1. Effects of a comprehensive character education program on student smoking – Findings from 4 studies
Brian R. Flay, D.Phil.
Professor, Public Health
Oregon State University
Corvallis, OR
Welcome to the Positive Action Program for Academics, Character, and Prevention.
Carol Gerber Allred, Ph.D. developed and taught Positive Action, as high school social studies elective in Twin Falls, Idaho from 1974 to 1977, then was asked to expand the program to the elementary school. In 1982, she founded Positive Action, Inc., and to date, the program has been used in over 10,000 schools, in every state in the U.S., as well as internationally. The number of students whose lives have been changed by the practice of positive actions is in the millions.
Brian Flay, D. Phil., a Professor at Oregon State University, a world-renowned social psychologist and researcher in health promotion and prevention, has conducted a number of evaluations and is now overseeing two randomized experimental studies.
The early quasi-experimental evaluations indicated numerous positive results, and Dr. Flay was intrigued. The comprehensive Positive Action program was confirming his theory, the Theory of Triadic Influence.
Eventually, another kind of positive result came out of this collaboration between program developer and researcher, Brian and Carol are now husband and wife.
Society for Research on Nicotine and Tobacco, Portland, OR, Feb

2. Outline The Positive Action program philosophy and theory
The Positive Action program components
Evaluations and results
Conclusions 2

3. 3

4. I. Overview of PA Program
Positive Action (PA) is a comprehensive school-based program designed to
promote student character and positive behavior,
prevent an array of student problem behaviors, and
improve student achievement.
PA is grounded in a broad theory of self-concept that posits
(a) students’ self-concepts and characters are determined by how they behave and how they feel about themselves when they do various behaviors and
(b) making positive and healthy behavioral choices results in feelings of self-worth.
Major features of the program include:
Teacher delivered scripted PA curriculum lessons in classroom
Teacher and school staff modeling/reinforcement of “PA behaviors” inside and outside of the classroom
School-wide activities (e.g., PA assemblies) led by principal and PA Committee 4

5. Positive Action Overview
The core of Positive Action is contained in an underlying philosophy.
The philosophy is described in the Thoughts-Actions-Feelings Circle.
Positive Action teaches the positive actions for the whole self through six units that are contained in five program components.
The five completely prepared components are:
K–12 curriculum,
Climate Development,
Counselors program,
Family program, and
Community program. 5

6. Ref. (Reference) Cognitive Behavior Therapy and Positive Psychology
Basic Philosophy (Theory of Action) of the Positive Action Program & Circle
You feel good about yourself when you do positive actions.
Ref. (Reference) Cognitive Behavior Therapy and Positive Psychology
The most profound concepts are often stated in the simplest terms: 
There are two things you need to know about Positive Action. 
One is the philosophy: You feel good about yourself when you do positive actions 
And the other is the Thoughts-Actions-Feelings Circle, demonstrating how our thoughts lead to our actions, which creates feelings about ourselves. The circle can be either positive or negative. 6

7. C.F. (Reference) Depression
Basic Philosophy (Theory of Action) of the Positive Action Program & Circle
...and
You feel bad about yourself when you do negative actions.
C.F. (Reference) Depression
And you feel bad about yourself when you do negative actions. 
Four-year-olds understand this. 7

8. II. The POSITIVE ACTION Program Components
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 8

9. Positive Action Focus Units (Learning Goals)
In the classroom curriculum and all other materials, the Positive Action content is taught through six focus units.
Unit 1: Self-Concept: What It Is, How It’s Formed, and Why It’s Important (Philosophy & Circle)
Unit 2: Physical and Intellectual Positive Actions for a Healthy Body and Mind (includes motivation to learn)
Unit 3: Social/Emotional Positive Actions for Managing Yourself Responsibly
Unit 4: Social/Emotional Positive Actions for Getting Along with Others by Treating Them the Way You Like to Be Treated (Social-Emotional Skills & Character)
Unit 5: Social/Emotional Positive Actions for Being Honest with Yourself and Others (Mental Health)
Unit 6: Social/Emotional Positive Actions for Improving Yourself Continually (Setting & Achieving Goals)
The purpose of the unit learning goals is to teach how our thoughts, actions, and feelings in the physical, intellectual, social, and emotional domains influence the development of character, self-concept, prevention of substance abuse and violence, development of intellectual skills and motivation to learn, creating positive relationships, academic and professional achievement, and the creation of a life worth having. 9

