A History of School Health Program Evaluation in the United States R. Morgan Pigg, HSD R. Morgan Pigg, Jr., H.S.D.; Assistant Professor o f Health Education; Department of Health and Safety; University of Georgia; Athens, G A 30602.
During the 19th century, no organized school health education program existed in American schools, but the foundations upon which the areas of health services, healthful living, and health instruction were to be laid were clearly present. Since no organized school health program existed, formal procedures to evaluate such programs received minimum attention prior to 1900. The advent of the 20th century brought changes which were to provide the impetus for the development of a distinct school health program and for procedures intended to assess the efficiency of such programs. Anderson’ (p8) suggests health education and physical education were considered synonymous until 1910 when the American Physical Education Association recognized a distinction between the two fields by utilizing “School Hygiene and Physical Education” as the theme for the 17th annual meeting. As the school health program developed, efforts to formally assess the effectiveness of various aspects of the program through evaluation became increasingly prevalent.
School Health Services In 1923, the American Child Health Association initiated a survey to determine what organized activities were being conducted by public and private agencies to improve the health of the school child. The results of the survey were published in 1925 as A Health Survey of 86 Cities2 The survey was significant in that the researchers realized a knowledge of child health practices as such was of limited value. As a result, a second study involving 70 cities was initiated in 1925 to provide data for use by administrators in t h e evaluation of local school health activities. The results of the second study were published as five School Health Research Monographs from 1929 to 1932: (pviii) THE JOURNAL OF SCHOOL HEALTH
One of the earliest intensive evaluations of a local school health services program was the Astoria Demonstration Study which was conducted from July, 1936 to June, 1940 under the direction of Dr. Dorothy B. Nyswander. Based on the findings of the previous American Child Health Association studies, the study was conducted to determine the effectiveness of the school health service program of the Astoria Health District of New York City. In essence, the study accomplished its main goal, providing better health services for the school child.3 By the late 1940s, efforts to evaluate the effectiveness of school health programs had been refined, and various organizations and agencies were actively involved in establishing evaluative criteria for school health service programs. I n 1947 t h e Michigan School Health Association in cooperation with the American School Health Association prepared a checklist to be used by school administrators and health officials in the evaluation of school health service programs. The checklist gave attention to the administrative aspects of school health services and included a section on school sanitation which health educators would eventually place under the area of the Healthful School Environment.’ The decade of the 1950s continued to reflect an increased sophistication in evaluation of school health services. A number of studies were conducted to evaluate the role of school health services and health service personnel. In 1952, Weatherbe’ produced a Check List for School Health Services, and in 1953, the American Public Health Association Committee on Professional Education released “A Proposed Report on the Educational Qualifications of School Physicians.”6 Shortly thereafter, Bland’ and Netche? focused attention on the evaluation of the school nurse in studies involving school nurses in Indiana. Poe and Irwin9 continued the emphasis on the school nurse by publishing an article in 1959 which delineated the functions of a school nurse. Of particular importance a t this time was the work of the Committee on School Nurse Policies and Practices of the American School Health Association. 583
Begun in 1952 under the direction of Miss Eunice Lamona and continued under the direction of Miss Lyda Smiley, the Committee published in 1956 a paper entitled “Recommended Policies and Practices for School Nursing”lo which has served as the basis for a number of revisions. In keeping with the mood and momentum of the preceding decade, the 1960s reflected a growing movement toward an expanded and defined school health service program. Studies by Watters” and Trausneck’l reflected the direction of the 1960s in that the studies produced extensive, definitive standards in the form of evaluation instruments to be used in assessing school health services. Studies conducted in the early 1960s by Bonvechi^,'^ the American Nurses’ Association,” and the National League for Nursing” expanded efforts begun in the 1950s to more clearly define and evaluate the role of the school nurse and the school physician in the school health service program. In addition, specialized evaluative criteria such as Kilander’s “Checklist for the Emergency Care Program in were continually being deSchools”’6 (pp510-513) veloped to accommodate the expanded scope of school health services. The decade of the 1970s appears to be developing as a period of consolidation and synthesis in the evaluation of school health services. Research activities, such as the study conducted by Baker,17 seem to be concentrating on the implementation of evaluative procedure developed during the 1960s. A review of existing information suggests evaluative research in school health services has tended to vacillate between generation and synthesis of data. For this reason, it seems reasonable to anticipate new evaluative research in school health services will be forthcoming during the 1970s.I t is encouraging to note certain accrediting organizations now routinely include evaluation of school health services within the accreditation process. The Commission on Secondary Schools of the North Central Associa tion’* has evaluative criteria for health services in the secondary school, while the National Study of School Evaluation has produced evaluative criteria for health services at the elementary,’9 junior high/ middle school,?0and secondary school2’levels. Such actions are merely another indication of the acceptance of the importance of school health services.
The Healthful School Environment There is no lack of quantitative, evaluative data relating to the school environment. In fact, the volume of material from the late 1800s and early 1900s 584
relating to the school environment makes it impractical to attempt a detailed report on the period. When one reviews the material from the preceding ?nod collectively, it becomes apparent evaluators of the period were primarily concerned with a quantitative assessment of the physical characteristics of the school environment. Numerous score cards, check lists, and reports were produced which dealt with such matters as heating, ventilation, seating, fire safety, water supply, plumbing facilities, lighting, building structure, and the school site. Any report of efforts to evaluate the school environment would be incomplete without some mention of the work of N.L. Engelhardt and G.D. Strayer of Columbia University Teachers College. During the early 19009, both individually and as a team, Engelhardt and Strayer were amazingly prolific in the quantity of evaluative standards they produced concerning various aspects of the school plant. Standards were established for rural school buildings,22city school b~ildings?~n~‘ elementary school building^?^ and high school buildings?6 In addition, evaluative materials were prepared concerning the planning of school building programs27and administrative policies and programs concerning the school plant.2* Utilizing the preceding materials, Engelhardt and Strayer evaluated scores of school plants in cities throughout the country. During the 1930s and early 1940s, evaluation of the school environment continued to be quantitative in nature. Researchers such as Holy and Arnold29’30continued to produce materials to be used in the quantitative evaluation of school facilities. By the late 1940s the school health program was emerging as a separate field, and health educators began to review the relationship between the school environment and the concept of a total school health program. In 1949,the Subcommittee on School Environment of the California State Joint Committee on School Health produced an extensive “Checklist for Healthful and Safe School E n ~ i r o n m e n t ” ~ ’ which reflected the emerging concept of the school environment as a specialized area with unique potential for contributing to the total health of the school child. The movement toward a philosophical revision of the role of the school environment in the total school health program continued to gain momentum during the 19509,and professional preparation institutions became involved in determining standards to be used in evaluating the school environment. During this period, the role of safety and safety education in relation to the total school health program received particular attention. In 1953,the National DECEMBER 1976 VOLUME XLVl NO. 10
