Brian R. Flay, D.Phil. Distinguished Professor Health Research and Policy Centers

Annenberg Public Policy Center, U Pennsylvania, June 28, 2002 1

UIC University of Illinois at Chicago

Health Research and Policy Centers

Positive Youth Development for the Improvement of Multiple Behaviors Character, Mental

Health and Academic Achievement

Brian R. Flay, D.Phil.Distinguished Professor

Health Research and Policy CentersUniversity of Illinois at Chicago

Based on a Presentation to the American Academy of Health Behavior Conference

in acceptance of the Research Laureate Award, Napa, CA, March 25, 2002

Presented at “Reducing Adolescent Risk: Toward an Integrated Approach” Annenberg Public Policy Center, University of Pennsylvania, June 27-30, 2002




Outline/Summary

1. Behaviors are related.Also predict and are predicted by each otherMust work towards a comprehensive, coherent, integrated approach to youth development.

2. All behaviors have common predictors/causesRisk and Protective FactorsThe Theory of Triadic Influence (Integrates theories)Importance of Community, Family and SchoolMust work toward comprehensive and coherent classroom, school-wide, family and community programs

3. Implications for prevention science, programs and policies




Substance Use and Abuse Behaviors are Highly Correlated and Predict

Each Other

IllicitAlcohol

TobaccoSubstanc

e

Ab/Use

And can be thought of as a latent variable




Problem/Risky Behaviors are Highly Correlated and Predict Each

Other

Substance

Ab/Use

Tobacco

Alcohol

Illicit

Weapons

Inter-personal

Violence

Fighting

Threats

Unsafe

Sex

No Condoms

Early

Multiple partners

Problem/Risky

Behavior




Health-Promoting Behaviors are Highly Correlated and Predict Each

Other

Health

Care

Hygiene

Teeth

Visits

Physical

Activity

ExerciseWalking

Sports

Eating/

Diet

Fruits & Veges

Meat/Dairy

Junk

HealthyBehaviors




Positive, Health and Social Behaviors are Highly Correlated and Predict

Each Other

Healthy

Behaviors

Conventional and Social

Behaviors

Eating/Diet

Health

Care

Physical

Low Risk, non-

Problem Behaviors

No Drugs

Nonviolent

Safe SexCommunity

BondingLaw Abiding

Achievement

Mental

Health

ADHA

Conduct Anxiety/Dep

Successful and Happy

Citizens




Conclusion #1Future prevention programs need to comprehensively and coherently address multiple behaviors and outcomes

- Prevention of Problem/Risky BehaviorsSubstance use and abuse, violence, and unsafe sex

- Promotion of health-enhancing behaviors

Good eating habits and adequate physical activity

- Psychological and mental health

- Positive character development Positive moral and social behavior

-School success




BUT, should we target single

or multiple behaviors?- We used to believe that effects would be larger if we targeted a single behavior, or a single domain, such as substance use

- Increasing evidence that many behaviors and domains are interrelated, and that programs should deal with them together

- Increasing evidence that programs that address multiple issues are effective

- Particularly if they address related issues -- problem behaviors, health behaviors, school behaviors




ABAN AYA significantly improved multiple behaviors

• Physical Violence• Provoking Behavior• Alcohol and Drug Use• School Delinquency• Frequency of sexual intercourse• Condom Use• Healthy & junk food

consumption• Physical Exercise• Standardized Test Scores




Positive Action Others

ES % ES %

Drug Use 0.54 26 0.24 12

Violence 1.49 60 0.16 8

Disciplinary 1.79 67 -- --

Absenteeism 0.41 20 -- --

Reading 0.58 28 0.5 25

Effect Sizes and percent improvement forPositive Action (with training)

and other social and skills-based programs

And Has Multiple Effects:




