Mechanisms of Influence on Youth Substance Use for a Social-Emotional and Character Development Program: A Theory-Based Approach.

Background: The Theory of Triadic Influence (TTI) provides a comprehensive framework for understanding adolescent substance use. Objectives: We examined mechanisms by which a TTI-guided social-emotional and character development program, Positive Action (PA), influences adolescent substance use. Study data come from the PA-Chicago, longitudinal matched-pairs cluster-randomized control trial. A diverse, dynamic cohort of approximately 1,200 students from 14 low-performing schools were assessed at eight points of time, between grades 3-8, across a six-year period. Students completed scales related to substance use, self-control, deviant peer affiliation, and school attachment, adapted from the Risk Behavior Survey, Social-Emotional and Character Development Scale, Conventional Friends Scale, and People in My Life Scale. After testing the overall effect of PA on substance use, we used latent growth modeling to assess whether effects on each outcome were mediated by longitudinal changes in three composite measures aligning with the TTIs three streams. Results: Students in PA schools reported fewer experiences with drinking, getting drunk, and overall substance use. In the multiple mediator models, significant indirect effects of PA on substance use via changes in self-control were evident. Conclusions/Importance: Findings are consistent with theory and past research suggesting the influence of self-control on youth substance use. Future studies should include implementation in different settings and additional theory-based measures.Trial RegistrationThis trial is registered at ClinicalTrials.gov NCT01025674.

Childhood Protective Factors and a Prevention Program Reduce Later Problem Behaviors.

Prior research has yet to elucidate how constellations of protective factors in childhood and prevention efforts simultaneously may influence youth involvement in problem behaviors across different points in development. The current study examines how latent classes of social and emotional learning (SEL) skills, parent-child relationships, and peer influences in third grade and receipt of an ongoing SEL intervention predict substance use and violence in fifth and eighth grade. The urban, predominantly low-income, sample (N = 1,169) was nested in 14 schools that were randomly assigned to the Positive Action program or business-as-usual. Membership in a latent class reflecting protective childhood factors predicted less substance use and violence in fifth grade; however, the SEL program predicted less substance use and violence in eighth grade. Findings generally support that SEL interventions can successfully target and boost developmentally appropriate positive behaviors and can prevail over initial risk factors with enough time and exposure.

Can Universal SEL Programs Benefit Universally? Effects of the Positive Action Program on Multiple Trajectories of Social-Emotional and Misconduct Behaviors.

Behavioral trajectories during middle childhood are predictive of consequential outcomes later in life (e.g., substance abuse, violence). Social and emotional learning (SEL) programs are designed to promote trajectories that reflect both growth in positive behaviors and inhibited development of negative behaviors. The current study used growth mixture models to examine effects of the Positive Action (PA) program on behavioral trajectories of social-emotional and character development (SECD) and misconduct using data from a cluster-randomized trial that involved 14 schools and a sample of predominately low-income, urban youth followed from 3rd through 8th grade. For SECD, findings indicated that PA was similarly effective at improving trajectories within latent classes characterized as "high/declining" and "low/stable". Favorable program effects were likewise evident to a comparable degree for misconduct across observed latent classes that reflected "low/rising" and "high/rising" trajectories. These findings suggest that PA and perhaps other school-based universal SEL programs have the potential to yield comparable benefits across subgroups of youth with differing trajectories of positive and negative behaviors, making them promising strategies for achieving the intended goal of school-wide improvements in student outcomes.

Effects of a School-Based Social-Emotional and Character Development Program on Health Behaviors: A Matched-Pair, Cluster-Randomized Controlled Trial.

There is considerable research that suggests that school-based social-emotional programs can foster improved mental health and reduce problem behaviors for participating youth; in contrast, much less is known about the impact of these programs on physical health, even though some of these programs also include at least limited direct attention to promoting physical health behaviors. We examined the effects of one such program, Positive Action (PA), on physical health behaviors and body mass index (BMI), and tested for mediation of program effects through a measure of social-emotional and character development (SECD). Participating schools in the matched-pair, cluster-randomized trial were 14 low-performing K-8 Chicago Public Schools. We followed a cohort of students in each school from grades 3 to 8 (eight waves of data collection; 1170 total students). Student self-reports of health behaviors served as the basis for measures of healthy eating and exercise, unhealthy eating, personal hygiene, consistent bedtime, and SECD. We collected height and weight measurements at endpoint to calculate age- and gender-adjusted BMI z-scores. Longitudinal multilevel modeling analyses revealed evidence of favorable program effects on personal hygiene [effect size (ES) = 0.48], healthy eating and exercise (ES = 0.21), and unhealthy eating (ES = -0.19); in addition, BMI z-scores were lower among students in PA schools at endpoint (ES = -0.21). Program effects were not moderated by either gender or student mobility. Longitudinal structural equation modeling demonstrated mediation through SECD for healthy eating and exercise, unhealthy eating, and personal hygiene. Findings suggest that a SECD program without a primary focus on health behavior promotion can have a modest impact on outcomes in this domain during the childhood to adolescence transition.

