Educational Achievement, Mental Health, Physical Violence, Sexual Violence, Violence Against Children
Conditions
Keywords
corporal punishment, violence, education, depression, anxiety, conduct disorder
Brief summary
The purpose of this study is to determine whether use of the Good Schools Toolkit is effective in reducing violence against children in primary schools.
Detailed description
Violence against children has profound effects on both children's health and their ability to do well at school. Fear, anxiety and injuries caused by violence may play a large role in both children's absenteeism and low educational achievement, and there is increasing interest from large bilateral donors in investigating this link in low income countries. The Good School Toolkit has been developed and refined for 6 years in Uganda by Raising Voices. The toolkit takes a systemic approach, involving an entire school in a process of change to reduce violence and improve teaching techniques. The Toolkit draws on the Transtheoretical Model and incorporates standard behaviour change techniques such as setting a goal and making an action plan, which are effective in modifying behaviour. This study aims to determine whether use of the Good School Toolkit reduces children's experience of violence by school staff. The investigators will also examine the effects of the Toolkit on children's educational outcomes, mental health and well-being. The investigators will conduct a cluster randomised controlled trial in 40 primary schools in Luwero District, Uganda. More than 3500 children in Primary 5, 6 and 7 will be surveyed (aged about 11-16 years). Half of the schools will receive the Toolkit, and other half will be put on a waiting list to receive the Toolkit at the end of the study. The results from this evaluation will be used to brief policy-makers within the Ministry of Education and Sports involved in developing country-wide policy and practice around violence against children in schools.
Interventions
BEHAVIORALGood School Toolkit
The Toolkit uses a six step process to create a school wide intervention that engages teachers, students, administration, and parents to reflect on how they can promote quality of education in their school. The Toolkit articulates complex ideas (what is a good learning environment, a good teacher, how to create positive discipline without using violence) through booklets, posters and school initiated learning processes. Specific modules on alternative discipline techniques and how staff can use positive discipline are included in the Toolkit. The intervention includes sessions on knowledge, attitudes and opportunities to practice new behavioural skills. Work is led by teachers and students, and supported by visits from Raising Voices staff. The Toolkit can be reviewed at (http://www.raisingvoices.org/children/good\_school\_toolkit.php).
Sponsors
Raising Voices
Institute of Education, UK
Makerere University
London School of Hygiene and Tropical Medicine
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
NONE
Eligibility
Sex/Gender
ALL
Healthy volunteers
No
Inclusion criteria
1. Inclusion Criteria: * Schools * in Luwero District, Uganda * more than 40 students registered in Primary 5 * Participants * registered as a Primary 5, 6 or 7 pupil * any school staff member 2.
Exclusion criteria
* Schools \-- existing program related to prevention of violence against children or school governance * Participants -- not able to understand consent and study procedures
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Physical Violence From School Staff | 2-year follow-up | past week experience of any physical violence from school staff |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Child Mental Health | 2-year follow-up | score on the Strengths and Difficulties Questionnaire (SDQ): 20 questions. Total difficulties score, divided by the number of completed items. Modelled as a continuous variable. Range 0 (no difficulties) to 2 (high difficulties). |
| Educational Achievement: Word Recognition in English | 2-year follow-up | Word recognition in English(words per minute). Early Grade Reading Assessment, Uganda version. Calculated as number of words read correctly (out of a maximum of 50), divided by the time (out of a maximum of 60 seconds). |
| Safety and Well-being at School | At 2 year follow-up | Five questions. Each question asked with response options: all the time, most of the time, sometimes, never: I feel that my teachers care about me. I feel safe in school. I feel like I belong at school. I like to spend time at school. I am scared of my teachers (reverse coded). Scores summed, modelled as a continuous variable. Range 0 (low) to 15 (high). Higher score is better safety and well-being at school. |
Countries
Uganda
Participant flow
Recruitment details
Cross-sectional baseline and endline surveys were conducted in 42 schools in June/July 2012 and June/July 2014. A simple random sample of up to 130 P5, 6 and 7 students were invited for individual interviews. If there were fewer than 130 P5-7 students in a school, all were invited for interview.
