The Journal of Primary Prevention

, Volume 37, Issue 1, pp 87–105 | Cite as

Effects of a School-Based Social–Emotional and Character Development Program on Health Behaviors: A Matched-Pair, Cluster-Randomized Controlled Trial

  • Niloofar BavarianEmail author
  • Kendra M. Lewis
  • Alan Acock
  • David L. DuBois
  • Zi Yan
  • Samuel Vuchinich
  • Naida Silverthorn
  • Joseph Day
  • Brian R. FlayEmail author
Original Paper


There is considerable research that suggests that school-based social–emotional programs can foster improved mental health and reduce problem behaviors for participating youth; in contrast, much less is known about the impact of these programs on physical health, even though some of these programs also include at least limited direct attention to promoting physical health behaviors. We examined the effects of one such program, Positive Action (PA), on physical health behaviors and body mass index (BMI), and tested for mediation of program effects through a measure of social–emotional and character development (SECD). Participating schools in the matched-pair, cluster-randomized trial were 14 low-performing K-8 Chicago Public Schools. We followed a cohort of students in each school from grades 3 to 8 (eight waves of data collection; 1170 total students). Student self-reports of health behaviors served as the basis for measures of healthy eating and exercise, unhealthy eating, personal hygiene, consistent bedtime, and SECD. We collected height and weight measurements at endpoint to calculate age- and gender-adjusted BMI z-scores. Longitudinal multilevel modeling analyses revealed evidence of favorable program effects on personal hygiene [effect size (ES) = 0.48], healthy eating and exercise (ES = 0.21), and unhealthy eating (ES = −0.19); in addition, BMI z-scores were lower among students in PA schools at endpoint (ES = −0.21). Program effects were not moderated by either gender or student mobility. Longitudinal structural equation modeling demonstrated mediation through SECD for healthy eating and exercise, unhealthy eating, and personal hygiene. Findings suggest that a SECD program without a primary focus on health behavior promotion can have a modest impact on outcomes in this domain during the childhood to adolescence transition.


Health behavior Social–emotional and character development School-based trial 



This project was funded by grants from the Institute of Education Sciences (IES), US Department of Education: R305L030072, R305L030004 and R305A080253 to the University of Illinois at Chicago (2003–2005) and Oregon State University (2005–2012). Preparation of this manuscript was supported, in part, by NIAAA T32 AA014125.

Author contribution

Brian Flay and David DuBois conceived the study and obtained funding, David DuBois and UIC staff oversaw program implementation, the program developer (Carol G. Allred) provided teacher/staff training, UIC and MPR staff collected all data, Niloofar Bavarian led the data analysis and wrote the first draft of this manuscript, and all co-authors assisted in paper revision and approved the final version.

Compliance With Ethical Standards

Conflict of Interest

The research described herein was done using the program, the training, and technical support of Positive Action, Inc. in which Dr. Flay’s spouse holds a significant financial interest; Dr. Flay was not involved in conducting data collection or analysis. Issues regarding conflict of interest were reported to the relevant institutions and appropriately managed following the institutional guidelines.


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Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  • Niloofar Bavarian
    • 1
    Email author
  • Kendra M. Lewis
    • 2
  • Alan Acock
    • 3
  • David L. DuBois
    • 4
  • Zi Yan
    • 5
  • Samuel Vuchinich
    • 3
  • Naida Silverthorn
    • 4
  • Joseph Day
    • 6
  • Brian R. Flay
    • 3
    Email author
  1. 1.College of Health and Human ServicesCalifornia State University, Long BeachLong BeachUSA
  2. 2.4-H Youth Development Program, Division of Agriculture and Natural ResourcesUniversity of CaliforniaDavisUSA
  3. 3.College of Public Health and Human SciencesOregon State UniversityCorvallisUSA
  4. 4.School of Public HealthUniversity of Illinois at ChicagoChicagoUSA
  5. 5.Health SciencesMerrimack CollegeNorth AndoverUSA
  6. 6.College of Health and Human ServicesGovernors State UniversityChicagoUSA

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