Advertisement

The Journal of Primary Prevention

, Volume 37, Issue 1, pp 87–105 | Cite as

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

  • Niloofar Bavarian
  • Kendra M. Lewis
  • Alan Acock
  • David L. DuBois
  • Zi Yan
  • Samuel Vuchinich
  • Naida Silverthorn
  • Joseph Day
  • Brian R. Flay
Original Paper

Abstract

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.

Keywords

Health behavior Social–emotional and character development School-based trial 

Notes

Acknowledgments

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.

Author contribution

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.

References

  1. 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
  2. Baron, R. M., & Kenny, D. A. (1986). The moderator–mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations. Journal of Personality and Social Psychology, 51, 1173–1182.CrossRefPubMedGoogle Scholar
  3. Basch, C. E. (2011). Breakfast and the achievement gap among urban minority youth. Journal of School Health, 81(10), 635–640.CrossRefPubMedGoogle Scholar
  4. 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
  5. 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
  6. 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
  7. 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
  8. Collaborative for Academic, Social, and Emotional Learning. (2005). Safe and sound: An educational leader’s guide to evidence-based social and emotional learning programsIllinois edition. Google Scholar
  9. Dewald, J. F., Meijer, A. M., Oort, F. J., Kerkhof, G. A., & Bogels, S. M. (2010). The influence of sleep quality, sleep duration and sleepiness on school performance in children and adolescents: A meta-analytic review. Sleep Medicine Reviews, 14(3), 179–189.CrossRefPubMedGoogle Scholar
  10. Durlak, J. A., Weissberg, R. P., Dymnicki, A. B., Taylor, R. D., & Schellinger, K. B. (2011). The impact of enhancing students’ social and emotional learning: A meta- analysis of school-based universal interventions. Child Development, 82, 405–432.CrossRefPubMedGoogle Scholar
  11. Economos, C. D., Hyatt, R. R., Must, A., Goldberg, J. P., Kuder, J., Naumova, E. N., et al. (2013). Shape Up Somerville two-year results: A community-based environmental change intervention sustains weight reduction in children. Preventive Medicine, 57(4), 322–327.CrossRefPubMedGoogle Scholar
  12. 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
  13. 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
  14. Gordon, R. A. A. (2012). Applied statistics for the social and health sciences. New York, NY: Routledge.Google Scholar
  15. Hox, J. J., & Maas, C. J. M. (2001). The accuracy of multilevel structural equation modeling with pseudobalanced groups and small samples. Structural Equation Modeling, 8(2), 157–174.CrossRefGoogle Scholar
  16. 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
  17. 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
  18. 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
  19. Lewis, K. M., DuBois, D. L., Bavarian, N., Acock, A., Silverthorn, N., Day, J., et al. (2013a). Effects of Positive Action on the emotional health of urban youth: A cluster-randomized trial. Journal of Adolescent Health, 53(6), 706–711.CrossRefPubMedGoogle Scholar
  20. Lewis, K. M., Schure, M. B., Bavarian, N., DuBois, D. L., Day, J., Ji, P., et al. (2013b). Problem behavior and urban, low-income youth: A randomized controlled trial of Positive Action in Chicago. American Journal of Preventive Medicine, 44(6), 622–630.PubMedCentralCrossRefPubMedGoogle Scholar
  21. Li, K. K., Washburn, I., DuBois, D. L., Vuchinich, S., Ji, P., Brechling, V., et al. (2011). Effects of the Positive Action programme on problem behaviours in elementary school students: A matched-pair randomised control trial in Chicago. Psychology & Health, 26(2), 187–204.CrossRefGoogle Scholar
