The development and evaluation of a multisystem social skills group training program for aggressive children

This research program assessed the effectiveness of a broad-based skills training program that targeted children's aggressive behaviors within the family, school, and peer systems. Children in Grades 1 to 6, referred by teachers, participated in 12 to 15 weeks of social skills training. Nine basic skills were targeted: listening, knowing your feelings, dealing with anger, using self control, joining in a group, following instructions, responding to teasing, keeping out of fights, and problem solving. For this evaluation, 74 aggressive children (63 boys and 11 girls) were randomly assigned to a social skills training group (SST) or a waiting list control group (WLC). Teachers rated children in the SST group as having fewer externalizing behavior problems following the program than children in the WLC group. There were no significant group differences in parent or peer ratings. Nine months following treatment, there was marginal maintenance of treatment gains. These results are discussed in light of recommendations for treatment and evaluation research. The present research highlights the importance of a broad-based intervention that addresses aggressive children's behavior problems in the various contexts of a child's life.     

Brief Nurse Consultations for Preventing Alcohol Use Among Urban School Youth

ABSTRACT: This study examined the effects of brief nurse consultations in preventing alcohol use among inner-city youth. Participants included 138 sixth-eighth grade students attending an inner-city public school in Jacksonville, Florida. Subjects were randomly assigned by computer to either the intervention (STARS program) or a control group. Baseline and three-month post-tests were conducted at the target school site. A significant difference was found on heavy alcohol use with intervention subjects showing a reduction and control subjects an increase in heavy drinking (t = −2.33, 120df p = .02). No differences were found between groups on other alcohol use measures. This study's findings indicate that a series of brief nurse consultations appear to reduce heavy alcohol consumption among urban school youth.     

Evaluation of a theoretically based AIDS/STD peer education program on postponing sexual intercourse and on condom use among adolescents attending high school

The effectiveness of an intervention based upon the theories of Ajzen and Triandis was evaluated among 698 junior and 306 senior high school students. The intervention to juniors was offered by senior students who were trained during a course integrated into the school curriculum. Respondents in the control and experimental groups completed a questionnaire at baseline and 9 months after the program. Compared to junior respondents in the control group, those in the experimental group positively modified their attitude, perceived behavioral control, personal normative beliefs, perceived role beliefs, anticipated regret and intention with respect to postponing sexual intercourse and with respect to condom use, as well as perceived self-efficacy to negotiate both behaviors. Compared to senior respondents in the control group, those in the experimental group showed a significant positive modification of all the above variables except perceived behavioral control (indirect measure), anticipated regret and intention with respect to postponing sexual intercourse. At post-test, seniors in the experimental group were more likely to use condoms on a regular basis than those in the control group. Program effects occurred among both sexes, but a few differences in response were observed among males and females. Results suggest this type of theory-based program is effective in modifying psychosocial variables related to postponing sexual intercourse and related to condom use among adolescents. Personal involvement in designing intervention appears to be effective in modifying the behavior of peer educators.     

Great Sensations: A Program to Encourage Heart Healthy Snacking by High School Students

The Great Sensations program consisted of three interrelated educational strategies--classroom instruction, parent outreach, and media campaign. These strategies were designed to teach inner-city high school students about salt and high blood pressure, and to encourage them to eat more low-salt snacks and fewer high-salt snacks. Eight classes at the experimental school were randomly assigned to class instruction or parent outreach in a factoral design. All students in the experimental school were exposed to the media campaign. Students at a nearby high school served as the comparison group. All but a few of the 490 students at the two schools were black. Students who received the classroom instruction reported lower Salty Snack selection and higher Target Snack selection at posttest and eight-week follow-up. Students receiving media only reported lower Salty Snack selection at posttest but this condition returned to baseline by eight weeks. The control group reported little change in snack selection at posttest and eight weeks. After six months, program effects were no longer evident for either experimental group.     

