1. Positive Youth Development for the Improvement of Multiple Behaviors Character, Mental Health and Academic Achievement
Brian R. Flay, D.Phil.
Distinguished Professor
Health Research and Policy Centers
University of Illinois at Chicago
Presented at “Reducing Adolescent Risk: Toward an Integrated Approach”
Annenberg Public Policy Center, University of Pennsylvania, June 27-30, 2002
Based on a Presentation to the American Academy of Health Behavior Conference
in acceptance of the Research Laureate Award, Napa, CA, March 25, 2002
Annenberg Public Policy Center, U Pennsylvania, June 28,

2. Annenberg Public Policy Center, U Pennsylvania, June 28, 2002 2
Outline/Summary
1. Behaviors are related.
Also predict and are predicted by each other
Must work towards a comprehensive, coherent, integrated approach to youth development.
2. All behaviors have common predictors/causes
Risk and Protective Factors
The Theory of Triadic Influence (Integrates theories)
Importance of Community, Family and School
Must work toward comprehensive and coherent classroom, school-wide, family and community programs
3. Implications for prevention science, programs and policies
Annenberg Public Policy Center, U Pennsylvania, June 28,

3. Annenberg Public Policy Center, U Pennsylvania, June 28, 2002 3
Substance Use and Abuse Behaviors are Highly Correlated and Predict Each Other
Illicit
Alcohol
Tobacco
Substance
Ab/Use
And can be thought of as a latent variable
Annenberg Public Policy Center, U Pennsylvania, June 28,

4. Problem/Risky Behaviors are Highly Correlated and Predict Each Other
Weapons
Inter-personal
Violence
Fighting
Threats
Substance
Ab/Use
Tobacco
Alcohol
Illicit
Unsafe
Sex
No Condoms
Early
Multiple partners
Problem/
Risky
Behavior
Annenberg Public Policy Center, U Pennsylvania, June 28,

5. Annenberg Public Policy Center, U Pennsylvania, June 28, 2002 5
Health-Promoting Behaviors are Highly Correlated and Predict Each Other
Physical
Activity
Exercise
Walking
Sports
Health
Care
Hygiene
Teeth
Visits
Eating/
Diet
Fruits & Veges
Meat/Dairy
Junk
Healthy
Behaviors
Annenberg Public Policy Center, U Pennsylvania, June 28,

6. Conventional and Social Behaviors Low Risk, non-Problem Behaviors
Positive, Health and Social Behaviors are Highly Correlated and Predict Each Other
Healthy
Behaviors
Conventional and Social Behaviors
Eating/Diet
Health Care
Physical
Low Risk, non-Problem Behaviors
No Drugs
Nonviolent
Safe Sex
Community Bonding
Law Abiding
Achievement
Mental Health
ADHA
Conduct
Anxiety/Dep
Successful
and Happy Citizens
Annenberg Public Policy Center, U Pennsylvania, June 28,

7. Annenberg Public Policy Center, U Pennsylvania, June 28, 2002 7
Conclusion #1
Future prevention programs need to comprehensively and coherently address multiple behaviors and outcomes
- Prevention of Problem/Risky Behaviors
Substance use and abuse, violence, and unsafe sex
- Promotion of health-enhancing behaviors
Good eating habits and adequate physical activity
- Psychological and mental health
- Positive character development
Positive moral and social behavior
-School success
Annenberg Public Policy Center, U Pennsylvania, June 28,

8. BUT, should we target single or multiple behaviors?
- We used to believe that effects would be larger if we targeted a single behavior, or a single domain, such as substance use
- Increasing evidence that many behaviors and domains are interrelated, and that programs should deal with them together
- Increasing evidence that programs that address multiple issues are effective
- Particularly if they address related issues -- problem behaviors, health behaviors, school behaviors
Annenberg Public Policy Center, U Pennsylvania, June 28,

9. ABAN AYA significantly improved multiple behaviors
Physical Violence
Provoking Behavior
Alcohol and Drug Use
School Delinquency
Frequency of sexual intercourse
Condom Use
Healthy & junk food consumption
Physical Exercise
Standardized Test Scores
Annenberg Public Policy Center, U Pennsylvania, June 28,

10. Annenberg Public Policy Center, U Pennsylvania, June 28, 2002 10
And Has Multiple Effects:
Annenberg Public Policy Center, U Pennsylvania, June 28,

11. Part 2: All Behaviors Have Common Causes
PERSONAL
Genetic
Personality
SELF-EFFICACY
SITUATIONAL
Community
Family
School
SOCIAL NORMATIVE BELIEFS
ENVIRONMENTAL
Broader socio-
cultural environment
VALUES/ ATTITUDES
Annenberg Public Policy Center, U Pennsylvania, June 28,