10. Logic/Theoretic Model of the Expected Effects of the Positive Action Program
Program Components
Immediate Outcomes
Climate Development, Family Kit,
Teacher/Staff Training,
K–12 Instruction Curriculum, Drug Education Supplements,
Community Kit,
Counseling Kit
* Improved relationships among school administrators, teachers, parents & community.
* Improved classroom management.
* Increased involvement of school with
parents & community.
Improved
Learning
Environment
Expected Effects
Expected Impact
PA Unit
Attitudes Toward Behaviors,
Social Normative Beliefs,
Self-Efficacy
Fewer Disciplinary
Problems; Reduced
Substance Use;
Less Violence
Improved character/self-concept
Learning/Study skills
Self-Management
Interpersonal/social skills
Self-honesty, responsibility
Goal setting, future orientation
Improved
Social
and
Character
Development
Improved School
Attendance, Grades
and Test Scores 10

11. Elementary Curriculum Kits - Grades K–6
Student activity sheets/booklets and materials for 30 students
Posters
Music
Reinforcement stickers
Hands-on activities
Puppets
Flannel board characters
Games
Others
K–6 Instructor’s Manuals
minute lessons
Role-playing
Plays
Stories
Questions
Poetry
Games 11

12. Drug Education Curriculum Grade 5 and Middle School
Grade 5 Drug Education Supplement Instructor’s Manual
to 20-minute lessons
Stories
Questions
Student activity booklets and materials for 30 students
Posters
Music
Middle School Drug Education Supplement Instructor’s Manual
to 20-minute lessons
Stories
Questions
Student activity booklets and materials for 30 students
Scripted play: “Escape from the Shadows”
Games
Posters
Music
Lessons are taught at the end of each unit of the regular PA curriculum.
The kits can also stand alone. 12

13. Elementary Climate Kit
Positive Notes
Notepads
Positive Action News
Music – 27 songs
CDs
Song books
Posters
Video
Overview
Implementation Plan
Scope and Sequence Booklet
Principal’s manual
Support Staff manual
Parents’ manual
Assemblies
Certificates of Achievement
Positive Action Balloons
Positive Action Calendar
Words-of-the-Week Cards
Reinforcement Stickers
ICU Boxes and Notes
Positive Action Tokens 13

14. Other Program Components
Counseling Program
Counselor Kit
Lessons for individual students or small groups
Family Program
Classes
Home Kit
Community Program
Community messages and activities
Civic engagement
Media messages 14

15. III. Four studies and results
I. Intensive Case Study
II. Matched control study using archival data
III. RCT in Hawaii elementary schools
IV. RCT in Chicago Public Schools 15

16. Study I: Intensive case study of program implement in a small rural school
First year of PA in a rural Title I school in Northern Florida.
Variation in level of implementation
None or Some (7 classrooms)
Almost All (7 classrooms)
Every Component and Lesson (11 classrooms)
Students, Teachers and Parents surveyed at beginning and end of year. 16

17. Clear dose-response relationship between level of program implementation and student smoking in grades 4 and 5 (Χ2 = 12.6, p < .01, with no diffs. at pretest) 17

18. Study II: Matched control study using school-level archival data
School Report Card data to find matching control schools for the PA schools
Poverty (as indicated by percentage of free/reduced lunches)
Mobility rates
Ethnic distribution
We had data on feeder patterns for each middle and high school.
Data on whether or not each elementary school had actively implemented PA for 4 or more years.
55 PA schools, 29 non-PA schools
Calculated % of PA graduates in each middle and high school.
Archival data included reports of disciplinary actions for cigarette smoking
ANCOVA adjusting for school characteristics.
Flay & Allred, Prevention Science, 2003 18

19. ANCOVA one-tailed p = .03 19

20. ANCOVA one-tailed p = .04 20

21. Study III: Randomized Trial in Hawaii Elementary Schools
Elementary schools (N = 20) on 3 Islands
5yr Effectiveness Trial
Random assignment
PA or Control conditions
Strata matched on multiple indicators of risk
PA schools received:
4yrs ( through )
Teacher training
Developer, Carol Allred 3-4hrs,initial yr; booster sessions 1-2hrs
Technical Support, Project Coordinator Howard Humphries
Proc Mixed ANOVA analyses accounting for students clustered within schools 21

22. Baseline Equivalence: 2000-01
No differences are close to being statistically significant except % free/reduced lunch p = .099 22

23. Baseline Equivalence on Ethnic Distribution
No differences are close to being statistically significant. Sample is fairly representative of all HI schools 23

24. Hawaii Trial: 30% reduction
p = .012 for scale of combine substance use,
accounting for nesting of students within schools 24

25. Hawaii program effects on absenteeism25

26. Hawaii dose-response relationship26

27. Study IV: Randomized Trial of PA in Chicago Public Schools
Elementary Schools (N = 14)
3 yr Effectiveness Trial
Random Assignment
PA or Control Conditions
Strata matched on multiple indicators of risk
PA Schools Received:
3 yrs ( through )
Teacher Training
Developer: Dr. Carol Allred 3-4 hrs training, initial yr; booster sessions 2 hrs, subsequent yrs
Technical Support: Chicago Project Coordinator, Vanessa Brechling
Data Collection
Local (UIC)
Multi-site (US Dept of Education) 27

