Study shows school-based prevention program reduces problem behaviors in fifth-graders

A study suggests that school-based prevention programs begun in elementary school can significantly reduce problem behaviors in students. Fifth graders who previously participated in a comprehensive interactive school prevention program for one to four years were about half as likely to engage in substance abuse, violent behavior, or sexual activity as those who did not take part in the program.

The study, supported by the National Institute on Drug Abuse (NIDA), a component of the National Institutes of Health, will appear in the August 2009 print issue of the American Journal of Public Health. The online version of the article is viewable today.

"This study provides compelling evidence that intervening with young children is a promising approach to preventing drug use and other problem behaviors," said NIDA Director Dr. Nora Volkow. "The fact that an intervention beginning in the first grade produced a significant effect on children's behavior in the fifth grade strengthens the case for initiating prevention programs in elementary school, before most children have begun to engage in problem behaviors."

The study was conducted in 20 public elementary schools in Hawaii. Participating schools had below-average standardized test scores and diverse student populations, with an average of 55 percent of students receiving free or reduced-price lunches.

The intervention tested was Positive Action (PA), a comprehensive K-12 social and emotional development program for enhancing behavior and academic achievement. Schools were randomly assigned from matched pairs either to implement PA or not. The program consists of daily 15-20 minute interactive lessons focusing on such topics as responsible self-management, getting along with others, and self-improvement. At schools implementing the intervention, these lessons occupied a total of about 1 hour per week beginning in the first or second grade.

In fifth grade, 976 students (most of whom were aged 10 or 11) responded to a written questionnaire that asked about their use of substances, including tobacco, alcohol, and illicit drugs; involvement in violent behaviors, such as carrying a knife or threatening someone; and voluntary sexual activity. The total number of students reporting that they had engaged in any of these behaviors was small. Strikingly, however, students exposed to the PA program were about half as likely to report engaging in any of these behaviors as students not exposed to PA. Among students who were exposed to PA, those who had received the lessons for 3 or more years reported the lowest rates of experience with any of these problem behaviors.

"This study demonstrates that a comprehensive, schoolwide social and character development program can have a substantial impact on reducing problem behaviors of public health importance in elementary-school-age youth," said Dr. Brian Flay of Oregon State University, the study's principal investigator.

PA is an interactive program that integrates teacher/student contact and opportunities for the exchange of ideas as well as feedback and constructive criticism. The program is schoolwide and involves teachers and parents as well as students. It takes a positive, holistic approach to social and emotional development rather than focusing on the negative aspects of engaging in substance abuse and violence. Additionally, at 1 hour per week, students' exposure to the program was intensive. "These features likely account for the large effect observed," concluded Dr. Flay.

Dr. Flay plans to conduct a follow up study to determine whether the beneficial effects of the PA program on fifth graders are sustained as the children grow older.

The National Institute on Drug Abuse is a component of the National Institutes of Health, U.S. Department of Health and Human Services. NIDA supports most of the world's research on the health aspects of drug abuse and addiction. The Institute carries out a large variety of programs to inform policy and improve practice. Fact sheets on the health effects of drugs of abuse and information on NIDA research and other activities can be found on the NIDA home page at www.drugabuse.gov. To order publications in English or Spanish, call NIDA's new DrugPubs Research Dissemination Center at 1-877-NIDA-NIH or 240-645-0228 (TDD), or fax or e-mail requests to 240-645-0227 or [email protected]. Online ordering is available at http://drugpubs.drugabuse.gov.