Dataset Information

Stop Sexual Harassment: A study protocol for a cluster randomised controlled trial in secondary schools in Norway.

ABSTRACT:

Background

Sexual- and gendered harassment are normalised in many peer groups, yet their associations with mental health concerns among adolescents are well-established. School based interventions that prevent and reduce sexual and gendered harassment among younger adolescents are scarce. For schools, protecting pupils from harassment may be challenging if the behaviour is trivialised among the pupils themselves. In the current study, the school intervention "Stop Sexual Harassment" was therefore developed to help teachers and pupils detect, address and stop sexual and gendered harassment among pupils ages 13-15 in Norwegian secondary schools.

Methods

In this study the effectiveness of "Stop Sexual Harassment" is evaluated via a cluster randomised controlled trial among pupils and teachers at 38 secondary schools. Schools were randomised into intervention and control groups. Primary outcomes are sexual and gendered harassment victimisation and perpetration, which will be assessed by the administration of questionnaires to pupils and teachers at baseline, and 2-, and 7-months follow-up. A process evaluation of the intervention implementation will be conducted through focus group interviews with pupils and teachers to gain insight about their experiences with the program components and implementation of the intervention.

Discussion

If the intervention yields positive effects, large-scale implementation of the program may be offered for secondary schools. The program may thus reduce sexual and gendered harassment among young adolescents.

Clinical trial registration

clinicaltrial.gov; identifier: NCT04716400.

SUBMITTER: Slaatten H

PROVIDER: S-EPMC9868763 | biostudies-literature | 2022

REPOSITORIES: biostudies-literature

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Publications

Stop Sexual Harassment: A study protocol for a cluster randomised controlled trial in secondary schools in Norway.

Slaatten Hilde H Haugland Bente Storm Mowatt BSM Bjørknes Ragnhild R Fyhn Tonje T Tveito Torill Helene TH Poteat V Paul VP Breivik Kyrre K

Frontiers in public health 20230109

<h4>Background</h4>Sexual- and gendered harassment are normalised in many peer groups, yet their associations with mental health concerns among adolescents are well-established. School based interventions that prevent and reduce sexual and gendered harassment among younger adolescents are scarce. For schools, protecting pupils from harassment may be challenging if the behaviour is trivialised among the pupils themselves. In the current study, the school intervention "Stop Sexual Harassment" was ...[more]

PMID: 36699896

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Project description:BackgroundAdolescence is characterized by identity formation, exploration and initiation of intimate relationships. Much of this occurs at school, making schools key sites of sexual harassment. Schools often lack awareness and understanding of the issue, and UK research on the topic is scarce. We explored prevalence and perceptions of sexual harassment in a school-based mixed-methods study of 13-17 year-old Scottish adolescents.MethodsA student survey (N = 638) assessed past 3-months school-based victimization and perpetration prevalence via 17 behavioral items based on the most commonly used school-based sexual harassment measure ('Hostile Hallways'). Eighteen focus groups (N = 119 students) explored which of 10 behaviors were perceived as harassing/unacceptable and why.ResultsTwo-thirds reported any victimization: 64.7% 'visual/verbal' (e.g. sexual jokes) and 34.3% 'contact/personally-invasive' behaviors (e.g. sexual touching; most of whom also reported experiencing visual/verbal types) in the past 3-months. Data suggested a gateway effect, such that contact/personally-invasive behaviors are more likely to be reported by those also reporting more common visual/verbal behaviors. Some survey participants reported being unsure about whether they had experienced certain behaviors; and in focus groups, participants expressed uncertainty regarding the acceptability of most behaviors. Ambiguities centered on behavioral context and enactment including: degree of pressure, persistence and physicality; degree of familiarity between the instigator-recipient; and perception of the instigator's intent. In attempting to resolve ambiguities, students applied normative schemas underpinned by rights (to dignity, respect and equality) and 'knowingness', usually engendered by friendship.ConclusionsOur study confirms school-based sexual harassment is common but also finds significant nuance in the ways in which students distinguish between acceptable and harassing. School-based strategies to tackle sexual harassment must engage with this complexity.

