Enhancing prevention programs' credibility through the use of a logic model.

Enhancing prevention programs' credibility through the use of a logic model. Dear Editor: As park, recreation and sport management professionals becomeincreasingly involved in youth development, they find themselvesoperating in a world requiring diverse and complementary programjustification. There is an interest to move beyond the provision offacilities and equipment for traditional sports activities to thedevelopment of programs that target specific outcomes that benefit youth(Ellis, Braff, & Hutchinson, 2001). Program justification has becomeessential for credibility. Credibility depends on a sound programmingprocess that clearly establishes a link between theory, the programmodel and subsequent behavioral changes in participating youth (McKenzie& Smeltzer, 1997). This pendulum shift has presented severalchallenges to park, recreation and sport management professionals. While park, recreation and sport professionals are quick to tout ToutTo promote a security in order to attract buyers.toutTo foster interest in a particular company or security. For example, a broker might tout a security to a client in the hope that the client will purchase the security. the positive impact of their programs for at-risk youth in terms ofincreased self-esteem, improved school achievement, and bettercommunication skills; however, the actual relationship betweenrecreation and beneficial outcomes has not been adequately explained(Baker & Witt, 2000). Baldwin (2000) stated there has been littlediscussion of the theoretical foundation of park and recreationprogramming for at-risk youth, despite the need for scientific rigor rigor/rig��or/ (rig��er) [L.] chill; rigidity.rigor mor��tis? the stiffening of a dead body accompanying depletion of adenosine triphosphate in the muscle fibers. toestablish the leisure services and sport field's credibility ofthese programs. Secondly, most professionals have not been trained in scientificevaluation or have not used their skills in years, consequently have notembraced evaluation as a programming process. These issues are furthercomplicated because the evaluation process in park, recreation and sportoften lacks specificity in the selection of possible program outcomesdespite recent improvements in program planning. Many programs aredominated by short-term, unstructured activities, such as recreationalbasketball, that do not focus on behavioral changes. Kleiber (1999)stated that these traditional activities do not provide the"challenge" necessary to promote development in participants. Recent research reveals that park and recreation practitioners areexpressing a desire to understand theory and incorporate it into theirprograms (McKenzie & Smeltzer, 1999). Practitioners realize thatsuch inclusion provides credence and a rationale for the intervention orprogram, as well as a foundation for the desired outcome. However, mostpark and recreation prevention programs have used broad/ vague programobjectives, making it difficult to assess specific program outcomes(Baldwin, 2000). Baldwin asserted that identifying the behavioralframework of the recreation program context is particularly challengingfor park and recreation professionals. To advance professional use of evaluation models, the authordeveloped a logic model to systematically illustrate and evaluate therelationship between theories, procedures, programmatic pro��gram��mat��ic?adj.1. Of, relating to, or having a program.2. Following an overall plan or schedule: a step-by-step, programmatic approach to problem solving.3. content,evaluation methods, and outcome of a multidisciplinary mul��ti��dis��ci��pli��nar��y?adj.Of, relating to, or making use of several disciplines at once: a multidisciplinary approach to teaching., community-basedprevention project that was designed for "high at-risk" youth.The author hopes that this experience will bridge theory and practice,and assist in advancing funding and collaborative opportunities. Whileit is not the intent of this communication to report findings of thestudy, the author does provide general information regarding the resultsto explain the interrelated in��ter��re��late?tr. & intr.v. in��ter��re��lat��ed, in��ter��re��lat��ing, in��ter��re��latesTo place in or come into mutual relationship.in components of the model. The projectexamined the outcomes of recreation and health related activities toimprove youth academic standing and reduce youth negative behaviors suchas drugs and criminal activities. A multidisciplinary team of educators,prevention professionals, community organizations, college students, andparents undertook the project referred to as Project WISE-UP, which wasfunded by a two-year grant from the U.S. Department of Juvenile Justice A Department of Juvenile Justice is found in many places. Examples of such a department are: The New South Wales Department of Juvenile Justice The Florida Department of Juvenile Justice The South Carolina Department of Juvenile Justice and the Florida Department Florida is a department (departamento) of Uruguay. Population and DemographicsAs of the census of 2004, there were 68,181 people and 21,938 households in the department. The average household size was 3.1. For every 100 females, there were 100.4 males. of Juvenile Justice. The goals of the projectwere: (a) to reduce the risk that youth will engage in dysfunctional dys��func��tionalso dis��func��tion ?n.Abnormal or impaired functioning, especially of a bodily system or social group.dys��func behavior such as drugs and criminal activities; and (b) to improveparticipants' academic standing while reducing their in-schoolsuspension rates. Specific objectives included increaseparticipants' GPA GPAabbr.grade point averageNoun 1. GPA - a measure of a student's academic achievement at a college or university; calculated by dividing the total number of grade points received by the total number attempted and decrease aggregate absences, suspensions andreferrals to the principal's office, and improve their leisureattitudes and behavior. The WISE-UP Logic Model (See Figure 1) illustrated a logic-flowfrom program activities to the anticipated short-and long-term impact ofthe intervention. Figure 1 shows the improved framework for the WISE-UP Logic Model.It consisted of five components: (1) Assumptions/Theoretical Premise,(2) Program Activities, (3) Immediate Outcomes/Evaluative Activities,(4) Intermediate Outcomes/Objectives, and (5) Final outcomes/Goals. [FIGURE 1 OMITTED] The assumption/theoretical premise, which included socialdevelopment theory, provided a foundation to define and design thecontent and structure of intervention activities. Social developmenttheory provided staff the means to understand the interrelatedness in��ter��re��late?tr. & intr.v. in��ter��re��lat��ed, in��ter��re��lat��ing, in��ter��re��latesTo place in or come into mutual relationship.in orcovariates of risk behavior. Jessor (1991) discussed the importance ofunderstanding adolescent risk behavior as a cluster instead ofattempting to focus on an independent or separate behavior to developeffective prevention programs. According to according toprep.1. As stated or indicated by; on the authority of: according to historians.2. In keeping with: according to instructions.3. Jessor, at-risk youths'lifestyle often involves a constellation Constellation, shipConstellation(kŏnstĭlā`shən), U.S. frigate, launched in 1797. It was named by President Washington for the constellation of 15 stars in the U.S. flag of that time. of risk behaviors (drivingafter drinking, unprotected sexual intercourse sexual intercourseor coitus or copulationAct in which the male reproductive organ enters the female reproductive tract (see reproductive system). , fighting, smoking,illicit drug illicit drugStreet drug, see there use, etc). Therefore, the development of a single-focusedprogram is not as effective as a comprehensive program designed to focuson the entire array of adolescent risk behaviors. A program that focuseson "Just say no to drugs" needs to concentrate on drugeducation, alcohol abuse, decision-making, self-esteem, and sexualprecocity precocity/pre��coc��i��ty/ (-kos��it-e) unusually early development of mental or physical traits.preco��cioussexual precocity? precocious puberty. , as a minimal to be effective. Jessor's theoreticalnotion-Conceptual Framework for Adolescent Risk Behavior: Risk andProtective Factors, Risk Behavior, and Risk Outcomes-provided the meansfor staff to understand risk behavior in the context of a "web ofcausation web of causation,n the interrelationships of several factors that precipitate a particular disease. " (Jessor, 1991). The conceptual framework For the concept in aesthetics and art criticism, see .A conceptual framework is used in research to outline possible courses of action or to present a preferred approach to a system analysis project. also providedan understanding of the interrelated nature of risk factors andprotective factors, risk behavior, and consequences of the riskbehaviors. Drawing from this theoretical notion, the staff designedProject WISE-UP as a comprehensive, multidisciplinary program thatincluded drug education, crime prevention, decision-making, tutoring,leisure education, recreation, family discussions, and life skills. The assumption/theoretical premises component also relies onmethods extrapolated from the Family Ecological Systems approach, whichis derived from theory and research in human development, cognitivedevelopment, child and adolescent psychology Adolescent Psychology addresses the specific issues of adolescents. AdolescenceAdolescence, the transitional stage of development between childhood and adulthood, represents the period of time during which a person experiences a variety of biological changes and , family therapy, andcommunity mental health (Henggeler, 1982). Henggeler's perspectiveis that the adolescent is embedded Inserted into. See embedded system. in and interacts with various systemsand subsystems, ranging from personal attributes, parents, siblings siblingsnpl (formal) → fr��res et s?urs mpl (de m��mes