title: Promoting social inclusion in schools: a group-randomized trial of effects on student health risk behavior and well-being.
abstract: OBJECTIVE
  We sought to test the efficacy of an intervention that was designed to promote social inclusion and commitment to education, in reducing among students health risk behaviors and improving emotional well-being.
  
  
  METHODS
  The design was a cluster-randomized trial in 25 secondary schools in Victoria, Australia. The subjects were 8th-grade students (aged 13 to 14 y) in 1997 (n=2545) and subsequent 8th-grade students in 1999 (n=2586) and 2001 (n=2463). The main outcomes were recent substance use, antisocial behavior, initiation of sexual intercourse, and depressive symptoms.
  
  
  RESULTS
  At 4-year follow-up, the prevalence of marked health risk behaviors was approximately 20% in schools in the comparison group and 15% in schools in the intervention group, an overall reduction of 25%. In ordinal logistic regression models a protective effect of intervention was found for a composite measure of health risk behaviors in unadjusted models (odds ratio [OR]= 0.69; 95% confidence interval [CI]= 0.50, 0.95) and adjusted models (OR= 0.71; CI =0.52, 0.97) for potential confounders. There was no evidence of a reduction in depressive symptoms.
  
  
  CONCLUSIONS
  The study provides support for prevention strategies in schools that move beyond health education to promoting positive social environments.
authors.affiliation: Centre for Adolescent Health and Murdoch Children's Research Institute, Melbourne, Australia. george.patton@rch.org.au
authors.forename: George C
authors.initials: GC
authors.lastname: Patton
authors.forename: Lyndal
authors.initials: L
authors.lastname: Bond
authors.forename: John B
authors.initials: JB
authors.lastname: Carlin
authors.forename: Lyndal
authors.initials: L
authors.lastname: Thomas
authors.forename: Helen
authors.initials: H
authors.lastname: Butler
authors.forename: Sara
authors.initials: S
authors.lastname: Glover
authors.forename: Richard
authors.initials: R
authors.lastname: Catalano
authors.forename: Glenn
authors.initials: G
authors.lastname: Bowes
mesh_terms: D000293:Adolescent; D003142:Communication; D003479:Curriculum; D004644:Emotions; D004777:Environment; D005260:Female; D015438:Health Behavior; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D008603:Mental Health; D012309:Risk-Taking; D012572:School Health Services; D012725:Sexual Behavior; D012919:Social Behavior; D019966:Substance-Related Disorders