source for reinforcement of the principles presentCommission on Safety Education of the National ed in health instruction classes, a universal model Education Association prepared a comprehensive for such a procedure has not been forthcoming. 325 item checklist to be used in evaluating the status Since the educational aspects of the school enof school safety and safety e d ~ c a t i o n .Shortly ~~ vironment have not been fully utilized, evaluators thereafter, Anderson (pp445-447)produced a “Surhave not incorporated the assessment of the efvey of Healthful School Living” which included a fectiveness of such efforts into the evaluation of categorized listing of over 100 questions dealing the school environment. With the proliferation of specifically with the school environment. research activities in school health education, the By the early 1960s, the philosophical foundation prospect for future evaluative research in the preunderlying the role of the school environment in receding area seems encouraging. lation to the total health education of the child had assumed a certain degree of substance. In addition Health Instruction to dealing with environmental and structural factors, evaluators began to direct attention toward Since 1843 when Horace Mann advocated physthe specialized aspects of the school environment. iology and hygiene be included in the c u r r i c ~ l u m ~ ~ The evaluation of safety and safety education prohealth educators have attempted to assess the regrams, present in the preceding decade, was encoursults of health instruction through the use of health aged by the development of additional evaluation knowledge tests. However, due to the relatively reinstruments.’6 (pp222-223) cent development of the concept of health instrucIn addition to programs in safety and safety edution as a multifaceted aspect of the total school cation, evaluators were involved in determining health program, efforts to evaluate health instrucstandards for the school food service program. In tion as an area have been modified in comparison 1963, Simon3‘ produced a comprehensive 21 page to earlier efforts. evaluation instrument to be used in determining Though the idea of a school health program was the efficiency of school food service programs. In merely in the developmental stage in the early 19OOs, School Health Administration published in 1964, health educators of the period believed school chilDr. Oliver B ~ r d ~ ~ i n c l u da echapter d on school lunchdren could benefit from a planned program of health instruction. As a result, a number of demonstration room sanitation. Within the chapter was included studies were conducted to evaluate the impact of “An Administrative Check List for Evaluation of School Lunchroom Sanitation” composed of 50 quesquality health instruction on school children. Demontions to be answered by the evaluator. stration studies were conducted in Baltimore, Maryland in 1914; in Malden, Massachusetts in 1922; in By the early 1970s, evaluation of the school environment had undergone considerable revisions Mansfield and Richland counties of Ohio from 19221925; in Fargo, North Dakota from 1923-1927;’ from the procedures employed during t h e early (pp8-10)and in other localities around the country. 1900s. Though consideration continued to be given The results of the demonstration studies supto evaluating the environmental and structural ported the contention that the level of health knowlaspects of the school plant, the concept of the healthedge of school children could be improved through a ful and safe school environment had been expanded to include evaluation of such factors as health proplanned health instruction program. Not only did the level of student health knowledge increase, but grams and personnel programs for school faculty improvements in health practices and in general members, the effect of the schedule of the school levels of health were observed among the students. day on the mental health of the child, and the emotional climate of the classroom: In 1971, A d c o ~ k ~ ~In addition to aiding the children, teachers, and localities involved in the studies; a mass of data produced a comprehensive, valid, and reliable evalconcerning health content and methodology was uation instrument which reflected the expanded congenerated which had the potential for national apcept of the school environment by giving attention plication. to the areas previously cited. Based on the demonstration studies and other Though contemporary efforts to evaluate the school environment have achieved a certain degree evaluative efforts of the early 19OOs, recent activities have been concerned with either ( 1) evaluating of sophistication, evaluators and health educators in general seem to remain somewhat undecided as the effectiveness of health instruction by assessing to the ultimate role of the school environment in the level of health education of public school sturelation to the total school health program. Though dents, or ( 2 ) developing instruments or criteria by the school environment is suggested as an excellent which the health instruction program may be eval-
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uated as one area of the total school health program. Perhaps no other evaluative effort in recent years had more influence on health instruction than did the School Health Education S t ~ d y ~ ~ c o n d u cdurted ing the early 1960s. This wide-ranging study involved a number of private, official, and voluntary organizations. Data were collected from students, teachers, and administrators from 38 states to evaluate the health practices of s t u d e n t s and t o determine the quality of health education programs in American schools. Though a wealth of useful information was collected from the School Health Education Study, a major contribution of the evaluation was to create a national awareness of school health education. Following the study, a number of state and local educational agencies initiated programs and legislation to provide health education in the schools. In addition to the School Health Education Study, other efforts to evaluate health instruction were conducted during the decade of the 1960s. In 1967, the Connecticut State Board of Education initiated a study to determine the health interests and concerns of students in grades K through 12. Released in 1969 under the title of Teach U s What We Want To the study quantified in detail those health areas which were of interest or concern to students of various ages. Due to its thoroughness and rele vancy, the study continues to influence curriculum planning in school health education. Besides conducting studies involving public school students, researchers engaged in the development of criteria which could be utilized to extensively evaluate the health instruction program as one area of the school health program. In the 1960s Wilson,’O Kilander,’6 (pp514-517) and Finnegan” prepared evaluation instruments of this nature which could be used in the evaluation of the health instruction program. The instruments included criteria for evaluating the personal and .professional qualifications of the school health educator, the school health curriculum, facilities for health instruction, methods of reporting pupil progress, and other areas. In 1971, Huntsinger4’ evaluated health instruction programs in Tennessee, and Carpenter4’ developed a detailed instrument for evaluating high school health instruction programs which included and expanded upon the areas previously mentioned. Clearly, evaluation of health instruction has included two distinct aspects. In one sense the evaluation of health instruction has involved the determination of the level of health education of the student. In another sense, evaluation has involved the assessment of the health instruction program as
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one area of the total school health program. Both approaches are acceptable and useful. In situations where evaluators are concerned with a complete evaluation of health instruction, both approaches can be employed by utilizing a general health instruction program evaluation instrument in combination with an acceptable health knowledge test, attitude scale, or practice inventory.