  22. Lipsey, M. W., & Wilson, D. B. (2001). Practical meta-analysis. Thousand Oaks: Sage.Google Scholar
  23. London, R. A., & Castrechini, S. (2011). A longitudinal examination of the link between youth physical fitness and academic achievement. Journal of School Health, 81(7), 400–408.CrossRefPubMedGoogle Scholar
  24. MacKinnon, D. P. (2008). Introduction to statistical mediation analysis. New York, NY: Lawrence Erlbaum Associates.Google Scholar
  25. MacKinnon, D. P., Lockwood, C. M., Hoffman, J. M., West, S. G., & Sheets, V. (2002). A comparison of methods to test mediation and other intervening variable effects. Psychological Methods, 7, 83–104.PubMedCentralCrossRefPubMedGoogle Scholar
  26. Malik, V. S., Shultze, M. B., & Hu, F. B. (2006). Intake of sugar-sweetened beverages and weight gain: A systematic review. The American Journal of Clinical Nutrition, 84(2), 274–288.PubMedCentralPubMedGoogle Scholar
  27. National Sleep Foundation. (2016). Children and sleep. Resource document. National Sleep Foundation. http://www.sleepfoundation.org/article/sleep-topics/children-and-sleep.
  28. Orsi, J. M., Margellos-Anast, H., & Whitman, S. (2010). Black–white health disparities in the United States and Chicago: A 15-year progress analysis. American Journal of Public Health, 100(2), 349–356.PubMedCentralCrossRefPubMedGoogle Scholar
  29. Rabe-Hesketh, S., & Skrondal, A. (2008). Multilevel and longitudinal modeling using Stata (2nd ed.). College Station: Stata Press.Google Scholar
  30. Raudenbush, S. W., & Bryk, A. S. (2002). Hierarchical linear models: Applications and data analysis methods, Col 1. Thousand Oaks: Sage.Google Scholar
  31. Sánchez-Meca, J., Marín-Martínez, F., & Chacón-Moscoso, S. (2003). Effect-size indices for dichotomized outcomes in meta-analysis. Psychological Methods, 8(4), 448–467.CrossRefPubMedGoogle Scholar
  32. Singer, J. D., & Willett, J. B. (2003). Applied longitudinal data analysis: Modeling change and event occurrence. New York: Oxford University Press.CrossRefGoogle Scholar
  33. 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
  34. 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
  35. Tobler, A. L., & Komro, K. A. (2011). Contemporary options for longitudinal follow-up: Lessons learned from a cohort of urban adolescents. Evaluation and Program Planning, 34(2), 87–96.PubMedCentralCrossRefPubMedGoogle Scholar
  36. Vuchinich, S., Flay, B. R., Aber, L., & Bickman, L. (2012). Person mobility in the design and analysis of cluster-randomized cohort prevention trials. Prevention Science, 13(3), 300–313.CrossRefPubMedGoogle Scholar
  37. 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
  38. Williams, J., & MacKinnon, D. P. (2008). Resampling and distribution of the product methods for testing indirect effects in complex models. Structural Equation Modeling, 15(1), 23–51.PubMedCentralCrossRefPubMedGoogle Scholar
  39. Zhang, Z., Zyphur, M. J., & Preacher, K. J. (2009). Testing multilevel mediation using hierarchical linear models. Organizational Research Methods, 12(4), 695–719.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  • Niloofar Bavarian
    • 1
  • Kendra M. Lewis
    • 2
  • Alan Acock
    • 3
  • David L. DuBois
    • 4
  • Zi Yan
    • 5
  • Samuel Vuchinich
    • 3
  • Naida Silverthorn
    • 4
  • Joseph Day
    • 6
  • Brian R. Flay
    • 3
  1. 1.College of Health and Human ServicesCalifornia State University, Long BeachLong BeachUSA
  2. 2.4-H Youth Development Program, Division of Agriculture and Natural ResourcesUniversity of CaliforniaDavisUSA
  3. 3.College of Public Health and Human SciencesOregon State UniversityCorvallisUSA
  4. 4.School of Public HealthUniversity of Illinois at ChicagoChicagoUSA
  5. 5.Health SciencesMerrimack CollegeNorth AndoverUSA
  6. 6.College of Health and Human ServicesGovernors State UniversityChicagoUSA

Personalised recommendations