questions, during the preliminary administration, relative to this point. School he a1th environment. Turner maintained that "a healthful school environment . . . provides a means of 21 teaching indirectly." It would follow, therefore, that considerable attention should be given to this important factor In evaluating health education outcomes.

A review

of the literature has revealed that this was the case. In this study the term "environment" was defined broadly to apply to all the forces which play upon the Individual because of the surroundings In which he happens to be.

^■*■0. E. Turner, School Health and Hea 1th Education (St. Louis; The G. V. Mosby Company, 1947"T* P* 182.

49 School health environment was thus defined as those forces within the school which may have had a hearing upon the individual's health education outcomes. School health environment, as defined, has been eval­ uated by a number of direct and indirect means.


of specific aspects of the school health program such as the medical and nursing services, school lunch programs, and custodial services, as well as the entire program were d e ­ scribed in the literature. uation was type.

The technique used in such eval­

generally of the check list, appraisal form

A number of the more recent studies which used some

form of evaluative device were consulted and items were chosen which would lend themselves

to a questionnaire type

appraisal of the school health environment. The studies 22 23 24 reviewed included those by Grout, Keeney, Southworth,

^ R . E. Grout, "Appraising A School Health Education Program," American Journa1 of Public H e a l t h , 30:797-805, July, 1940. . P. Keeney, "Study of Health Education in Schools of the Central District," Research Quarterly of the American Association for Health, Physical Education and Recreation, 15773=75,"' MarcE ." — --------------------------------^ W a r r e n H. Southworth, "Testing Techniques and Pro­ cedures Employed in the Massachusetts Study of Health in Senior High Schools," The J ourna1 of School Hea1th, 12:311318, December, 1942.

50 Wyatt?^* Elliott?® Leonard?*^ and Davis and Mas lay?®


served as a basis for the construction of Section V of The Persona 1 Inventory. The preliminary draft of the section on school health environment included nineteen items with a total of 33 pos­ sible responses.

As in the other sections described above,

the unit-zero method of scoring was used.


between individual items and the score made on the total section on the preliminary test appear in Table V, and were used to analyze each item.

Generally these appeared to be

high due possibly to the nature of the questions which re­ quested specific information relative to conditions of health­ ful living within the school.

Since this was descriptive

of school environment, high positive correlation coefficients would be the expected result.


Clarence Hodges W y a t t , The Status of Health and Phys ica 1 Bducat ion in the Secondary SchooIs In~~KentucTEy~ (±545-46) {Commonwea1th of Kentucky Educational Bulletin, Vol. 14, Ho. 5. Frankfort: Department of Education, July, 1946), pp. 431-480. 2 ®Eugene B. Elliott, A Check List for Surveying the Secondary School HeaIth Program ("Bulletin No” 346. Lans ing, Michigan: department of Public Instruction, 1946), 16pp. 2^Margaret L. Leonard, "Evaluation of Programs of Health Education," California Journal of Secondary Educ a tlon, 23:89-92, February, 1948. 28Arthur F. Davis and John W. Mas ley, "Present Prac­ tices in Health Instruction in the Public Secondary Schools of Pennsylvania," Pennsylvania Journal of He al t h , Physical Education and Recreation, I S O c t o b e r , 1949.



Item number

Item correlation

Item number

Item correlation

1 2 3 4 5 6 V 8 9 10

.25 .68 .67 .62 .77 .58 .40 ,80 .55 .58

11 12 13 14 15 16 17 18 19

.28 .69 .76 .73 .59 .58 .60 .70 .75

52 Examination of Table V revealed no item with a s uf ­ ficiently low correlation coefficient to warrant exclusion in the final draft;

thus, all items which appeared in the

preliminary draft were retained in the final form of the scale which can be found in the Appendix. School hea 1th instruction program.

Section VI of

The Personal Inventory attempted tc evaluate the school health Instruction program In terms of specific units of work, available facilities and materials, and extent of In­ tegration with other subjects.

Numerous references were

found In the literature citing examples of evaluative procedures based on those factors.


teen recent studies in this category.


listed four­

In addition, the

studies used in the construction of Section V of The P e r­ sona 1 Inventory were also applicable, as they included a section on the evaluation of school health instruction pro­ grams.

Resource materials from these several sources were

used in the construction of this section of The Personal Inventory. Both the preliminary and final forms of Section VI contained seven multiple Items, a total of 44 separate r e ­ sponses being called for.

Items one through six were scored

using the unit-zero method described above.

Item seven,

^iJelbert oberteuffer, School Health Education York: Harper and Brothers, 1949), pp. 390-59X1


53 which called Tor responses indicating specific units which were taught in the health courses and/or other courses, was scored by giving two points for each unit taught in the health course and one point for those taught in other courses. The various item correlations with the total score on the preliminary test appear in Table VI.

It Is evident

that items one and two, which are areas of study which the subject had in high school, were not measuring the same factor that Section VI as a whole was measuring.


both items were retained as it was desirable to Investigate further possible relationships between course patterns in high school and possible health education outcomes.


final form of Section VI appears In the Appendix. Units of hea1th in the schoo1 program.

The factor

of units In the school health program was measured by having the subject indicate the specific units which were Included both In the junior and senior high school health courses and In other courses which offered some health instruction in the curriculum.

Thus was indicated the specific areas

of work which were at least covered in the school health instruction program, but not a measure of the adequacy of the Instructional program. Ten specific units were included which represented the areas deemed essential in a well-rounded health Instruc­ tion program.

In order to quantify this factor for further



Item number 1 2 3 4

Item correlation .13 .11 .50 .76

Item number 5 6 7

Item correlat ion .73 .70




analysis, the responses were scored on the basis of two points for each unit received In the health course and one point for each unit taught in courses other than the health course.

This method of scoring was necessary in order to

give a proportionally greater weight to units covered in the health course, but In no way Implied that the teaching In the health courses was superior or inferior.

The meas­

ure as defined merely indicated the emphasis placed upon the health Instruction program by considering the respective number of units included in the health course as well as in other courses. Units of health in the school program appeared in The Personal Inventory as item seven of Section VI.


numerical value was considered In the total score of the school health Instruction program in addition to being con­ sidered as a separate factor.