Total School Health Program Nowhere is the parallel between the development of the total school health program and the development of efforts to evaluate the program more apparent than in those activities designed to evaluate all areas of the school health program collectively. Generally, efforts to evaluate the total school health program have been undertaken either by individuals or by committees of specialists in health education. and Phelan45 produced As early as 1934, instruments and standards designed to evaluate the total program, and during the 1940s various educational agencies became involved in the evaluation process. In 1947, the Michigan Superintendent of Public Instruction prepared a check list to be utilized in the evaluation of secondary school health programs.46 Two years later, the Child Welfare Division of the New York City Board of Education reported the results of an Evaluative Study of Health Education in the Public Schools of the City of New York. The extensive evaluation involved the total school health program and included analysis of the health education curriculum, facilities for the health program, qualifications of health personnel, and other areas.4 Efforts to evaluate the total program displayed a marked increase during the 1950s. Both individuals and committees of health education specialists were active in either evaluating specific programs or in generating criteria-based instruments which could be utilized in evaluating specific programs. During this decade, Texas,’8 I l l i n ~ i s ?Arkansas?O ~ Ohio,” and California” were among those states that produced or revised evaluation instruments to be utilized in determining the status of the school health programs within the respective states. In addition to state agencies, local organizations such as the Tulare County (California) School Health Advisory Board5’ produced criteria to be utilized in evaluating specific programs. I n a detailed s t u d y entitled Evaluation of the Health Program in the Los Angeles City Schools ( 1954-19611, considerable attention was directed toward evaluating the areas of health services, the healthful environment, health instruction, and health
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coordination. Forty-one appraisal studies were conducted in the preceding four areas of the elementary, junior high, senior high, and junior college health programs in the h s Angeles area.” In 1955, efforts were undertaken to initiate what was to become the Brookline (Massachusetts) School Health Study. Originally, school ruld public health personnel were concerned with reorganization of the school health service program in the Brookline schools. At the recommendation of the Superintendent of Schools, the study was expanded to include the total school health program for the purpose of collecting information about all aspects of the school health During the 19608, health educators at various professional preparation institutions became involved in the construction of criteria-based instruments which could be universally applied in evaluating school health programs. In 1952, the State University of New York at Albany prepared an “Evaluation of School Health E d ~ c a t i o n . ”In~ ~1959, Oregon State University produced a “School Health Program Evaluation S ~ a l e ” ~the ~ i nform of a score card which assigned a total point value to each area of the program and specific point values to the individual items comprising the area. During this period, Rash5*produced a work entitled Tentative Standards for School Health Surveys which provided criteria for use in accomplishing a detailed evaluation of the total program. Following a series of subsequent revisions, the original work served as the basis for a 1973 instrument entitled School Health Program Evaluation 59 which includes program standards in score card form which can be used to evaluate the total school health program. The 1960s witnessed a continuation of the growth experienced in the preceding decade. Individual r e searchers, such as Bryan?’ Granell:’ and Gentry62 continued to produce evaluation instruments which could be used in a variety of situations, and state departments of education displayed a continuing interest in producing criteria-based materials for use in evaluating and improving the school health programs within the state. The California State Department of Education produced detailed instruments for use in evaluating elementary school health programsa and high school health programs.’” Both instruments employed a rating system which allowed the evaluator to indicate the degree to which the program conformed to the criteria which comprised the instrument. Based on the results of the evaluation, suggestions could be made for improving the program where deficiencies were noted. In addition to individual evaluators THE JOURNAL OF SCHOOL HEALTH
and state departments of education, professional organizations such as the Michigan School Health A s ~ o c i a t i o nand ~ ~ the Ohio Association for Health, Physical Education, and Recreation& produced instruments to be used in evaluating health programs within the state. Many of the evaluative efforts of the 1970s are a reflection of activities initiated in the preceding two decades. However, agencies such as the Illinois Superintendent of Public I n ~ t r u c t i o ncontinue ~~ to produce or revise evaluative criteria for state school health programs. In 1974, a comprehensive study entitled School Health Program which sought to synthesize and revalidate a maximum number of school health program evaluative criteria generated during the 20th century was completed. A total of 3,384 distinct guidelines was identified for use in establishing or improving school health programs. Progress toward the acceptance of the school health program as a distinct entity is reflected in the desire of contemporary accrediting associations, such as the National Study of School Evaluation,?’ to evaluate health education as a separate program. The 1950s and 1960s were so active in generating evaluative materials for the total school health program that the direction for the 1970s remains unclear. Perhaps the forthcoming period will serve as a time when health education practitioners can synthesize and utilize the work of the preceding two decades to improve existing programs.
Conclusion The increasing sophistication of school health program evaluation procedures tended to parallel or reflect the development and maturation of the total school health program. I t might be said that evaluation in all areas of the program increasingly reflected the concept of total health as opposed to the earlier concept of health as a physical entity. Beginning in 1950, specific attention was directed toward developing comprehensive evaluation procedures for virtually every aspect of the total school health program. Since 1950, program evaluation has become a refined procedure reflecting the emerging autonomy of the school health program as a distinct area. The collective evaluation of health education and physical education programs is illustrative of the change in emphasis occumng since 1960. In 1940, D e a r b ~ r produced n~~ a check list for evaluating secondary school health and physical education programs. During the 195Os, other evaluation ins t r u m e n t ~ , ~ including ~‘” the La P ~ r t e ~ ~ s ccards, ore were prepared which evaluated health education as 587
an aspect of the total physical education program. However, it is interesting to note since the 1950s efforts to jointly evaluate health education and physical education have not only subsided, but a situation now exists where a number of evaluation instruments evaluate physical education as a sub-
area under the area of the Healthful School Environment. Such a diametric change not only illustrates a changing emphasis in evaluation procedures, but it reflects a growing autonomy for the school health movement.
REFERENCES 1. Anderson CL: School Health Practice, ed 5. St. Louis, CV Mosby Co, 1972. 2. A Health Survey of 86 Cities, American Child Health Association, New York, 1935. 3.Nyswander DB: Solving School Health Problems. New York, The Commonwealth Fund, 1942. 4. Appraisal form for evaluating school health services, Michigan School Health Association. J Sch Health 18:l-12,1948. 5. Weatherbe HR: A Check List for School Health Services. Stanford University Press, 1952. 6.Proposed report on educational qualifications of school physicians, APHA Committee on Professional Education. A m J Public Health 43:75-82,1953. 7. Bland HB: A n Analysis of the Activities of Indiana School Nurses Employed by Boards of Education, dissertation. Indiana University, Bloomington, 1956. 8. Netcher JR: Recommended Activities of Public School Nurses Employed by Boards of Education in Indiana, dissertation. Indiana University, Bloomington, 1956. 9.Poe NA, Irwin LW: Functions of a school nurse. Res Q A m Assoc Health Phys Educ 30:452-464,1959. 10. Recommended policies and practices for school nursing, ASHA Committee on School Nurse Policies and Practices. J Sch Health 26:13-26,1956. 11. Watters R: A n Evaluation Instrument for the School Health Service Program, dissertation. Indiana University, Bloomington, 1960. 12. Trausneck WM: Development of an Instrument for the Self-Evahation of School Health Service Programs, dissertation. University of Virginia, Charlottesville, 1963. 13. Bonvechio LR: Recommended Responsibilities for School Physicians, dissertation. Indiana University, 1960. 14. Functions and Qualifications for School Nurses, American Nurses' Association, New York, 1960. 15. Florentine HG: Preparation and the Role of School Nurses in School Health Programs: Guidelines for the Use of Administrators, Educators, and Students. New York, National League for Nursing, 1962. 16. Kilander HF: School Health Education New York, Macmillan co, 1968. 17.Baker WR: The Status of School Health Service Progmms in the Public Senior High Schools o f Indiana, dissertation. Indiana University, Bloomington, 1972. 18. NCA Evaluation Guide for Secondary Schools, ed 2. North Central Association Commission on Secondary Schools. Chicago, 1970. 19. Elementary School Evaluative Criteria. National Study of School Evaluation, Arlington, Virginia, 1973. 20. Junior High School/Middle School Evaluative Criteria National Study of School Evaluation, Washington, DC, 1970. 21.Evaluative Criteria for the Evaluation of Secondary Schools, ed 4. National Study of Secondary School Evaluation, Washing ton DC, 1969.