Violence Prevention: An Evaluation of Program Effects with Urban African American Students

While many violence prevention programs have been developed to combat the problems of violence and aggression among youth, few programs have been evaluated. This study examines the impact of a violence prevention program among African American students in two inner-city schools in Chicago. Students in 5th through 8th grade participated in Second Step: A Violence Prevention Program, and completed surveys at pretest and posttest. Aggressive behavior and prosocial behavior were assessed through self-report, peer-report, and teacher-report. In addition, knowledge and skills related to violence, empathy, impulsivity, and sense of school membership were assessed. The findings revealed significant increases in self-reported knowledge and skills, self-reported empathy, and teacher-reported prosocial behavior. Increases in empathy significantly predicted less aggressive behavior. School setting influenced several outcomes, including sense of school membership. Implications for primary prevention and evaluation are discussed with a focus on the importance of context.     

Integrating life skills into a theory-based drug-use prevention program: effectiveness among junior high students in Taiwan

BACKGROUND: Drug use has been noted among students in Taiwan during the past decade and schools have a role in preventing or delaying students' drug use. We developed and evaluated a school‐based, drug‐use prevention program integrating the theory of planned behavior (TPB) and life skills for junior high school students. METHODS: We recruited 441 seventh graders from randomly selected schools: N = 143 experimental groups, N = 142 conventional groups, and N = 156 control groups. The experimental group received ten 45‐minute sessions of theory‐based interventions. The conventional group got traditional didactic teaching and drug refusal skills. The control group received no intervention. RESULTS: Compared to the control group, experimental group students showed greater improvement in attitude, subjective norm, perceived behavioral control, life skills, and intention not to use drugs. Compared to the conventional group, the experimental group had significantly higher posttest scores for 4 of the 5 outcomes, including life skills (96.53 vs. 90.92, p < .001), attitude (27.43 vs. 24.40, p = .012), subjective norm (29.51 vs. 28.06, p = .002), and perceived behavioral control (18.59 vs. 16.81, p < .001). The conventional group scored significantly higher in behavioral intention than did the control group. CONCLUSION: Study results demonstrated the effectiveness of a drug‐use prevention program integrating the TPB and life skills.     

Evaluation of a motivational education program for cardiovascular risk reduction: Effects on knowledge and behavior

The purposes of this study were 1) to compare the effectiveness of an interactive/reflective lifestyle education program with an instrumental program in changing nutrition behavior for the reduction of cardiovascular risk, and 2) to evaluate the effects of interactive/reflective nutrition education practice on patients' development of critical/creative thinking and problem-solving skills. Patients were stratified according to risk, and randomly assigned to the experimental (interactive/reflective) or control (instrumental) group. Measures of knowledge and nutrition behavior were administered prior to and immediately following the intervention, six weeks after program completion, and three months later to assess maintenance effects. Of 32 relatively well-educated patients completing the study, participants in interactive/reflective sessions demonstrated improvements in nutrition behavior relative to the control group that could not be attributed to gains in knowledge scores. Qualitative evaluation of the learning process suggested that the development of critical/creative thinking and problem-solving skills among experimental group participants may have contributed to behavior change.     

Effectiveness of a universal drug abuse prevention approach for youth at high risk for substance use initiation

BACKGROUND: Universal school-based prevention programs for alcohol, tobacco, and other drug use are typically designed for all students within a particular school setting. However, it is unclear whether such broad-based programs are effective for youth at high risk for substance use initiation. METHOD: The effectiveness of a universal drug abuse preventive intervention was examined among youth from 29 inner-city middle schools participating in a randomized, controlled prevention trial. A subsample of youth (21% of full sample) was identified as being at high risk for substance use initiation based on exposure to substance-using peers and poor academic performance in school. The prevention program taught drug refusal skills, antidrug norms, personal self-management skills, and general social skills. RESULTS: Findings indicated that youth at high risk who received the program (n = 426) reported less smoking, drinking, inhalant use, and polydrug use at the one-year follow-up assessment compared to youth at high risk in the control condition that did not receive the intervention (n = 332). Results indicate that a universal drug abuse prevention program is effective for minority, economically disadvantaged, inner-city youth who are at higher than average risk for substance use initiation. CONCLUSIONS: Findings suggest that universal prevention programs can be effective for a range of youth along a continuum of risk.     

Stress reduction training changed number of sexual partners but not immune function in men with HIV.