Adolescent Substance Use Following Participation in a Universal Drug Prevention Program: Examining Relationships With Program Recall and Baseline Use Status.

BACKGROUND: The study examined whether adolescents receiving a universal, school based, drug prevention program in Grade 7 varied, by student profile, in substance use behaviors post program implementation. Profiles were a function of recall of program receipt and substance use at baseline. METHODS: A secondary analysis was conducted on data from the Adolescent Substance Abuse Prevention Study, a large, geographically diverse, longitudinal school-based cluster-randomized controlled trial of the Take Charge of Your Life drug prevention program. Profiles were created using self-reported substance use (preintervention) and program recall (postintervention) at Grade 7. First, characteristics of each of the 4 profiles of treatment students who varied by program recall and baseline substance use were explored. Then, multilevel logistic regression analyses were used to examine differences in the odds of substance use (alcohol, tobacco, and marijuana) among student profiles at the 6 additional study waves (Time 2 [Grade 7] through Time 7 [Grade 11]). RESULTS: Pearson's chi-square tests showed sample characteristics varied by student profile. Multilevel logistic regression results were consistent across all examined substance use behaviors at all time points. Namely, as compared with students who had no baseline substance use and had program recall (No Use, Recall), each of the remaining 3 profiles (No Use, No Recall; Use, Recall; Use, No Recall) were more likely to engage in substance use. Post hoc analyses showed that for the 2 subprofiles of baseline substance users, there were only 2 observed, and inconsistent, differences in the odds of subsequent substance use by recall status. CONCLUSIONS: Findings suggest that for students who were not baseline substance users, program recall significantly decreased the likelihood of subsequent substance use. For students who were baseline substance users, program recall did not generally influence subsequent substance use. Implications for school-based drug prevention programs are discussed.

Identification of Important Factors When Measuring School Climate: Latent Construct Validation and Exploration.

BACKGROUND: Researchers regularly must decide what information is necessary to understand school climate and how to include climate in a study. For example, which factors and/or scales should be used, is using just 1 scale for school climate sufficient, and to what extent does the selection of a single scale influence the research findings? AIMS: Understanding what factors to consider and which available scales to review will assist those interested in measuring school climate. METHODS: This study explores 8 validated scales related to school climate. Data used are from a previous study (Social and Character Development cooperative agreement funded by IES #R305L030072 and #R305A080253) that looked at Positive Action, a social emotional and character development program for elementary-, middle-, and high-school students. RESULTS AND CONCLUSION: Scale correlations and factor analyses show how these scales work together to measure overall middle school climate.

Meeting the Challenges of Longitudinal Cluster-Based Trials in Schools: Lessons From the Chicago Trial of Positive Action.

We describe challenges in the 6-year longitudinal cluster randomized controlled trial (CRCT) of Positive Action (PA), a social-emotional and character development (SECD) program, conducted in 14 low-income, urban Chicago Public Schools. Challenges pertained to logistics of study planning (school recruitment, retention of schools during the trial, consent rates, assessment of student outcomes, and confidentiality), study design (randomization of a small number of schools), fidelity (implementation of PA and control condition activities), and evaluation (restricted range of outcomes, measurement invariance, statistical power, student mobility, and moderators of program effects). Strategies used to address the challenges within each of these areas are discussed. Incorporation of lessons learned from this study may help to improve future evaluations of longitudinal CRCTs, especially those that involve evaluation of school-based interventions for minority populations and urban areas.

Effects of the Positive Action Program on Indicators of Positive Youth Development Among Urban Youth.

This study evaluated effects of Positive Action, a school-based social-emotional and character development (SECD) intervention, on indicators of positive youth development (PYD) among a sample of low-income, ethnic minority youth attending 14 urban schools. The study used a matched-pair, cluster-randomized controlled design at the school level. A multiple-measure self-report protocol assessed four key strengths and resources for PYD: self-concept, peer affiliations, ethics, and social skills. Students (n=1170) were assessed from grades 3 to 8, the duration of the intervention, with drop-outs and late entrants included in analyses. Growth curve analyses revealed evidence of favorable program effects on each of the four types of resources. The study contributes to PYD research by providing evidence for school-based interventions in low-income, urban contexts for ethnic minority youth.

Effects of Positive Action on the emotional health of urban youth: a cluster-randomized trial.

