In a study, 28 adults with mild periodontal disease are assessed before and 6 months after implementation of a dental-education program intended to promote better oral hygiene. After 6 months, periodontal status improved in 15 patients, declined in 8, and remained the same in 5. 9.1 Assess the impact of the program statistically (use a two-sided test). Suppose patients are graded on the degree of change in periodontal status on a 7-point scale, with +3 indicating the greatest improvement, 0 indicating no change, and −3 indicating the greatest decline. The data are given in Table 9.9. 9.2 What nonparametric test can be used to determine whether a significant change in periodontal status has occurred over time? 9.3 Implement the procedure in Problem 9.2 and report a p-value.

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