We tested the impact of stress management training on sexual behavior and immune functioning in 64 gay men infected with human immunodeficiency virus (HIV). Subjects randomized to the stress management group met for eight two-hour sessions and one all day retreat to learn systematic relaxation, health behavior change, and stress management skills. Compared to those randomized to a wait list control, treatment subjects reported significantly fewer sexual partners in the prior month at post-test (1.10 vs 2.29 for controls). There were no differences between groups in lymphocyte numbers and function.     

青少年及其家长生殖健康知识、交流技能培训效果评价

目的评估学生及其家长进行生殖健康知识、交流技能培训的效果。方法采用整群抽样方法选取天津市3所中学的初二学生及其家长分别进行生殖健康知识、交流技能培训,在培训前后采用定量和定性方法(问卷调查和焦点人群座谈)分别进行调查,并与对照组(家长未培训)进行比较。结果培训后,学生和家长的生殖健康知识、交流能力有明显提高,与对照组比较有统计学意义(P<0.05)。结论对青少年开展性与生殖健康教育的同时,组织家长进行性与生殖健康知识、、交流技能的培训效果更显著。     

Building skills of recovering women drug users to reduce heterosexual AIDS transmission

Although most women infected with HIV are intravenous drug users, some contact the virus through sexual contact with IV drug users. To reach at-risk women, public health officials must develop a range of prevention strategies. One approach, skills training, holds promise as a means of altering risk-related sexual behavior. In this study, 91 women methadone patients were pretested and randomly assigned to an information-only control control group or a skills-building intervention group. Skills-building intervention consisted of five sessions of small groups in which participants identified their own high risk sexual behaviors, discussed their negative associations with condoms, and practiced skills which involved asking partners to use condoms. Compared with members of the control group, respondents in the intervention group reported that they initiated discussion of sexual issues with their partners more frequently, felt more comfortable talking with them about safer sex, and reported using and carrying condoms more frequently. The high rates of attendance and program retention by skills-building participants suggest that such groups may be supportive and useful in the design of risk reduction and drug abuse treatment programs. The modest outcomes of this study underscore the difficulty of altering risk behavior but also serve as a basis for future AIDS prevention studies.     

Behavioral interventions to reduce incidence of HIV, STD, and pregnancy among adolescents: a decade in review.

PURPOSE: To review adolescent sexual risk-reduction programs that were evaluated using quasi-experimental or experimental methods and published in the 1990s. We describe evaluated programs and identify program and evaluation issues for health educators and researchers. METHODS: We systematically searched seven electronic databases and hand-searched journals to identify evaluations of behavioral interventions to reduce sexual risk behaviors among adolescents. Articles were included if they were published in the 1990s, provided a theoretical basis for the program, information about the interventions, clear aims, and quasi-experimental or experimental evaluation methods. We identified 101 articles, and 24 met our criteria for inclusion. RESULTS: We reviewed these evaluations to assess their research and program characteristics. The majority of studies included randomized controlled designs and employed delayed follow-up measures. The most commonly measured outcomes were delay of initiation of sexual intercourse, condom use, contraceptive use, and frequency of sexual intercourse. Programs ranged from 1 to 80 sessions, most had adult facilitators, and commonly included skills-building activities about sexual communication, decision-making, and problem solving. The programs included a wide range of strategies for content delivery such as arts and crafts, school councils, and community service learning. CONCLUSIONS: Analysis of these programs suggest four overall factors that may impact program effectiveness including the extent to which programs focus on specific skills for reducing sexual risk behaviors; program duration and intensity; what constitutes the content of a total evaluated program including researchers' assumptions of participants' exposure to prior and concurrent programs; and what kind of training is available for facilitators.     

