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Heather S. Lonczak, PhD; Robert D. Abbott, PhD; J. David Hawkins, PhD; Rick Kosterman, PhD; Richard F. Catalano, PhD

Arch Pediatr Adolesc Med. 2002;156:438-447.

Objective  To examine the long-term effects of the full Seattle Social Development Project intervention on sexual behavior and associated outcomes assessed at age 21 years.

Design  Nonrandomized controlled trial with long-term follow-up.

Setting  Public elementary schools serving children from high-crime areas in Seattle, Wash.

Participants  Ninety-three percent of the fifth-grade students enrolled in either the full-intervention or control group were successfully interviewed at age 21 years (n = 144 [full intervention] and n = 205 [control]).

Interventions  In-service teacher training, parenting classes, and social competence training for children.

Main Outcome Measures  Self-report measures of all outcomes.

Results  The full-intervention group reported significantly fewer sexual partners and experienced a marginally reduced risk for initiating intercourse by age 21 years as compared with the control group. Among females, treatment group status was associated with a significantly reduced likelihood of both becoming pregnant and experiencing a birth by age 21 years. Among single individuals, a significantly increased probability of condom use during last intercourse was predicted by full-intervention group membership; a significant ethnic group x intervention group interaction indicated that after controlling for socioeconomic status, single African Americans were especially responsive to the intervention in terms of this outcome. Finally, a significant treatment x ethnic group interaction indicated that among African Americans, being in the full-intervention group predicted a reduced probability of contracting a sexually transmitted disease by age 21 years.

Conclusion  A theory-based social development program that promotes academic success, social competence, and bonding to school during the elementary grades can prevent risky sexual practices and adverse health consequences in early adulthood.

From the Schools of Social Work (Dr Lonczak) and Educational Psychology (Dr Abbott), and the Social Development Research Group (Drs Hawkins, Kosterman, and Catalano), University of Washington, Seattle.

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