Project description:ObjectivesAssess feasibility, acceptability and costs of delivering a physically active lessons (PAL) training programme to secondary school teachers and explore preliminary effectiveness for reducing pupils' sedentary time.Design and settingSecondary schools in East England; one school participated in a pre-post feasibility study, two in a pilot cluster-randomised controlled trial. In the pilot trial, blinding to group assignment was not possible.ParticipantsAcross studies, 321 randomly selected students (51% male; mean age: 12.9 years), 78 teachers (35% male) and 2 assistant head teachers enrolled; 296 (92%) students, 69 (88%) teachers and 2 assistant head teachers completed the studies.InterventionPAL training was delivered to teachers over two after-school sessions. Teachers were made aware of how to integrate movement into lessons; strategies included students collecting data from the environment for class activities and completing activities posted on classroom walls, instead of sitting at desks.Primary and secondary outcomesQuantitative and qualitative data were collected to assess feasibility and acceptability of PAL training and delivery. Outcomes were assessed at baseline and ~8 weeks post-training; measures included accelerometer-assessed activity, self-reported well-being and observations of time-on-task. Process evaluation was conducted at follow-up.ResultsIn the feasibility study, teachers reported good acceptability of PAL training and mixed experiences of delivering PAL. In the pilot study, teachers' acceptability of training was lower and teachers identified aspects of the training in need of review, including the outdoor PAL training and learning challenge of PAL strategies. In both studies, students and assistant head teachers reported good acceptability of the intervention. Preliminary effectiveness for reducing students' sedentary time was not demonstrated in either study.ConclusionsNo evidence of preliminary effectiveness on the primary outcome and mixed reports of teachers' acceptability of PAL training suggest the need to review the training. The results do not support continuation of research with the current intervention.Trial registration numberISRCTN38409550.

Project description:BackgroundDepression and anxiety are increasingly prevalent in adolescents. The Brief Educational Workshops in Secondary Schools Trial investigated the effectiveness of a brief self-referral stress workshop programme for sixth-form students aged 16-18 years old.ObjectiveThis study conducted a secondary analysis on the outcomes of participants with elevated depressive symptoms at baseline.MethodsThis is an England-wide, multicentre, cluster randomised controlled trial to evaluate the clinical effectiveness and cost-effectiveness of a brief cognitive-behavioural therapy workshop (DISCOVER) compared with treatment-as-usual (TAU) (1:1). The primary outcome was depression symptoms (Mood and Feelings Questionnaire (MFQ)) at 6-month follow-up, using the intention-to-treat (ITT) population and analysed with a multilevel linear regression estimating a between-group adjusted mean difference (aMD). Cost-effectiveness, taking a National Health Service (NHS) and personal social services perspective, was explored using quality-adjusted life years (QALYs).FindingsBetween 4 October 2021 and 10 November 2022, 900 adolescents at 57 schools were enrolled. 314 students were identified as having elevated symptoms of depression at baseline (>27 on MFQ). In this prespecified subgroup, the DISCOVER arm included 142 participants and TAU included 172. ITT analysis included 298 participants. Primary analysis at 6 months found aMD to be -3.88 (95% CI -6.48, -1.29; Cohen's d=-0.52; p=0.003), with a similar reduction at 3 months (aMD=-4.00; 95% CI -6.58, -1.42; Cohen's d=0.53; p=0.002), indicating a moderate, clinically meaningful effect in the DISCOVER arm. We found an incremental cost-effectiveness ratio of £5255 per QALY, with a probability of DISCOVER being cost-effective at between 89% and 95% compared with TAU.Conclusions and clinical implicationsDISCOVER is clinically effective and cost-effective in those with elevated depressive symptoms. This intervention could be used as an early school-based intervention by the NHS.Trial registration numberISRCTN90912799.