The units considered and the

format of the question can be seen in the final form of The Personal Inventory which appears in the Appendix. The number of semester periods of h e a 1 th .


VII of The Personal Inventory measured the amount of health Instruction in terms of semester periods of course work in health education courses taken In junior and senior high school.

The subjects indicated the number of periods per

week the health class met as w e l l as the number of semesters per year which the health course was offered.


the number of periods per week by the number of semesters


which the student indicated she had health instruction in a health education class produced the number of semester periods of health. In addition to the above information regarding the number of periods of health instruction, a question was asked relative to the length In minutes of the various health courses.

The response to this question varied a great deal,

however, no attempt was made to reduce the number of semes­ ter periods of health to a common factor on the basis of the length of time which the health class met. Section VII as it appeared In final form was the same, with one addition, as It appeared in the preliminary draft. For the sake of clarity, health education was described more fully by contrasting it with the physical education program. Subjects were specifically directed to consider only the number of periods which the health education class met, being sure not to include the physical education periods in their reply.

The final form of Section VII appears in

the Appendix. The number of periods per week of health instruction. Item three, Section VII required that a response be given to the question, "How many periods per week did the Health Education Glass meet in your high school?"

The number of

periods thus Indicated was a measure of the relative con­ centration of the health education course.

Responses could

range from zero periods per week to five periods per week


indicating no health, instruction to health instruction on a par with other so-called "academic" subjects.

This again

was not a measure of the quality of the instruction program in the separate health class, rather it was a measure of the relative concentration of health instruction. II.


The Pennsylvania State College Academic Aptitude E x ­ amination

was designed to measure the eligibility of a p ­

plicants for admission to college and was therefore a type of scholastic aptitude test.

It was constructed b y Profes­

sors Moore and Nell of The Pennsylvania State College and was described in a series of m a s t e r ’s theses and doctoral dissertations In the Department of Psychology at that In­ stitution.

Those works which described the examination and 30 Its validity were doctoral dissertations by Coblentz and 31 32 Castore and a master's thesis by Whittaker. The original examination was composed of five sub-

Irving Coblentz, "Prognosis of Freshmen Academic Achievement at The Pennsylvania State College," (unpublished Doctoral dissertation, The Pennsylvania State College, State College, 1942), 234pp. •^George F. Castore, "A Screening and Selection B a t ­ tery for Prospective Physicists and Chemical Engineers," (unpublished Doctoral dissertation, The Pennsylvania State College, State College, 1948), 147pp. Betty Ann Whittaker, "A Validation Study of the Prognosis of Academic Success," (unpublished Master's thesis, The Pennsylvania State College, State College, 1943), 47pp.

58 tests v/hich included the areas or vocabulary, paragraph reading, arithmetic processes, English usage, and algebraic processes.

The items were of the multiple choice type v/ith

five alternative responses throughout the examination. In 33 1947, Castore undertook an extensive revision of the orig­ inal test b y analyzing the several items and the various sections of the examination.

The revised form Included

all areas considered in the original test with the exception of English usage, which was eliminated.

The questions In

the revision were of the same general pattern as those In the original form.

The 1947 revision of The Pennsylvania

State College Academic Aptitude Examination was used to secure data in this study. The scores made on various

parts of the test were

combined to give a total score for the examination.


subjects took the test In the areas of vocabulary, paragraph reading and arithmetic processes, and their three part total score became the scholastic aptitude score used in this Investigation.

In addition, those subjects who elected

technical science curricula took the algebraic processes examination.

These scores, however, were not used In this



l o c. o l t .

59 III.


The Bernreuter Personality Inventory used in this study was a measure of several different aspects of person­ ality.

It has "been described by the author in a series of

art icles ^ 4 - 3 5 - 3 6 - 3 7 - 3 8

inventory consisted of 125

items to which the subjects answered "yes," "no," or " ?"; the latter response being used when neither yes nor no was a correct answer.

Bernreuter's personality inventory meas­

ured six aspects of personality which he has called Bl-N (neurotic tendency), B2-S (self-sufficiency), B3-I (Introversion-extroveraion), B4-D (dominance-submission), Pl-G (confidence), and F2-S (sociability).

This study made use

of the Bl-N, B2-S, and B4-D measures only. The Bl-N factor referred to the extent of the inabil­ ity of an individual to overcome emotional strains, worry

^ R o b e r t G-. Bernreuter, "The Measurement of SelfSufficiency," The Journal of A b n o rm a1 and Social Psychology, 28:291-300, October-December, 1533. 35 Robert G. Bernreuter, Manual for the Personality Inventory (Stanford University: Stanford University Press, 1935 Tl 7 p p . •2C

Robert G. Bernreuter, "The Theory and Construction of the Personality Inventory," The Journa1 of Soc ial Psy­ c h o l og y, 4:387-405, November, 1933. ^ R o b e r t G. Bernreuter, "Validity of the Personality Inventory," The Personnel Journal, 9:383-386, April, 1933. ^®Robert G. Bernreuter, "Chance and Personality In­ ventory Scores," The Journal of Educational Psychology, 26: 279-283, April, 1333.


and emotional upset.

The factor B2-S, or self-sufficiency

factor, referred to the extent to which the individual pre­ ferred to do things by himself as well as the extent to which he was free from the need of companionship.

The third

factor B4-D indicated the extent to which the individual tended to dominate his peers and was thus free from tenden­ cies toward submissiveness.

Scores for each factor, which

were determined through use of standardized scoring keys, represented the relative possession of each aspect of pe r ­ sonality by the individual subject.

High scores indicated

strong tendencies in the defined areas, low scores indicated the reverse. IV.


Form W of The Strong Vocational Interest Blank (Re­ vised ), was used as a measure of vocational interest.


device measured the patterns of interest possessed by the individual subjects, ascertaining whether a given individ­ u a l ’s interest coincided with a characteristic set of likes and dislikes which differentiate persons in various occupa­ tions . The blank consisted of 400 items to which the subject responded by indicating whether she liked, disliked or was

3 ^Edward K. Strong, Jr., Vocational Interests of Men and Women (Stanford University: Stanford University Press,

T343), 746pp.