28. 28

29. 29

30. p = .023 for scale of combined substance use,
accounting for clustering of students within schools 30

31. and significant for suspensions (p = .037) using one-tailed tests.
Effects on School-Level reports of misconducts and suspensions (Chicago)
In ANCOVA models predicting year 4 differences from year 1 levels and condition,
differences at year 4 are marginally significant for misconducts (p = .054)
and significant for suspensions (p = .037) using one-tailed tests. 31

32. IV. Conclusions
Implementing school-wide character education programs to address a wide range of outcomes is challenging
Limited resources of urban school systems
NCLB
Evaluation of school-based character/social development programs is complicated by control schools implementing similar programs under “business as usual” conditions
Clear dose-response relationships were evident in quasi-experimental evaluations
In RCTs program effects on smoking at 5th grade were obtained after 3 or 4 years of programming
School-level reports of misconducts and suspensions strengthen the robustness of the findings
Time trends in outcomes and long-term follow-up studies suggest increasing effects over time
School-wide social and character development education can be effective at:
decreasing multiple negative behaviors, including smoking
Implementation challenge in context of NCLB
NCLB influences teachers to focus time on students’ standardized test score performance rather than on teaching PA as means to enhance student ability to improve test scores.
Evaluation challenges
Lack of True Counterfactuals – control schools had school-based prevention programs as well 32

33. Why does Positive Action have such strong effects in multiple domains?
Links all behaviors/actions to feelings, thoughts and values
Increases awareness of social influences and correction of normative beliefs
Emphasizes universal values and principles, and is appropriate for all ethnic and SES groups
Is consistent with multiple theories of education, learning and behavior development and change
Works on the multiple social ecologies in which youth live and develop
School, home, community 33

34. Future Research
Investigate potential differential impacts of PA based on student gender, child risk level, etc.
Investigate whether schools with different levels in the quality of implementation yield different “impacts”
Examine impact of PA as student cohort progresses into upper elementary grades (grades 6-8)
Critical transitional period within emotional, behavioral, and academic domains 34

35. Future Work/Needs – The bigger picture
Larger scale trials
ICCs for attitudes (.03-.1) and behavior ( ) are generally smaller than for achievement (.15-.2)
Still need Ns of 20 or more per condition rather than 7-10
Improved measures of integrity and dosage delivered and received
Teacher, student and observer reports
Contractual reporting systems?
Longer term follow-ups
Effects take several years to even start emerging
Prior work suggests important long-term effects are possible
Methods of analysis to accommodate differential implementation
Propensity scoring, CACE, instrumental variable 35

36. Acknowledgments
Studies I and II were unfunded, conducted by the author at the University of Illinois at Chicago (UIC).
Study III was funded by grant #R01-DA13474 from NIH/NIDA to Brian Flay, initially at UIC then at Oregon State University (OSU).
The findings reported from Study IV are based on research conducted as part of the Social and Character Development (SACD) research program funded by the Institute of Education Sciences (IES), U.S. Department of Education through Grant # R215S to UIC ( ) and OSU ( ). The SACD Consortium consists of representatives from IES, the Centers for Disease Control and Prevention (CDC), and the national evaluation contractor, Mathematica Policy Research, Inc. (MPR), and each grantee site participating in the evaluation. The content of this presentation does not necessarily reflect the views or policies of the SACD Consortium members including IES, CDC, and MPR, nor does mention of trade names, commercial products, or organizations imply endorsement by the U.S. Government.
Correspondence concerning this presentation should be addressed to Brian R. Flay, D.Phil., Principle Investigator, Department of Public Health, 254 Waldo Hall, Oregon State University, Corvallis, OR 97330, 36

37. SACD disclaimer statement:
The Social and Character Development (SACD) research program funded by the Institute of Education Sciences (IES), U.S. Department of Education includes a national evaluation study conducted by Mathematica Policy Research (MPR), and complementary research studies conducted by each grantee. The findings reported here are based on the complementary research activities carried out by Brian Flay, Oregon State University, and David L. DuBois, University of Illinois at Chicago, under the SACD program. These findings may differ from the results reported for the SACD national evaluation study. The findings presented in this conference presentation are based on a smaller sample size of children, classrooms, and teachers, utilized a different set of outcome measures, and sought to answer complementary research questions. The content of this presentation does not necessarily reflect the views or policies of the SACD Consortium including IES, CDC, and MPR, nor does mention of trade names, commercial products, or organizations imply endorsement by the U.S. Department of Education. 37

38. Have a Positive Action Day!38