Effectiveness of a Violence Prevention Curriculum Among Children in Elementary School:  A Randomized Controlled Trial

David C. Grossman, MD, MPH; Holly J. Neckerman, PhD; Thomas D. Koepsell, MD, MPH; Ping-Yu Liu, PhD; Kenneth N. Asher, PhD; Kathy Beland, MEd; Karin Frey, PhD; Frederick P. Rivara, MD, MPH
JAMA. 1997;277(20):1605-1611. doi:10.1001/jama.1997.03540440039030.
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Objective.  —To determine if a commonly used violence prevention curriculum, Second Step: A Violence Prevention Curriculum, leads to a reduction in aggressive behavior and an increase in prosocial behavior among elementary school students.

Design.  —Randomized controlled trial.

Setting.  —Urban and suburban elementary schools in the state of Washington.

Participants.  —Six matched pairs of schools with 790 second-grade and third-grade students. The students were 53% male and 79% white.

Intervention.  —The curriculum uses 30 specific lessons to teach social skills related to anger management, impulse control, and empathy.

Main Outcome Measures.  —Aggressive and prosocial behavior changes were measured 2 weeks and 6 months after participation in the curriculum by parent and teacher reports (Achenbach Child Behavior Checklist and Teacher Report Form, the School Social Behavior Scale, and the Parent-Child Rating Scale) and by observation of a random subsample of 588 students in the classroom and playground/ cafeteria settings.

Results.  —After adjusting for sex, age, socioeconomic status, race, academic performance, household size, and class size, change scores did not differ significantly between the intervention and control schools for any of the parent-reported or teacher-reported behavior scales. However, the behavior observations did reveal an overall decrease 2 weeks after the curriculum in physical aggression (P=.03) and an increase in neutral/prosocial behavior (P=.04) in the intervention group compared with the control group. Most effects persisted 6 months later.

Conclusions.  —The Second Step violence prevention curriculum appears to lead to a moderate observed decrease in physically aggressive behavior and an increase in neutral and prosocial behavior in school.


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