Participants by arm
| Arm | Count |
|---|---|
| Good School Toolkit Schools in the intervention arm will receive the Good Schools Toolkit materials and implementation support.
Good School Toolkit: The Toolkit uses a six step process to create a school wide intervention that engages teachers, students, administration, and parents to reflect on how they can promote quality of education in their school. The Toolkit articulates complex ideas (what is a good learning environment, a good teacher, how to create positive discipline without using violence) through booklets, posters and school initiated learning processes. Specific modules on alternative discipline techniques and how staff can use positive discipline are included in the Toolkit. The intervention includes sessions on knowledge, attitudes and opportunities to practice new behavioural skills. Work is led by teachers and students, and supported by visits from Raising Voices staff. The Toolkit can be reviewed at (http://www.raisingvoices.org/children/good\_school\_toolkit.php). | 1,824 |
| Control Schools in this arm will receive the Good Schools Toolkit materials and some implementation support after the end of the trial. | 1,882 |
| Total | 3,706 |
Baseline characteristics
| Characteristic | Good School Toolkit | Control | Total |
|---|---|---|---|
| Age, Continuous | 13.1 years STANDARD_DEVIATION 1.5 | 13.0 years STANDARD_DEVIATION 1.5 | 13.0 years STANDARD_DEVIATION 1.5 |
| Sex: Female, Male Female | 927 Participants | 1010 Participants | 1937 Participants |
| Sex: Female, Male Male | 897 Participants | 872 Participants | 1769 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | — / — | — / — |
| other Total, other adverse events | 0 / 1,921 | 0 / 1,899 |
| serious Total, serious adverse events | 0 / 1,921 | 0 / 1,899 |
Outcome results
Primary
Physical Violence From School Staff
past week experience of any physical violence from school staff
Time frame: 2-year follow-up
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Good School Toolkit | Physical Violence From School Staff | 595 participants |
| Control | Physical Violence From School Staff | 924 participants |
Comparison: Does the Toolkit intervention reduce physical violence from school staff to Ugandan primary school students.p-value: <0.000195% CI: [0.26, 0.64]Regression, Logistic
Secondary
Child Mental Health
score on the Strengths and Difficulties Questionnaire (SDQ): 20 questions. Total difficulties score, divided by the number of completed items. Modelled as a continuous variable. Range 0 (no difficulties) to 2 (high difficulties).
Time frame: 2-year follow-up
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Good School Toolkit | Child Mental Health | 0.44 units on a scale | Standard Deviation 0.26 |
| Control | Child Mental Health | 0.44 units on a scale | Standard Deviation 0.26 |
Secondary
Educational Achievement: Word Recognition in English
Word recognition in English(words per minute). Early Grade Reading Assessment, Uganda version. Calculated as number of words read correctly (out of a maximum of 50), divided by the time (out of a maximum of 60 seconds).
Time frame: 2-year follow-up
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Good School Toolkit | Educational Achievement: Word Recognition in English | 48.6 words per minute | Standard Deviation 27.7 |
| Control | Educational Achievement: Word Recognition in English | 49.7 words per minute | Standard Deviation 27.7 |
Secondary
Safety and Well-being at School
Five questions. Each question asked with response options: all the time, most of the time, sometimes, never: I feel that my teachers care about me. I feel safe in school. I feel like I belong at school. I like to spend time at school. I am scared of my teachers (reverse coded). Scores summed, modelled as a continuous variable. Range 0 (low) to 15 (high). Higher score is better safety and well-being at school.
Time frame: At 2 year follow-up
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Good School Toolkit | Safety and Well-being at School | 11.7 units on a scale | Standard Deviation 2.4 |
| Control | Safety and Well-being at School | 11.1 units on a scale | Standard Deviation 2.5 |