Promoting Positive Action: Results of a Longitudinal Program Evaluation Targeting Risk and Protective Factors in a Low-Income, Rural School System

Background: Positive Action (PA) is a school-based intervention that targets individual, relational, and community-level risk factors. The program aims to improve academic achievement, school attendance, problem behaviors (e.g., substance use, violence, suspension, disruptive behaviors), parent-child bonding, family cohesion, and family functioning. PA was implemented in 13 middle schools in an ethnically diverse rural county over a 3-year period. The current study examines the impact of PA on self-esteem, school hassles, aggression, and internalizing symptoms. Analyses also investigate how dosage of the PA program impacts outcomes.

Methods: Over 2,000 middle school students in a low-income, violent rural county in the Southeast participated in the PA program over three years; a sample from a neighboring county served as the comparison group. Participants were tracked longitudinally as they moved through middle- and high-school, allowing an assessment of the long term effects of PA. Following multiple imputation and propensity score analysis, four two-level hierarchical linear models were estimated using self-esteem, school hassles, aggression, and internalizing symptoms as dependent variables. Models were estimated using inverse probability of treatment weighting average treatment effect, inverse probability of treatment weighting average treatment effect for the treated, and 1-to-1 nearest-neighbor within caliper matching. A similar method was used to assess the impact that PA dosage (years and number of lessons) had on participant self-esteem, school hassles, aggression, and internalizing symptoms.

Results: Results indicated that relative to the comparison group, PA youth reported significantly higher self-esteem (1.8%, p<.05) and significantly lower school hassles (3.9%, p<.001). Results for aggression indicated beneficial results for PA youth, however the finding was not statistically significant. For internalizing symptoms, youth from the intervention county had a higher internalizing score than those from the PA county (2.6%, p<.001). In terms of dosage, students who received 3-years of PA had a self-esteem score that was 5.3% higher than those who received zero years. Students who received one year of PA had a school hassles score that was 1.6% lower than those who received zero years.

Discussion: To date, the majority of PA research has been conducted in urban areas and the current research suggests that PA has some positive results when implemented in a low-income, diverse, rural community. Further, increased dosage of the program was beneficial for some outcomes, but not others, suggesting that changes might be needed in PA to adapt it to rural settings and if improvements in mental health are desired.