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Promoting Mental Health and Preventing Substance Abuse and Violence in Elementary Students: A Randomized Control Study of the Michigan Model for Health


  • We gratefully acknowledge the support and collaboration of Kyle Guerrant, Karen Yoder, Mary Ann George, Martha Neilsen, Merry Stanford, Angela O’Neill, Shelli Doll, Paula Nettleton, Mary Teachout, Elizabeth Haller, Rachel Kusch, Taggert Doll, Jessica Shaffer, Sophia Hines, Heidi Harris, Rochelle Hurst, Steve Sukta, Kathy Gibson, and the Comprehensive School Health Coordinators Association. Special thanks to Marc Zimmerman and Jean Shope for suggestions during the initial phases of this project. We also express our gratitude to the many school administrators, teachers, support staff, and students involved in this study. This research was supported by grants from the Michigan Department of Education and the Michigan Department of Community Health. The Michigan Model for Health (MMH) is listed on several online program registries, including the National Registry of Evidence-based Programs and Practices (NREPP). The authors have no financial interest in the MMH.

James M. O'Neill, Professor, (, Department of Psychology, Madonna University, 36600 Schoolcraft Road, Livonia, MI 48150.


BACKGROUND: In elementary grades, comprehensive health education curricula mostly have demonstrated effectiveness in addressing singular health issues. The Michigan Model for Health (MMH) was implemented and evaluated to determine its impact on multiple health issues, including social and emotional skills, prosocial behavior, and drug use and aggression.

METHODS: Schools (N = 52) were randomly assigned to intervention and control conditions. Participants received 24 lessons in grade 4 (over 12 weeks) and 28 more lessons in grade 5 (over 14 weeks), including material focusing on social and emotional health, interpersonal communication, social pressure resistance skills, drug use prevention, and conflict resolution skills. The 40-minute lessons were taught by the classroom or health teacher who received curriculum training and provided feedback on implementation fidelity. Self-report survey data were collected from the fourth-grade students (n = 2512) prior to the intervention, immediately after the intervention, and 6 weeks after the intervention, with the same data collection schedule repeated in fifth grade.

RESULTS: Students who received the curriculum had better interpersonal communication skills, social and emotional skills, and drug refusal skills than the control group students. Intervention students also reported lower intentions to use alcohol and tobacco, less alcohol and tobacco use initiated during the study and in the past 30 days, and reduced levels of aggression.

CONCLUSION: The effectiveness of the MMH in promoting mental health and preventing drug use and aggression supports the call for integrated strategies that begin in elementary grades, target multiple risk behaviors, and result in practical and financial benefits to schools.