The Effectiveness of Universal School-Based Programs for the Prevention of Violent and Aggressive Behavior: A Report on Recommendations of the Task Force on Community Preventive Services

To determine whether an interactive curriculum that integrates dating violence prevention with lessons on healthy relationships, sexual health, and substance use reduces physical dating violence (PDV).Design: Cluster randomized trial with 2.5-year followup; prespecified subgroup analyses by sex.Setting: Grade 9 health classes.Participants: A total of 1722 students aged 14-15 from 20 public schools (52.8% girls).Intervention: A 21-lesson curriculum delivered during 28 hours by teachers with additional training in the dynamics of dating violence and healthy relationships. Dating violence prevention was integrated with core lessons about healthy relationships, sexual health, and substance use prevention using interactive exercises. Relationship skills to promote safer decision making with peers and dating partners were emphasized. Control schools targeted similar objectives without training or materials. Main Outcome Measures:The primary outcome at 2.5 years was self-reported PDV during the previous year. Secondary outcomes were physical peer violence, sub-stance use, and condom use. Analysis was by intentionto-treat. Results:The PDV was greater in control vs intervention students (9.8% vs 7.4%; adjusted odds ratio, 2.42; 95% confidence interval, 1.00-6.02; P = .05). A significant group ϫ sex interaction effect indicated that the intervention effect was greater in boys (PDV: 7.1% in controls vs 2.7% in intervention students) than in girls (12.1% vs 11.9%). Main effects for secondary outcomes were not statistically significant; however, sex ϫ group analyses showed a significant difference in condom use in sexually active boys who received the intervention (114 of 168; 67.9%) vs controls (65 of 111 [58.6%]) (PϽ.01). The cost of training and materials averaged CA$16 per student. Conclusion:The teaching of youths about healthy relationships as part of their required health curriculum reduced PDV and increased condom use 2.5 years later at a low per-student cost.

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A School-Based Program to Prevent Adolescent Dating Violence

Wolfe¹,

Crooks²,

Jaffe³

et al. 2009

Arch Pediatr Adolesc Med

424

360

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Effects of a Youth Substance Use Prevention Program on Stealing, Fighting, and Weapon Use

et al. 2014

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Using a sample of sixth graders in 11 public schools in a large Southwestern city, this longitudinal study examined how a model substance use prevention program, keepin’ it REAL, that was implemented in 7th grade, influenced three other problem behaviors (fighting, weapon use, stealing), measured in 8th grade. Using a non-equivalent control group design, we compared 259 students in the intervention to 322 students in a treatment-as-usual condition. At baseline, 37% of the sample reported fighting in the last 30 days; 31% reported stealing in the last 30 days, and 16% reported using a weapon in the last 30 days. Regression analyses adjusted for students nested in schools through multi-level modeling and for missing data through multiple imputation. We found that at posttest the rates of all three behaviors were lower in the intervention group than the control group at posttest: 35% versus 37% got into a fight in the last 30 days; 24% versus 31% stole something in the last 30 days; and 16% versus 25% used a weapon in the last 30 days. The program impact for fighting and stealing was not statistically significant and involved minimal effect sizes. The program impact for weapon use was not statistically significant but had an effect size comparable to that for other problem behavior interventions. Promoting positive development via life skills may be a key to broadening program impact.

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Participants’ Perceptions of a Violence Prevention Curriculum for Middle School Students: Was It Relevant and Useful?

et al. 2015

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School-based youth violence prevention programs, particularly those focused on middle school students, have generally had limited effects that are often not sustained over time. Although many interventions focus on teaching social-cognitive skills, few studies have explored the extent to which students master these skills, actually use them, and find them effective in dealing with problem situations. This study examined these issues based on interviews with 141 students attending one county and two urban middle schools in classrooms where the Second Step violence prevention program had been implemented. We coded interviews to assess participants' general reactions to the interventions, use of skills, and effectiveness of skills. We also asked participants to describe outcomes they experienced when they used specific skills taught in the intervention in response to problem situations. Participants had generally positive reactions to the intervention. Their suggestions for improving the intervention primarily concerned improving its relevance. Participants described changes they had made based on the intervention, particularly controlling anger and improving relations with others. Their responses indicated that they sometimes misunderstood or misused specific intervention skills, especially problem solving and empathy. Students' descriptions of the outcomes they experienced when using intervention skills were not uniformly positive. This was especially true for situations involving peers such as peer pressure and bullying. These results underscore the need for more intensive efforts to ensure that students master intervention skills and are able to use them correctly. In addition, interventions should address the broader social context (e.g., peers, school) to maximize the effectiveness of skills.

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The Effectiveness of Universal School-Based Programs for the Prevention of Violent and Aggressive Behavior: A Report on Recommendations of the Task Force on Community Preventive Services

Cited by 20 publications

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A School-Based Program to Prevent Adolescent Dating Violence

A School-Based Program to Prevent Adolescent Dating Violence

Effects of a Youth Substance Use Prevention Program on Stealing, Fighting, and Weapon Use

Participants’ Perceptions of a Violence Prevention Curriculum for Middle School Students: Was It Relevant and Useful?

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