School-based prevention program reduces problem behaviours in fifth graders by half

A study suggests that school-based prevention programs begun in elementary school can significantly reduce problem behaviours 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 behaviour, or sexual activity as those who did not take part in the program. The study, supported by the US 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 behaviours," said NIDA Director Dr Nora Volkow. "The fact that an intervention beginning in the first grade produced a significant effect on children’s behaviour in the fifth grade strengthens the case for initiating prevention programs in elementary school, before most children have begun to engage in problem behaviours."

The study was conducted in 20 public elementary schools in Hawaii. Participating schools had below-average standardised 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 behaviour and academic achievement. Schools were randomly assigned from matched pairs 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 one hour a week beginning in the first or second grade.

In fifth grade, 976 students (most 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 behaviours, 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 behaviours was small. Strikingly, however, students exposed to the PA program were about half as likely to report engaging in any of these behaviours as students not exposed to PA. Among students who were exposed to PA, those who had received the lessons for three or more years reported the lowest rates of experience with any of these problem behaviours.

"This study demonstrates that a comprehensive, school wide social and character development program can have a substantial impact on reducing problem behaviours 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 school wide 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. Finally, at one hour a 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.

(Source: National Institute on Drug Abuse: American Journal of Public Health: June 2009)