During 1993-94, the Morrison Institute for Public Policy at Arizona State University conducted a study on behalf of the Arizona Department of Education. This document presents findings of that study, which examined linkages between health services and schools for a comprehensive service delivery to students. Following the introduction, chapter 1 provides a national overview on children's health and the public schools, presenting national and legislative initiatives and a framework for linking health services and schools. Chapter 2 reviews what is known about the major issues in child health in Arizona and its schools, synthesizing health data from several sources.

Survey results from 531 Arizona school principals about school-based/school-linked health and social services are also analyzed. A discussion of the Arizona perspective follows in chapter 3, which examines the philosophy guiding state initiatives, key players, the processes that support school-based/school-linked health services, and a sample of current state activities. The fourth chapter provides a view of how some Arizona schools are attempting to address these issues through the provision of student health services at or near school sites. The last chapter reviews action necessary to facilitate linkages between schools and health services, and the status of Arizona efforts. It concludes with some considerations for the future. A conclusion is that the state is making significant progress toward promoting and, in some schools, implementing such services. Eight tables and seven figures are included.

Between May and July of 1996, members of the council were asked to participate in a series of interviews. The primary purpose of the interviews was to elicit council members' views of and expectations for Arizona's STW initiative. A second reason was to clarify the mission of the council itself. This paper highlights salient points from the interviews. Quotes are used verbatim.

In spring 1998, 1,057 10th-grade students were surveyed as one component of a statewide evaluation of Arizona's school-to-work system designed by the Morrison Institute for Public Policy. This second survey measured attitudes toward and participation in career activities. Results were compared to baseline data collected from over 2,000 10th-grade students in 1997. Data indicated that, in both years, nearly all students had at least an idea of their career area of interest; gender differences were observed in students' selections of career interests. Student participation in activities increased. Statistically significant differences in participation by sex were evident: more girls reported learning about careers in class and participating in volunteer activities; and more boys participated in internships with pay, worked for pay in a job unrelated to their careers, and had business mentors. The share of students who had selected a career interest increased as participation rose. All 14 activities were at least "somewhat" helpful to students in making career selections. In both years, students ranked family, teachers, and friends most highly as influencing career interests. One-fourth of students in 1998 compared to one-third of students in 1997 indicated they never received career guidance at school. Less than one-half of students were aware of courses related to career interests; even fewer actually took a course related to their interests.

One component of a multi-faceted evaluation of the state's STW initiative involves surveying tenth grade students. Thus, the survey was designed to assess the extent to which Arizona tenth grade students have selected career majors, planned a course of study for high school and beyond, and received adult guidance related to careers. As part of the evaluation, the intent was to look at the extent to which career preparation and work experiences truly are system-wide and impact students. In contrast, the purpose was not to evaluate whether STW program participants are receiving school-based learning components.

Tenth-grade students in Arizona school to work (STW) regional partnerships were polled in 1997, 1998, and 1999, to determine whether systemic change was occurring across the state. Study results were mixed. Three activities increased significantly over the baseline year: class projects, computer use, and volunteerism. The use of career inventories declined over the same period. The role of adults in helping students explore career choices remained relatively stable. Further, the number of students who had some idea of their career interests had not changed significantly. Gender differences still existed and were largely unchanged. Fewer students reported taking courses related to their career interests. The relationship of participation in career-related activities to an ability to state a career interest continued to be strong. Students felt job shadowing, business mentors, and internships would be most helpful. However, fewer students participated in these activities. The participating students were better able to articulate their career interests and, in general, had more frequent and positive attitudes about participation in STW. Statewide programs reported positive student outcomes as a result of STW activities. Evidence of systemic change was beginning to be seen. Most significantly, class projects, computer use, and volunteer projects showed consistent gains over the three years.

This report deals with state-level technical assistance and other activities pertinent to at-risk issues in the current context of educational reform. Specifically, the report discusses state options to support Arizona schools in delivering comprehensive services and implications for Arizona policymakers.

The "fit" of "at-risk" education in Arizona was examined in relation to reform initiatives. Focusing on technical assistance and related issues at the state level, researchers examined literature, interviewed a sample of Arizona Dept. of Education personnel, surveyed Arizona principals statewide, and gathered information from other states.

One component of a multi-faceted evaluation of the state's STW initiative involves surveying seventh grade students regarding career awareness and career exploration and counseling in order to help students who may be interested to identify, and select or reconsider, their interests, goals and career majors, including those options that may not be traditional for their gender, race, or ethnicity.

In spring 1998, 1,020 seventh-grade students were surveyed as one component of a statewide evaluation of Arizona's school-to-work system designed by the Morrison Institute for Public Policy. This second survey measured attitudes toward and participation in career activities. Results were compared to baseline data collected from over 2,000 seventh-grade students in 1997. Data showed that student participation in activities increased. Top-ranked activities were the same in both years: classroom speakers, discussions with adults, class projects, field trips, and job shadowing. In both years, more than 60 percent said at least one activity helped them think about choosing a career; roughly 35 percent indicated having a definite idea of what they want to do in the future; and student participation in various activities was positively related to their ability to define a career interest. In both years, mentoring by other adults was up, whereas mentoring by school personnel had decreased. Students who talked to adults about their careers were significantly more likely to have identified a career interest. In both years, fewer boys were apt to report any adult talked to them about careers. The number of students who planned to take classes in high school that teach job skills showed a statistically significant decrease. Girls were more certain they would take classes. In both years, about one-third of students agreed some jobs are best for women, and some for men; boys agreed most often.

Arizona seventh-grade students were polled in 1997, 1998, and 1999, to determine the extent of their participation in career awareness and exploration activities, the impact that the activities have had, and how they were delivered. Survey results provided evidence of systemic change in the regional school-to-work (STW) partnerships. Further, data suggested that the way career awareness activities are delivered makes a difference in their effectiveness. The comparative survey conducted in 1999 supported the contention that STW students differed from their classmates and that STW made a difference for students. The regional analysis compared randomly selected classrooms over 3 years. Changes between 1997 and 1999 were measured in participation metrics and the role of adult mentors. The relative share of students who had at least some idea of their career interests was consistently high (86.8 percent). The mean number of STW activities per pupil increased significantly and the share of students participating in five types of activities rose. A key finding supported over the 3-year period was that students who participated in a variety of activities were better able to identify their career interests. The role of adult mentors intensified. The share of students who talked to adults about careers, and who discussed careers with a counselor, increased significantly between 1997-99.

In spring 1997, Arizona repeated a spring 1996 statewide public poll that established baseline measures of public attitudes toward school-to-work (STW). Samples were drawn from three constituent groups: parents, businesses, and educators. Over 2,700 Arizonans participated each year. Overall awareness of STW was up significantly among every group. The belief that local schools were involved increased, but many parents, businesses, and teachers still said their schools were not involved or they were unsure.

In both studies, a majority of educators rated the overall quality of education positively, whereas parents and businesses were more moderate in their ratings. Well over 90 percent of all groups said some degree of change was needed. Almost 90 percent of each group advocated that schools teach more than just basic skills. Three-quarters or more of all groups supported changing teachers' duties to emphasize instruction in teamwork, work habits, and work-related concerns; ensuring more collaboration in program and curriculum design; providing more comprehensive learning programs; providing "Career Majors"; and creating student employment opportunities.

Two beliefs pervaded the emerging STW system: the state must do a better job of identifying and serving special populations and not everyone is optimistic STW will succeed. Over half of all groups would be willing to pay additional taxes to support STW programs and all groups would vote for candidates supportive of STW.