Use of a social and character development program to prevent substance use, violent behaviors, and sexual activity among elementary-school students in Hawaii

Am J Public Health. 2009 Aug;99(8):1438-45. doi: 10.2105/AJPH.2008.142919. Epub 2009 Jun 18.

Abstract

Objectives: 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.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Character*
  • Child
  • Female
  • Hawaii / epidemiology
  • Humans
  • Male
  • Prevalence
  • Sexual Behavior / psychology*
  • Social Behavior*
  • Students / psychology*
  • Students / statistics & numerical data*
  • Substance-Related Disorders / epidemiology
  • Substance-Related Disorders / prevention & control*
  • Surveys and Questionnaires
  • Violence / prevention & control*
  • Violence / statistics & numerical data