High School program linked to lower substance use, better health behaviors

The findings, published Dec. 16 in the peer-reviewed journal Pediatrics, suggests that the Advancement via Individual Determination (AVID) program, aimed at increasing educational opportunities for under-represented and economically disadvantaged students, also significantly reduces substance use.

"Academic tracking" is a common practice in high schools through which lower-performing students are clustered with others of similar academic achievement. Although intended to tailor academic rigor to students' level of preparation, the study findings suggest that this practice may be counterproductive by reinforcing risky behaviors that students pick up from their peers.

"Untracking" these students by mixing them in with higher-performing peers may lead to better physical and psychological health, said lead author Dr. Rebecca Dudovitz, associate professor of pediatrics and director of pediatric health services research at the David Geffen School of Medicine at UCLA.

"This is the first randomized controlled trial of AVID in the United States, so it's really exciting to see that this program that was designed to help open up educational opportunities for kids, also improved their health," Dudovitz said.

AVID works with high school students earning B or C grade averages who might not otherwise be placed in more rigorous college preparatory tracks. It operates in 5,400 secondary schools, including both middle and high school, in 46 states and exposes academically middling students to tougher courses than they would have been assigned to under normal circumstances. AVID helps students develop agency, relational capacity, and opportunity knowledge.

"We believe that surrounding students with a supportive community and providing them with the skills and resources they need to reach their goals within existing educational structures is how we make college and career readiness possible for every student," said Thuan Nguyen, AVID's CEO. "The findings of the UCLA study are not surprising because AVID educators invest so much in their students' lives."

The researchers randomized 270 students in five large public schools who were placed in either an AVID group or in usual school programs. Students completed surveys at the end of 8^th grade or beginning of 9^th grade, and again at the end of 9^th grade.

They found that students in the AVID group had lower odds of using substances -- a 33% reduced risk compared to the control group -- in addition to a 26% lower risk of associating with substance-using peers and about 1.7 times the odds of socializing with peers who were more involved with academics.

In addition, AVID males experienced lower stress and higher self-efficacy, determination and engagement with school than their peers who were assigned to the usual tracked academic program. These effects, however, were not seen among females, possibly because supportive academic environment have a greater effect on boys of color, the researchers write.

"AVID positively impacts social networks, health behaviors, and psycho-social outcomes suggesting academic untracking may have substantial beneficial spillover effects on adolescent health," the researchers write.

The study has some limitations. The schools were all from a single school district and primarily serve low-income Latino students, and the findings were all from one school year, the researchers note. They did not directly observe how AVID was implemented or examine if the program actually increased college enrollment. In addition, it was not possible to blind the participants, meaning that students knew who was assigned to each group, which could have led them to respond to survey questions in ways that they thought the researchers would view favorably.

While more research is needed, the findings still provide important evidence that "ensuring schools have the resources and structures necessary to expand access to educational opportunities and facilitate healthy social connections, particularly in marginalized communities, may be key to achieving education and health equity more broadly," the researchers write.

The Robert Wood Johnson Foundation Evidence for Action Program (Grant 74086) and National Institutes of Health (1K23DA040733-01A1) funded this research.

Study co-authors are Dr. Paul Chung, Kulwant Dosanjh, Meredith Phillips, Christopher Biely, Chi-Hong Tseng, and Dr. Mitchell Wong of UCLA; Joan Tucker of RAND Corporation; Mary Ann Pentz of USC; and Arzie Galvez and Guadalupe Arellano of Los Angeles Unified School District. Chung is also affiliated with Kaiser Permanente.