Project description:BackgroundThere are increasing rates of internalising difficulties, particularly anxiety and depression, being reported in children and young people in England. School-based, universal prevention programmes are thought to be one way of helping tackle such difficulties. This protocol describes a four-arm cluster randomised controlled trial, investigating the effectiveness of three different interventions when compared to usual provision, in English primary and secondary pupils. The primary outcome for Mindfulness and Relaxation interventions is a measure of internalising difficulties, while Strategies for Safety and Wellbeing will be examined in relation to intended help-seeking. In addition to the effectiveness analysis, a process and implementation evaluation and a cost-effectiveness evaluation will be undertaken.Methods and analysisOverall, 160 primary schools and 64 secondary schools will be recruited across England. This corresponds to 17,600 participants. Measures will be collected online at baseline, 3-6 months later, and 9-12 months after the commencement of the intervention. An economic evaluation will assess the cost-effectiveness of the interventions. Moreover, a process and implementation evaluation (including a qualitative research component) will explore several aspects of implementation (fidelity, quality, dosage, reach, participant responsiveness, adaptations), social validity (acceptability, appropriateness and feasibility), and their moderating effects on the outcomes of interest, and perceived impact.DiscussionThis trial aims to address important questions about whether schools' practices around the promotion of mental wellbeing and the prevention of mental health problems can: (1) be formalised into feasible and effective models of school-based support and (2) whether these practices and their effects can be sustained over time. Given the focus of these interventions on mirroring popular practice in schools and on prioritising approaches that present low-burden, high-acceptability to schools, if proved effective, and cost-effective, the findings will indicate models that are not only empirically tested but also offer high potential for widespread use and, therefore, potentially widespread benefits beyond the life of the trial.Trial registrationISRCTN16386254. Registered on 30 August 2018.

Project description:BACKGROUND:Children and adolescents spend a lot of time sitting at school. Implementing standing desks in the classroom is one potential strategy to reduce and break up sitting time. The first aim was to evaluate the effect of implementing standing desks in classrooms in primary and secondary schools on pupils' sitting-related behaviour and determinants. The second aim was to quantitatively and qualitatively evaluate the process of implementing the desks in the classroom. METHODS:We conducted a cluster-randomised controlled trial with a pre-, mid-, and post-test design including 10 intervention schools (5 primary, 5 secondary schools) and 9 control schools (5 primary, 4 secondary schools) across Flanders, Belgium. Three standing desks were placed in one class in each intervention school for 6 months. At pre-, mid- and post-test, all pupils (n?=?311; 54.5% girls) completed a questionnaire whilst a subsample of three pupils per class wore an activPAL inclinometer for one school week. Focus groups with pupils and interviews with teachers were conducted at mid-test. Process evaluation questions were added to the mid- and post-test questionnaire for the intervention group. Qualitative data were analysed using NVivo 11. Multilevel regression analyses were conducted in MLwiN 2.31. RESULTS:Few significant intervention effects were observed, although activPAL data showed favourable intervention effects on primary school pupils' sitting and standing time and bouts. Focus groups and interviews showed a generally positive attitude towards using standing desks in both teachers and pupils, although some barriers and suggestions for future implementation were noted, for example regarding the amount of desks per classroom. Quantitative process evaluation data showed a low individual use of standing desks (between 57 and 83 min per week), which significantly decreased across the school year for primary school pupils only. CONCLUSIONS:Although pupils and teachers were generally positive about the desks, relatively few intervention effects were found. Future studies should consider how to optimise the use of standing desks in classrooms to impact on sitting time, by for example, determining the most feasible intervention design and by encouraging the continued use of standing desks throughout the school year. Moreover, additional intervention strategies (e.g. educational strategies) might be needed. TRIAL REGISTRATION:NCT03163004 . ClinicalTrials.gov. Registered 22 May 2017 (retrospectively registered).

Project description:BackgroundBullying, aggression, and violence among children and young people are some of the most consequential public mental health problems. We tested the Learning Together intervention, which involved students in efforts to modify their school environment using restorative practice and by developing social and emotional skills.MethodsWe did a cluster randomised trial, with economic and process evaluations, of the Learning Together intervention compared with standard practice (controls) over 3 years in secondary schools in south-east England. Learning Together consisted of staff training in restorative practice; convening and facilitating a school action group; and a student social and emotional skills curriculum. Primary outcomes were self-reported experience of bullying victimisation (Gatehouse Bullying Scale; GBS) and perpetration of aggression (Edinburgh Study of Youth Transitions and Crime (ESYTC) school misbehaviour subscale) measured at 36 months. We analysed data using intention-to-treat longitudinal mixed-effects models. This trial was registered with the ISRCTN registry (10751359).FindingsWe included 40 schools (20 in each group); no schools withdrew. 6667 (93·6%) of 7121 students participated at baseline and 5960 (83·3%) of 7154 at 36 months. Mean GBS bullying score at 36 months was 0·34 (SE 0·02) in the control group versus 0·29 (SE 0·02) in the intervention group, with a significant adjusted mean difference (-0·03, 95% CI -0·06 to -0·001; adjusted effect size -0·08). Mean ESYTC score at 36 months was 4·33 (SE 0·20) in the control group versus 4·04 (0·21) in the intervention group, with no evidence of a difference between groups (adjusted difference -0·13, 95% CI -0·43 to 0·18; adjusted effect size -0·03). Costs were an additional £58 per pupil in intervention schools than in control schools.InterpretationLearning Together had small but significant effects on bullying, which could be important for public health, but no effect on aggression. Interventions to promote student health by modifying the whole-school environment are likely to be one of the most feasible and efficient ways of addressing closely related risk and health outcomes in children and young people.FundingNational Institute for Health Research, Educational Endowment Foundation.

