***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: A population -based r and omized intervention trial for the prevention of conduct problems ( i.e. , oppositional defiant disorder and conduct disorder ) is described . The LIFT ( Linking the Interests of Families and Teachers ) intervention was design ed for all first- and fifth- grade elementary school boys and girls and their families living in at-risk neighborhoods characterized by high rates of juvenile delinquency . The 10-week intervention strategy was carefully targeted at proximal and malleable antecedents in three social domains that were identified by a developmental model of conduct problems . From 12 elementary schools , 671 first and fifth grade rs and their families participated either in the theory-based universal preventive intervention or in a control condition . The intervention consisted of parent training , a classroom-based social skills program , a playground behavioral program , and systematic communication between teachers and parents . A multiple measure assessment strategy was used to evaluate participant satisfaction and participation , fidelity of implementation , and the immediate impacts of the program on targeted antecedents This study reports on aggressive outcomes from a cluster r and omized trial of the Promoting Alternative Thinking Strategies ( PATHS ) curriculum .  Fourteen elementary schools were r and omly assigned to intervention or control condition and third grade students were followed through the fifth grade .  Teacher and self-reports of student aggression , conduct problems , delinquency , acting out problems , and social information processing ( SIP ) variables were collected . Linear change for each of the SIP variables was noted with control students demonstrating increased normative beliefs about aggression , increased aggressive social problem solving , increased hostile attribution bias , and increased aggressive interpersonal negotiation strategies over time while PATHS students remained relatively stable . Teachers reported significant curvilinear change in student aggression , conduct problems , and acting out behavior problems ; all favoring PATHS students OBJECTIVE To report experimental impacts of a universal , integrated school-based intervention in social-emotional learning and literacy development on change over 1 school year in 3rd- grade children 's social-emotional , behavioral , and academic outcomes . METHOD This study employed a school-r and omized , experimental design and included 942 3rd- grade children ( 49 % boys ; 45.6 % Hispanic/Latino , 41.1 % Black/African American , 4.7 % non-Hispanic White , and 8.6 % other racial/ethnic groups , including Asian , Pacific Isl and er , Native American ) in 18 New York City public elementary schools . Data on children 's social-cognitive processes ( e.g. , hostile attribution biases ) , behavioral symptomatology ( e.g. , conduct problems ) , and literacy skills and academic achievement ( e.g. , reading achievement ) were collected in the fall and spring of 1 school year . RESULTS There were main effects of the 4Rs Program after 1 year on only 2 of the 13 outcomes examined . These include children 's self-reports of hostile attributional biases ( Cohen 's d = 0.20 ) and depression ( d = 0.24 ) . As expected based on program and developmental theory , there were impacts of the intervention for those children identified by teachers at baseline with the highest levels of aggression ( d = 0.32 - 0.59 ) on 4 other outcomes : children 's self-reports of aggressive fantasies , teacher reports of academic skills , reading achievement scaled scores , and children 's attendance . CONCLUSIONS This report of effects of the 4Rs intervention on individual children across domains of functioning after 1 school year represents an important first step in establishing a better underst and ing of what is achievable by a schoolwide intervention such as the 4Rs in its earliest stages of unfolding . The first-year impacts , combined with our knowledge of sustained and exp and ed effects after a second year , provide evidence that this intervention may be initiating positive developmental cascades both in the general population of students and among those at highest behavioral risk . ( PsycINFO Data base Record ( c ) 2010 APA , all rights reserved ) The Media Ready Program was design ed as a middle school , media literacy education , preventive intervention program to improve adolescents '  media literacy skills and reduce their intention to use alcohol or tobacco products . In a short-term efficacy trial , schools in North Carolina were r and omly assigned to conditions ( Media Ready : n = 214 ; control : n = 198 ) . Boys in the Media Ready group reported significantly less intention to use alcohol in the future than did boys in the control group . Also , students in the Media Ready group who had used tobacco in the past reported significantly less intention to use tobacco in the future than did students in the control group