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Abstract: Background: The illicit use of prescription stimulants (IUPS) has emerged as a high-risk behavior of the 21st century college student. As the study of IUPS is relatively new, we aimed to understand (1) characteristics of IUPS (i.e., initiation, administration routes, drug sources, motives, experiences), and (2) theory-guided intrapersonal, interpersonal, and environmental correlates associated with use. Methods: Using one-stage cluster sampling, 520 students (96.3% response rate) at one Pacific Northwest University completed a paper-based, in-classroom survey on IUPS behaviors and expected correlates. Aim 1 was addressed using descriptive statistics and aim 2 was addressed via three nested logistic regression analyses guided by the Theory of Triadic Influence. Results: The prevalence of ever engaging in IUPS during college was 25.6%. The majority (>50.0%) of users reported initiation during college, oral use, friends as the drug source, academic motives, and experiencing desired outcomes. Intrapersonal correlates associated with use included identifying as White, lower grade point average, diagnoses of attention deficit disorder, and lower avoidance self-efficacy. Interpersonal correlates of use included off-campus residence, varsity sports participation, IUPS perceptions by socializing agents, and greater behavioral norms. Exposure to prescription drug print media, greater prescription stimulant knowledge, and positive attitudes towards prescription stimulants were environmental correlates associated with use. In all models, IUPS intentions were strongly associated with use. Conclusions: IUPS was prevalent on the campus under investigation and factors from the intrapersonal, interpersonal and environmental domains were associated with the behavior. Implications for prevention and future research are discussed. [Copyright &y& Elsevier]

This article presents an adapted version of an established model for assessing community readiness along with an illustrative case example from the evaluation of Positive Action, a school-based social and character development intervention, implemented as part of a randomized controlled trial in Chicago Public Schools from 2004 through 2010. Community readiness is an emerging assessment approach that can be used to gauge the level of understanding, desire, and ownership that community members have regarding a community problem and/or intervention. This approach is useful in engaging the community and leveraging particular aspects of readiness that the community may exhibit in order to maximize an intervention’s successful implementation. The article concludes with a discussion of ways in which a community readiness model may be useful in health promotion practice, both in schools and in other community settings. [ABSTRACT FROM PUBLISHER]

The Social-Emotional and Character Development Scale (SECDS) is intended as a measure of social-emotional skills and character for elementary school-age children. This study investigated the measure's psychometric properties using data collected over 5 waves for a cohort of students followed from Grades 3 to 5 in 14 urban elementary schools (N Range = 500 to 593). Confirmatory factor analysis indicated good fit to the measure's hypothesized first- and second-order factor structure at each wave. Scales corresponding to the first-order factor structure demonstrated adequate internal consistency and test-retest reliability. Consistent with previous research using similar measures of social-emotional skills and character, a longitudinal analysis indicated that the means for these scales decreased over the 5 waves. The validity of the SECDS general and individual scales was supported via their patterns of association with measures of expected correlates of social-emotional skills and character. Overall, findings suggest the SECDS is appropriate for assessing the development of different facets of social-emotional skills and character during elementary grades and that it could be useful for investigating their role in the developmental pathways for a range of important youth outcomes. [ABSTRACT FROM AUTHOR]

The recent Institute of Medicine report on prevention (National Research Council & Institute of Medicine, 2009) noted the substantial interrelationship among mental, emotional, and behavioral disorders and pointed out that, to a great extent, these problems stem from a set of common conditions. However, despite the evidence, current research and practice continue to deal with the prevention of mental, emotional, and behavioral disorders as if they are unrelated and each stems from different conditions. This article proposes a framework that could accelerate progress in preventing these problems. Environments that foster successful development and prevent the development of psychological and behavioral problems are usefully characterized as nurturing environments. First, these environments minimize biologically and psychologically toxic events. Second, they teach, promote, and richly reinforce prosocial behavior, including self-regulatory behaviors and all of the skills needed to become productive adult members of society. Third, they monitor and limit opportunities for problem behavior. Fourth, they foster psychological flexibility-the ability to be mindful of one's thoughts and feelings and to act in the service of one's values even when one's thoughts and feelings discourage taking valued action. We review evidence to support this synthesis and describe the kind of public health movement that could increase the prevalence of nurturing environments and thereby contribute to the prevention of most mental, emotional, and behavioral disorders. This article is one of three in a special section (see also Muñoz Beardslee, & Leykin, 2012; Yoshikawa, Aber, & Beardslee, 2012) representing an elaboration on a theme for prevention science developed by the 2009 report of the National Research Council and Institute of Medicine. [ABSTRACT FROM AUTHOR]