22. Strayer GD, Engelhardt NL: Score card for village and rural school buildings of four teachers or less. Columbia University Teachers' College Bulletin, January 3, 1920. 23. Engelhardt NL: School Building Program in American Cities. New York, Bureau of Publications, Columbia University Teachers' College, 1928. 24. Strayer GD, Engelhardt NL: Score Card for City School Buildings. New York, Bureau of Publications, Columbia University Teachers' College. 1920. 25. Strayer GD, Engelhardt NL: Standards for Elementary School Buildings. New York, Bureau of Publications, Columbia University Teachers' College, 1923. 26. Strayer GD, Engelhardt NL: Standards fo: High School Buildings. New York, Bureau of Publications, Columbia University Teachers' College, 1924. 27. Engelhardt NL, Engelhardt F: Plonning School Building Programs. New York, Bureau of Publications, Columbia University Teachers' College, 1930. 28. Strayer GD, Engelhardt NL: A Checking List for Administrative Policies and Programs Concerned with School Housing. New York, Bureau of Publications, Columbia University Teachers' College, 1926. 29. Holy TC, Arnold WE: Score Card for the Evaluation of Elementary School Buildings, Bureau of Educational Research, The Ohio State University, Columbus, 1936. 30. Holy TC, Amold WE: Score Card for the Evaluation of Junior and Senior High-School Buildings. Bureau of Educational Research, The Ohio State University, Columbus, 1936. 31. Check List for Healthful and Safe School Environment, Subcommittee on School Environment, California State Joint Committee on School Health, State Department of Education, Sacramento, 1949. 32. Criteria for School Rating System, Indiana University Department of Health and Safety, Bloomington, 1954. 33. Checklist on Safety and Safety Education in Your School, National Commission on Safety Education, National Education Association, Washington, DC, 1953. 34. Simon CH: A Survey Instrument for the Evaluation of the Economic-Efficiency of School Food Services, dissertation. Indiana University, Bloomington, 1963. 35. Byrd OE: School Health Administration. Philadelphia, WB Saunders Co, 1964, pp 399-401. 36. Adcock AG: A n Instrument for the Evaluation of the Healthful School Environment in Elementary Schools, dissertation. Indiana University, Bloomington, 1971. 37. Means RK: A History of Health Education in the United States. Philadelphia, Lea & Febiger, 1962, p 33. 38. Sliepcevich EM: School Health Education Study: A Summ r y Report. School Health Education Study, Washington, DC, 1964. 39. Byler RV: Teach Us What We Want To Know. New York, Mental Health Materials Center Inc, 1969. 40. Wilson HB: A n Instrument for Evaluating Health In-
struction in Secondary Schools, Grades 9-12, dissertation. Indiana University, Bloomington, 1961. 41. Finnegan HO: The Development and Field Testing of a Manual for Evaluating a Senior High School’s Health Instruction Program, dissertation. Washington State University, Pullman, 1966. 42. Huntsinger PG: The Status of Health Instruction in the Public Schools of Tennessee, dissertation. University of Tennessee, Knoxville, 1971. 43. Carpenter GA: A Score Card for Evaluation of Health Instruction Progmms in High Schools, dissertation. University of Utah, Salt Lake City, 1971. 44. Grout RE: Handbook on Health Education Garden City, New York, Doubleday Doran & Co Inc. 1934. 45. Phelan AM: A Study of School Health Standards. Menasha, Wisconsin, George Banta Pub Co, 1934. 46.Health Education in Secondary Schools, bulletin 345. Superintendent of Public Instruction, Lansing, Michigan, 1947. 47. Evaluative Study of Health Education in Public Schools of the City of New York, Division of Child Welfare, Board of Education, New York, 1949. 48. A Checklist: Appraising the Elementary and Secondary School Health Progmm, bulletin 519. Texas Education Agency, Austin, 1951. 49. Illinois Secondary School Curriculum Progmm Consensus Study Number 4, inventories A and B. Superintendent of Public Instruction, Springfield, 1951. M). Checklist on Health Education, form J . Department of Education, Little Rock, Arkansas, 1952. 51. Ohio’s Check List for Evaluating the School Health Program, Ohio Department of Health. Ohio’s Health 4:l-12,1952. 52. How’s Your School Health Program?, bulletin 58. State D e partment of Education, Sacramento, California, 1967. 53. School Health Progmm Essentials: Administrators Check List, Tulare County School Health Advisory Board, Visalia, California, 1957. 64. Evaluation of the Health Pmgmm in the Los Angeles City Schools 1964-1961, publication 673. Los Angeles City Schools, 1962. 65. Young MAC: The Brookline school health study. J Sch Health 31:47-55.1961. 56. Evaluation of School Health Education, State University of New York, Albany, 1962. 57. School Health Program Evaluation Scale, Oregon State University, Corvallis, 1969.
58. Rash JK: Tentative Standards for School Health Surveys. Indiana University, Bloomington, 1959. 69.Rssh JK: School Health Pmgmm Evaluation Indiana University, Bloomington, 1973. 60.Bryan CH: Guide for Evduation of a Public School Health Program, dissertation. University of Pittsburgh, Pittsburgh, 1964. 61. Granell V: A Survey Study of the Health Services, Healthful Environment, Health Education, and Health Coordination of the Florida Elementary and Secondary Schools Health Programs, dissertation. West Virginia University. Morgantown, 1966. 62. Gentry RL: The Development of an Instrument to Evaluate Health Education Programs in the Secondary Schools of Kentucky, dissertation. University of Kentucky, Lexington, 1968. 63. Criteria for Evaluating the Elementary School Health Prog m , State Department of Education, Sacramento, California, 1962. 61. Criteria for Evaluating the High School Health Progmm, State Department of Education, Sacramento. California, 1962. 65.A n Appmisal Form for Studying School Health Programs, Michigan School Health Association, 1962. 66. Evaluative Criteria for Health Education, Ohio Association for Health, Physical Education, and Recreation, 1966. 67. Guidelines for Evaluating Progmms in Health Education, Superintendent of Public Instruction, Springfield. Illinois. 1971. 68. Pigg RM: School Health Progmm Quidelines, dissertation. Indiana University, Bloomington. 1974. 69. Dearborn TH: A Check List for the Survey of Health and Physical Education Programs in Secondary Schools. Stanford University Press, 1940. 70. Criteria for Evaluating Junior High Schools: Health, Physical and Safety Education, Texas Junior High School Criteria Studv. 1956. 71. Nirril HR: A Score Card for Evaluating Canadian High School Health and Physical Education Progmms, dissertation. Indiana University, Bloomington, 1959. 72. LaPorte WR: Health and Physical Education Score Card Los Angeles. Parker & Co. 1961.
The author of this article is R. Morgan Pigg, Jr, HSD, Assistant Professor, Department of Health and Safety, The University of Georgia, Athens, G A 30602.