12. Annenberg Public Policy Center, U Pennsylvania, June 28, 2002 12
All Behaviors Have Common Causes: The Basics of the Theory Of Triadic Influence
& Personality
Biology
Sense of
Self
Social
Skills
Determin-
ation
SELF
EFFICACY
Competence
DNA
Bonding
Perceived
Norms
Motivation
to Comply
Others'
Beh&&Atts
SOCIAL
NORMATIVE
BELIEFS
Context
Social
BEHAVIOR
Decisions/
Intentions
Values
Evaluations
Environment
Religion
Culture
ATTITUDES
Informational
Cultural
Knowledge
Expectancies
Annenberg Public Policy Center, U Pennsylvania, June 28,

13. Annenberg Public Policy Center, U Pennsylvania, June 28, 2002 13

14. All Behaviors Have Common Causes
Local Community,
Families, Schools
National
Socio-Cultural Environment
Intrapersonal Biology, Personality
Relationships with Others.
Others’ Attitudes, Behaviors.
Social Normative Beliefs
Political, Economic,
Media, Religious.
Values, Attitudes
Self-Concept,
Social Skills.
Self-Efficacy
Physical
Physical
Health Care
Health Care
Community Bonding
Safe Sex
Eating/Diet
Eating/Diet
Law Abiding
Nonviolent
Mental Health
Healthy Behaviors
Achievement
Low Risk, non-Problem Behaviors
Conventional and Social Behaviors
No Drugs
Successful and Happy Citizens
Annenberg Public Policy Center, U Pennsylvania, June 28,

15. The Critical Importance of Community, Family and School
Student Health, Behavior and Academic Performance
Annenberg Public Policy Center, U Pennsylvania, June 28,

16. Annenberg Public Policy Center, U Pennsylvania, June 28, 2002 16
Conclusion #2
Future prevention programs need to involve whole schools, families and communities in an integrated and coherent way
- Classroom curricula can teach content and skills
Should be school-wide, scoped and sequenced for every grade
- Teacher training can address
class/behavior management and teaching effectiveness
- School-wide climate change can provide
a safe learning environment
provide common language and consistently reinforce desired behaviors
- Family programs can
improve parenting skills
provide common language and consistently reinforce positive behaviors
- Community programs can
link schools and communities
get students observing and doing community service
provide common language and consistently reinforce positive behaviors
Annenberg Public Policy Center, U Pennsylvania, June 28,

17. Example: The POSITIVE ACTION Program
K–12 classroom curriculum
over 1,200 lessons - using Teacher’s Kits (manuals and materials for each grade), classroom teachers present 15–20-minute lessons
Principal’s Kits (Elementary and Secondary)
a school-climate program to promote the practice and reinforcement of positive actions in the whole school population (students and staff)
Counselor’s Kit
used with selected individual students, small groups and families
Family Kit
contains prepared weekly home lessons paralleling the school program along with school parent-involvement activities
Community Kit
manuals and materials that align and encourage collaboration of all the environments (schools, families and community) involved in the program
Annenberg Public Policy Center, U Pennsylvania, June 28,

18. Annenberg Public Policy Center, U Pennsylvania, June 28, 2002 18
Part 3: Implications: Promotion Programs of the Future Must Be Designed to be …
EARLY AND OFTEN
Start early, scoped and sequenced, many doses, over a long time
POSITIVE
Focus on asset and strength development
Address protective factors more than risk factors
Include positive reinforcement and environmental contingencies
COMPREHENSIVE
Multiple domains: behaviors, feelings, thoughts, character, achievement
Multiple protective/risk factors
Multiple levels: students, teachers, school, families, community
REPLICABLE
Diverse teaching strategies
Complete materials, user friendly
Minimal training required, but necessary training easily provided
EFFECTIVE
Large effects that are sustained
Annenberg Public Policy Center, U Pennsylvania, June 28,

19. Annenberg Public Policy Center, U Pennsylvania, June 28, 2002 19
SUMMARY
It is critically important to link behavior, character, mental health, and academic achievement
Positive, problem, health, and mental health behaviors are all related, and are all related to character and academic achievement
All behaviors and related outcomes have the same causes, many of which reside in families, schools and communities
Future prevention/promotion research, programs, and policies need to be comprehensive, integrated and coherent across behaviors, grades/ages, and social ecologies (schools, homes and communities)
Annenberg Public Policy Center, U Pennsylvania, June 28,