parents)andextended family, to the school, church, and community organizations. TheFamily Ecological System designates five spheres of influence on anindividual, including the following: personal attributes of theindividual (intrapersonal in��tra��per��son��al?adj.Existing or occurring within the individual self or mind.intra��per system); interpersonal in��ter��per��son��al?adj.1. Of or relating to the interactions between individuals: interpersonal skills.2. relations within theimmediate settings in which an adolescent develops and interacts(microsytem); linkages between two or more elements in the microsystem;social structures that influence power over the adolescent indirectly(exosystem); and patterns of cultures, values and belief (macrosystem).It is within these systems that the individual's behavior anddevelopment are shaped. This theoretical notion aided the staff inunderstanding the interrelations among the adolescent, family, andextrafamilial systems. Given this theoretical premise, the authorestablished a partnership with the adolescents (intrapersonal system);parents, extended family, siblings, peers, teachers and the recreationstaff (microsystem & mesosystem); and community organizations andthe school system (exosystem). Figure 1 presents additional theoretical notions regardingdecision-making and problem-solving knowledge and skills, constructiveuse of leisure activities, healthy lifestyles, and good study habitsthat guided the development of the program and evaluation activities.For example, one theoretical notion that influenced program developmentwas the belief that constructive and wise use of a diverse range ofenjoyable and rewarding leisure activities will deter drug use andcriminal behavior. Additionally, research suggests that having a greatdeal of unstructured, unsupervised discretionary time can underminepositive youth development (Curruthers and Busser, 2000). From theseassumptions, the author designed the programmatic activities for ProjectWISE-UP that included crime prevention, drug education, leisureeducation, life skills (decision-making, problem solving problem solvingProcess involved in finding a solution to a problem. Many animals routinely solve problems of locomotion, food finding, and shelter through trial and error. and conflictresolution), teen courts Teen courts are authorized by law in many United States to provide an alternative disposition for juveniles who have committed a delinquent act and are otherwise eligible for diversion. , a tutorial An instructional book or program that takes the user through a prescribed sequence of steps in order to learn a product. Contrast with documentation, which, although instructional, tends to group features and functions by category. See tutorials in this publication. program, field trips, chess, andparental involvement. It was offered in two-hour sessions, four times aweek for 32 weeks over two-years, using the university semester se��mes��ter?n.One of two divisions of 15 to 18 weeks each of an academic year.[German, from Latin (cursus) s as aframework. All project activities were held in the participants'community, a federally subsidized housing Subsidized housing (aka social housing) is government supported accommodation for people with low to moderate incomes. To meet these goals many governments promote the construction of affordable housing. project, where they residedand attended public school. All middle school students, ages 11-14 and a younger sibling sibling/sib��ling/ (sib��ling) any of two or more offspring of the same parents; a brother or sister. sib��lingn. , wereinvited to participate in the program. Thirty-seven (37) students agreedto participate. Fifty-nine percent of participants were males and 41%were females. All participants were African Americans African AmericanMulticulture A person having origins in any of the black racial groups of Africa.See Race. with 100% of themreceiving free school lunches. Most of the participants were "high-at risk" students from households headed by a single parent whosehousehold income fell below the state's poverty level. They wereexposed to multiple risk factors: economic disadvantage, alcohol anddrug experimentation, chronic failure in school, learning disabilities,et cetera ET CETERA. A Latin phrase, which has been adopted into English; it signifies. "and the others, and so of the rest," it is commonly abbreviated, &c. 2. Formerly the pleader was required to be very particular in making his defence. (q.v. . All participants had poor academic achievement records, poorschool attendance, and very high in/out of school suspensions based onmisconduct MISCONDUCT. Unlawful behaviour by a person entrusted in any degree: with the administration of justice, by which the rights of the parties and the justice of the, case may have been affected. 