George C. Patton ^1*, Lyndal Bond ¹, John B. Carlin ², Lyndal Thomas ², Helen Butler ¹, Sara Glover ², Richard Catalano ³, Glenn Bowes ²

¹ Murdoch Childrens Research Institute
² University of Melbourne
³ University of Washington

^* To whom correspondence should be addressed. E-mail: george.patton{at}rch.org.au.

	Abstract

Objectives. We sought to test the efficacy of an intervention that was designed to promote social inclusion and commitment to education, in reducing among students health risk behaviors and improving emotional well-being.

Methods. The design was a cluster-randomized trial in 25 secondary schools in Victoria, Australia. The subjects were 8th-grade students (aged 13 to 14 y) in 1997 (n=2545) and subsequent 8th-grade students in 1999 (n=2586) and 2001 (n=2463). The main outcomes were recent substance use, antisocial behavior, initiation of sexual intercourse, and depressive symptoms.

Results. At 4-year follow-up, the prevalence of marked health risk behaviors was approximately 20% in schools in the comparison group and 15% in schools in the intervention group, an overall reduction of 25%. In ordinal logistic regression models a protective effect of intervention was found for a composite measure of health risk behaviors in unadjusted models (odds ratio [OR]= 0.69; 95% confidence interval [CI]= 0.50, 0.95) and adjusted models (OR= 0.71; CI =0.52, 0.97) for potential confounders. There was no evidence of a reduction in depressive symptoms.

Conclusion. The study provides support for prevention strategies in schools that move beyond health education to promoting positive social environments.

Key Words: Adolescent Health, Health Education, Health Promotion, Mental Health, Prevention, Substance Abuse

This article has been cited by other articles:

				J. Pommier, D. Jourdan, D. Berger, C. Vandoorne, B. Piorecka, and G. S. De Carvalho School health promotion: organization of services and roles of health professionals in seven European countries Eur J Public Health, August 17, 2009; (2009) ckp117v1. [Abstract] [Full Text] [PDF]

				P. Hawe and L. Ghali Use of social network analysis to map the social relationships of staff and teachers at school Health Educ. Res., February 1, 2008; 23(1): 62 - 69. [Abstract] [Full Text] [PDF]

				C Bonell, A Fletcher, and J McCambridge Improving school ethos may reduce substance misuse and teenage pregnancy BMJ, March 24, 2007; 334(7594): 614 - 616. [Full Text] [PDF]

				E. G. Jessop Another public health triumph J. Public Health Med., December 1, 2006; 28(4): 297 - 298. [Full Text] [PDF]