Call for Resolutions Annually the American School Health Association addresses itself to significant problems in the field of child health and school health education. The full span of the discussion on many of these problems is made known through a series of Resolutions passed by the Governing Council. The membership is invited to suggest problems which might serve as the basis for action of this sort. Such suggestions should be transmitted to the Chairman of the Resolutions Committee, American School Health Association, Kent, OH 44240. THE JOURNAL OF SCHOOL HEALTH
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During the 19th century, no organized school health education program existed in American schools, but the foundations upon which the areas of health services, healthful living, and health instruction were to be laid were clearly present. Since no organized school health program existed, formal procedures to evaluate such programs received minimum attention prior to 1900. The advent of the 20th century brought changes which were to provide the impetus for the development of a distinct school health program and for procedures intended to assess the efficiency of such programs. Anderson’ (p8) suggests health education and physical education were considered synonymous until 1910 when the American Physical Education Association recognized a distinction between the two fields by utilizing “School Hygiene and Physical Education” as the theme for the 17th annual meeting. As the school health program developed, efforts to formally assess the effectiveness of various aspects of the program through evaluation became increasingly prevalent.
School Health Services In 1923, the American Child Health Association initiated a survey to determine what organized activities were being conducted by public and private agencies to improve the health of the school child. The results of the survey were published in 1925 as A Health Survey of 86 Cities2 The survey was significant in that the researchers realized a knowledge of child health practices as such was of limited value. As a result, a second study involving 70 cities was initiated in 1925 to provide data for use by administrators in t h e evaluation of local school health activities. The results of the second study were published as five School Health Research Monographs from 1929 to 1932: (pviii) THE JOURNAL OF SCHOOL HEALTH
One of the earliest intensive evaluations of a local school health services program was the Astoria Demonstration Study which was conducted from July, 1936 to June, 1940 under the direction of Dr. Dorothy B. Nyswander. Based on the findings of the previous American Child Health Association studies, the study was conducted to determine the effectiveness of the school health service program of the Astoria Health District of New York City. In essence, the study accomplished its main goal, providing better health services for the school child.3 By the late 1940s, efforts to evaluate the effectiveness of school health programs had been refined, and various organizations and agencies were actively involved in establishing evaluative criteria for school health service programs. I n 1947 t h e Michigan School Health Association in cooperation with the American School Health Association prepared a checklist to be used by school administrators and health officials in the evaluation of school health service programs. The checklist gave attention to the administrative aspects of school health services and included a section on school sanitation which health educators would eventually place under the area of the Healthful School Environment.’ The decade of the 1950s continued to reflect an increased sophistication in evaluation of school health services. A number of studies were conducted to evaluate the role of school health services and health service personnel. In 1952, Weatherbe’ produced a Check List for School Health Services, and in 1953, the American Public Health Association Committee on Professional Education released “A Proposed Report on the Educational Qualifications of School Physicians.”6 Shortly thereafter, Bland’ and Netche? focused attention on the evaluation of the school nurse in studies involving school nurses in Indiana. Poe and Irwin9 continued the emphasis on the school nurse by publishing an article in 1959 which delineated the functions of a school nurse. Of particular importance a t this time was the work of the Committee on School Nurse Policies and Practices of the American School Health Association. 583
Begun in 1952 under the direction of Miss Eunice Lamona and continued under the direction of Miss Lyda Smiley, the Committee published in 1956 a paper entitled “Recommended Policies and Practices for School Nursing”lo which has served as the basis for a number of revisions. In keeping with the mood and momentum of the preceding decade, the 1960s reflected a growing movement toward an expanded and defined school health service program. Studies by Watters” and Trausneck’l reflected the direction of the 1960s in that the studies produced extensive, definitive standards in the form of evaluation instruments to be used in assessing school health services. Studies conducted in the early 1960s by Bonvechi^,'^ the American Nurses’ Association,” and the National League for Nursing” expanded efforts begun in the 1950s to more clearly define and evaluate the role of the school nurse and the school physician in the school health service program. In addition, specialized evaluative criteria such as Kilander’s “Checklist for the Emergency Care Program in were continually being deSchools”’6 (pp510-513) veloped to accommodate the expanded scope of school health services. The decade of the 1970s appears to be developing as a period of consolidation and synthesis in the evaluation of school health services. Research activities, such as the study conducted by Baker,17 seem to be concentrating on the implementation of evaluative procedure developed during the 1960s. A review of existing information suggests evaluative research in school health services has tended to vacillate between generation and synthesis of data. For this reason, it seems reasonable to anticipate new evaluative research in school health services will be forthcoming during the 1970s.I t is encouraging to note certain accrediting organizations now routinely include evaluation of school health services within the accreditation process. The Commission on Secondary Schools of the North Central Associa tion’* has evaluative criteria for health services in the secondary school, while the National Study of School Evaluation has produced evaluative criteria for health services at the elementary,’9 junior high/ middle school,?0and secondary school2’levels. Such actions are merely another indication of the acceptance of the importance of school health services.
The Healthful School Environment There is no lack of quantitative, evaluative data relating to the school environment. In fact, the volume of material from the late 1800s and early 1900s 584
relating to the school environment makes it impractical to attempt a detailed report on the period. When one reviews the material from the preceding ?nod collectively, it becomes apparent evaluators of the period were primarily concerned with a quantitative assessment of the physical characteristics of the school environment. Numerous score cards, check lists, and reports were produced which dealt with such matters as heating, ventilation, seating, fire safety, water supply, plumbing facilities, lighting, building structure, and the school site. Any report of efforts to evaluate the school environment would be incomplete without some mention of the work of N.L. Engelhardt and G.D. Strayer of Columbia University Teachers College. During the early 19009, both individually and as a team, Engelhardt and Strayer were amazingly prolific in the quantity of evaluative standards they produced concerning various aspects of the school plant. Standards were established for rural school buildings,22city school b~ildings?~n~‘ elementary school building^?^ and high school buildings?6 In addition, evaluative materials were prepared concerning the planning of school building programs27and administrative policies and programs concerning the school plant.2* Utilizing the preceding materials, Engelhardt and Strayer evaluated scores of school plants in cities throughout the country. During the 1930s and early 1940s, evaluation of the school environment continued to be quantitative in nature. Researchers such as Holy and Arnold29’30continued to produce materials to be used in the quantitative evaluation of school facilities. By the late 1940s the school health program was emerging as a separate field, and health educators began to review the relationship between the school environment and the concept of a total school health program. In 1949,the Subcommittee on School Environment of the California State Joint Committee on School Health produced an extensive “Checklist for Healthful and Safe School E n ~ i r o n m e n t ” ~ ’ which reflected the emerging concept of the school environment as a specialized area with unique potential for contributing to the total health of the school child. The movement toward a philosophical revision of the role of the school environment in the total school health program continued to gain momentum during the 19509,and professional preparation institutions became involved in determining standards to be used in evaluating the school environment. During this period, the role of safety and safety education in relation to the total school health program received particular attention. In 1953,the National DECEMBER 1976 VOLUME XLVl NO. 10