2. . Most participants had been administratively promoted forseveral grades. Project staff tested these hypotheses and refined assumptionsthrough various programmatic and evaluative activities. For instance,evaluative activities for the leisure education module included"pre" and "post" surveys to assess subjects'perceptions of satisfaction and value of leisure, combined with aself-inventory of leisure behavior. The immediate outcomes resulteddirectly from an activity and led to intermediate outcomes; for example,enriched knowledge of the harmful effects of drugs; advanced perceptionsand attitudes toward leisure activities, decision-making and problemsolving skills; increased family bonding; and improved study skills.Intermediate objectives were evaluated by comparing theparticipants' GPAs, school attendance, in/out of schoolsuspensions, and disciplinary referrals at various intervals. Data wereobtained from the school board, one of the project's partners. Ifthe project was effective, then improved GPAs, reduced days of absence,reduced suspensions, and reduced referrals should have followed theimproved knowledge and attitudes of drugs, improved leisure attitudesand perceptions, improved life skills, and improved family bonding andcommunication. Table 1 presents a summary of the intermediate outcomes for Year 1and Year 2. By the end of Year 1, data revealed participants' GPAdecreased from 2.21 to 1.95; days of absence increased from 14.4 to19.06 days; and school suspensions increased from 2.19 to 7.91 times. The only area that suggested program effectiveness in Year 1 wasdisciplinary referrals to the principal or dean of student'soffice. It decreased from an average of 9.66 to 6.53 times. Year 2 datarevealed improvements in all areas, consequently demonstrating thelogical progression of the project's impact. By the end of Year 2,39% (n = 12) of participants improved in their GPA. The averageimprovement for the project participants was .15. The number ofreferrals to the principal or dean of student's office decreased byan average of 2.3 encounters, which represented 55% of the participantsshowing a decrease in referrals. The average number of schoolsuspensions decreased by 5.5 times, and 71% of the participants showed adecrease in the number of school suspensions. The average days ofabsences decreased by 1.7 days, with 38% of participants showing adecrease in absences. At the end of Year 1, data on participants' drug and alcoholknowledge showed an 11% increase overall. Forty-six percent ofparticipants (n = 14) improved their knowledge (See Table 2). Thirty-six percent of participants (n = 11) improved theirattitudes toward drugs and alcohol abuse. Fifty-five percent ofparticipants (n = 17) improved their leisure attitudes. These weremeasured using a Likert-type scale using a range of 1 to 5. Data onparticipants' decision-making and conflict resolution knowledgerevealed that 55% of participants (n = 17) reported an improvement. Datarevealed 64% percent of participants (n = 20) improved theirdecision-making behaviors and forty-six (46%) (n = 14) of participantsimproved family bonding and communication scores. Students were presented a series of questions, which wereindicators of parental involvement in their completion of homework,problems, and social decisions. Data revealed 36% (n = 11) of theparticipants improved their study habits during Year 1. One obviouslimitation of the study was an inability to control for otherintervening variables An intervening variable is a hypothetical concept that attempts to explain relationships between variables, and especially the relationships between independent variables and dependent variables. that may have contributed to participants'success. Park, recreation and sport professionals of youth-serving agenciesare facing increasing challenges to align align (līn),v to move the teeth into their proper positions to conform to the line of occlusion. programs with policydirections that endorse a youth development approach. Such an approachrequires program documentation of outcomes and the utilization of asound programming process that clearly establishes a link betweentheory, program model and subsequent behavioral changes in participatingyouths. Documentation of the value of park, recreation and sportactivities is the most difficult type of evaluation because it requiresa systematic methodology for collecting information, a careful topology topology,branch of mathematics, formerly known as analysis situs, that studies patterns of geometric figures involving position and relative position without regard to size. of activities, clearly defined goals and performance outcomes, andspecific measures of outcomes and perceived benefits. Perhaps this iswhy only a few studies have been conducted that specifically evaluateprogram effectiveness (Baker & Witt, 1996). These challenges willrequire more dialogue of the theoretical foundation of park, recreationand sport programming for at-risk youth, funding, and staff training.Establishing programs on a sound theoretical base enhances the rigor andquality of programs and subsequent outcome evaluation (Baldwin, 2000).Through this research endeavor, the author hopes to advance professionaluse of evaluation models and to facilitate their use in park,recreation, sport, and leisure services. It has been the