Changing social and HIV/AIDS risk behaviours: Effects of life skills education among urban street youths

Abstract

The objective of this study was to examine the effect of a life skills education intervention among male and female youth in Ibadan, Nigeria, on knowledge about prevention and safe sexual practices, sexual roles and responsibilities, HIV/AIDS, money management, assertiveness and communication through follow-up interviews four weeks and eight weeks following the intervention. The participants were 98 males and females, and part of an initial survey of social and health problems of street youths in Ibadan, Nigeria. They were locality-separated, with consecutive assignments to two groups of experimental (n?=?54, exposure to a manual driven life skills education) and control (n?=?44, non-exposure to life skills education, but attention given) participants, and evaluated subsequently at four weeks and then at eight-week follow-ups. At the four-week post-intervention assessment, the experimental group showed significantly increased scores in the knowledge of antisocial behaviour prevention (p < 0.01), about HIV/AIDS (p < 0.001), about safe sexual practices (p < 0.001), about social roles and responsibilities and about assertiveness and communication (p < 0.01). At eight-week follow-up assessment, substantial significant reductions in reported antisocial and unsafe sexual behaviours were observed across the experimental group compared with the control group. The results suggest that street youths can be empowered through life skills education but with limitation to safe sexual practices over a sustained period of time in Nigeria.     

AIDS education for drug abusers: evaluation of short-term effectiveness.

BACKGROUND. Interventions are needed to assist drug abusers in reducing risky drug and sexual behavior. METHODS. A randomized controlled trial compared three small-group AIDS educational interventions among 567 clients of a 21-day inpatient drug detoxification program: a two-session informational intervention, given either during the first (early) or second (late) week of treatment; and a six-session enhanced intervention. Changes in knowledge, attitudes, and psychomotor skills were assessed before and after each intervention, and behavioral outcomes were assessed at follow-up 10 to 18 weeks after admission. RESULTS. Immediately after the interventions, enhanced group members reported significantly greater self-efficacy to talk themselves out of AIDS-risky behavior; other knowledge and attitude scales did not differ by intervention. At follow-up, significant reductions in risky drug use were reported by all groups. Enhanced group members reported significantly greater reduction in injection frequency than did late informational subjects. CONCLUSIONS. No beneficial effect was detected of delaying AIDS education for clients entering detoxification. At this early stage of follow-up, there is only weak evidence that an enhanced intervention improved outcomes.     

Effects of health facilitator performance and attendance at training sessions on the acquisition of tobacco refusal skills among multi-ethnic, high-risk adolescents

The study examined the effectiveness of a psycho-social tobacco use prevention intervention with a refusal skills training component on the refusal skills of high-risk adolescents, and investigated skill acquisition as related to subject demographics, performance of health facilitators and attendance at skills training sessions. Tobacco refusal skills were assessed for a group (n = 389) of high-risk, seventh-grade students participating as intervention and control subjects in Project SHOUT, a large tobacco use prevention program in the San Diego area. In addition, subject demographics, ratings of health facilitator performance and information about subjects' attendance at skills training sessions were collected. Subjects' responses to audiotaped peer offers of cigarettes and smokeless tobacco were coded for content and quality. Greater tobacco refusal skills among intervention subjects was hypothesized. Further health facilitator performance, attendance at training sessions and subject demographics were thought to be related to skill acquisition. High-risk intervention subjects gave significantly higher quality tobacco-refusal responses than did controls, although the differences between means were small. Results suggested that Hispanic adolescents were particularly receptive to the refusal skills training. The association between health facilitator performance and skill acquisition varied by subject ethnicity, as did the relationship between attendance at training sessions and skill acquisition.     

校外青少年生殖健康高危行为与社会心理因素关系

目的 了解上海市青少年生殖健康知识点掌握情况,评估干预对促进中学生性与生殖健康相关知识掌握的效果。 方法 于2015年1 — 12月,采用多阶段随机整群抽样方法,抽取上海市4所中学学生,随机分为对照组和干预组,应用流行病学干预研究方法,在干预组根据干预方案进行宣传教育和培训干预活动,并评估干预效果。 结果 2015年1 — 3月,基线调查共调查795人,其中对照组389人,干预组406人。终末调查于2015年9 — 12月进行,共调查 745人,对照组383人,干预组362人。基线调查时对照组性与生殖健康知识得分及格比例为58.87 %,干预组为54.93 %,2组比较差异无统计学意义（χ² = 1.26,P = 0.26）;终末调查时干预组知识得分及格比例为72.93 %,对照组为55.61 %,干预组及格率提高,差异有统计学意义（χ² = 26.70,P < 0.01）。采用logistic回归分析组别和时间的交互作用,调查对象知识得分是否及格的组别和时间交互作用项有统计学意义（χ² = 19.01,P < 0.01）;多因素logistic回归分析显示,干预、居住方式和人均家庭月收入是知识是否及格的影响因素。 结论 中学生性与生殖健康干预项目提高了中学生对相关知识的掌握水平,对促进青少年性与生殖健康水平具有重要意义。     