source for reinforcement of the principles presentCommission on Safety Education of the National ed in health instruction classes, a universal model Education Association prepared a comprehensive for such a procedure has not been forthcoming. 325 item checklist to be used in evaluating the status Since the educational aspects of the school enof school safety and safety e d ~ c a t i o n .Shortly ~~ vironment have not been fully utilized, evaluators thereafter, Anderson (pp445-447)produced a “Surhave not incorporated the assessment of the efvey of Healthful School Living” which included a fectiveness of such efforts into the evaluation of categorized listing of over 100 questions dealing the school environment. With the proliferation of specifically with the school environment. research activities in school health education, the By the early 1960s, the philosophical foundation prospect for future evaluative research in the preunderlying the role of the school environment in receding area seems encouraging. lation to the total health education of the child had assumed a certain degree of substance. In addition Health Instruction to dealing with environmental and structural factors, evaluators began to direct attention toward Since 1843 when Horace Mann advocated physthe specialized aspects of the school environment. iology and hygiene be included in the c u r r i c ~ l u m ~ ~ The evaluation of safety and safety education prohealth educators have attempted to assess the regrams, present in the preceding decade, was encoursults of health instruction through the use of health aged by the development of additional evaluation knowledge tests. However, due to the relatively reinstruments.’6 (pp222-223) cent development of the concept of health instrucIn addition to programs in safety and safety edution as a multifaceted aspect of the total school cation, evaluators were involved in determining health program, efforts to evaluate health instrucstandards for the school food service program. In tion as an area have been modified in comparison 1963, Simon3‘ produced a comprehensive 21 page to earlier efforts. evaluation instrument to be used in determining Though the idea of a school health program was the efficiency of school food service programs. In merely in the developmental stage in the early 19OOs, School Health Administration published in 1964, health educators of the period believed school chilDr. Oliver B ~ r d ~ ~ i n c l u da echapter d on school lunchdren could benefit from a planned program of health instruction. As a result, a number of demonstration room sanitation. Within the chapter was included studies were conducted to evaluate the impact of “An Administrative Check List for Evaluation of School Lunchroom Sanitation” composed of 50 quesquality health instruction on school children. Demontions to be answered by the evaluator. stration studies were conducted in Baltimore, Maryland in 1914; in Malden, Massachusetts in 1922; in By the early 1970s, evaluation of the school environment had undergone considerable revisions Mansfield and Richland counties of Ohio from 19221925; in Fargo, North Dakota from 1923-1927;’ from the procedures employed during t h e early (pp8-10)and in other localities around the country. 1900s. Though consideration continued to be given The results of the demonstration studies supto evaluating the environmental and structural ported the contention that the level of health knowlaspects of the school plant, the concept of the healthedge of school children could be improved through a ful and safe school environment had been expanded to include evaluation of such factors as health proplanned health instruction program. Not only did the level of student health knowledge increase, but grams and personnel programs for school faculty improvements in health practices and in general members, the effect of the schedule of the school levels of health were observed among the students. day on the mental health of the child, and the emotional climate of the classroom: In 1971, A d c o ~ k ~ ~In addition to aiding the children, teachers, and localities involved in the studies; a mass of data produced a comprehensive, valid, and reliable evalconcerning health content and methodology was uation instrument which reflected the expanded congenerated which had the potential for national apcept of the school environment by giving attention plication. to the areas previously cited. Based on the demonstration studies and other Though contemporary efforts to evaluate the school environment have achieved a certain degree evaluative efforts of the early 19OOs, recent activities have been concerned with either ( 1) evaluating of sophistication, evaluators and health educators in general seem to remain somewhat undecided as the effectiveness of health instruction by assessing to the ultimate role of the school environment in the level of health education of public school sturelation to the total school health program. Though dents, or ( 2 ) developing instruments or criteria by the school environment is suggested as an excellent which the health instruction program may be eval-
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uated as one area of the total school health program. Perhaps no other evaluative effort in recent years had more influence on health instruction than did the School Health Education S t ~ d y ~ ~ c o n d u cdurted ing the early 1960s. This wide-ranging study involved a number of private, official, and voluntary organizations. Data were collected from students, teachers, and administrators from 38 states to evaluate the health practices of s t u d e n t s and t o determine the quality of health education programs in American schools. Though a wealth of useful information was collected from the School Health Education Study, a major contribution of the evaluation was to create a national awareness of school health education. Following the study, a number of state and local educational agencies initiated programs and legislation to provide health education in the schools. In addition to the School Health Education Study, other efforts to evaluate health instruction were conducted during the decade of the 1960s. In 1967, the Connecticut State Board of Education initiated a study to determine the health interests and concerns of students in grades K through 12. Released in 1969 under the title of Teach U s What We Want To the study quantified in detail those health areas which were of interest or concern to students of various ages. Due to its thoroughness and rele vancy, the study continues to influence curriculum planning in school health education. Besides conducting studies involving public school students, researchers engaged in the development of criteria which could be utilized to extensively evaluate the health instruction program as one area of the school health program. In the 1960s Wilson,’O Kilander,’6 (pp514-517) and Finnegan” prepared evaluation instruments of this nature which could be used in the evaluation of the health instruction program. The instruments included criteria for evaluating the personal and .professional qualifications of the school health educator, the school health curriculum, facilities for health instruction, methods of reporting pupil progress, and other areas. In 1971, Huntsinger4’ evaluated health instruction programs in Tennessee, and Carpenter4’ developed a detailed instrument for evaluating high school health instruction programs which included and expanded upon the areas previously mentioned. Clearly, evaluation of health instruction has included two distinct aspects. In one sense the evaluation of health instruction has involved the determination of the level of health education of the student. In another sense, evaluation has involved the assessment of the health instruction program as
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one area of the total school health program. Both approaches are acceptable and useful. In situations where evaluators are concerned with a complete evaluation of health instruction, both approaches can be employed by utilizing a general health instruction program evaluation instrument in combination with an acceptable health knowledge test, attitude scale, or practice inventory.