author'sexperience that most stakeholders StakeholdersAll parties that have an interest, financial or otherwise, in a firm-stockholders, creditors, bondholders, employees, customers, management, the community, and the government. perceive recreation programs asnonessential non��es��sen��tialadj.Being a substance required for normal functioning but not needed in the diet because the body can synthesize it. and intangible service. Most stakeholders understand therelationship between recreation and economic impact and/or personalfitness; but too few perceive recreation as a vital element inbehavioral modification or youth development. The author found this tobe the case in seeking funding for the discussed project. Prior to thestate agency's approval of funding, the author was summoned to ameeting of prevention, law enforcement, and youth development personnelto discuss strategies to achieve such long-term goals Long-term goalsFinancial goals expected to be accomplished in five years or longer. . When the authornoted the second goal of the project--to reduce youth dysfunctionalbehaviors, such as drugs and criminal activities, the question wasraised: "How are you going to achieve it." The logic--modelwas a "saving grace" in explaining how the intervention hadbeen conceptualized to enhance youth development. Having studied theessence of social learning theory, Jessor's Conceptual Frameworkfor Adolescent Risk Behavior, and the Family Ecological Model (Jessor,1991), the author was able to provide a "map" of criticalprogram variables and their relationship to theory and practice. In addition to the model providing a paradigm to systematicallyexplain the relationship between theoretical premise, programintervention, immediate and long-term outcomes, it provided a logicalexplanation of the logic flow from program activities to the anticipatedshort and long-term impact of the intervention. The results at the end of Year 1 were not as positive as those atthe end of Year 2. After one year of intervention, the only area thatsuggested program effectiveness was disciplinary referrals. As noted, itdecreased from an average of 9.66 to 6.53 times. For Year 1, datarevealed that the project was effective only in slowing the rate ofacademic deterioration de��te��ri��o��ra��tionn.The process or condition of becoming worse. after the first year. This result was somewhatexpected, recalling that these were high-risk youth, and many of themhad been administratively promoted. It is the contention of the authorthat without the prevention program, the participants'dysfunctional behavior would have increased significantly in the absenceof the project intervention. Second year data revealed improvements inall areas, consequently suggesting the logical progression of theproject's impact. These findings support the literature, whichholds youth development takes time and is most effectively addressed byprograms that focus on an array of risk factors. As illustrated in the logic model, immediate objective measuresneed to occur before indicators of intermediate outcome/objectives orfinal outcomes can be expected. Results of the data analysis supportthis logical progression. Participants' academic performance anddisciplinary behaviors improved after they showed improvements in drugand alcohol knowledge and attitudes, leisure attitudes and perception,study habits, family bonding and communication, and in decision-makingknowledge and skills. In conclusions, there are several implications for this study. Themodest improvements in the participants' academic performance andimproved knowledge and skills in decision-making, drug education, andimproved leisure attitudes and recreation participation suggest thatpark and recreation programs can make a positive contribution to youthdevelopment. The study results also give credence to park, recreationand sport prevention programs that target youth who are failing in theschool system. The logic model suggests that agency effectiveness may beenhanced if there is a direct link between assumptions/theoreticalnotions, goals, programs and the valued outcomes, which give credence toBaldwin (2000), Cato, Chen and Corbett-Perez (1998), and McKenzie's(1997) assertions. The model also provides a strategy for managers ofyouth serving agencies who are encountering high demands for services,scrutiny from funders, and the need to go an extra step in justifyingthe benefits of recreation in youth development. Despite this effort, as well as other advancements in theevaluation and documentation of park, recreation and sport preventionprograms, there are still issues to be resolved. On-going research isrequired to further test the model and document the value of suchprograms in the behavior modification behavior modificationn.1. The use of basic learning techniques, such as conditioning, biofeedback, reinforcement, or aversion therapy, to teach simple skills or alter undesirable behavior.2. See behavior therapy. and youth development. If park,recreation and sport professionals want to move beyond traditionalrecreation programming