Effects of a School-Based Social–Emotional and Character Development Program on Health Behaviors: A Matched-Pair, Cluster-Randomized Controlled Trial
- 616 Downloads
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.
KeywordsHealth behavior Social–emotional and character development School-based trial
This project was funded by grants from the Institute of Education Sciences (IES), US Department of Education: R305L030072, R305L030004 and R305A080253 to the University of Illinois at Chicago (2003–2005) and Oregon State University (2005–2012). Preparation of this manuscript was supported, in part, by NIAAA T32 AA014125.
Brian Flay and David DuBois conceived the study and obtained funding, David DuBois and UIC staff oversaw program implementation, the program developer (Carol G. Allred) provided teacher/staff training, UIC and MPR staff collected all data, Niloofar Bavarian led the data analysis and wrote the first draft of this manuscript, and all co-authors assisted in paper revision and approved the final version.
Compliance With Ethical Standards
Conflict of Interest
The research described herein was done using the program, the training, and technical support of Positive Action, Inc. in which Dr. Flay’s spouse holds a significant financial interest; Dr. Flay was not involved in conducting data collection or analysis. Issues regarding conflict of interest were reported to the relevant institutions and appropriately managed following the institutional guidelines.
- Aud, S., Fox, M., & KewalRamani, A. (2010). Status and trends in the education of racial and ethnic groups (NCES 2010–2015). U.S. Department of Education, National Center for Education Statistics. Washington, DC: U.S. Government Printing Office.Google Scholar
- Bavarian, N., Lewis, K. M., DuBois, D. L., Acock, A., Vuchinich, S., Silverthorn, N., et al. (2013). Using social–emotional and character development to improve academic outcomes: A matched-pair, cluster-randomized trial in low-income, urban schools. Journal of School Health, 83(11), 771–779.CrossRefPubMedGoogle Scholar
- Beets, M. W., Flay, B. R., Vuchinich, S., Snyder, F. J., Acock, A., Li, K. K., et al. (2009). Use of a social and character development program to prevent substance use, violent behaviors, and sexual activity among elementary-school students in Hawaii. American Journal of Public Health, 99(8), 1438–1445.PubMedCentralCrossRefPubMedGoogle Scholar
- Bickman, L., Riemer, M., Brown, J. L., Jones, S. M., Flay, B. R., Li, K. K., & Massetti, G. (2009). Approaches to measuring implementation fidelity in school-based program evaluations. Journal of Research in Character Education, 7(2), 75–101.Google Scholar
- Brown, C. H., Wang, W., Kellam, S. G., Muthen, B. O., Petras, H., Toyinbo, P., et al. (2008). Methods for testing theory and evaluating impact in randomized field trials: Intent-to-treat analyses for integrating the perspectives of person, place, and time. Drug and Alcohol Dependence, 95(S1), S74–S104.PubMedCentralCrossRefPubMedGoogle Scholar
- Collaborative for Academic, Social, and Emotional Learning. (2005). Safe and sound: An educational leader’s guide to evidence-based social and emotional learning programs—Illinois edition. Google Scholar
- Flay, B. R., & Allred, C. G. (2010). The Positive Action program: Improving academics, behavior and character by teaching comprehensive skills for successful learning and living. In T. Lovat, R. Tommey, & N. Clement (Eds.), International research handbook on values education and student wellbeing (pp. 471–501). Dordrecht: Springer.CrossRefGoogle Scholar
- Flay, B. R., Snyder, F., & Petraitis, J. (2009). The theory of triadic influence. In R. J. DiClemente, M. C. Kegler, & R. A. Crosby (Eds.), Emerging theories in health promotion practice and research (2nd ed., pp. 451–510). San Francisco, CA: Jossey-Bass.Google Scholar
- Gordon, R. A. A. (2012). Applied statistics for the social and health sciences. New York, NY: Routledge.Google Scholar
- Ji, P., DuBois, D. L., & Flay, B. (2013). Social–emotional and character development scale: Development and initial validation with urban elementary school students. Journal of Research on Character Education, 9(2), 121–147.Google Scholar
- Ji, P., DuBois, D. L., Flay, B. R., & Brechling, V. (2008). “Congratulations, you have been randomized into the control group!(?)”: Issues to consider when recruiting schools for matched-pair randomized control trials of prevention Programs. Journal of School Health, 78(3), 131–139.CrossRefPubMedGoogle Scholar
- Lewis, K. M., Bavarian, N., Snyder, F. J., Acock, A., Day, J., DuBois, D. L., et al. (2012). Direct and mediated effects of a social–emotional and character development program on adolescent substance use. The International Journal of Emotional Education, 4(1), 56–78.PubMedCentralPubMedGoogle Scholar
- Lipsey, M. W., & Wilson, D. B. (2001). Practical meta-analysis. Thousand Oaks: Sage.Google Scholar
- MacKinnon, D. P. (2008). Introduction to statistical mediation analysis. New York, NY: Lawrence Erlbaum Associates.Google Scholar
- National Sleep Foundation. (2016). Children and sleep. Resource document. National Sleep Foundation. http://www.sleepfoundation.org/article/sleep-topics/children-and-sleep.
- Rabe-Hesketh, S., & Skrondal, A. (2008). Multilevel and longitudinal modeling using Stata (2nd ed.). College Station: Stata Press.Google Scholar
- Raudenbush, S. W., & Bryk, A. S. (2002). Hierarchical linear models: Applications and data analysis methods, Col 1. Thousand Oaks: Sage.Google Scholar
- Snyder, F., Vuchinich, S., Acock, A., Washburn, I., Beets, M., Li, K. K., et al. (2010). Impact of the Positive Action program on school-level indicators of academic achievement, absenteeism, and disciplinary outcomes: A matched-pair, cluster randomized, controlled trial. Journal of Research on Educational Effectiveness, 3(1), 26–55.PubMedCentralCrossRefPubMedGoogle Scholar
- Social and Character Development Research Consortium. (2010). Efficacy of school wide programs to promote social and character development and reduce problem behavior in elementary school children (NCER 2011–2001). Washington, DC: National Center for Education Research, Institute of Education Sciences, U.S. Department of Education.Google Scholar
- Washburn, I. J., Acock, A., Vuchinich, S., Snyder, F., Li, K. K., Ji, P., et al. (2011). Effects of a social–emotional and character development program on the trajectory of behaviors associated with social–emotional and character development: Findings from three randomized trials. Prevention Science, 12(3), 314–323.CrossRefPubMedGoogle Scholar