Use of a social and character development program to prevent substance use, violent behaviors, and sexual activity among elementary-school students in Hawaii.
OBJECTIVE
We assessed the effectiveness of a 5-year trial of a comprehensive school-based program designed to prevent substance use, violent behaviors, and sexual activity among elementary-school students.


METHODS
We used a matched-pair, cluster-randomized, controlled design, with 10 intervention schools and 10 control schools. Fifth-graders (N = 1714) self-reported on lifetime substance use, violence, and voluntary sexual activity. Teachers of participant students reported on student (N = 1225) substance use and violence.


RESULTS
Two-level random-effects count models (with students nested within schools) indicated that student-reported substance use (rate ratio [RR] = 0.41; 90% confidence interval [CI] = 0.25, 0.66) and violence (RR = 0.42; 90% CI = 0.24, 0.73) were significantly lower for students attending intervention schools. A 2-level random-effects binary model indicated that sexual activity was lower (odds ratio = 0.24; 90% CI = 0.08, 0.66) for intervention students. Teacher reports substantiated the effects seen for student-reported data. Dose-response analyses indicated that students exposed to the program for at least 3 years had significantly lower rates of all negative behaviors.


CONCLUSIONS
Risk-related behaviors were substantially reduced for students who participated in the program, providing evidence that a comprehensive school-based program can have a strong beneficial effect on student behavior.
Beets
Michael W
MW
Department of Public Health, Oregon State University, Corvallis, USA. beets@gwm.sc.edu
Flay
Brian R
BR
Vuchinich
Samuel
S
Snyder
Frank J
FJ
Acock
Alan
A
Li
Kin-Kit
KK
Burns
Kate
K
Washburn
Isaac J
IJ
Durlak
Joseph
J
D002605:Character; D002648:Child; D005260:Female; D006254:Hawaii / Q000453:epidemiology; D006801:Humans; D008297:Male; D015995:Prevalence; D012725:Sexual Behavior / Q000523:psychology*; D012919:Social Behavior; D013334:Students / Q000523:psychology* / Q000706:statistics & numerical data*; D019966:Substance-Related Disorders / Q000453:epidemiology / Q000517:prevention & control*; D011795:Surveys and Questionnaires; D014754:Violence / Q000517:prevention & control* / Q000706:statistics & numerical data