Promoting social inclusion in schools: a group-randomized trial of effects on student health risk behavior and well-being

Am J Public Health. 2006 Sep;96(9):1582-7. doi: 10.2105/AJPH.2004.047399. Epub 2006 Jul 27.


Objectives: 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.

Conclusion: The study provides support for prevention strategies in schools that move beyond health education to promoting positive social environments.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Communication
  • Curriculum
  • Emotions
  • Environment
  • Female
  • Health Behavior*
  • Humans
  • Interpersonal Relations
  • Male
  • Mental Health*
  • Risk-Taking*
  • School Health Services*
  • Sexual Behavior
  • Social Behavior*
  • Substance-Related Disorders