沿海三城市高中生预防艾滋病同伴干预中期随访效果评价

【目的】 评价沿海三个城市高中学生预防艾滋病同伴干预的中期随访效果,探讨同伴干预效果的可持续性。 【方法】 从上海、三明、北海三所城市按照重点、普通和职业学校分层后随机抽取了18个班级的高中阶段学生分为干预组和对照组,在干预组实施预防艾滋病同伴干预,在干预前、干预后两周和一年的用相同的问卷实施调查。 【结果】 干预组学生艾滋病相关知识得分、对安全性行为益处的认知以及安全性行为意向得分在干预两周及随访一年时均明显高于干预前(P<0.001),两周及一年时的各项得分也高于同期对照组。 【结论】 同伴干预在高中生中提高艾滋病预防相关知识、认知和行为意向方面是有效的,并能维持较长时间。     

A Behavior-Based Intervention That Prevents Sexual Assault: the Results of a Matched-Pairs,Cluster-Randomized Study in Nairobi,Kenya

Design

The study’s design was a cluster-randomized, matched-pairs, parallel trial of a behavior-based sexual assault prevention intervention in the informal settlements.

Methods

The participants were primary school girls aged 10–16. Classroom-based interventions for girls and boys were delivered by instructors from the same settlements, at the same time, over six 2-h sessions. The girls’ program had components of empowerment, gender relations, and self-defense. The boys’ program promotes healthy gender norms. The control arm of the study received a health and hygiene curriculum. The primary outcome was the rate of sexual assault in the prior 12 months at the cluster level (school level). Secondary outcomes included the generalized self-efficacy scale, the distribution of number of times victims were sexually assaulted in the prior period, skills used, disclosure rates, and distribution of perpetrators. Difference-in-differences estimates are reported with bootstrapped confidence intervals.

Results

Fourteen schools with 3147 girls from the intervention group and 14 schools with 2539 girls from the control group were included in the analysis. We estimate a 3.7 % decrease, p?=?0.03 and 95 % CI?=?(0.4, 8.0), in risk of sexual assault in the intervention group due to the intervention (initially 7.3 % at baseline). We estimate an increase in mean generalized self-efficacy score of 0.19 (baseline average 3.1, on a 1–4 scale), p?=?0.0004 and 95 % CI?=?(0.08, 0.39).

Interpretation

This innovative intervention that combined parallel training for young adolescent girls and boys in school settings showed significant reduction in the rate of sexual assault among girls in this population.

     

Improving smoking cessation counseling by family practice residents.

BACKGROUND. While programs to train residents in smoking cessation counseling skills have been devised, few have assessed trainee behavioral changes in practice settings where residents were blind to the evaluation of their behavior. This study assessed the effectiveness of a training program in smoking cessation counseling and chart-prompting system in increasing the frequency and quality of counseling by residents at three clinic sites. METHODS. Twenty-eight residents participated in a training program that included epidemiology, discussion of attitudes, counseling techniques, videotaped examples, and small group role play. The chart-prompting system was implemented at two clinics 1 month after training. Patient exit interviews, during which information on resident counseling on smoking cessation was obtained, were conducted before training, after training, at 3-month follow-up, and at 6-month follow-up. Questionnaires assessing knowledge, attitudes, and self-perceived counseling behaviors were completed by residents at pretraining, posttraining, and 6-month follow-up periods. RESULTS. Interviews with 517 smokers were analyzed. Results showed an increase in counseling at 3-month follow-up but a regression toward baseline at 6 months. Counseling improved at clinics where chart prompting was initiated. The number of counseling behaviors decreased when the number of patients seen increased. Whether a patient received counseling was positively associated with prior contact with the physician. There was no correlation between resident self-perception and patient report. CONCLUSIONS. A training program in smoking cessation counseling and a chart-prompting system did not result in a lasting change in resident behavior. System factors may play an important role in long-term behavior change.