Part 2: All Behaviors Have Common

CausesPERSONAL

GeneticPersonality

SELF-EFFICACY

SITUATIONALCommunityFamilySchool

SOCIAL NORMATIVE BELIEFS

ENVIRONMENTALBroader socio-cultural environment

VALUES/ ATTITUDES




All Behaviors Have Common Causes:The Basics of the Theory Of Triadic Influence

BEHAVIOR

Decisions/Intentions

& PersonalityBiology

Sense of Self

SocialSkills

SelfDetermin-

ation

SELFEFFICACY

SocialCompetence

DNA

ValuesEvaluations

Environment

ReligionCulture

ATTITUDES

InformationalEnvironment

CulturalKnowledgeExpectancies

EvaluationsValues

Environment

Bonding

PerceivedNorms

Motivationto Comply

Others'Beh&&Atts

SOCIALNORMATIVEBELIEFSContext

Social




All Behaviors Have Common CausesNationalSocio-

Cultural Environment

Political, Economic,Media, Religious.

Values, Attitudes

Local Community,Families, SchoolsRelationships with Others.

Others’ Attitudes, Behaviors.

Social Normative BeliefsSelf-Concept,Social Skills.

Self-Efficacy

Intrapersonal Biology,

Personality

Low Risk, non-

Problem Behaviors

Nonviolent

Safe Sex

Successful and Happy Citizens

Conventional and Social

Behaviors

Community Bonding

Law Abiding

AchievementNo Drugs

Health

Care

Physical

Healthy Behavior

s

Eating/Diet

Health

Care

Physical

Mental Health

Eating/Diet




The Critical Importance of Community, Family and

SchoolCommunity

Family School

Student Health,

Behavior and Academic

Performance




Conclusion #2Future prevention programs need to involve whole schools, families and communities in an integrated and coherent way- Classroom curricula can teach content and skills

Should be school-wide, scoped and sequenced for every grade

- Teacher training can address class/behavior management and teaching effectiveness

- School-wide climate change can provide a safe learning environmentprovide common language and consistently reinforce desired behaviors

- Family programs can improve parenting skills provide common language and consistently reinforce positive behaviors

- Community programs canlink schools and communitiesget students observing and doing community serviceprovide common language and consistently reinforce positive behaviors




Example: The POSITIVE ACTION ProgramK–12 classroom curriculum

over 1,200 lessons - using Teacher’s Kits (manuals and materials for each grade), classroom teachers present 15–20-minute lessons

Principal’s Kits (Elementary and Secondary)a school-climate program to promote the practice and reinforcement of positive actions in the whole school population (students and staff)

Counselor’s Kitused with selected individual students, small groups and families

Family Kit contains prepared weekly home lessons paralleling the school program along with school parent-involvement activities

Community Kitmanuals and materials that align and encourage collaboration of all the environments (schools, families and community) involved in the program




Part 3: Implications: Promotion Programs of the Future Must Be

Designed to be …• EARLY AND OFTEN

– Start early, scoped and sequenced, many doses, over a long time

• POSITIVE– Focus on asset and strength development– Address protective factors more than risk factors– Include positive reinforcement and environmental contingencies

• COMPREHENSIVE– Multiple domains: behaviors, feelings, thoughts, character,

achievement– Multiple protective/risk factors– Multiple levels: students, teachers, school, families, community

• REPLICABLE– Diverse teaching strategies– Complete materials, user friendly– Minimal training required, but necessary training easily provided

• EFFECTIVE– Large effects that are sustained




SUMMARY

• It is critically important to link behavior, character, mental health, and academic achievement

• Positive, problem, health, and mental health behaviors are all related, and are all related to character and academic achievement

• All behaviors and related outcomes have the same causes, many of which reside in families, schools and communities

• Future prevention/promotion research, programs, and policies need to be comprehensive, integrated and coherent across behaviors, grades/ages, and social ecologies (schools, homes and communities)

Brian R. Flay, D.Phil. Distinguished Professor Health Research and Policy Centers

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