This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Contact me when this article is cited  Related Content  • Similar articles in JAMA  Social Bookmarking   What's this?

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.

Abstract
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.

Author Affiliations
From the Departments of Pediatrics (Drs Grossman and Rivara), Health Services (Drs Grossman and Koepsell), Epidemiology (Drs Koepsell and Rivara), Educational Psychology (Dr Frey), and the Harborview Injury Prevention and Research Center (Drs Grossman, Neckerman, Koepsell, Liu, Asher, and Rivara), University of Washington, Seattle; and the Committee for Children, Seattle, Wash (Dr Frey and Ms Beland).

Footnotes
Dr Frey and Ms Beland are employees of the Committee for Children, a nonprofit organization that derives income from sales of the curriculum.

This study was presented in part at the annual meeting of the Ambulatory pediatric Association, washington, DC, May 1995.

Reprints: David Grossman, MD, MPH, Harborview Injury Prevention and Research Center, 325 Ninth Ave, Box 359960, Seattle, WA 98104.

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Mass Murder at School and Cumulative Strain: A Sequential Model
Levin and Madfis
American Behavioral Scientist 2009;52:1227-1245.
ABSTRACT  

Unraveling the Link Between Trauma and Delinquency: The Mediating Role of Negative Affect and Delinquent Peer Exposure
Maschi et al.
Youth Violence and Juvenile Justice 2008;6:136-157.
ABSTRACT  

A Policy-Based School Intervention to Prevent Overweight and Obesity
Foster et al.
Pediatrics 2008;121:e794-e802.
ABSTRACT | FULL TEXT  

Preventive Interventions Addressing Underage Drinking: State of the Evidence and Steps Toward Public Health Impact
Spoth et al.
Pediatrics 2008;121:S311-S336.
ABSTRACT | FULL TEXT  

Outcomes of the Social Competence Program Second Step in Norwegian Elementary Schools
Holsen et al.
School Psychology International 2008;29:71-88.
ABSTRACT  

Behavioral Strategies for Constructing Nonviolent Cultures With Youth: A Review
Mattaini and McGuire
Behav Modif 2006;30:184-224.
ABSTRACT  

Cross-national Study of Fighting and Weapon Carrying as Determinants of Adolescent Injury
Pickett et al.
Pediatrics 2005;116:e855-e863.
ABSTRACT | FULL TEXT  

Implementation of a Comprehensive Schoolwide Behavioral Intervention: The ABC Program
Pelham et al.
J Atten Disord 2005;9:248-260.
ABSTRACT  

Reducing Violence and Aggression in Schools
Greene
Trauma Violence Abuse 2005;6:236-253.
ABSTRACT  

Conduct Problems and Peer Rejection in Childhood: A Randomized Trial of the Making Choices and Strong Families Programs
Fraser et al.
Research on Social Work Practice 2004;14:313-324.
ABSTRACT  

Relational Aggression in Middle School: Educational Implications of Developmental Research
Yoon et al.
The Journal of Early Adolescence 2004;24:303-318.
ABSTRACT  

School-Based Mental Health Services
Committee on School Health
Pediatrics 2004;113:1839-1845.
ABSTRACT | FULL TEXT  

Intervention Research in Social Work: Recent Advances and Continuing Challenges
Fraser
Research on Social Work Practice 2004;14:210-222.
ABSTRACT  

Estimating the Effects of Interventions That are Deployed in Many Places: Place-Randomized Trials
Boruch et al.
American Behavioral Scientist 2004;47:608-633.
ABSTRACT  

Identifying and Intervening With Girls at Risk for Violence
Thomas
The Journal of School Nursing 2003;19:130-139.
ABSTRACT | FULL TEXT  

The Carolina Child Checklist of Risk and Protective Factors for Aggression
Macgowan et al.
Research on Social Work Practice 2002;12:253-276.
ABSTRACT  

Statistical and design issues in studies of groups
Cummings and Koepsell
Inj. Prev. 2002;8:6-7.
FULL TEXT  

Children's Reports of Bullying and Safety at School
Beran and Tutty
Canadian Journal of School Psychology 2002;17:1-14.
ABSTRACT  

Contamination in trials: is cluster randomisation the answer?
Torgerson
BMJ 2001;322:355-357.
FULL TEXT  

A Report Card on Quality Improvement for Children's Health Care
Ferris et al.
Pediatrics 2001;107:143-155.
ABSTRACT | FULL TEXT  

Reducing Adolescents' Aggressive and Hostile Behaviors: Randomized Trial Effects of a Brief Family Intervention 4 Years Past Baseline
Spoth et al.
Arch Pediatr Adolesc Med 2000;154:1248-1257.
ABSTRACT | FULL TEXT  

Components of Effective Youth Violence Prevention Programs for 7- to 14-Year-Olds
Cooper et al.
Arch Pediatr Adolesc Med 2000;154:1134-1139.
ABSTRACT | FULL TEXT  

Firearm-Related Injuries Affecting the Pediatric Population
Committee on Injury and Poison Prevention
Pediatrics 2000;105:888-895.
ABSTRACT | FULL TEXT  

Outcome evaluation of a multi-component violence-prevention program for middle schools: the Students for Peace project
Orpinas et al.
Health Educ Res 2000;15:45-58.
ABSTRACT | FULL TEXT  

Adapting the Gang Model: Peer Mentoring for Violence Prevention
Sheehan et al.
Pediatrics 1999;104:50-54.
ABSTRACT | FULL TEXT  

Age-Within-School-Class and Adolescent Gun-carrying
Hayes and Hemenway
Pediatrics 1999;103:64e-64.
ABSTRACT | FULL TEXT  

Reducing Obesity via a School-Based Interdisciplinary Intervention Among Youth: Planet Health
Gortmaker et al.
Arch Pediatr Adolesc Med 1999;153:409-418.
ABSTRACT | FULL TEXT  

The Implementation and Enforcement of Tobacco Control Laws: Policy Implications for Activists and the Industry
Jacobson and Wasserman
Journal of Health Politics, Policy and Law 1999;24:567-598.
ABSTRACT  

Family Violence: Implications for the Pediatrician
Knapp and Dowd
Pediatr. Rev. 1998;19:316-321.
FULL TEXT  

Discussion Sections in Reports of Controlled Trials Published in General Medical Journals: Islands in Search of Continents?
Clarke and Chalmers
JAMA 1998;280:280-282.
ABSTRACT | FULL TEXT  

A Violence Prevention Curriculum
Green and Wintfeld
JAMA 1997;278:979-980.
ABSTRACT  

A CURRICULUM TO REDUCE VIOLENCE IN YOUNG CHILDREN
JWatch General 1997;1997:6-6.
FULL TEXT  

Applying Science to Violence Prevention
Rosenberg et al.
JAMA 1997;277:1641-1642.
ABSTRACT