BACKGROUND: School safety and quality affect student learning and success. This study examined the effects of a comprehensive elementary school-wide social-emotional and character education program, Positive Action, on teacher, parent, and student perceptions of school safety and quality utilizing a matched-pair, cluster-randomized, controlled design. The Positive Action Hawai'i trial included 20 racially/ethnically diverse schools and was conducted from 2002-2003 through 2005-2006. METHODS: School-level archival data, collected by the Hawai'i Department of Education, were used to examine program effects at 1-year post-trial. Teacher, parent, and student data were analyzed to examine indicators of school quality such as student safety and well-being, involvement, and satisfaction, as well as overall school quality. Matched-paired t-tests were used for the primary analysis, and sensitivity analyses included permutation tests and random-intercept growth curve models. RESULTS: Analyses comparing change from baseline to 1-year post-trial revealed that intervention schools demonstrated significantly improved school quality compared to control schools, with 21%, 13%, and 16% better overall school quality scores as reported by teachers, parents, and students, respectively. Teacher, parent, and student reports on individual school-quality indicators showed improvement in student safety and well-being, involvement, satisfaction, quality student support, focused and sustained action, standards-based learning, professionalism and system capacity, and coordinated team work. Teacher reports also showed an improvement in the responsiveness of the system. CONCLUSIONS: School quality was substantially improved, providing evidence that a school-wide social-emotional and character education program can enhance school quality and facilitate whole-school change. [ABSTRACT FROM AUTHOR]

The effects of a school-based social-emotional and character development program, Positive Action, on the developmental trajectory of social-emotional and character-related behaviors was evaluated using data from three school-based randomized trials in elementary schools. Results come from 1) 4 years of data from students in 20 Hawai'i schools, 2) 3 years of data from students in 14 schools in Chicago and 3) 3 years of data from students in 8 schools in a southeastern state. Random intercept, multilevel, growth-curve analyses showed that students in both control and Positive Action schools exhibited a general decline in the number of positive behaviors associated with social-emotional and character development that were endorsed. However, the Positive Action intervention significantly reduced these declines in all three trials. Taken together, these analyses 1) give insight into the normative trajectory of behaviors associated with social-emotional and character development and 2) provide evidence for the effectiveness of Positive Action in helping children maintain a relatively beneficial developmental trajectory. [ABSTRACT FROM AUTHOR]

Living in poverty and living in areas of concentrated poverty pose multiple risks for child development and for overall health and wellbeing. Poverty is a major risk factor for several mental, emotional, and behavioral disorders, as well as for other developmental challenges and physical health problems. In this paper, the Promise Neighborhoods Research Consortium describes a science-based framework for the promotion of child health and development within distressed high-poverty neighborhoods. We lay out a model of child and adolescent developmental outcomes and integrate knowledge of potent and malleable influences to define a comprehensive intervention framework to bring about a significant increase in the proportion of young people in high-poverty neighborhoods who will develop successfully. Based on a synthesis of research from diverse fields, we designed the Creating Nurturing Environments framework to guide community-wide efforts to improve child outcomes and reduce health and educational inequalities. [ABSTRACT FROM AUTHOR]

This study examined the effects of the Positive Action (PA) programme in Chicago Public Schools on problem behaviours among a cohort of elementary school students from grade three through grade five. Using a matched-pair, randomised control design with 14 elementary schools, approximately 510 fifth-graders self-reported lifetime substance use, serious violence-related behaviour, and current bullying and disruptive behaviours. Three-level (i.e. students nested within schools within school pairs) overdispersed Poisson models were used to examine programme effects on the number of items endorsed for each of the four outcomes. Findings indicated that students in the intervention endorsed 31% fewer substance use behaviours (incidence rate ratio [IRR] = 0.69), 37% fewer violence-related behaviours (IRR = 0.63) and 41% fewer bullying behaviours (IRR = 0.59), respectively, compared to students in the control schools. Reduction in reported disruptive behaviours was of a similar magnitude (27%, IRR = 0.73), but was not statistically significant. These results replicate findings of an earlier randomised trial of the PA programme and extend evidence of its effectiveness to youth attending large urban school systems. [ABSTRACT FROM AUTHOR]