Total School Health Program Nowhere is the parallel between the development of the total school health program and the development of efforts to evaluate the program more apparent than in those activities designed to evaluate all areas of the school health program collectively. Generally, efforts to evaluate the total school health program have been undertaken either by individuals or by committees of specialists in health education. and Phelan45 produced As early as 1934, instruments and standards designed to evaluate the total program, and during the 1940s various educational agencies became involved in the evaluation process. In 1947, the Michigan Superintendent of Public Instruction prepared a check list to be utilized in the evaluation of secondary school health programs.46 Two years later, the Child Welfare Division of the New York City Board of Education reported the results of an Evaluative Study of Health Education in the Public Schools of the City of New York. The extensive evaluation involved the total school health program and included analysis of the health education curriculum, facilities for the health program, qualifications of health personnel, and other areas.4 Efforts to evaluate the total program displayed a marked increase during the 1950s. Both individuals and committees of health education specialists were active in either evaluating specific programs or in generating criteria-based instruments which could be utilized in evaluating specific programs. During this decade, Texas,’8 I l l i n ~ i s ?Arkansas?O ~ Ohio,” and California” were among those states that produced or revised evaluation instruments to be utilized in determining the status of the school health programs within the respective states. In addition to state agencies, local organizations such as the Tulare County (California) School Health Advisory Board5’ produced criteria to be utilized in evaluating specific programs. I n a detailed s t u d y entitled Evaluation of the Health Program in the Los Angeles City Schools ( 1954-19611, considerable attention was directed toward evaluating the areas of health services, the healthful environment, health instruction, and health
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coordination. Forty-one appraisal studies were conducted in the preceding four areas of the elementary, junior high, senior high, and junior college health programs in the h s Angeles area.” In 1955, efforts were undertaken to initiate what was to become the Brookline (Massachusetts) School Health Study. Originally, school ruld public health personnel were concerned with reorganization of the school health service program in the Brookline schools. At the recommendation of the Superintendent of Schools, the study was expanded to include the total school health program for the purpose of collecting information about all aspects of the school health During the 19608, health educators at various professional preparation institutions became involved in the construction of criteria-based instruments which could be universally applied in evaluating school health programs. In 1952, the State University of New York at Albany prepared an “Evaluation of School Health E d ~ c a t i o n . ”In~ ~1959, Oregon State University produced a “School Health Program Evaluation S ~ a l e ” ~the ~ i nform of a score card which assigned a total point value to each area of the program and specific point values to the individual items comprising the area. During this period, Rash5*produced a work entitled Tentative Standards for School Health Surveys which provided criteria for use in accomplishing a detailed evaluation of the total program. Following a series of subsequent revisions, the original work served as the basis for a 1973 instrument entitled School Health Program Evaluation 59 which includes program standards in score card form which can be used to evaluate the total school health program. The 1960s witnessed a continuation of the growth experienced in the preceding decade. Individual r e searchers, such as Bryan?’ Granell:’ and Gentry62 continued to produce evaluation instruments which could be used in a variety of situations, and state departments of education displayed a continuing interest in producing criteria-based materials for use in evaluating and improving the school health programs within the state. The California State Department of Education produced detailed instruments for use in evaluating elementary school health programsa and high school health programs.’” Both instruments employed a rating system which allowed the evaluator to indicate the degree to which the program conformed to the criteria which comprised the instrument. Based on the results of the evaluation, suggestions could be made for improving the program where deficiencies were noted. In addition to individual evaluators THE JOURNAL OF SCHOOL HEALTH
and state departments of education, professional organizations such as the Michigan School Health A s ~ o c i a t i o nand ~ ~ the Ohio Association for Health, Physical Education, and Recreation& produced instruments to be used in evaluating health programs within the state. Many of the evaluative efforts of the 1970s are a reflection of activities initiated in the preceding two decades. However, agencies such as the Illinois Superintendent of Public I n ~ t r u c t i o ncontinue ~~ to produce or revise evaluative criteria for state school health programs. In 1974, a comprehensive study entitled School Health Program which sought to synthesize and revalidate a maximum number of school health program evaluative criteria generated during the 20th century was completed. A total of 3,384 distinct guidelines was identified for use in establishing or improving school health programs. Progress toward the acceptance of the school health program as a distinct entity is reflected in the desire of contemporary accrediting associations, such as the National Study of School Evaluation,?’ to evaluate health education as a separate program. The 1950s and 1960s were so active in generating evaluative materials for the total school health program that the direction for the 1970s remains unclear. Perhaps the forthcoming period will serve as a time when health education practitioners can synthesize and utilize the work of the preceding two decades to improve existing programs.
Conclusion The increasing sophistication of school health program evaluation procedures tended to parallel or reflect the development and maturation of the total school health program. I t might be said that evaluation in all areas of the program increasingly reflected the concept of total health as opposed to the earlier concept of health as a physical entity. Beginning in 1950, specific attention was directed toward developing comprehensive evaluation procedures for virtually every aspect of the total school health program. Since 1950, program evaluation has become a refined procedure reflecting the emerging autonomy of the school health program as a distinct area. The collective evaluation of health education and physical education programs is illustrative of the change in emphasis occumng since 1960. In 1940, D e a r b ~ r produced n~~ a check list for evaluating secondary school health and physical education programs. During the 195Os, other evaluation ins t r u m e n t ~ , ~ including ~‘” the La P ~ r t e ~ ~ s ccards, ore were prepared which evaluated health education as 587
an aspect of the total physical education program. However, it is interesting to note since the 1950s efforts to jointly evaluate health education and physical education have not only subsided, but a situation now exists where a number of evaluation instruments evaluate physical education as a sub-
area under the area of the Healthful School Environment. Such a diametric change not only illustrates a changing emphasis in evaluation procedures, but it reflects a growing autonomy for the school health movement.
REFERENCES 1. Anderson CL: School Health Practice, ed 5. St. Louis, CV Mosby Co, 1972. 2. A Health Survey of 86 Cities, American Child Health Association, New York, 1935. 3.Nyswander DB: Solving School Health Problems. New York, The Commonwealth Fund, 1942. 4. Appraisal form for evaluating school health services, Michigan School Health Association. J Sch Health 18:l-12,1948. 5. Weatherbe HR: A Check List for School Health Services. Stanford University Press, 1952. 6.Proposed report on educational qualifications of school physicians, APHA Committee on Professional Education. A m J Public Health 43:75-82,1953. 7. Bland HB: A n Analysis of the Activities of Indiana School Nurses Employed by Boards of Education, dissertation. Indiana University, Bloomington, 1956. 8. Netcher JR: Recommended Activities of Public School Nurses Employed by Boards of Education in Indiana, dissertation. Indiana University, Bloomington, 1956. 9.Poe NA, Irwin LW: Functions of a school nurse. Res Q A m Assoc Health Phys Educ 30:452-464,1959. 10. Recommended policies and practices for school nursing, ASHA Committee on School Nurse Policies and Practices. J Sch Health 26:13-26,1956. 11. Watters R: A n Evaluation Instrument for the School Health Service Program, dissertation. Indiana University, Bloomington, 1960. 12. Trausneck WM: Development of an Instrument for the Self-Evahation of School Health Service Programs, dissertation. University of Virginia, Charlottesville, 1963. 13. Bonvechio LR: Recommended Responsibilities for School Physicians, dissertation. Indiana University, 1960. 14. Functions and Qualifications for School Nurses, American Nurses' Association, New York, 1960. 15. Florentine HG: Preparation and the Role of School Nurses in School Health Programs: Guidelines for the Use of Administrators, Educators, and Students. New York, National League for Nursing, 1962. 16. Kilander HF: School Health Education New York, Macmillan co, 1968. 17.Baker WR: The Status of School Health Service Progmms in the Public Senior High Schools o f Indiana, dissertation. Indiana University, Bloomington, 1972. 18. NCA Evaluation Guide for Secondary Schools, ed 2. North Central Association Commission on Secondary Schools. Chicago, 1970. 19. Elementary School Evaluative Criteria. National Study of School Evaluation, Arlington, Virginia, 1973. 20. Junior High School/Middle School Evaluative Criteria National Study of School Evaluation, Washington, DC, 1970. 21.Evaluative Criteria for the Evaluation of Secondary Schools, ed 4. National Study of Secondary School Evaluation, Washing ton DC, 1969.
