SAFE GC Coalition: Prevention Ed May Reduce Use Over Generations

A recent study funded by the National Institute on Drug Abuse (NIDA) indicates decreased substance use in children who participated in The Raising Healthy Children (RHC) program. This program is a social development approach to positive youth development that incorporates school, family and individual programs to promote key elements that research has shown are critical for creating strong connections and bonds that children need to succeed in school and life; opportunities, skills, and recognition. The RHC program focuses on creating a caring community of learners, facilitating strong connections in students' lives by committing to comprehensive schoolwide action to strengthen instructional practices and family involvement.

No single entity can ensure the positive development of a community's young people. That's why the RHC program involves the school, the family, and peers to promote the positive development of students. Preventive interventions delivered to school-aged children and their caregivers and teachers offer a promising approach to head off the onset of substance use and other harmful behaviors during adolescence. Several trials of such interventions initiated in the 1980s and following participants over long periods of time have demonstrated that behavioral and health benefits could be sustained well into the participants’ adulthood.

According to NIDA, the RHC intervention delivered to elementary school children was associated with improved outcomes for the children of the original intervention recipients—potentially a transgenerational effect. Children of RHC recipients showed improved developmental functioning before age 5, as well as fewer problem behaviors; better academic, cognitive, and emotional skills; and less risk behavior from ages 6 to 18.

The study examined outcomes of the children of people who received the RHC program in the 1980s to grades 1 to 6 at elementary schools in disadvantaged Seattle neighborhoods and provided specialized training for teachers, parents, and the children themselves. For example, teachers participated in workshops for improved classroom management and instruction; parents received training through workshops or in-home problem-solving sessions on family management and how to help their children succeed in school; and children received social and emotional skill development, as well as summer camps or in-home services for students with academic or behavior problems.

About 800 children had been assigned either to the RHC intervention (not all of them receiving the full intervention) or to a control group, and they were followed until they reached age 39 in 2014. Analysis identified numerous improved outcomes in those who had received the full RHC intervention. During that time, many of the participants became parents themselves, prompting researchers to ask if the intervention differences could be transferred to the next generation. To address this, they conducted a separate analysis that included those participants who had become parents and their oldest biological child with whom they had face-to-face contact at least once a month. Researchers then evaluated these children on several outcomes, including:

• Developmental functioning at ages 1 to 5 years as reported by the parents.
• Problem behaviors; academic, cognitive, and emotional skills; as well as grades and performance at ages 6 to 18 based on teacher reports.
• Risk behaviors (e.g., substance use, early onset of sex, delinquency) at ages 6 to 18 based on the children’s self-reports.

Children of RHC parents demonstrated improved outcomes. The analyses included 72 youths whose parents had received the initial RHC intervention and 110 youths whose parents had been in the control group. By the last data collection, the youths ranged in age from 1 to 22 years. Significant differences were found between children whose parents had received the RHC intervention and those whose parents were in the control group. For example, up to age 5, children of parents in the RHC group had fewer developmental delays in communication skills, gross and fine motor skills, and an overall measure of developmental functioning. They also had lower teacher-rated scores on certain externalizing problem behaviors (e.g., oppositional defiance, attention deficit/hyperactivity disorder, and an overall externalizing measure) and higher scores on academic, cognitive, and emotional skills at ages 6 to 18.

Finally, children of parents receiving the RHC intervention were significantly less likely to have tried any drugs (i.e., alcohol, cigarettes, or marijuana) by age 18; to a lesser extent, they also showed reductions in other risk behaviors. It is not yet clear which factors mediate the intervention’s transgenerational impact as previous analyses indicated that adults who had received the RHC intervention in elementary school showed significantly more healthy close relationships, better mental and physical health, better socioeconomic success, and generally more positive adult functioning. The researchers speculate that growing up in families with these characteristics would contribute to the better outcomes of the next generation they studied.

These findings are hopeful for those that practice prevention intervention however, more research, duplicating these favorable results is required to definitively say that this program directly reduced risk factors and its negative consequences. If so, these extended benefits could significantly improve future cost-benefit analyses of preventive interventions.

The National Institute on Drug Abuse (NIDA) is a United States federal-government research institute whose mission is to "lead the Nation in bringing the power of science to bear on drug abuse and addiction”. For more information please visit www.drugabuse.gov.

SAFE, Inc. is the only alcohol and substance abuse prevention agency in the City of Glen Cove. To learn more about SAFE and the SAFE Glen Cove Coalition that provides prevention education services and programs please visit www.safeglencove.org.