SPORT Prevention Plus Wellness is a brief program intended to increase physical activity and reduce alcohol and drug use among high school students. The program is based on the Integrative Behavior-Image Model (BIM), in which positive personal and social images serve as key motivators for health development, and also unify health-promoting and health-risk-avoiding habits within a single intervention. An experimental evaluation of SPORT Prevention Plus Wellness found statistically significant positive results for program participants at three months after the program, both for more frequent physical activity, and for reduced alcohol and drug use, compared with those not receiving the program. At twelve months after the program, many of these results held up, although at diminished levels.
DESCRIPTION OF PROGRAM
Target population: High school students
SPORT Prevention Plus Wellness is a brief, one-time, multi-health behavior program for high school-aged adolescents, that combines positive messages about physical activity with messages about alcohol use prevention. The program is based on the Integrative Behavior-Image Model (BIM), in which positive personal and social images serve as key motivators for health development, and unify health-promoting and health-risk-avoiding habits within a single intervention. SPORT Prevention Plus Wellness is intended to reduce alcohol use, and increase physical activity, by yoking targeted negative behaviors (substance abuse) to salient productive behaviors (physical activity). The program consists of a one-time, in-school, in-person health behavior screen and a one-on-one fitness consultation. At the end of each consultation, the participant receives a take-home fitness prescription. The consultation is followed by a reinforcing follow-up flyer mailed to each participant’s home.
The cost of implementing SPORT Prevention Plus Wellness in 2002-2003 was $9.25 per participant, including $3.00 for materials and postage, and $6.25 for each one-on-one consultation (based on four consults per hour @ $25/hr). The materials and postage for the control group is $5.00 per participant.
EVALUATION OF PROGRAM
Evaluated Population: The study included 604 students (335 in ninth grade, and 269 in eleventh grade) from a single suburban high school in northeast Florida.
Of the participants, 51 percent were Caucasian, 22 percent African-American, 56 percent female, and the mean age was 15.2 years. Nearly thirteen percent participated in the reduced cost lunch program, 38.7 percent had a family member with a drinking or drug problem, and 60.9 percent reported some alcohol or drug education within the last year.
Approach: Participants in the evaluation study (N=604) were randomly assigned within grade levels to receive either SPORT Prevention Plus Wellness (Project SPORT) (n=302), or a minimal intervention control (n=302) consisting of a wellness brochure provided in school, and a pamphlet about teen health and fitness mailed to each participant’s home. The Youth Alcohol and Health Survey was used to collect data on alcohol and drug use, risk and protective factors associated with alcohol use, and exercise activity. These included measures of frequency and quantity of alcohol consumption, negative consequences associated with drinking, length of time using alcohol, and stage of initiation of health behavior. Drug-use behaviors measured included frequency of cigarette smoking and marijuana use. Measures of moderate and vigorous physical activity, along with cognitive, social and environmental risk factors, and protective factors found in previous research to mediate alcohol consumption, were also collected.
Prior to implementation of SPORT Prevention Plus Wellness, baseline data were collected. At baseline, the only difference on socio-demographic measures between the treatment and control groups was that a greater proportion of those in the control group (42.7 percent) reported a family alcohol or drug problem than those receiving the program (34.9 percent). Data were collected at three months after implementation, and again at 12 months after implementation. All outcome data were collected from participants, assembled by classrooms in the school auditorium, by trained project staff following a standardized protocol.
Results: The study found several positive, statistically significant results for participants in SPORT Prevention Plus Wellness compared with those in the control group. At the three-month follow-up, statistically significant positive results were found for several measures of alcohol use: 30-day frequency, 30-day quantity, 30-day heavy use, stage of initiation, and length of use. Statistically significant positive results were also found for some Cognitive Social Theory and Health Belief Model constructs, including negative expectancy beliefs, behavioral capability, and perceived susceptibility. Statistically significant positive results were also found for parental monitoring, and parent/child communication. Other statistically significant positive results for alcohol-use risk included intention to drink in the future, alcohol attitudes, and suggestibility. Youth exposed to the SPORT Prevention Plus Wellness program engaged in more moderate physical activity, and smoked cigarettes less frequently, compared with those in the control group.
At the 12-month follow-up, statistically significant positive results were found for alcohol-use risk and protective factors, drug behaviors, and drug use initiation. Students receiving the program used alcohol for briefer periods of time, and had better parent/child communication, but had less protection on perceived susceptibility, a Health Belief Model construct, compared with students in the control group. There were statistically significant positive results for intentions to drink in the next six months frequency of smoking cigarettes), and stage of initiation of smoking
Statistically significant positive interaction effects were found for alcohol consumption and initiation, alcohol risk and protective factors, and drug initiation. Trends on those measures for those receiving the program showed decreases at three months and increases at 12 months, while those in the control group showed increases at both times. Similar trends were found for parent/child communication, intentions to drink, past 30-day cigarette frequency of use, and stage of initiation for using cigarettes.
Statistically significant positive interaction effects were found between prior marijuana and/or cigarette use, and measured outcomes. At three months, significant results were found for alcohol-consumption behaviors, drug-use behaviors, and drug initiation, with more positive impacts for previously drug-using adolescents who received the program. Similar results were also found at 12 months, and adolescents previously using drugs and exposed to SPORT Prevention Plus Wellness engaged in more frequent vigorous physical activity and moderate physical activity, compared with their counterparts in the control group.
SOURCES FOR MORE INFORMATION
Werch, C., Moore, M.J., DiClemente, C.C., Bledsoe, R., Jobli, E. (2005). A multihealth behavior intervention integrating physical activity and substance use prevention for adolescents. Society for Prevention Science, 6, 213-226.
KEYWORDS: Adolescents (12-17), High School, Males and Females (Co-ed), Suburban, School-Based, Cost, Counseling/Therapy, Health Status/Conditions, Tobacco Use, Marijuana/Illicit/Prescription Drugs, Alcohol Use
Program information last updated on 9/6/2015.