Purpose: Interventions to improve school ethos can reduce substance use but “upstream” causal pathways relating to implementation and school-level changes are uncertain. We use qualitative and quantitative data from a pilot trial to build hypotheses regarding these. Methods: The Healthy School Ethos intervention involved two schools being provided with facilitation, training, and funding to plan and implement actions (some mandatory and some locally determined) to improve school ethos over one year. The evaluation involved a pilot-trial with two intervention and two comparison schools; semi-structured interviews with facilitators, staff, and students; and baseline and follow-up surveys with students aged 11 to 12 years. Results: Student accounts linked participation in planning or delivering intervention activities with improved self-regard and relationships with staff and other students. Some activities such as re-writing school rules involved broad participation. Students in receipt of actions such as peer-mediation or motivational sessions reported benefits such as improved safety and relationships. Some student accounts linked improved self-regard and relationships with increased engagement and aspirations, and reduced substance use. At 9-month follow-up, students in intervention schools reported less hurting and teasing of others and feeling unsafe at school. Other outcomes suggested intervention benefits but were not significant. Conclusions: School-ethos interventions may reduce substance use through upstream pathways involving the aforementioned factors. Future phase-III trials should quantitatively model the extent to which these mediate intervention effects. [Copyright &y& Elsevier]

This study compared the impact of the Aban Aya Youth Project (AAYP; Archives of Pediatric and Adolescent Medicine 158: 377-384, 2004) social development classroom curriculum (SDC), school/family/community (SC) intervention curriculum, and a health enhancement curriculum (HEC) attention placebo control on changes over time in violent behaviors among participating youth. Grade 5 pretest and grades 5-8 posttest data were used to investigate the possibility of differential intervention effects, especially the extent to which the SDC and SC interventions were differentially efficacious across age. Unlike most previous investigations of AAYP intervention effects, this study included youth who joined the study after baseline data collection in the outcome analyses. Findings indicated that, regardless of age level, the SDC limited the growth of violence of participating students when compared to students in the control condition. In the SC, however, reduction in the growth of violence emerged only among older participants. Importantly, this included joiners who received less exposure to the intervention. Findings for the SDC are consistent with recent meta-analyses of school based programs, whereas SC findings suggest that violence prevention curricula alone are not sufficient for highly mobile students and that interventions for such populations need to engage multiple social ecological systems. Editors' Strategic Implications: The authors present promising violence prevention findings, and they also provide important answers to dosage and developmental timing questions with their analyses of these longitudinal data. [ABSTRACT FROM AUTHOR]

This study illustrates a method to evaluate mediational mechanisms in a longitudinal prevention trial, the Aban Aya Youth Project (AAYP). In previous studies, interventions of AAYP were found to be effective in reducing the growth of violence, substance use and unsafe sex among African American adolescents. In this article, we hypothesized that the effects of the interventions in reducing the growth of substance use behavior were achieved through their effects in changing intermediate processes such as behavioral intentions, attitudes toward the behavior, estimates of peers’ behaviors, best friends’ behaviors, and peer group pressure. In evaluating these mediational mechanisms, difficulties arise because the growth trajectories of the substance use outcome variable and some of the mediating variables were curvilinear. In addition, all of the multivariate mediational measures had planned missing data so that a score from the multiple items for a mediator could not be formed easily. In this article, we introduce a latent growth modeling (LGM) approach; namely, a two-domain LGM mediation model, in which the growth curves of the outcome and the mediator are simultaneously modeled and the mediation effects are evaluated. Results showed that the AAYP intervention effects on adolescent drug use were mediated by normative beliefs of prevalence estimates, friends’ drug use behavior, perceived friends’ encouragement to use, and attitudes toward the behavior. [ABSTRACT FROM AUTHOR]

Objectives. We assessed the effectiveness of a 5-year trial of a comprehensive school-based program designed to prevent substance use, violent behaviors, and sexual activity among elementary-school students. Methods. We used a matched-pair, cluster-randomized, controlled design, with 10 intervention schools and 10 control schools. Fifth-graders (N = 1714) self-reported on lifetime substance use, violence, and voluntary sexual activity. Teachers of participant students reported on student (N-1225) substance use and violence. Results. Two-level random-effects count models (with students nested within schools) indicated that student-reported substance use (rate ratio [RR] = 0.41; 90% confidence interval [CI] = 0.25. 0.66) and violence (RR-0.42; 90% CI = 0.24, 0,73) were significantly lower for students attending intervention schools. A 2-level random-effects binary model indicated that sexual activity was lower (odds ratio=0.24; 90% CI = 0.08, 0.66) for intervention students. Teacher reports substantiated the effects seen for student-reported data. Dose-response analyses indicated that students exposed to the program for at least 3 years had significantly lower rates of all negative behaviors. Conclusions. Risk-related behaviors were substantially reduced for students who participated in the program, providing evidence that a comprehensive school-based program can have a strong beneficial effect on student behavior. (Am J Public Health. 2009;99:1438-1445. doi: 10.2105/AJPH.2008.142919) [ABSTRACT FROM AUTHOR]

