Social Development Research Group, School of Social Work, University of Washington, 9725 3rd Avenue N. E., Suite 401, Seattle, WA, 98115, USA.
Department of Psychology and Neuroscience, Institute of Behavioral Science, University of Colorado Boulder, Boulder, CO, USA.
Prev Sci. 2019 Oct;20(7):986-995. doi: 10.1007/s11121-019-01023-3.
Elementary schools can be effective sites for universal preventive interventions. Less is known about how long effects of intervention in elementary grades last. Can they improve outcomes in adulthood? To test effects of a social developmental intervention in the elementary grades on adult life through the 30s, the Seattle Social Development Project, a nonrandomized controlled trial, followed all consenting 5th-grade students (N = 808) from 18 Seattle public elementary schools from age 10 (in 1985) to age 39 (in 2014), with 88% retention. The sample was gender balanced and ethnically and economically diverse. The full intervention, called Raising Healthy Children, continued from Grades 1 through 6 and consisted of teacher in-service training in classroom management and instructional methods; cognitive, social, and refusal skills training for children; and parent workshops in child behavior monitoring and management, academic support, and anticipatory guidance. Using structural equation modeling, we examined intervention effects from age 30 to age 39 across 9 constructs indicating 3 domains of adult life: health behavior, positive functioning, and adult health and success. An omnibus test across all 9 constructs indicated a significant positive overall intervention-control difference. Examined individually, significant intervention effects included better health maintenance behavior, mental health, and overall adult health and success. Significant effects were not found on substance use disorder symptoms, sex-risk behaviors, or healthy close relationships in the 30s. Results indicate that sustained, theory-based, multicomponent intervention in the elementary grades can produce lasting changes in health maintenance, mental health, and adult functioning through the 30s.
小学可以成为普及预防干预的有效场所。但是，对于干预在小学阶段的效果能持续多久，我们了解得较少。它们能否改善成年人的结局？为了检验小学阶段社会发展干预对成年人生活的影响，直到 30 多岁，西雅图社会发展项目（一个非随机对照试验）对来自 18 所西雅图公立小学的所有同意参与的五年级学生（N=808）进行了追踪，这些学生的年龄从 10 岁（1985 年）到 39 岁（2014 年）不等，其中 88%的学生保留了下来。该样本在性别、种族和经济方面具有多样性。完整的干预措施称为“培养健康儿童”，从 1 年级持续到 6 年级，包括教师在职培训课堂管理和教学方法；儿童认知、社会和拒绝技能培训；以及家长研讨会，内容涉及儿童行为监测和管理、学业支持和前瞻性指导。我们使用结构方程模型，从 30 岁到 39 岁，对 9 个表明成年人生活 3 个领域的结构进行了干预效果检验：健康行为、积极功能和成年人的健康和成功。对所有 9 个结构的整体检验表明，干预组与对照组之间存在显著的积极差异。单独检查时，干预组在健康维持行为、心理健康和整体成年人健康和成功方面有显著效果。但是，在 30 多岁时，在物质使用障碍症状、性行为风险或健康亲密关系方面，没有发现显著的干预效果。结果表明，在小学阶段持续、基于理论、多成分的干预可以在整个 30 多岁期间产生持久的健康维持、心理健康和成年人功能的变化。