PURPOSE: We examined the effects of Positive Action (PA), a school-based social-emotional learning and health promotion program, on the emotional health of predominately low-income and ethnic minority urban youth. METHODS: The study was a matched-pair, cluster-randomized controlled trial involving 14 Chicago public schools. Outcomes were assessed over a 6-year period of program implementation for a cohort of youth in each school, followed from grades 3 to 8. Youth reported on their emotional health (positive affect, life satisfaction, depression, anxiety) and social-emotional and character development. Growth-curve and structural-equation modeling analyses assessed overall program effects on the emotional health outcomes as well as mediation of these effects via the program's impact on youths' social-emotional and character development. RESULTS: Students in PA schools, compared with those in control schools, had more favorable change over the course of the study in positive affect (standardized mean difference effect size [ES] = .17) and life satisfaction (ES = .13) as well as significantly lower depression (ES = -.14) and anxiety (ES = -.26) at study end point. Program effects for positive affect, depression, and anxiety were mediated by more favorable change over time in social-emotional and character development for students in PA schools. CONCLUSIONS: Results suggest that universal, school-based programs can benefit the emotional health of youth in low-income, urban settings. The modest magnitude of effects over an extended period of program implementation, however, reflects the challenges of both mounting interventions and offsetting formidable risks for mental health problems in such environments.

Using social-emotional and character development to improve academic outcomes: a matched-pair, cluster-randomized controlled trial in low-income, urban schools.

BACKGROUND: School-based social-emotional and character development (SECD) programs can influence not only SECD but also academic-related outcomes. This study evaluated the impact of one SECD program, Positive Action (PA), on educational outcomes among low-income, urban youth. METHODS: The longitudinal study used a matched-pair, cluster-randomized controlled design. Student-reported disaffection with learning and academic grades, and teacher ratings of academic ability and motivation were assessed for a cohort followed from grades 3 to 8. Aggregate school records were used to assess standardized test performance (for entire school, cohort, and demographic subgroups) and absenteeism (entire school). Multilevel growth-curve analyses tested program effects. RESULTS: PA significantly improved growth in academic motivation and mitigated disaffection with learning. There was a positive impact of PA on absenteeism and marginally significant impact on math performance of all students. There were favorable program effects on reading for African American boys and cohort students transitioning between grades 7 and 8, and on math for girls and low-income students. CONCLUSIONS: A school-based SECD program was found to influence academic outcomes among students living in low-income, urban communities. Future research should examine mechanisms by which changes in SECD influence changes in academic outcomes.

Problem behavior and urban, low-income youth: a randomized controlled trial of positive action in Chicago.

BACKGROUND: Youth problem behaviors remain a public health issue. Youth in low-income, urban areas are particularly at risk for engaging in aggressive, violent, and disruptive behaviors. PURPOSE: To evaluate the effects of a school-based social-emotional learning and health promotion program on problem behaviors and related attitudes among low-income, urban youth. DESIGN: A matched-pair, cluster RCT. SETTING/PARTICIPANTS: Participants were drawn from 14 Chicago Public Schools over a 6-year period of program delivery with outcomes assessed for a cohort of youth followed from Grades 3 to 8. Data were collected from Fall 2004 to Spring 2010, and analyzed in Spring 2012. INTERVENTION: The Positive Action program includes a scoped and sequenced K-12 classroom curriculum with six components: self-concept, social and emotional positive actions for managing oneself responsibly, and positive actions directed toward physical and mental health, honesty, getting along with others, and continually improving oneself. The program also includes teacher, counselor, family, and community training as well as activities directed toward schoolwide climate development. MAIN OUTCOME MEASURES: Youth reported on their normative beliefs in support of aggression and on their bullying, disruptive, and violent behaviors; parents rated youths' bullying behaviors and conduct problems; schoolwide data on disciplinary referrals and suspensions were obtained from school records. RESULTS: Multilevel growth-curve modeling analyses conducted on completion of the trial indicated that Positive Action mitigated increases over time in (1) youth reports of normative beliefs supporting aggressive behaviors and of engaging in disruptive behavior and bullying (girls only) and (2) parent reports of youth bullying behaviors (boys only). At study end-point, students in Positive Action schools also reported a lower rate of violence-related behavior than students in control schools. Schoolwide findings indicated positive program effects on both disciplinary referrals and suspensions. Program effect sizes ranged from -0.26 to -0.68. CONCLUSIONS: These results extend evidence of the effectiveness of the Positive Action program to low-income, minority, urban school settings, and to middle school-aged youth.

Direct and Mediated Effects of a Social-Emotional and Character Development Program on Adolescent Substance Use.

Mitigating and preventing substance use among adolescents requires approaches that address the multitude of factors that influence this behavior. Such approaches must be tested, not only for evidence of empirical effectiveness, but also to determine the mechanisms by which they are successful. The aims of the present study were twofold: 1) To determine the effectiveness of a school-based social-emotional and character development (SECD) program, Positive Action (PA), in reducing substance use (SU) among a sample of U.S. youth living in a low-income, urban environment, and 2) to test one mechanism by which the program achieves its success. We used longitudinal mediation analysis to test the hypotheses that: 1) students attending PA intervention schools engage in significantly less SU than students attending control schools, 2) students attending PA intervention schools show significantly better change in SECD than students attending control schools, and 3) the effect of the PA intervention on SU is mediated by the change in SECD. Analyses revealed program effects on both SECD and SU, a relationship between SECD and SU, and the effects of PA on SU were completely mediated by changes in SECD. Future research directions and implications for school-based social-emotional and character development efforts and substance use prevention are addressed.