61 indifferent to each item. areas were sampled.

Likes and dislikes in several

There were items which referred to

occupations, amusements, school subjects, activities and peculiarities of people.

The blanks were scored separately

for each occupation, a standard scale being used.


were expressed in terms of a six point scale of A* B/, B, B-, C/, and G.

A score of A indicated that the blank was

answered in a manner typical of successful persons in that vocation; a score of C indicated there was little in common with the successful persons in the particular field, so far as interests were concerned. While scales were available for twenty-seven differ­ ent occupations, only ten were considered in this study. These were: dietitian, physical education teacher, occupa­ tional therapist, nurse, medical doctor, artist, librarian, lawyer, buyer, and office worker. considered in two groups,

These occupations were

the first five representing o c ­

cupations where knowledge of health and health practices was desirable, the last five representing occupations in which this knowledge was not essential.

This division was

more or less arbitrary, based on the considered opinions of persons in the fields of health education, education and psychology. V.


The Johns Health Practice Inventory was a group a d ­

62 ministered test, designed to measure the health practices 40 of an individual or group. Health practice or behavior was defined as the habitual manner in which an individual reacts to given health situations.

This action may be c o n ­

ditioned by knowledge possessed by the individual, by force of public opinion, attitudes toward health,

or by previous

training. The inventory was composed of thirty-six healthpractice statements to which the subject indicated her frequency of performance by checking "never," "rarely,” "sometimes," "usually," or "always," for each statement. The statements represented a wide sampling of health prac­ tices, including the areas of nutrition, excretion, exer­ cise, posture, defense against disease, safety, mental h y ­ giene, use of scientific services, and evaluation of health information. The inventory was scored using the scoring device experimentally determined by the author.


to each

item were scored and the total of these represented the total score for the inventory.

Responses of "never" r e ­

ceived 1 point, "rarely" 2 points, "sometimes" 3 points, "usually" 4 points, and "always" 5 points.


the total

possible score for the inventory was 180, while 36 was the

4^Wed B. Johns, Information Manua1 Hea1th Practice Inventory (Stanford University: Stanford University Press,

TU43T,"“4 pp .


minimum score. VI.


The 1948 revision of the K1 lander Hea1th Knowledge Test 4 1 was used as a measure of health knowledge possessed by the freshmen college women considered in this investig­ ation.

The relative degree of health knowledge possessed

by an individual was considered to be the amount of f a c ­ tual information which that individual had at her command. Health knowledge was in no way construed as a measure of behavior or attitude, but merely a measure of information. There were one-hundred multiple choice Items in the test, the number or choices varying from three to six. The subject indicated her knowledge of the question being considered by selecting the one response which she thought was the correct answer for that question.

If the question

was not understood or If the subject did not know the a n ­ swer, she was directed to leave It unanswered.

The ques­

tions sampled a wide range of knowledge relative to health. Six separate areas were considered which included?


trition, safety and first aid, community hygiene and san­ itation, mental and social health, common errors and super-

4=1h. P. Kilander, "Health Knowledge of High School and College Students," Research Quarterly of the American Association for Health and Physical Education, 8:3-32, ■UctoEer/ 1937".----------------- -----------------

stitions regarding health, and general fields of health. The test was scored using a prepared key, disagree­ ment with the key being checked as an incorrect response. The total number of correct responses was the score on the test.

Thus, the possible score was 100, the minimum score

z ero. VII.


The Personal Inventory.

The reliability of the sev­

eral sections of The Persona1 Inventory was estimated through use of the split-haIf method.

The scores made on the odd

numbered items were correlated with those made on the even numbered Items and the resulting coefficients corrected b y using the Spearman-Brown prophecy formula to produce an estimate of the reliability of the section as a whole. The section reliabilities were estimated on the basis of the responses given b y the 473 college freshmen women which comprised the sample in this Investigation.

The odd-even

correlation coefficients and the coefficients of reliabil­ ity, corrected by the Spearman-Brown formula, appear in Table VII. Examination of Table VII showed no section to have a reliability lower than .724, that being Community Health Environment.

That section appeared to present the greatest

difficulty to the subjects filling out the Inventory as many were not thoroughly familiar with the health agencies



Socio-Economic Status Home Environment Parental Attitude Toward Health Community Health Environment School Health Environment Health Instruction Program Units of Health

Odd-even correlation

Coefficient of reliability

.658 .675 .577 .568 .628 .724 .669

.794 .805 .732 .724 .771 .840 .802



and facilities In their community.

While a reliability of

.724 is low for Individual prediction, it has definite value in group studies such as the one -undertaken. It must also be pointed out that no reliablity was reported for Section VII of The Personal Inventory.


section measured the number of periods per week in which the subject had health Instruction and the number of semes­ ter periods of health which were taken in junior and senior high school.

The number of items being limited, a split-

half approach was impractical.

A re-test could have been

used, but administrative difficulties in giving a second test prevented this. The methods of determining the validity of The Per­ sonal Inventory were classified into three categories; namely, by definition of the areas to be tested, use of items which had been previously validated, and consensus of competent judges as to the adequacy of the Items which were Included. While all these methods were not used to validate each of the separate sections of the inventory, the validity of each section was determined by as many means possible. The measure of socio-economic status was defined in terms of possession of certain items which distinguished persons at one economic level from those at another.


which were used were those which had previously been found to produce valid results in similar type scales.


Items similar to those which were used in The Personal In-

67 ventory, Leahy


round a validity coefficient of .94 when

correlating scores made by 200 families on her test with with scores made on the Sims Seale, which was an accepted valid measure of socio-economic status.

K e r r ^ found that

similar items, which were used in his American Home Scale, correlated .915 with a criterion of home visits to determine socio-economic status. Gough 44 further substantiated Leahy's and Kerr's findings through a factor analysis of several items which were found in both scales, and listed twenty-one separate items which he maintained were the best single measures of whatever the several scales of socio­ economic status were measuring in common.

