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This Article Full Text Full Text (PDF) All Versions of this Article: AJPH.2008.142919v1 99/8/1438    most recent Submit a response View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Web of Science (1) Citing Articles via Google Scholar Google Scholar Articles by Beets, M. W. Articles by Durlak, J. Search for Related Content PubMed PubMed Citation Articles by Beets, M. W. Articles by Durlak, J. Related Collections Health Promotion School Health Health Education Other Child and Adolescent Health Alcohol Drugs

Michael W. Beets, PhD, MPH, Brian R. Flay, DPhil, Samuel Vuchinich, PhD, Frank J. Snyder, MPH, Alan Acock, PhD, Kin-Kit Li, MS, Kate Burns, PhD, Isaac J. Washburn and Joseph Durlak, PhD

At the time of the study, Michael W. Beets, Brian R. Flay, Frank J. Snyder, and Kate Burns were with the Department of Public Health, Oregon State University, Corvallis. Samuel Vuchinich, Alan Acock, and Isaac J. Washburn were with the Department of Human Development and Family Sciences, Oregon State University, Corvallis. Kin-Kit Li was with the Department of Nutrition and Exercise Science, Oregon State University, Corvallis. Joseph Durlak was with the Department of Psychology, Loyola University, Chicago, IL.

Correspondence: Correspondence should be sent to Michael W. Beets, PhD, MPH, Department of Exercise Science, Arnold School of Public Health, University of South Carolina, 921 Assembly St, RM 131, Columbia, SC 29208 (e-mail: beets{at}gwm.sc.edu). Reprints can be ordered at http://www.ajph.org by clicking on the "Reprints/Eprints" link.

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.