Effects of 2 prevention programs on high-risk behaviors among African American youth: a randomized trial

Abstract

Objective: To test the efficacy of 2 programs designed to reduce high-risk behaviors among inner-city African American youth.

Design: Cluster randomized trial.

Setting: Twelve metropolitan Chicago, Ill, schools and the communities they serve, 1994 through 1998.

Participants: Students in grades 5 through 8 and their parents and teachers.

Interventions: The social development curriculum (SDC) consisted of 16 to 21 lessons per year focusing on social competence skills necessary to manage situations in which high-risk behaviors occur. The school/community intervention (SCI) consisted of SDC and school-wide climate and parent and community components. The control group received an attention-placebo health enhancement curriculum (HEC) of equal intensity to the SDC focusing on nutrition, physical activity, and general health care.

Main outcome measures: Student self-reports of violence, provocative behavior, school delinquency, substance use, and sexual behaviors (intercourse and condom use).

Results: For boys, the SDC and SCI significantly reduced the rate of increase in violent behavior (by 35% and 47% compared with HEC, respectively), provoking behavior (41% and 59%), school delinquency (31% and 66%), drug use (32% and 34%), and recent sexual intercourse (44% and 65%), and improved the rate of increase in condom use (95% and 165%). The SCI was significantly more effective than the SDC for a combined behavioral measure (79% improvement vs 51%). There were no significant effects for girls.

Conclusions: Theoretically derived social-emotional programs that are culturally sensitive, developmentally appropriate, and offered in multiple grades can reduce multiple risk behaviors for inner-city African American boys in grades 5 through 8. The lack of effects for girls deserves further research.

Figure

Changes in school delinquency for boys and girls by condition from the beginning of grade 5 to the end of grade 8. Baseline intercepts shown are the average of the 3 conditions for each sex. HEC indicates health enhancement curriculum; SDC, social development curriculum; and SCI, school/community intervention.