The effects and costs of an anti-bullying program (KiVa) in UK primary schools: a multicenter cluster randomized controlled trial.

IF 5.9 2区 医学 Q1 PSYCHIATRY
Lucy Bowes, Malavika Babu, Julia R Badger, Matthew R Broome, Rebecca Cannings-John, Suzy Clarkson, Elinor Coulman, Rhiannon Tudor Edwards, Tamsin Ford, Richard P Hastings, Rachel Hayes, Fiona Lugg-Widger, Eleri Owen-Jones, Paul Patterson, Jeremy Segrott, Mia Sydenham, Julia Townson, Richard C Watkins, Holly Whiteley, Margiad E Williams, Judy Hutchings
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引用次数: 0

Abstract

Background: Childhood bullying is a public health priority. We evaluated the effectiveness and costs of KiVa, a whole-school anti-bullying program that targets the peer context.

Methods: A two-arm pragmatic multicenter cluster randomized controlled trial with embedded economic evaluation. Schools were randomized to KiVa-intervention or usual practice (UP), stratified on school size and Free School Meals eligibility. KiVa was delivered by trained teachers across one school year. Follow-up was at 12 months post randomization. Primary outcome: student-reported bullying-victimization; secondary outcomes: self-reported bullying-perpetration, participant roles in bullying, empathy and teacher-reported Strengths and Difficulties Questionnaire. Outcomes were analyzed using multilevel linear and logistic regression models.

Findings: Between 8/11/2019-12/02/2021, 118 primary schools were recruited in four trial sites, 11 111 students in primary analysis (KiVa-intervention: n = 5944; 49.6% female; UP: n = 5167, 49.0% female). At baseline, 21.6% of students reported being bullied in the UP group and 20.3% in the KiVa-intervention group, reducing to 20.7% in the UP group and 17.7% in the KiVa-intervention group at follow-up (odds ratio 0.87; 95% confidence interval 0.78 to 0.97, p value = 0.009). Students in the KiVa group had significantly higher empathy and reduced peer problems. We found no differences in bullying perpetration, school wellbeing, emotional or behavioral problems. A priori subgroup analyses revealed no differences in effectiveness by socioeconomic gradient, or by gender. KiVa costs £20.78 more per pupil than usual practice in the first year, and £1.65 more per pupil in subsequent years.

Interpretation: The KiVa anti-bullying program is effective at reducing bullying victimization with small-moderate effects of public health importance.

Funding: The study was funded by the UK National Institute for Health and Care Research (NIHR) Public Health Research program (17-92-11). Intervention costs were funded by the Rayne Foundation, GwE North Wales Regional School Improvement Service, Children's Services, Devon County Council and HSBC Global Services (UK) Ltd.

英国小学反欺凌项目(KiVa)的效果和成本:一项多中心集群随机对照试验。
背景:儿童欺凌是一个公共卫生重点问题。我们评估了KiVa的有效性和成本,KiVa是一个全校反欺凌项目,以同龄人为目标。方法:采用嵌入经济评价的两组多中心随机对照试验。学校被随机分为kiva干预或常规做法(UP),根据学校规模和免费校餐资格分层。KiVa是由训练有素的教师在一个学年中讲授的。随机分组后12个月随访。主要结果:学生报告的欺凌受害;次要结局:自我报告的欺凌行为、参与者在欺凌中的角色、共情和教师报告的优势和困难问卷。结果分析采用多水平线性和逻辑回归模型。研究结果:2019年8月11日- 2021年2月12日,在4个试验点共招募118所小学,11111名小学生参与小学分析(kiva干预:n = 5944;49.6%的女性;UP: n = 5167, 49.0%女性)。在基线时,在UP组中有21.6%的学生报告受到欺凌,在kiva干预组中有20.3%,在随访时UP组和kiva干预组分别降至20.7%和17.7%(优势比0.87;95%置信区间0.78 ~ 0.97,p值= 0.009)。KiVa组的学生明显有更高的同理心和更少的同伴问题。我们发现在欺凌行为、学校福利、情绪或行为问题上没有差异。先验亚组分析显示,社会经济梯度或性别对有效性没有差异。KiVa第一年每位学生的费用比常规做法高出20.78英镑,随后几年每位学生的费用高出1.65英镑。解释:KiVa反欺凌项目在减少欺凌受害者方面是有效的,对公共卫生的重要性具有中小型影响。资助:本研究由英国国家卫生与保健研究所(NIHR)公共卫生研究项目资助(17-92-11)。干预费用由Rayne基金会、GwE北威尔士地区学校改善服务、儿童服务、德文郡议会和汇丰全球服务(英国)有限公司资助。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Psychological Medicine
Psychological Medicine 医学-精神病学
CiteScore
11.30
自引率
4.30%
发文量
711
审稿时长
3-6 weeks
期刊介绍: Now in its fifth decade of publication, Psychological Medicine is a leading international journal in the fields of psychiatry, related aspects of psychology and basic sciences. From 2014, there are 16 issues a year, each featuring original articles reporting key research being undertaken worldwide, together with shorter editorials by distinguished scholars and an important book review section. The journal''s success is clearly demonstrated by a consistently high impact factor.
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