Minimizing Health-Compromising Behaviors via School-Based Programs: An Optimization Approach.

School health programs are united by their desire to promote health and health-related outcomes among youth. They are also united by the fact that their expected effects are contingent on successful program implementation, which is often impeded by a multitude of real-world barriers. Techniques used in management science may help optimize school-based programs by accounting for implementation barriers. In this exploratory study, we present a detailed example of the first known application of linear programming (LP), which is an optimization technique, to Positive Action (PA). PA is a social emotional and character development program that includes a six-unit, teacher-delivered, classroom curriculum. We specify how we used LP to calculate the optimal levels of program implementation needed to minimize substance use, subject to known levels of implementation barriers (e.g., disruptive behavior, teacher education, teacher attitudes towards character development, school resources, and school safety). We found that LP is a technique that can be applied to data from a school health program. Specifically, we were able to develop a model that calculated the number of lessons that should be taught to minimize a specific health-compromising behavior, given expected levels of predetermined implementation barriers. Our findings from this exploratory study support the utility of applying LP during the program planning and implementation processes of school health programs.