On the basis of

the several studies mentioned, items used in The Peraona1 Inventory were assumed to be valid, and that Section I was a valid measure of socio-economic status of the family as def.ined. Section II of The Persona 1 Inventory, which dealt with home environment, was validated In a similar manner to that of Section I.

Studies which reported Items similar

to those used in Section II indicated their respective val-


Alice M. Leahy, The Measurement of Urban Home En ­ vironment (Minneapolis; The University of Minnesota Press, 1936), p. 57. ~3Kerr, _op. cit. , p. 29. 44 Gough, op. c i t ., pp. 52-56.





reported, the comparison made between re ­

sults on his Intra-Family Questionnaire and social case histories of selected homes and concluded that the sections of parent-parent and child-parent relations were valid meas­ ures.

Analyzing the items on their FR (Family Relationships) Questionnaire, Havighurst and Taba 46 correlated the subject’s score on the questionnaire with ratings made by a research group after an intensive case study and found a validity coefficient of .46 which they concluded gave

a reasonably valid picture of the type of affectional family relations which existed within the home.

Thus the assump­

tion was made that since similar items were used in Section II of The Personal Inventory, that section was a valid meas­ ure of home environment. The measurement of parental attitude toward health, Section III, was validated through consideration of the several items by persons in the field of health education, competent to judge them, and elimination of those items deemed unrelated to the factor being measured.

The items 47 in this section were similar to those used by Kech in

her study, however, no statistical evidence was presented relative to the validity of the measure.

45 Myers, _op. c it ., pp. 17-25. ^6Havighurst and Taba, op. c i t., p. 239, ^Kech,

op. cit., pp. 1-23.

69 Sections TV through VII which included community health environment, school health environment, school health instruction program, units of health In the school program, number of semester periods of health, and number of periods per week of health instruction were validated by definition of the areas to be tested through consideration of each item by persons competent to judge the adequacy of the sev­ eral Items in each section.. The literature in health education abounded with statements which defined and described subjectively the limits of the several factors considered.

Many statements

were found which made specific reference as to the points which should be taken into account when evaluating these factors.

Then too, studies such as those by Colcord, Goody-

koontz, Grout, Keeney, Southworth, Wyatt, Elliott, Leonard, and Davis and Mas ley, previously mentioned, served as guides in defining the respective areas of work.


the validations of the instruments used In those studies were not of the statistical type, however, they were accepted by recognized leaders In the several areas as valid. In addition to selecting only Items which appeared to have the consensus of agreement in the literature, each item used in the Inventory was submitted to two members of the health education faculty at The Pennsylvania State College for their considered opinion as to its validity as a measure of the factor under consideration.

Of the forty-

70 eight original items thus submitted for consideration, all were retained as being valid;

however, several were edited

and modified to a slight degree.

Thus, a relatively valid

instrument was constructed to measure the several factors. The Pennsylvania State College Academic Aptitude E x ­ amination.

The complete validity of the 1947 revision of

The Pennsylvania State College Academic Aptitude Examina­ tion has not as yet been established;

however, indications

of its ability to measure what it is supposed to measure were presented in several separate studies.

Working with

the original form of the examination, Coblentz 48 established validity coefficients for each of its five separate parts. Using 1,038 male freshmen at The Pennsylvania State College who were enrolled in the Schools of Chemistry and Physics, Mineral Industries, Engineering, Liberal Arts, and Agricul­ ture, he determined the median correlation coefficient b e ­ tween the separate parts of the test and the first semester averages of the students in the several schools.

The cor­

relation coefficients for the various parts were as followss vocabulary .287, paragraph reading

.220, arithmetic proc­

esses .351, English usage .326, and algebraic processes .526.

Weighting the several parts of the test and combining

them into a battery, Coblentz was able to produce markedly higher correlation coefficients between scores made on the


Coblentz, op. cit., p. 174.

71 test and first semester averages.

The weighted scores pro­

duced correlations which ranged between .342 and .714, the higher being secured by students in the School of Mineral Industries, the lower in the non-technical agriculture cur­ riculum in the School of Agriculture. 49 Whittaker, using essentially the same subjects as Coblentz, attempted to validate a prediction battery, which included The Pennsylvania State College Academic Aptitude Examination, by correlating predicted averages with earned first year averages.

An r of .617 between predicted aver­

ages and earned averages was achieved with chemistry and physics students.

A battery composed of high school rank,

arithmetic processes, English usage, and algebraic processes was used to find the predicted average.

With engineering

students, a correlation of .622 was obtained when a battery of high school rank, arithmetic processes, and algebraic processes was used as a predictor.

Lower division Liberal

Arts students yielded a correlation of .650 when high school rank and the weighted Pennsylvania State College Academic Aptitude Examination was employed as a battery to predict their first year averages. In a more recent work, Castore,


found that The

Pennsylvania State College Academic Aptitude Examination

^ W h i tt ak er , _op. c i t ., pp. 16-20. 5 ^Castore, op. cit., p. 8.

72 produced a correlation coefficient of .374 when correlated with first semester averages of one-hundred chemistry and physics students and .432 when correlated with the second semester averages of eighty-six of the same students. While the reported correlations were not true meas­ ures of the validity of the revised battery, they indicated the lowest possible limits of its validity.

Since the

individual items of the original test were each correlated with an independent criterion of scholastic success to pro­ duce the revised test, it would seem that the revision would be a more valid measure.

The reliabilities of the separate

parts of the examination and the reliability of the total battery were not reported. Bernreuter Personality Inventory.

Bernreuter 51 r e ­

ported validity coefficients ranging from .67 to .94 for the various scales In his personality test.


the scores of elementary psychology students, made on three sections of his test with scores made on previously vali­ dated tests, a validity coefficient was derived.

The re­

ported correlations between the Bl-N (neurotic tendency) scale and Thurstone Neurotic Inventory were .94 for a class of seventy students and .91 for a class of thirty-two.


B2-S (self sufficiency) scale correlated with the Bernreuter

SlRobert G-. Bernreuter, Manua 1 for the Personality Inventory (Stanford University; Stanford University Press, 1935), p. 4.

