Online Program

School Cluster Randomized Trial Reduced Risk Behaviors Such as Bullying, Fighting, And Substance Use Among Sixth Grade Students in Northwest Indiana Largely Rural Communities

Wednesday, November 4, 2015

Harry Piotrowski, MS, ITMESA, LLC (Inquiry Through Measurement Evaluation and Statistical Analysis), Oak Park, IL
Don Hedeker, PhD, Department of Public Health Studies - Department of Medicine, The University of Chicago Biological Sciences, Chicago, IL
Purpose: Randomized school cluster treatment and control 3-month follow-up intervention study results are reported with students with a high rate of school-based violence and who start alcohol, tobacco and other drugs  

Methods: Northwest Indiana largely rural communities. Evaluate Be the Exception Grade 6 program (1 of 3 Positive Potential, PATH INC, longiitudinal curriculum, Grades 6-7-8) includes instruction on making healthy choices and avoidance of risky behaviors in 5 50-minute sessions and a multi-media assembly.

 School-cluster randomized design, Treatment and usual instruction Control; 14/16 schools (2 dropped out);  1,776 students (eligible 62% consent/assent) yielded analytic 1,703 sample (930/773); baseline, 3-month follow-up questionnaires, 10-items adapted from MS-YRBS; students were asked, In the past year if they engaged in: bullying-2, fighting-2, substance use-5, viewing pornography-1. Data included demographic items (gender, race, ethnicity, age) and subscales: school attitudes, making healthy-choices and positive-future orientation, parent-teen communication, self-report of school grades, and suspension/expelled.     

 Analysis:  Separate three-level (L1-3,370 observations, L2-1,703 students, L3-103 classrooms) mixed effects regression models (Supermix) with ordinal outcomes for 6 scales: Total Risk Behaviors; Substance Use; and, Violence with  subscales Bullying, Fighting, viewing Pornography. School level (ICC less than 0.5%) was dropped; p<.05 defined significance. Focus of analysis is group, time, group-by-time effect.

Results:  51% female, 94% white, 13% Hispanic, 94% age 11-12; baseline: total risk behavior, at least one, 46%;  substance use, 9%; violence, 42%; fighting, 36%; bullying, 18%; pornography, 11%.  Tx group significantly higher weights on 4/6 scales at baseline; control group significantly higher weights at 3-month-follow-up on 5/6 scales; and, significant group-by-time interaction on 5/6 scales. Control group showed increased level of risk behaviors, treatment group remained at same level.  No differences in Pornography. Ordinal models illustrated ordered categories of riskness. 

 Conclusion: The grade 6  Be The Exception Program had a positive effect on students. Level of risk behaviors such as bullying, fighting and substance use increased for control and did not increase for treatment groups.

Learning Areas:

Conduct evaluation related to programs, research, and other areas of practice
Implementation of health education strategies, interventions and programs
Social and behavioral sciences

Learning Objectives:
Identify a newly developed middle school 6 session instruction program which demonstrates positive impact in self-report of risk behaviors such as bullying, fighting and substance use. Describe strategies and analytic methods used to implement a school-based cluster randomized trial among 14 schools and measure 3-month follow-up outcomes.

Keyword(s): Evaluation, Youth Violence

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the Evaluation Director for the project directed by PATH, INC, Valparaiso, IN, over the last 4 years. I have conducted research in the area of health promotion and disease prevention behaviors among adolescents over the last 10 years.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.