Specific Aims: The aims of this study are to examine the effectiveness of a 17-month, integrated multidimensional intervention on psychological, behavioral, physiological and health outcomes 9 and 10-year old children initially and over time. The multidimensional approach of cognitive-behavioral and physical activity strategies will be used in the integrated anger and stress management and self-concept enhancement program that is designed to reduce anger and stress and enhance self-concept and positive coping strategies. Background and Significance: Anger, chronic stress, ineffective methods of expressing anger and coping are risk factors for disease and have negative health outcomes for children. High levels of anger and stress and low levels of self-confidence are amenable to intervention in children. Most previous interventions have been limited to a single focus (anger management or stress management) and were unidimensional in their approach (cognitive-behavioral or physical activity). Although the unidimensional approaches and single focus programs have been effective, the effects have been limited. An integrated program with multidimensional approaches is anticipated to produce synergistic and longer-lasting effects on the psychological, behavioral, physiological, and health outcomes. Design and Method: A two-group, repeated measures, experimental design is employed in this study. Schools will be randomly assigned to experimental or control groups. At least 490 4th grade children (245 experimental; 245 control) will be recruited. Using standardized instruments and laboratory assays, data will be collected 6 times over the course of the study: once prior to the intervention (baseline), immediately after the intensive phase, at 3 and 6 months of the reinforcement phase, immediately after and 3 months after the intervention. Dependent Measures and Analysis: The impact of the intervention will be measured on psychological (trait anger, patterns of anger expression, self-concept, perceived resources for coping), behavioral (use of coping strategies, in-school behavior problems), physiological (blood pressure, salivary cortisol, secretory IgA) and health (number of viral infections, illness related absences) outcomes. Two by five mixed effects generalized linear models will be used to examine the group differences in the repeated measures of outcome variables.
NIH ExPorter
NIH ExPorter