73 Self-Sufficiency Teat produced an r of .89 in a class of seventy and .86 in a class of forty-six.

The B4-D (domin­

ance -submission) scale when correlated with the Allport Ascendence-Subinission Reaction Study yielded correlations of .81 in a class of fifty-five men,

.67 in another class

of fifty-five men, and .82 in a class of twenty-nine women. 52 Krupa has reported a study in which scores made by 450 men on the several scales of The Bernreuter Personality Inventory were correlated with the relative standing of stu­ dents on a "Guess V/ho?" questionnaire.

By having freshmen

men select other freshmen men who possessed an extremely high or low degree of a defined personality trait, the rel­ ative standing of the students were determined.

The cor­

relations thus obtained were reported as follows: Bl-N .317, B2-S .148, and B4-D .426.

From these data Krupa concluded

that the scales possessed a moderately high validity when used to detect extremes for each trait. The reliabilities of the various scales of the per53 sonality Inventory were reported by Bernreuter. Using the split-half method and applying the Spearman-Brown proph­ ecy formula, he found reliabilities ranging from .85 to .92

^ J o s e p h Henry Krupa, "Further Validation of the Bernreuter, Bell, and Link Personality Inventories," (un­ published Master’s thesis, The Pennsylvania State College, State College, 1939), p. 18. 5^ B e r n r e u t e r , M a n u a 1 for the P ers ona lit y I n v e n t o r y , l o c . cit.

74 for the various scales.

With a class of seventy elementary

psychology students the following coefficients of reliabil­ ity were reported? Bl-N .91, B2-S .92, B4-D .89.

A class

of one-hundred twenty-eight similar students produced coef­ ficients as follows? Bl-N .88, B2-S .85, B4-D .88. The Strong Vocational Interest Blank.

Strong val­

idated his vocational Interest blank by several indirect methods, none of which employed extraneous criteria.


methods which were used Included; (1) tryout upon a new or control group,

(2) comparison of differences in interest

scores of different groups and computation of the percent­ age of ”overlapping,11 (3) validation through use.


tical data were not presented In the usual form of validity coefficients; rather the validity was Implied through use of methods listed above. In two studies involving 116 college senior men and 101 college senior freshmen respectively, Strong 54 presented data to substantiate several propositions which implied validity of his blank.

He found that men, continuing in

occupations for nine to ten years, averaged higher interest scores In that occupation than in any other.

Similarly he

reported that men continuing In an occupation obtained a higher score in it than men who entered another occupation. He also found that men who continued In an occupation ob-

5^Strong, op. cit., pp. 381-411.

75 tained higher scores in it than men who changed from that occupation to some other. Strong 55 reported reliabilities of the several parts of his occupational scale.

These were derived in two in­

dependent studies of 500 married women and 238 elementary school teachers using the odd-even technique, corrected with the Spearman-Brown formula.

In the study involving married

women the reliability coefficients ranged from .74 for fem­ ininity -masculinity and life insurance saleswoman to .94 for author, while the study of elementary school teachers showed coefficients of reliability of .71 for life Insur­ ance saleswoman and Y W C A secretaries and .98 for femininity-masculinity.

The mean reliability reported in the

former study was .85, In the latter .82. Johns Health Practice Inventory.




that the validity of his health practice inventory was es­ tablished in a number of ways, two of which Included sta­ tistical analysis.

Among these methods were included the

careful selection of statements from authoritative health education sources, together with analysis and criticism of the selected statements by recognized leaders in health

55 lb id., p. 79. ^®Burt Edward Johns, "The Measurement of Health Prac­ tices," (unpublished Doctoral dissertation, Leland Stanford Junior University, Stanford University, 1943), pp. 77-78; 84-109.

76 education, including teachers, physicians, public health officers, and state directors of health, physical education and recreation. Statistical data were available on a study involving thirty-two college men as subjects in which a preliminary form of the inventory was used.

When the scores made on

the inventory were correlated with ratings of health habits made by the subjects* roommate, the relationship was found to be high ( r - .89), with the majority of the subjects exhibiting the tendency to underrate themselves on the Hea1th Practice Inventory; their roommates rated them higher on a rating scale. In a second study involving fifteen college men, the author of the test lived in a fraternity house with these men and observed their health habits for a period of two and one-haIf month.

Without knowledge that they had

been rated, these men took the Hea1th Prac tice Inventory; the resulting correlation between the scores on the test and the rating procedure was .935, with the scores on the test consistently lower than those on the rating scale. The evidence thus presented tended to indicate the validity of the measure. The reliability of the inventory was established by the author In three separate studies using the splithalf method, corrected by the Spearman-Brown formula.


the first study, in which 600 Oregon high school and college

77 students were used, the reliability reported was



sidering one-hundred California high school and college students produced a reliability coefficient of .88, while one-hundred Stanford University students had inventory scores whose reliability was




on the other

hand reported a reliability of .73 obtained from a sample of 141 entering college freshmen women at Sam Houston State Teachers College, but concluded that the inventory was sat­ isfactory for group usage. A reliability coefficient was computed for the pres­ ent sample of 473 college freshmen women using the splithalf method, correcting the resulting correlation coeffi­ cient through use of the Spearman-Brown formula.

7/hen scores

made on the odd numbered items were correlated with those made on the even numbered items an r of .749 resulted, which when corrected, produced a reliability coefficient of .856. This was considered satisfactory for the group type analysis used in the present investigation. co Kilander Health Knowledge Test.


has pre­

sented some data relative to the validity of his original health knowledge test.

Validation consisted of careful

^ M a r g a r e t Powell, "An Analysis of Relationships Existent Between Health Practice, Adjustment, and Physical Performance of Freshmen Women," Research Quarterly of the American Association for Health, Physica1 Educatxon and RecreatTonl 18:175, October, 1947T 5®Kilander, _op. c i t ., pp. 3-32.

78 selection of items to tie included in the test as well as analysis of each item on the basis of the percent of correct responses.

After the items in the test had been selected,

careful consideration was given to the correct response to each item.

