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NIDA Home > Publications > NIDA Notes > Vol. 20, No. 1 > Research Findings |
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First-Grade Intervention Reduces Smoking Initiation in Middle School |
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Research Findings
Vol. 20, No. 1 (August 2005) |
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![]() By Lori Whitten, NIDA NOTES Staff Writer
First graders who receive systematic help in learning to concentrate and control their behavior are less likely to begin smoking in the middle-school years than children who receive no special intervention, a NIDA-funded study has found. Investigators at the Center for Prevention and Early Intervention at The Johns Hopkins Bloomberg School of Public Health in Baltimore developed two interventions that are broad-based rather than specific to substance abuse, and have been testing them in schools since the early 1990s. In 1993, Drs. Sheppard Kellam, Nicholas Ialongo, and colleagues randomly assigned first-grade teachers and 678 of their students in Baltimore public schools to either a classroom-centered or a family-school partnership (FSP) intervention, or to the standard curriculum. During the summer, the investigators gave the teachers who would participate in the classroom-centered intervention 60 hours of training in strategies for managing behavior and helping children overcome academic problems. This training used detailed manuals, checklists, and other standardized materials. Meanwhile, the teachers, school social workers, and psychologists who would participate in the FSP intervention learned how to conduct workshops designed to help parents improve their behavior management and homework-assistance skills and partner with school professionals. School staff delivered both interventions throughout the students' year in first grade. During this time, the investigators visited the classrooms and conducted regular assessments of the interventions, and met monthly or as often as needed with the participating school staff. At the end of seventh or eighth grade, when the children were 13 years old on average, the researchers followed up to see whether those who received the interventions had fared any differently from the control group. Overall, 39 percent of the 566 young people they were able to assess at this time had initiated smoking. Of those who participated in the classroom-centered or FSP interventions, however, a significantly lower percentage had begun smoking—34 and 36 percent, respectively—compared with 47 percent of the control group. The classroom-centered intervention was associated with a smaller prevalence of reported cocaine and heroin use in middle school—3 percent compared with 7 percent in the standard curriculum; however, the researchers note that only 29 of 566 participants had tried these drugs, a number of subjects too small to draw definitive conclusions. Although many youths in both the intervention and control groups had tried alcohol, marijuana, or inhalants, the percentage was marginally smaller among those who experienced the interventions. Dr. Ialongo cites the long-term significance of the findings and advocates extending such efforts throughout children's school careers. "Fewer kids smoking in middle school eventually should produce a measurable clinical and public health impact in the form of reduced smoking-related disease in these children's later lives. These gains probably will be more sizable if teachers present these interventions throughout elementary school and add standard approaches to drug abuse prevention in the middle-school years," he says. Building the InterventionsThe classroom-centered and FSP programs represent the culmination of more than three decades of research on human development and problem behaviors. Evidence from studies in the 1970s and 1980s suggested that certain characteristics evident as early as first grade—poor academic achievement, difficulty with concentration, and aggressive and shy behaviors—are associated with later substance abuse, depression, and antisocial behavior. However, the field lacked randomized, controlled intervention trials showing that a reduction of these characteristics can reduce later problem behaviors in the general population of children. Dr. Kellam, then at the Prevention Intervention Research Center at The Johns Hopkins University, and his colleagues Lisa Ulmer and Hendricks Brown, began in the mid-1980s to develop, refine, and assess interventions that address antecedents of problem behaviors—efforts that eventually produced the classroom-centered and FSP programs. "Effective prevention programs encompass key elements of raising healthy children—positive child-rearing practices at home, good behavior management at school, and a strong school-family connection. Youths need consistent messages and support at home and school for healthy development. Forging a strong link between the activities, values, and practices across the family, school, and community throughout childhood and adolescence has enduring effects," says Dr. Shakeh Kaftarian of NIDA's Division of Epidemiology, Services and Prevention Research. Dr. Ialongo and his colleagues have shown other lasting effects of the interventions in previous studies. For example, boys who showed aggressive behavior at the beginning of first grade and received the intervention improved by sixth grade. "It's common sense that improvements in first-graders' concentration and readiness to learn produce better students and citizens and may delay or prevent tobacco and illegal drug use. But it's not enough to intervene once in first grade to improve academic achievement and classroom behavior—prevention is a long-term commitment," says Dr. Ialongo. Source
Volume 20, Number 1 (August 2005) |
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