Project description:IntroductionEmotional problems are leading contributors to health burden among adolescents worldwide. There is an urgent need for evidence-based psychological interventions for young people. This study aims to evaluate the effectiveness of a school-based, group psychological intervention, Early Adolescent Skills for Emotions (EASE) developed by the WHO to improve psychosocial distress in Pakistani adolescents.Method and analysisA two-arm, single-blinded, cluster randomised controlled trial, with a wait-list control arm is being conducted in school settings of rural Pakistan. Forty eligible public-school clusters have been randomised (stratified by gender) on a 1:1 allocation ratio into intervention (n=20) and control arm (n=20). Following informed consent, 564 adolescents with psychosocial distress (Youth-reported Paediatric Symptoms Checklist, cut-off ≥28) from 40 schools have been enrolled into the trial (14±3 average cluster size) between 2 November 2021 and 30th November 2021. Participants in the intervention arm will receive EASE in 7-weekly adolescents and 3-biweekly caregivers group sessions in schools. The adolescent sessions involve the components of psychoeducation, stress management, behavioural activation, problem-solving and relapse prevention. Caregivers will receive training to learn and implement active listening; spending quality time and using praise as a strategy to help their children. The primary outcome is reduction in psychosocial distress at 3 months postintervention. Secondary outcomes include symptoms of depression and anxiety, caregiver-adolescent relationship and caregivers' well-being. Outcomes will be assessed at baseline, immediate 1 week and 3-months postintervention. Qualitative process evaluation will explore barriers and facilitators to programme implementation in low-resource school settings.EthicsEthics approval has been obtained from Central Ethics Committee of University of Liverpool, UK, Ethics Review Committee of WHO Geneva and from the Institutional Review Board of Human Development Research Foundation (HDRF), Pakistan.DisseminationThe findings of the study will be disseminated by WHO and through peer-reviewed publications.Trial registration numberISRCTN17755448.

Project description:ObjectiveThe aim of the current study was to provide estimates of both overall and specific forms of sexual harassment among male and female college and university students.Design and settingData stem from a recent national student health survey from 2018 for higher education in Norway (the SHoT study (Students' Health and Wellbeing Study)).Participants50 054 full-time students (69.1% women) aged 18-35 years participated, yielding a response rate of 31%.Main outcome measureSexual harassment was defined according to Norwegian legal regulations, and was assessed by self-report on seven items covering verbal, non-verbal and physical sexual harassment. We also collected data on the timeframe and frequency of the sexual harassment, in addition to the formal position of the perpetrator of the harassment.ResultsLifetime sexual harassment was reported by 24.2% (women 31.3%, men 8.0%), while 16.7% (women 21.6%, men 5.7%) reported having been sexually harassed within the past year. The most common forms of lifetime (ever having experienced) sexual harassments were 'sexual expressions, suggestions or comments about your body' and 'unwanted touching, hugging or kissing' (both 15.4%), while rape and rape attempt were reported by 3.4% and 2.1%, respectively. Exposure to all forms of past-year sexual harassments was significantly more common among women and the youngest age cohorts. Fellow students committed the past-year sexual harassment in 18%-29% of the instances, while a university staff member was reported to have committed the harassment in 0.6%-4.6% of cases.ConclusionGiven the potential consequences suffered by those exposed to sexual harassment and assault, both the institutions and student welfare organisations should intensify their efforts to put the theme on the agenda and provide both legal and health services to victims of sexual harassment. The low response rate means that care should be taken in interpreting and generalising the findings to the whole student population.

Dataset Information

Stop Sexual Harassment: A study protocol for a cluster randomised controlled trial in secondary schools in Norway.

Background

Methods

Discussion

Clinical trial registration

Publications

Stop Sexual Harassment: A study protocol for a cluster randomised controlled trial in secondary schools in Norway.

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