The test was given to a sample which included

844 high school seniors, 504 college freshmen and 430 adults. The per cent of individuals who chose each alternative to each item was computed and the results analyzed.


revealed that only in a few scattered items did the percent­ age of persons choosing the incorrect alternative exceed those choosing the correct response. Data relative to the validity of the 1948 revision of the test were not available.

It was assumed, however,

that the validity of the revised form was greater than that of the original form.

Basis for this assumption was found

in the fact that each item in the original test was analyzed and those not meeting certain criteria relative to discrim­ inatory power were eliminated. The reliability of the original scale was also r e ­ ported by the author of the test.

In a sample of 682 high

school seniors he reported a reliability coefficient of .83, while a sample of 402 college freshmen produced a reliabil­ ity coefficient of .80. In the present investigation, the reliability of the 1948 revision of the test was estimated using the split-half method with the Spearman-Brown correction.

A sample of 473

79 college freshmen women produced a reliability coefficient of .756.

This was considerably lower than the reliability

coefficients reported by Kilander on his original test, however, the present sample was considerably more homogene­ ous as evidenced by the relatively smaller variability of the sample.

Kilander reported a standard deviation of 10.20

for his high school group and 9.62 for his college sample. The standard deviation for the sample used in the present investigation was 8.16.

It would follow, therefore, that

a more heterogeneous sample may have produced a higher re­ liability coefficient. VIII.


The Instruments used to collect data In this study consisted of a personal Inventory blank and several stand­ ardized tests.

The Personal Inventory was constructed to

measure certain socio-economic and environmental factors in the home, school and community, while the standardized tests measured certain psycho-educationa1 factors.


bilities and validities of the several measures were reported. The reliability coefficients of the several parts of The Persona1 Inventory were reported as follows: socio-econ­ omic status

.794, home environment .805, parental attitude

toward health .732, community health environment.724, school health environment .771, health instruction program .840, and units of health .802.

The validity of this instrument-


was determined through definition of the areas tested, use of items which had been previously validated, and use of a criterion of expert opinion.

No statistical validity was

reported for The Persona 1 Inventory. The reliabilities and validities of the standardized tests used in this study were indicated by means of descrip­ tive and statistical methods.

The Pennsylvania State College

Academic Aptitude Examination was validated against a cri­ terion of academic achievement; no reliability coefficient was given.

The Bernreuter Personality Inventory had valid­

ity coefficients ranging from .67 to .94 when correlated with external criteria; reliabilities ranged from .85 to .92 for the various scales.

The Strong Vocational Interest

Blank was validated by several indirect methods, none of which employed extraneous criteria; reliabilities were re­ ported which ranged from .71 to .98 for the various parts of the blank.

The Johns Health Prac tice Inventory had sta­

tistical validities which ranged from .89 to .935 when cor­ related with roommates ratings of health habits; reliabil­ ities reported ranged from .73 to .88.

The Kilander Health

Knowledge Test had a descriptive validity based upon care­ ful selection of Items and correct response; reliabilities ranged between .736 and .83 for varying samples of subjects.



THE SUBJECTS AND PROCEDURES USED IN THE STUDY Literature related to this problem has shown that desired health education outcomes were influenced by many factors and the extent to which those outcomes were attained were dependent upon factors of environment, socio-economic status, and educational background.

These together with

the individual's own personality, intelligence and under­ standing were determining factors in the attainment of the desired goals. Since the influences of environmental, socio-econ­ omic and educational factors upon health education outcomes were complex, this study approached the problem through a biometric form of analysis.

A relatively large sample was

considered in which the relationships and interrelationships between these factors were studied for the purpose of ascer­ taining the relative influence of the several factors in the total situation.

The subjects used and the procedures which

were followed to accomplish this are described in this chapter I.


The subjects considered in this study were 473 women,

82 regularly enrolled In the 1949-5 0 Freshman Class at The Pennsylvania State College.

This represented a sample of

the 501 women who were enrolled in the required hygiene course at the college.

The twenty-eight individuals who

were omitted from consideration were not excluded by any previously determined criterion.

Twenty-seven of the women

had not taken all of the tests used in the investigation, for one reason or another, and thus the data on these sub­ jects were incomplete.

One subject had taken her prepara­

tory work in Japan and many questions of The Persona1 In­ ventory were not readily answerable in light of her back­ ground . The scholastic backgrounds of the subjects were al­ most wholly Pennsylvanian with only a few showing evidence of work at the elementary or secondary level outside of the Commonwealth.

This was not construed to indicate that their

educational backgrounds were similar as subjects came from large metropolitan areas, urban communities, and rural sec­ tions of Pennsylvania.

Nor had all of their secondary work

been in public secondary schools;

some indicated work taken

at private and parochial institutions, though the majority had attended public schools. There were factors present which tended to make the sample homogeneous in nature.

The factor of selective ad­

missions, where students were admitted only if they were in the upper fifths of their high school graduating classes,


eliminated subjects who were in the lower scholarship ranges. The economic factor eliminated those subjects who were un­ able to pay the fees at The Pennsylvania State College, The factor of parent prestige, no doubt, was a factor in the final selection of freshmen who were to attend school at the State College Campus as the number of enrollees for the fall semester 1949-50 was limited to 500 women.


these selective factors were not measured and their respec­ tive influences were not known, they were considered and analyzed, when describing the population from which the sam­ ple was drawn. The ages of the subjects ranged from sixteen to twenty-two years, with eighteen being the mode and 17.73 years the mean age.

Table VIII shows the distribution of

subjects according to age. The scholastic interests of the subjects were described in terms of their elected curricula.

Fifty-four separate

areas of major work were designated in five schools of The Pennsylvania State College.

Schools in which the subjects

were registered and the number in each were as follows; Liberal Arts, 150; Agriculture, 32;

Education, 140;

Home Economics, 131;

Chemistry and Physics, 20.

Ho subjects

reported being registered in either the School of Engineer­ ing or the School of Mineral Industries.

Those subjects

registered in the School of Physical Education and Athletics were not included in this study as they were not enrolled




16 17 18 19 20 21 22

4 174 262 21 7 3 2 N -'"4Y3-"

Mean S.D. Range

17,73 .74 16-22

85 in the required hygiene course.