22. Strayer GD, Engelhardt NL: Score card for village and rural school buildings of four teachers or less. Columbia University Teachers' College Bulletin, January 3, 1920. 23. Engelhardt NL: School Building Program in American Cities. New York, Bureau of Publications, Columbia University Teachers' College, 1928. 24. Strayer GD, Engelhardt NL: Score Card for City School Buildings. New York, Bureau of Publications, Columbia University Teachers' College. 1920. 25. Strayer GD, Engelhardt NL: Standards for Elementary School Buildings. New York, Bureau of Publications, Columbia University Teachers' College, 1923. 26. Strayer GD, Engelhardt NL: Standards fo: High School Buildings. New York, Bureau of Publications, Columbia University Teachers' College, 1924. 27. Engelhardt NL, Engelhardt F: Plonning School Building Programs. New York, Bureau of Publications, Columbia University Teachers' College, 1930. 28. Strayer GD, Engelhardt NL: A Checking List for Administrative Policies and Programs Concerned with School Housing. New York, Bureau of Publications, Columbia University Teachers' College, 1926. 29. Holy TC, Arnold WE: Score Card for the Evaluation of Elementary School Buildings, Bureau of Educational Research, The Ohio State University, Columbus, 1936. 30. Holy TC, Amold WE: Score Card for the Evaluation of Junior and Senior High-School Buildings. Bureau of Educational Research, The Ohio State University, Columbus, 1936. 31. Check List for Healthful and Safe School Environment, Subcommittee on School Environment, California State Joint Committee on School Health, State Department of Education, Sacramento, 1949. 32. Criteria for School Rating System, Indiana University Department of Health and Safety, Bloomington, 1954. 33. Checklist on Safety and Safety Education in Your School, National Commission on Safety Education, National Education Association, Washington, DC, 1953. 34. Simon CH: A Survey Instrument for the Evaluation of the Economic-Efficiency of School Food Services, dissertation. Indiana University, Bloomington, 1963. 35. Byrd OE: School Health Administration. Philadelphia, WB Saunders Co, 1964, pp 399-401. 36. Adcock AG: A n Instrument for the Evaluation of the Healthful School Environment in Elementary Schools, dissertation. Indiana University, Bloomington, 1971. 37. Means RK: A History of Health Education in the United States. Philadelphia, Lea & Febiger, 1962, p 33. 38. Sliepcevich EM: School Health Education Study: A Summ r y Report. School Health Education Study, Washington, DC, 1964. 39. Byler RV: Teach Us What We Want To Know. New York, Mental Health Materials Center Inc, 1969. 40. Wilson HB: A n Instrument for Evaluating Health In-
struction in Secondary Schools, Grades 9-12, dissertation. Indiana University, Bloomington, 1961. 41. Finnegan HO: The Development and Field Testing of a Manual for Evaluating a Senior High School’s Health Instruction Program, dissertation. Washington State University, Pullman, 1966. 42. Huntsinger PG: The Status of Health Instruction in the Public Schools of Tennessee, dissertation. University of Tennessee, Knoxville, 1971. 43. Carpenter GA: A Score Card for Evaluation of Health Instruction Progmms in High Schools, dissertation. University of Utah, Salt Lake City, 1971. 44. Grout RE: Handbook on Health Education Garden City, New York, Doubleday Doran & Co Inc. 1934. 45. Phelan AM: A Study of School Health Standards. Menasha, Wisconsin, George Banta Pub Co, 1934. 46.Health Education in Secondary Schools, bulletin 345. Superintendent of Public Instruction, Lansing, Michigan, 1947. 47. Evaluative Study of Health Education in Public Schools of the City of New York, Division of Child Welfare, Board of Education, New York, 1949. 48. A Checklist: Appraising the Elementary and Secondary School Health Progmm, bulletin 519. Texas Education Agency, Austin, 1951. 49. Illinois Secondary School Curriculum Progmm Consensus Study Number 4, inventories A and B. Superintendent of Public Instruction, Springfield, 1951. M). Checklist on Health Education, form J . Department of Education, Little Rock, Arkansas, 1952. 51. Ohio’s Check List for Evaluating the School Health Program, Ohio Department of Health. Ohio’s Health 4:l-12,1952. 52. How’s Your School Health Program?, bulletin 58. State D e partment of Education, Sacramento, California, 1967. 53. School Health Progmm Essentials: Administrators Check List, Tulare County School Health Advisory Board, Visalia, California, 1957. 64. Evaluation of the Health Pmgmm in the Los Angeles City Schools 1964-1961, publication 673. Los Angeles City Schools, 1962. 65. Young MAC: The Brookline school health study. J Sch Health 31:47-55.1961. 56. Evaluation of School Health Education, State University of New York, Albany, 1962. 57. School Health Program Evaluation Scale, Oregon State University, Corvallis, 1969.
58. Rash JK: Tentative Standards for School Health Surveys. Indiana University, Bloomington, 1959. 69.Rssh JK: School Health Pmgmm Evaluation Indiana University, Bloomington, 1973. 60.Bryan CH: Guide for Evduation of a Public School Health Program, dissertation. University of Pittsburgh, Pittsburgh, 1964. 61. Granell V: A Survey Study of the Health Services, Healthful Environment, Health Education, and Health Coordination of the Florida Elementary and Secondary Schools Health Programs, dissertation. West Virginia University. Morgantown, 1966. 62. Gentry RL: The Development of an Instrument to Evaluate Health Education Programs in the Secondary Schools of Kentucky, dissertation. University of Kentucky, Lexington, 1968. 63. Criteria for Evaluating the Elementary School Health Prog m , State Department of Education, Sacramento, California, 1962. 61. Criteria for Evaluating the High School Health Progmm, State Department of Education, Sacramento. California, 1962. 65.A n Appmisal Form for Studying School Health Programs, Michigan School Health Association, 1962. 66. Evaluative Criteria for Health Education, Ohio Association for Health, Physical Education, and Recreation, 1966. 67. Guidelines for Evaluating Progmms in Health Education, Superintendent of Public Instruction, Springfield. Illinois. 1971. 68. Pigg RM: School Health Progmm Quidelines, dissertation. Indiana University, Bloomington. 1974. 69. Dearborn TH: A Check List for the Survey of Health and Physical Education Programs in Secondary Schools. Stanford University Press, 1940. 70. Criteria for Evaluating Junior High Schools: Health, Physical and Safety Education, Texas Junior High School Criteria Studv. 1956. 71. Nirril HR: A Score Card for Evaluating Canadian High School Health and Physical Education Progmms, dissertation. Indiana University, Bloomington, 1959. 72. LaPorte WR: Health and Physical Education Score Card Los Angeles. Parker & Co. 1961.
The author of this article is R. Morgan Pigg, Jr, HSD, Assistant Professor, Department of Health and Safety, The University of Georgia, Athens, G A 30602.
Call for Resolutions Annually the American School Health Association addresses itself to significant problems in the field of child health and school health education. The full span of the discussion on many of these problems is made known through a series of Resolutions passed by the Governing Council. The membership is invited to suggest problems which might serve as the basis for action of this sort. Such suggestions should be transmitted to the Chairman of the Resolutions Committee, American School Health Association, Kent, OH 44240. THE JOURNAL OF SCHOOL HEALTH
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