Effects of 2 prevention programs on high-risk behaviors among African American youth: a randomized trial.

OBJECTIVE To test the efficacy of 2 programs designed to reduce high-risk behaviors among inner-city African American youth. DESIGN Cluster randomized trial. SETTING Twelve metropolitan Chicago, Ill, schools and the communities they serve, 1994 through 1998. PARTICIPANTS Students in grades 5 through 8 and their parents and teachers. INTERVENTIONS The social development curriculum (SDC) consisted of 16 to 21 lessons per year focusing on social competence skills necessary to manage situations in which high-risk behaviors occur. The school/community intervention (SCI) consisted of SDC and school-wide climate and parent and community components. The control group received an attention-placebo health enhancement curriculum (HEC) of equal intensity to the SDC focusing on nutrition, physical activity, and general health care. MAIN OUTCOME MEASURES Student self-reports of violence, provocative behavior, school delinquency, substance use, and sexual behaviors (intercourse and condom use). RESULTS For boys, the SDC and SCI significantly reduced the rate of increase in violent behavior (by 35% and 47% compared with HEC, respectively), provoking behavior (41% and 59%), school delinquency (31% and 66%), drug use (32% and 34%), and recent sexual intercourse (44% and 65%), and improved the rate of increase in condom use (95% and 165%). The SCI was significantly more effective than the SDC for a combined behavioral measure (79% improvement vs 51%). There were no significant effects for girls. CONCLUSIONS Theoretically derived social-emotional programs that are culturally sensitive, developmentally appropriate, and offered in multiple grades can reduce multiple risk behaviors for inner-city African American boys in grades 5 through 8. The lack of effects for girls deserves further research.