A professional course in

health education was taken by this group in place of r e ­ quired hygiene. The most frequently occurring curriculum was General Home Economics with eighty-three enrolled, Elementary E d ­ ucation was next with sixty-six, and there were fifty who chose the School of Liberal Arts with no curricular desig­ nation.

Of the total number of subjects 418 were registered

in non-technical science curricula, while fifty-five were pursuing work of a technical science nature. II.


The experimental design used in this investigation consisted of measuring a large number of factors in a rela­ tively large sample for the purpose of determining the ex­ tent of interrelationship and consequent influence of the several factors. considered;

In all, a total of twenty factors were

eighteen being regarded as Independent varia­

bles, two as criterion or dependent variables.

The two

criterion variables were measures of health education out­ comes, health information or knowledge and health practices. The other variables were measures of certain socio-economic, environmental and educational factors in the home, school and community which were related in varying degrees to the criterion variables and interrelated among themselves. Knowledge of these relationships and Interrelationships

86 made it possible to analyze the relative influence of the independent variables on the measured health education out­ comes and to draw certain conclusions relative thereto. The advantages of an experimental design of this type were found in its practical approach.

Measuring a number

of factors at one time permitted consideration of the simul­ taneous variation of many factors rather than study of the variation of a single factor with others held constant. Thus the attendant difficulties in controlling factors were either eliminated or reduced to a minimum.

It was also

recognized that this approach had certain limitations, one of which was the omission of relevant variables for which adequate measures were not available.

The validity of any

conclusions drawn in an investigation of this type was d e ­ pendent upon a thorough consideration of all variables. Thus, this investigation was limited to the extent that variables, of necessity, were not included. The tests and Inventories used to collect data were administered during September and October of 1949.


Pennsylvania State College Academic Aptitude Examination, Bernreuter Personality Inventory and Strong Vocationa1 Interest Blank were administered to the freshmen women by the Psycho-Educational Clinic of The Pennsylvania State College during the freshmen orientation week exercises. The Kilander Health Knowledge Test also was given to the same group during orientation week by members of the womens'


staff in the School of Physical Education and Athletics. The administration of these tests was standardized and was followed hut with one exception.

Instead of using

the examination booklet in which to record the answers to The Kilander Health Knowledge Test, a standard answer sheet was prepared and used for that purpose.

Scoring of these

tests and inventories was done by faculty and trained as­ sistants in the respective departments in which they were administered, the final results being made available for the purpose of this investigation. The Johns Health Practice Inventory was administered by the investigator with the assistance of women instructors In the required freshman hygiene courses.

It was given

during the first period of the required hygiene course in the fall semester 1949.

The freshmen women had been assigned

to sections of the required hygiene course on the basis of the results made on The Kilander Hea1th Knowledge Test and during the first part of the period these assignments were made.

While the sections were still together in one group,

the Inventory was distributed and directions given for filling It out.

The standardized directions were read and

In addition It was emphasized that the results of the in­ ventory were to be used in a scientific study;

the re­

sponses were to be kept in strict confidence and would In no way effect the students’ mark In the course nor her rep­ utation In college.

The subjects were reminded to answer

88 each question in accordance With what she did rather than what she thought the answer should be.

An average of twenty

minutes was required by each student to complete the inven­ tory.

The inventory was administered to six groups of sub­

jects which ranged in size from forty to one-hundred and ten individuals.

Two days were required for this operation,

four groups being tested the first day, two the second. The attitude of the subjects and the Instructors who assisted in the administration of the inventory was one of co-oper­ ation. Scoring the inventory was accomplished in accordance with the standardized directions described on page 62 of this report.

After this process was completed, the inven­

tory was re-scored using a special key which produced a score for the odd numbered items and the even numbered items. This was used to determine the reliability of the measure using the split-haIf method. The Personal Inventory was administered by the author with the assistance of women instructors in the required freshman hygiene courses.

It was given approximately four

weeks after the beginning of the fall semester in 1949. As with the health practice inventory, The Personal Inven­ tory was administered in the required hygiene classes.


sections meeting at the same time were assembled in one room for the purpose of filling out the inventory, thus the six groups which had previously taken the Johns inven-

tory were again together to take The Personal Inventory. The blanks were distributed, and directions for filling them out were read with special emphasis being given to the use of the data in a scientific study and the confidential n a ­ ture of the responses. one of co-operation.

The attitude of the subjects was An average of forty minutes was re­

quired to complete the inventory. The Persona1 Inventory was scored according to the procedures outlined on pages 33 and 34, by giving one point to the best alternative to each question.

A key was used

to facilitate scoring the multiple items.

After the total

score was determined for each section, the score made on the odd numbered and the even numbered Items was calculated for the purpose of determining the reliability of the sev­ eral sections. III.


A sample of 473 freshmen women entering The Pennsyl­ vania State College and regularly enrolled In the required hygiene course were used as subjects in this study.


their scholastic backgrounds were varied, certain factors operated to make the sample homogeneous In nature.


subjects ranged in age from sixteen to twenty-two years and had a wide range of scholastic interest as evidenced by their elected curricula. A personal inventory which was designed to measure


certain socio-economic and environmental factors In the home, school and community was administered to this sample of entering freshmen women at The Pennsylvania State College. This, together with measures of scholastic aptitude, per­ sonality, vocational Interest, health knowledge, and health habits were given during the first few weeks of the fall semester 1949-50.

The scores of the several tests consti­

tuted the data used in this Investigation.

CHAPTER V ANALYSIS OF THE DATA AND RESULTS The available data consisted of the scores made on the several tests together with the quantitative results on each section of The Personal Inventory.

Analysis of

the data was accomplished through use of International Business Machines tabulating equipment.

The data from the

Kilander Hea1th Knowledge T e s t , Johns Hea1th Practice In­ ventory and The persona 1 Inventory were tabulated on master sheets and later punched on Hollerith cards.

