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Incorporating Well-Adjusted Peers in a Conduct Problems Prevention Program: Evaluation of Acceptability, Fidelity, and Safety of Implementation

March 2017
School Mental Health 9(1)

DOI:10.1007/s12310-016-9199-7

Authors:

Joel M. Hektner

North Dakota State University

Alison L Brennan

Montana State University

In order to prevent iatrogenic effects associated with interventions that aggregate youth with behavior problems and to promote the integration of these youth into normative peer groups, a comprehensive evidence-based prevention program, Early Risers “Skills for Success” (August et al. in Preventing substance abuse: science-based programs for children and adolescents, American Psychological Association, Washington, 2007), was augmented to include well-adjusted children in a strategic peer affiliation component, or buddy system. A total of 190 kindergartners and first graders from five schools in a Midwestern US city were randomly assigned by school to receive the program or serve as controls. In the first summer program component, the children received 72 h of programming in academics, social skills, and creative arts, all within a highly structured social environment. The feasibility of the program was investigated through examination of acceptability, fidelity, and safety of programming, with special attention to acceptability and safety for well-adjusted peer mentors. Results showed that intervention fidelity, as measured by independent observers, was high. Acceptability was high as well, with no differences in attendance between well-adjusted children and children with behavioral problems. There was no evidence of iatrogenic effects or other unsafe outcomes: Peer-reported victimization did not increase, and well-adjusted children did not increase in aggression. In contrast, both well-adjusted children and their peers with behavior problems increased in teacher-rated social skills, and well-adjusted children increased in leadership. The results suggest that the pairing of well-adjusted children with behavior-problem children in a highly structured program such as Early Risers is a feasible program tactic in which the well-adjusted children may also derive some benefit.

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ORIGINAL PAPER

Incorporating Well-Adjusted Peers in a Conduct Problems

Prevention Program: Evaluation of Acceptability, Fidelity,

and Safety of Implementation

Joel M. Hektner

•Alison L. Brennan

•Gerald J. August

Published online: 25 October 2016

ÓSpringer Science+Business Media New York 2016

Abstract In order to prevent iatrogenic effects associated

with interventions that aggregate youth with behavior

problems and to promote the integration of these youth into

normative peer groups, a comprehensive evidence-based

prevention program, Early Risers ‘‘Skills for Success’’

(August et al. in Preventing substance abuse: science-based

programs for children and adolescents, American Psycho-

logical Association, Washington, 2007), was augmented to

include well-adjusted children in a strategic peer afﬁliation

component, or buddy system. A total of 190 kindergartners

and ﬁrst graders from ﬁve schools in a Midwestern US city

were randomly assigned by school to receive the program

or serve as controls. In the ﬁrst summer program compo-

nent, the children received 72 h of programming in aca-

demics, social skills, and creative arts, all within a highly

structured social environment. The feasibility of the pro-

gram was investigated through examination of acceptabil-

ity, ﬁdelity, and safety of programming, with special

attention to acceptability and safety for well-adjusted peer

mentors. Results showed that intervention ﬁdelity, as

measured by independent observers, was high. Accept-

ability was high as well, with no differences in attendance

between well-adjusted children and children with behav-

ioral problems. There was no evidence of iatrogenic effects

or other unsafe outcomes: Peer-reported victimization did

not increase, and well-adjusted children did not increase in

aggression. In contrast, both well-adjusted children and

their peers with behavior problems increased in teacher-

rated social skills, and well-adjusted children increased in

leadership. The results suggest that the pairing of well-

adjusted children with behavior-problem children in a

highly structured program such as Early Risers is a feasible

program tactic in which the well-adjusted children may

also derive some beneﬁt.

Keywords Preventive intervention Peer afﬁliation 

Feasibility Peer mentoring

Introduction

Childhood social withdrawal and aggression have been

identiﬁed as strong predictors of later internalizing and

externalizing problems (Coie, Lochman, Terry, & Hyman,

1992; Mofﬁtt, 1993). Aggressive or withdrawn children are

more likely than other children to experience peer rejec-

tion, and the experience of being rejected by peers inde-

pendently contributes to the development of more serious

and chronic problem behaviors including conduct disorder

(Coie et al., 1992; Miller-Johnson, Coie, Maumary-Gre-

maud, Bierman & The Conduct Problems Prevention

Research Group, 2002). As a result of rejection by

nonaggressive peers, aggressive children tend to afﬁliate

with one another, which is worrisome because aggressive

and inappropriate behaviors occur more often when chil-

dren associate with aggressive peers (Hektner, August, &

Realmuto, 2000). Withdrawn children also tend to afﬁliate

with one another, and when they do, their levels of vic-

timization and depression increase (Zhao, Chen, Ellis, &

Zarbatany, 2016). Thus, interventions must not only

address risk factors such as underlying skill deﬁcits and

problem behaviors that contribute to rejection but also

should address protective factors such as planned activities

&Joel M. Hektner

joel.hektner@ndsu.edu

North Dakota State University, Dept. 2615,

PO Box 6050, Fargo, ND 58108, USA

University of Minnesota, Minneapolis, MN, USA

123

School Mental Health (2017) 9:66–77

DOI 10.1007/s12310-016-9199-7

Content courtesy of Springer Nature, terms of use apply. Rights reserved.

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