A social development intervention administered in elementary school appears to have positive effects on mental health, sexual health and educational and economic achievement assessed 15 years after the intervention ended, according to a report in the December issue of Archives of Pediatrics & Adolescent Medicine, one of the JAMA/Archives journals.

Unemployment, poverty and disorganized neighborhoods are common problems plaguing U.S. cities, according to background information in the article. Many urban families and children must contend with crime, drug use, teen pregnancy, school dropouts and mental health problems. "Public schools, available to all children in the United States beginning at age 5 or 6 years, are a potentially powerful setting for preventive intervention," the authors write.

J. David Hawkins, Ph.D., and colleagues at the University of Washington, Seattle, studied the long-term effects of one such prevention program, the Seattle Social Development Project. "The objective of the intervention was to improve the skills of teachers, parents and children to increase positive functioning in school and decrease problems related to mental health, risky sexual behavior, substance use and criminal behavior," the authors write. Beginning in fall of 1981, some first-grade students in Seattle elementary schools began the program, which was eventually expanded to 15 public elementary schools serving diverse neighborhoods. Parents, teachers and students in the intervention received special instruction in areas such as behavior management, refusal, social skills training and academic development.

At ages 24 and 27, childhood participants completed a self-assessment of their school, work and community life, along with their mental health, sexual behavior, substance use and crime. Court records were also referenced. A total of 598 young adults (146 who began the intervention in first grade, 251 who began the intervention in grades five or six and 201 in a control group who did not receive the intervention) completed the 15-year follow-up at age 27.

Participants who received the full intervention reported improved functioning in almost all areas assessed. No differences were observed in rates of substance abuse or crime. However, compared with the control group, those who participated in the intervention:

• Were more likely to be at or above the median in educational attainment or household income
• Were more likely to have continued their education beyond high school
• Reported higher levels of community involvement and volunteerism
• Had fewer symptoms of mental health disorders, and any mental health problems they reported were lower in magnitude
• Had a lower prevalence of sexually transmitted diseases

"A universal intervention for urban elementary schoolchildren, which focused on classroom management and instruction, children's social competence and parenting practices, positively affected mental health, sexual health and educational and economic achievement 15 years after the intervention ended," the authors conclude.