for youth, to the development of programs thattarget specific outcomes for at-risk youth, they must provide diverseand complementary program strategies that are objective and measurable.Intervention programs that can document positive behavioral changes inparticipants enhance collaborative and funding opportunities. References Baker, D. A., & Witt, R A. (2000). Multiple stakeholders'views of the goals and content of two after-school enrichment enrichmentFood industry The addition of vitamins or minerals to a food–eg, wheat, which may have been lost during processing. See White flour; Cf Whole grains. programs.Journal of Park and Recreation Administration, 18, 68-86. Baldwin, C. K. (2000). Theory, programs, and outcomes: Assessingthe challenges of evaluating at-risk youth recreation programs. Journalof Park and Recreation Administration, 18, 19-33. Cato, B., Chen, W., & Corbett-Perez, S. (1998). Logic model: Atool for planning and evaluating health and recreation preventionprojects. Journal of Physical Education, Recreation and Dance, 69,57-61. Curruthers, C., & Busser, J. A. (2000). A qualitative outcomestudy of boys and girls boys and girlsmercurialisannua. club program leaders, club members, and parents.Journal of Park and Recreation Administration, 18, 5-67. Ellis, J. M., Braff, E., & Hutchinson, S. L. (2001). Youthrecreation and resiliency The ability to recover from a failure. The term may be applied to hardware, software or data. : Putting theory into practice in FairfaxCount. Therapeutic Recreation Journal, 35, 307-319. Henggeler, S. W. (1982). The family-ecological systems theory. InS. W. Henggeler (Ed.), Delinquency delinquencyCriminal behaviour carried out by a juvenile. Young males make up the bulk of the delinquent population (about 80% in the U.S.) in all countries in which the behaviour is reported. and adolescent psychopathology psychopathology/psy��cho��pa��thol��o��gy/ (-pah-thol��ah-je)1. the branch of medicine dealing with the causes and processes of mental disorders.2. abnormal, maladaptive behavior or mental activity. : Afamily ecological systems approach. Boston: John Wright. PSG PSG,n polysomnograph; polygraph performed during sleep. Physiological variables such as pulse, blood pressure, and respiration are monitored and charted. Inc. Jessor, R. (1991). Risk behavior in adolescence adolescence,time of life from onset of puberty to full adulthood. The exact period of adolescence, which varies from person to person, falls approximately between the ages 12 and 20 and encompasses both physiological and psychological changes. : A psychologicalframework for understanding and action. Journal of Adolescent Health,12, 597-605. Kleiber, D. (1999). Leisure experience and human development: Adialectical di��a��lec��tic?n.1. The art or practice of arriving at the truth by the exchange of logical arguments.2. a. interpretation. New York New York, state, United StatesNew York,Middle Atlantic state of the United States. It is bordered by Vermont, Massachusetts, Connecticut, and the Atlantic Ocean (E), New Jersey and Pennsylvania (S), Lakes Erie and Ontario and the Canadian province of : Basic Books. McKenzie, J. E, & Smeltzer, J. L. (1997). Planning,implementing, and evaluating health promotion programs: A primer prim��ern.A segment of DNA or RNA that is complementary to a given DNA sequence and that is needed to initiate replication by DNA polymerase. (2nded.) Needham Heights, MA: Allyn and Bacon. Bertha ber��tha?n.A wide deep collar, often of lace, that covers the shoulders of a dress.[French berthe, after Bertha (died 783), Carolingian queen as the wife of Pepin the Short.] Cato, Department of Tourism, Recreation and SportsManagement, College of Health & Human Performance, University ofFlorida University of Florida is the third-largest university in the United States, with 50,912 students (as of Fall 2006) and has the eighth-largest budget (nearly $1.9 billion per year). UF is home to 16 colleges and more than 150 research centers and institutes. Table 1Project WISE-UP Intermediate DataYear 1 and Year 2 Beginning Year 2 CHANGES Year 1 End of N = 30 N = 32 Year 1GPA (0-4) 2.21 1.95 -0.26ABSENCES(Days) 14.41 19.06 +4.65REFERRALS(Frequency) 9.66 6.53 -3.13SCHOOLSUSPENSIONS(Frequency) 2.19 7.91 +5.72 Year 2 CHANGES % PARTICIPANT End of IMPROVED N = 31 Year 2 Year 1 & 2GPA (0-4) 2.10 +0.15 38.71ABSENCES(Days) 17.36 -1.70 37.93REFERRALS(Frequency) 4.22 -2.31 55.17SCHOOLSUSPENSIONS(Frequency) 2.42 -5.49 70.97Table 2Project WISE-UP Intermediate Outcome DataYear 1 % of ParticipantOutcome Measures Pre-test Post-test Changes % ImprovedDrug & Alcohol Knowledge (20) * 10.68 11.86 +11.05 45.45Drug & Alcohol Attitudes (20) 15.54 15.91 +2.38 36.36Leisure Perception (40) 29.18 30.00 +2.81 50.00Leisure Attitudes (40) 29.32 31.45 +7.3 54.55Conflict Resolution (10) 5.55 6.09 +9.7 54.55Decision Making (10) 7.45 8.18 +9.8 54.55Decision Making Behavior (20) 14.54 16.36 +12.54 63.64Family Bonding (60) 45.27 47.64 +5.2 45.45Study Habits (28) 22.32 22.86 +2.4 36.36* Total possible scores for each variable is presented in parenthesis