Use of a Social and Character Development Program to Prevent Substance Use, Violent Behaviors, and Sexual Activity Among Elementary-School Students in Hawaii
Open accessAbstract
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.
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- Authors
- Beets, M. W., Flay, B. R., Vuchinich, S., Snyder, F. J., Acock, A., Li, K.-K., Burns, K., Washburn, I. J., & Durlak, J.
- Affiliations
- Oregon State University (US)
- Venue
- American Journal of Public Health
- Publisher
- American Public Health Association
- Published
- 2009-08
- Volume
- 99
- Issue
- 8
- Pages
- 1438-1445
- ISSN
- 0090-0036 (ISSN-L)
- 1541-0048
- PMC
- PMC2707473
- OpenAlex
- W2074594173
- Cited by
- 231
- References
- 47
- Citations by year
- 2026: 3 · 2025: 5 · 2024: 8 · 2023: 9 · 2022: 10 · 2021: 13 · 2020: 48 · 2019: 14 · 2018: 13 · 2017: 14 · 2016: 15 · 2015: 17 · 2014: 18 · 2013: 14 · 2012: 7
- FWCI
- 6.75
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- American Journal of Public Health (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- RePEc: Research Papers in Economics (submittedVersion)
- Funders
- Oregon State University
- National Institute on Drug Abuse (P30DA018760, DA018760, R01DA013474, DA13474)
- Topics
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Health Sciences › Health Professions › General Health Professions › Adolescent Sexual and Reproductive Health
- Health Sciences › Health Professions › General Health Professions › Adolescent Health and Behaviors
- Keywords
- school-based prevention, substance use prevention, adolescent sexual activity, elementary school students, fifth grade students, dose-response relationship, program effectiveness, Hawaii
- MeSH terms
- Character, Child, Female, Hawaii, Humans, Male, Surveys and Questionnaires, Sexual Behavior, Social Behavior, Students, Violence, Prevalence, Substance-Related Disorders
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