Abstract: Background: Underage heavy episodic drinking is a major contributor to alcohol-related morbidity/mortality. Reports indicate underage binge drinking among college students is widespread and has remained stable over the past decade. This study describes individual characteristics and calendar-specific events associated with binge drinking episodes over the course of freshman college academic year (2002–2003). Methods: Students (N =827, age 18 years), with a prior history of tobacco use, attending a large Midwest university completed weekly web-based surveys on the number of drinks consumed for each of the past 7 days over the duration of 35 consecutive weeks (avg. number of weeks reported 16.0±10.5). Results: Average prevalence of binge episodes across the academic year was 17.2±14.4%, 23.6±8.3%, and 66.3±11.2% for weekdays, Thursdays, and weekend days, respectively. Two-level random effects logit survival models for repeated events indicated the prevalence of weekday and Thursday binge drinking was associated with specific university/community events (Local festival odds ratio [OR] 6.03, 95% confidence interval [CI] 4.34–8.36), holidays (New Year''s Eve OR 18.48, CI 12.83–26.63), and academic breaks (Spring Break OR 6.45, CI 4.57–9.08). Expected associations of younger age of first heavy drinking, past 12-month drinking, and experiencing negative consequences from heavy drinking were observed. Conclusions: Although individual characteristics were related to engaging in a binge episode, binge episodes were strongly associated with time-specific calendar events. Effective interventions to prevent immediate and long-term health consequences associated with binge drinking should consider environmental and institutional policy-level controls to reduce high levels of binge drinking on college campuses connected with holidays and university/community events. [Copyright &y& Elsevier]

This article focuses on issues related to implementing school-based social and character development programs in the context of a large multiprogram evaluation study funded by the Institute of Education Sciences and the Centers for Disease Control and Prevention. Implementation analysis is a relatively new but important research area. The first section describes why this analysis is especially important when null results are obtained. It is also noted that not only does the intervention need to be documented but activities at the comparison site require explication. The wide range of implementation methods used at four of the seven sites in the Social and Character Development Research Program is described and difficulties in studying implementation at multiple sites are discussed. [ABSTRACT FROM AUTHOR]

Sustaining effective school-based prevention programs is critical to improving youth and population-based health. This article reports on results from the Aban Aya Sustainability Project, an effort to sustain a school-based prevention program that was tested via a randomized trial and targeted violence, drug use, and risky sex-related behaviors among a cohort of 5th-grade African American children followed through 10th grade. Sustainability project health educators trained parent educators to deliver the Aban Aya prevention curriculum in five schools, and project researchers studied the resultant curricular implementation and relations between the research and school-based teams. Study results showed uneven implementation across the five schools that we largely attributed to parent educator preparation and parent educator-health educator relations. These and related results are discussed to answer the study's primary research question: How viable was the sustainability project's parent-centered approach to sustaining a school-based prevention program? [ABSTRACT FROM AUTHOR]

Teacher- and school-level factors influence the fidelity of implementation of school-based prevention and social character and development (SACD) programs. Using a diffusion of innovations framework, the relationships among teacher beliefs and attitudes towards a prevention/SACD program and the influence of a school’s administrative support and perceptions of school connectedness, characteristics of a school’s climate, were specified in two cross-sectional mediation models of program implementation. Implementation was defined as the amount of the programs’ curriculum delivered (e.g., lessons taught), and use of program-specific materials in the classroom (e.g., ICU boxes and notes) and in relation to school-wide activities (e.g., participation in assemblies). Teachers from 10 elementary schools completed year-end process evaluation reports for year 2 ( N = 171) and 3 ( N = 191) of a multi-year trial. Classroom and school-wide material usage were each favorably associated with the amount of the curriculum delivered, which were associated with teachers’ attitudes toward the program which, in turn, were related to teachers’ beliefs about SACD. These, in turn, were associated with teachers’ perceptions of school climate. Perceptions of school climate were indirectly related to classroom material usage and both indirectly and directly related to the use of school-wide activities. Program developers need to consider the importance of a supportive environment on program implementation and attempt to incorporate models of successful school leadership and collaboration among teachers that foster a climate promoting cohesiveness, shared visions, and support. [ABSTRACT FROM AUTHOR]