who had previously used tobacco . Multilevel multiple mediation analyses suggest that the set of logical analysis Message Interpretation Processing variables mediated the program 's effect on students ' intentions to use alcohol or tobacco in the future OBJECTIVE To test the efficacy of 2 programs design ed to reduce high-risk behaviors among inner-city African American youth . DESIGN Cluster r and omized trial . SETTING Twelve metropolitan Chicago , Ill , schools and the communities they serve , 1994 through 1998 . PARTICIPANTS Students in grade s 5 through 8 and their parents and teachers . INTERVENTIONS The social development curriculum ( SDC ) consisted of 16 to 21 lessons per year focusing on social competence skills necessary to manage situations in which high-risk behaviors occur . The school/community intervention ( SCI ) consisted of SDC and school-wide climate and parent and community components . The control group received an attention-placebo health enhancement curriculum ( HEC ) of equal intensity to the SDC focusing on nutrition , physical activity , and general health care . MAIN OUTCOME MEASURES Student self-reports of violence , provocative behavior , school delinquency , substance use , and sexual behaviors ( intercourse and condom use ) . RESULTS For boys , the SDC and SCI significantly reduced the rate of increase in violent behavior ( by 35 % and 47 % compared with HEC , respectively ) , provoking behavior ( 41 % and 59 % ) , school delinquency ( 31 % and 66 % ) , drug use ( 32 % and 34 % ) , and recent sexual intercourse ( 44 % and 65 % ) , and improved the rate of increase in condom use ( 95 % and 165 % ) . The SCI was significantly more effective than the SDC for a combined behavioral measure ( 79 % improvement vs 51 % ) . There were no significant effects for girls . CONCLUSIONS Theoretically derived social-emotional programs that are culturally sensitive , developmentally appropriate , and offered in multiple grade s can reduce multiple risk behaviors for inner-city African American boys in grade s 5 through 8 . The lack of effects for girls deserves further research Six schools were r and omly assigned to a multilevel bullying intervention or a control condition .  Children in Grade s 3 - 6 ( N=1,023 ) completed pre- and posttest surveys of behaviors and beliefs and were rated by teachers . Observers coded playground behavior of a r and om sub sample ( n=544 ) . Hierarchical analyses of changes in playground behavior revealed declines in bullying and argumentative behavior among intervention-group children relative to control-group children , increases in agreeable interactions , and a trend toward reduced destructive byst and er behavior . Those in the intervention group reported enhanced byst and er responsibility , greater perceived adult responsiveness , and less acceptance of bullying/aggression than those in the control group . Self-reported aggression did not differ between the groups . Implication s for future research on the development and prevention of bullying are discussed This study examined the effects of the Positive Action ( PA ) programme in Chicago Public Schools on problem behaviours among a cohort of elementary school students from grade three through grade five . Using a matched-pair , r and omised control design with 14 elementary schools , approximately 510 fifth- grade rs self-reported lifetime substance use , serious violence-related behaviour , and current bullying and disruptive behaviours .  Three-level ( i.e. students nested within schools within school pairs ) overdispersed Poisson models were used to examine programme effects on the number of items endorsed for each of the four outcomes . Findings indicated that students in the intervention endorsed 31 % fewer substance use behaviours ( incidence rate ratio [ IRR ] = 0.69 ) , 37 % fewer violence-related behaviours ( IRR = 0.63 ) and 41 % fewer bullying behaviours ( IRR = 0.59 ) , respectively , compared to students in the control schools . Reduction in reported disruptive behaviours was of a similar magnitude ( 27 % , IRR = 0.73 ) , but was not statistically significant . These results replicate findings of an earlier r and omised trial of the PA programme and extend evidence of its effectiveness to youth attending large urban school systems Study objective : The aim of this study was to determine the effect of a multilevel school based intervention on  adolescents ’ emotional wellbeing and health risk behaviours . Design : School based cluster r and omised controlled trial . Students were surveyed using laptop computers , twice in the first year of intervention and annually thereafter for a further two years . Setting : Secondary schools . Participants : 2678 year 8 students ( 74 % ) participated in the first wave of data collection . Attrition across the waves was less than 3 % , 8 % , and 10 % respectively with no differential response rate between intervention and control groups at the subsequent waves ( 98 % v 96 % ; 92 % v 92 % , and 90 % v 89 % respectively ) . Main results : A comparatively consistent 3 % to 5 % risk difference was found between intervention and control students for any drinking , any and regular smoking , and friends ’ alcohol and tobacco use across the three waves of follow up . The largest effect was a reduction in the reporting of regular smoking by those in the intervention group ( OR 0.57 , 0.62 , and 0.72 at waves 2 , 3 , and 4 respectively ) . There was no significant effect of the intervention on depressive symptoms , and social and school relationships . Conclusions : While further research is required to determine fully the processes of change , this study shows that a focus on general cognitive skills and positive changes to the social environment of the school can have a substantial impact on important health risk behaviours PURPOSE To evaluate the impact of the Second Step : Student Success Through Prevention ( SS-SSTP ) Middle School Program on reducing youth violence including peer aggression , peer victimization , homophobic name calling , and sexual violence perpetration and victimization among middle school sixth- grade students . METHODS The study design was a nested cohort ( sixth grade rs ) longitudinal study . We r and omly assigned 18 matched pairs of 36 middle schools to the SS-SSTP or control condition . Teachers implemented 15 weekly lessons of the sixth- grade curriculum that focused on social emotional learning skills , including empathy , communication , bully prevention , and problem-solving skills . All sixth grade rs ( n = 3,616 ) in intervention and control conditions completed  self-report measures assessing verbal/relational bullying , physical aggression , homophobic name calling , and sexual violence victimization and perpetration before and after the implementation of the sixth- grade curriculum . RESULTS Multilevel analyses revealed significant intervention effects with regard to physical aggression . The adjusted odds ratio indicated that the intervention effect was substantial ; individuals in intervention schools were 42 % less likely to self-report physical aggression than students in control schools . We found no significant intervention effects for verbal/relational bully perpetration , peer victimization , homophobic teasing , and sexual violence . CONCLUSIONS Within a 1-year period , we noted significant reductions in self-reported physical aggression in the intervention schools . Results suggest that SS-SSTP holds promise as an efficacious prevention program to reduce physical aggression in adolescent youth We report results from a group-r and omized trial of a prevention program aim ed at preventing bullying and other aggressive behaviors . Fourth grade classrooms at 28 public elementary schools were assigned to receive selected modules of the Youth Matters prevention curriculum or to a no-treatment control condition . Cross-classified multilevel models were fitted to four waves of data collected over 2 years to test the effect of the intervention on self-reported bullying and bully victimization . No systematic change in bullying other students was observed . In a continuous outcome growth model , bully victim scale scores declined over the course of the study and the rate of decline in victimization was significantly higher in experimental schools relative to control schools . But the results from binary outcome growth models indicate no significant treatment effects on bully status or bully victim status over time . Implication s of findings for the implementation of anti-bullying strategies in urban public school setting s are discussed OBJECTIVES We sought to test the efficacy of an intervention that was design ed to promote social inclusion and commitment to education , in reducing among students health risk behaviors and improving emotional well-being . METHODS The design was a cluster-r and omized trial in 25 secondary schools in Victoria , Australia . The subjects were 8th- grade students ( aged 13 to 14 y ) in 1997 ( n=2545 ) and subsequent 8th- grade students in 1999 ( n=2586 ) and 2001 ( n=2463 ) . The main outcomes were recent substance use , antisocial behavior , initiation of sexual intercourse , and depressive symptoms . RESULTS At 4-year follow-up , the prevalence of marked health risk behaviors was approximately 20 % in schools in the comparison group and 15 % in schools in the intervention group , an overall reduction of 25 % . In ordinal logistic regression models a protective effect of intervention was found for a composite measure of health risk behaviors in unadjusted models ( odds ratio [OR]= 0.69 ; 95 % confidence interval [CI]= 0.50 , 0.95 ) and adjusted models ( OR= 0.71 ; CI = 0.52 , 0.97 ) for potential confounders . There was no evidence of a reduction 
    Output:
    
Evidence was concentrated in KS2 , with few evaluations in KS3 or KS4 , and evaluations had few consistent effects ; evaluations in KS3 and KS4 did not suggest effectiveness .
Evaluations did not shed light on the value of different approaches to integration