School-based health promotion: Substance abuse and sexual behavior

Abstract

As the limitations of curative medicine have become increasingly apparent and epidemiologic studies have established the linkage between lifestyle and disease, health promotion interventions have been developed to address public health problems in a proactive manner. The school has become a natural locus of health promotion efforts. School-based health promotion efforts have utilized several different strategies including information dissemination efforts, fear-arousal tactics, modifying normative expectations, and both problem-specific and generic skills training approaches. This paper focuses on two health areas that include several major public health problems and which have received considerable attention during the past decade: substance abuse (cigarette smoking, alcohol abuse, and illicit drug abuse) and sexual behavior (AIDS, sexually transmitted diseases, and unwanted pregnancy). School-based health promotion approaches to these problems have evolved in a largely separate yet parallel manner. These problems appear to have strikingly similar etiologies and may be prevented using similar intervention strategies. Information dissemination approaches have been consistently found to be of limited effectiveness. Interventions targeting social and psychological factors are the most promising. Research concerning sexual behavior has generally lagged behind that of substance abuse prevention. It is argued that careful consideration should be given to the application of strategies found effective in preventing substance abuse to the prevention of AIDS, STDs, and unwanted pregnancy.