Data from the

Pennsylvania State College Academic Aptitude Examination Bernreuter Personality Inventory and Strong Vocational In­ terest Blank were reproduced on the Hollerith cards used In this study from those used by the Psycho-Educational Clinic of The Pennsylvania State College. Analysis by the IBM tabulating machines produced Q the values of £X and for each variable as well as the sum of the cross product 2 X Y between each variable.


addition, the cards were sorted on the basis of several dichotomous variables and values of

and 2-X2 were obtained

in both parts of the dichotomy for certain of the contin­ uous variables.

92 With the resulting data in the form of the sums of the raw scores and. the sums of the raw scores squared for each factor, as well as the sum of the cross products of the fifteen continuous variables, the first step was the determination of the range and variability of the several measures as well as their central tendencies through use of standard raw score formulas.

Relationships between vari­

ables were determined through computation of correlation coefficients, while the significance of differences between means of selected groups were Investigated using the t-ratio. Characteristics of the d at a .

Examination of Table IX

revealed several significant findings.

The average number

of semester periods of health instruction reported by the subjects exceeded the requirement established in the Penn­ sylvania Department of Public Instruction Course of Study in Hea1th Education for Secondary Schools^ of one period of health instruction per week throughout the junior and senior high school years.

Computing the state requirement

on a similar basis to that of the present investigation, it was found that twelve semester periods was the amount of health instruction required in Pennsylvania schools. This, compared to 13.106 semester periods found in this study, seemed to bear out the findings of a survey made in 1949

^Course of Study in Health Education for Secondary Schools (De par tinent of Public Instruction Bulletin 313, Harrisburg: Commonwealth of Pennsylvania, 1944), p. 12.




Socio-Economic Status Home Environment Parental Attitude Toward Health Community Health Environment School Health Environment Health Instruction Program Semester Periods of Health Units of Health Periods of Health Instruction Health Habits Health Knowledge Scholastic Aptitude Neurotic Tendency Self-Sufficiency Dominance-SubmissIon

27.330 35.429 16.273 15.074 21.080 31.987 13.106 17.161 1.493 142 .106 66.801 100.560 220.720 234.190 294.230

Standard Deviation 5.340 5.195 3.345 4.457 4.070 8.446 8.171 5.490 1.030 11.649 8.156 23.121 75.050 50.970 57.000


9- 40 10- 46 6- 25 4- 28 5- 30 4- 49 0- 58 2- 29 0- 5 99-169 37- 91 42-172 70-470 110-390 100-410

94 which reported 22.3 per cent of the public schools in Penn­ sylvania were exceeding the state requirement relative to the amount of health instruction.


Along this line, it was also found that the relative concentration of health instruction in terms of the number of periods per week was greater than the required one period. The mean of 1.49 periods of health instruction per week also indicated acceptance of the 1945 recommendations of the Pennsylvania Branch of the National Association of Second ary School Principals,

that the time allotment in health

instruction be increased.

That figure also reflected the

findings of the 1949 survey which showed 20.4 per cent of the schools had adopted some form of concentrated health instruction program other than the required one period per week.^ The health habits scores of the 473 entering fresh­ men women appeared to be higher than those of a similar group of 141 women at the Sam Houston State Teachers College,

^Arthur P. Davis and John W. Mas ley, "Present Prac­ tices in Health Instruction in the Public Secondary Schools of Pennsylvania,'1 Pennsylvania Journa 1 of Health, Physica 1 Education and Recreation, IST7, October, 1949. ^Holgar P. Kilander, "The Concentrated Health Course," Journal of Health and Physical Education, 18:2, January, 1947. ^Davis and Mas.ley, loc . c i t .

95 Huntsville, Texas. appear in Table X.


A comparison of the two sets of data The t-ratio of 7.05 for a sample over

six-hundred indicated a very significant difference, one of 2.59 being significant at the one per cent level of con­ fidence The magnitude of this difference between means was determined in terms o^' standard measures by dividing the difference between the means by the standard deviation of 7 the scores of the two groups combined. This difference was found to be .75 standard deviations of the combined sample. It was also observed that the scores of the present group were much less variable than those of the Sam Houston freshmen.

To test the significance of this difference a

t-ratio was computed and found to be 3.97, again Indicating, for so large a sample, a difference occurring more than 99 times In 100.

This evidence tended to substantiate pre­

vious data which indicated the present sample was homogene-

^Virginia Margaret Powell, "An Analysis of Relation­ ships Existent Between Current Health Practices, Personal and Social Adjustment, and Physical Performance," (unpub­ lished Doctoral dissertation, Hew York University, New York, 1946), 128pp. ®I-Ienry E. Garrett, Statistics in Psychology and Ed­ ucation (New York: Lon«mansY Green ana” Co. , 1947) , TaTsle 29,

p7"15I7 ^Charles C. Peters and Walter R. VanVoorhis, Statistlca1 Procedures ana Their Mathematical Bases (New Y o r k : McGraw-Hill book "Company, Inc ., 1940), p. 453.



Powell study N M R din

Mas ley study

141 132.03 15.66 87-165 1.32 D If fe renc e tfd t-ratio

473 142.11 11.65 99-169 .54 10.08 1.43 7.05

97 ous and possibly selective in nature due to the admissions requirements and tuitional costs at The Pennsylvania State College. Comparison of the two groups on the basis of health education backgrounds was not possible due to the lack of data.

While the present investigation measured several

aspects of the school health education program, the data in the Powell study relative thereto was not reported other than a statement that the school programs of Texas varied from well arranged programs to programs with little or no . ,, 8 organxzation. Further indication of the possible homogeneity and selectivity of the sample was found when health knowledge scores were compared with those of a sample of 402 freshmen a who were enrolled in five different colleges. A compar­ ison of the two sets of data appear in Table XI.

The t-

ratio of 6.72 indicated a very significant difference b e ­ tween the means of the two groups of scores, the present sample exhibiting a greater amount of health information as measured by the K1lander Health Knowledge Test.


difference expressed in terms of standard deviations of the

8Powell, _op. c i t ., p. 8. ^K. F. Kilanaer, "Health Knowledge of High School and College Students," Research Quarterly of the American Association for Hea1th, Physical Education and Recreation, 8:3-32, October, 1937.