Depression, Peer Violence
Conditions
Brief summary
This is a RCT conducted with 1752 children in 40 public middle schools in Hyderabad Pakistan with the goal of evaluating the effectiveness of the international non-governmental organisation Right To Play's Positive Child and Youth Development program on reducing peer violence perpetration and victimisation and child depression in a two arm trial where this intervention is compared to a no intervention arm.
Detailed description
Peer violence is an important violence exposure for young adolescents and has been linked to later perpetration or experience of violence in intimate relationships. It is an obstacle to learning and may impact school students' mental health. Prevention of peer violence requires an intervention that empowers youth and teaches them empathy and stronger social skills. The non-governmental organisation Right To Play operates in 18 countries and has a flagship programme that is used in all countries that has never been subject to most rigorous evaluation. It is a multi-faceted programme that has at its heart an intervention that is delivered throughout the school year in two 35 minute sessions games following activities from the manual Red Ball Child Play that focus on 4 areas of youth development: physical, cognitive, social, and emotional components. These structural activities are designed to improve critical thinking, confidence and resilience. They are complimented by a range of additional activities including junior leader training for selected promising young leaders, week long summary camps, sports days and activities to engage parents and members of the community. The main intervention is delivered by coaches employed by Right To Play and given a 3 week training initially, with subsequent regular refresher engagement. They are supported by junior leaders in the games after junior leader training. Training to teachers on the intervention is also provided. A two-arm, cluster randomised controlled trial based in middle schools in Hyderabad, Sindh province, Pakistan is evaluating this intervention. It is being conducted in 40 schools, half are boys schools (20) and half (20) girls'. Twenty of the schools have been randomised to the intervention arm and twenty to the control (delayed intervention) arm. The outcomes will be addressed using quantitative methods with data collected from students in Grade 6 at the start of the trial. These measures will be conducted pre-intervention and 12, and 24 month follow up periods.
Interventions
BEHAVIORALRight To Play's Positive Child and Youth Development program
1. Right To Play's Red Ball Child Play manual provided for 60 hours per annum for two years 2. Training of junior leaders 3. Related play-based activities such as sports days 4. Quarterly awareness sessions with community groups and parents 5. Summer camps for children 6. training of teachers on Right To Play's foundational resources, positive disciplining, and gender and child protection
Sponsors
Aga Khan University
Texas Woman's University
Medical Research Council, South Africa
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
NONE
Intervention model description
open label, randomised, efficacy study
Eligibility
Sex/Gender
ALL
Healthy volunteers
Yes
Inclusion criteria
* Schools: single sex, public middle schools in Hyderabad; willing to participate and commit time during the school day, twice a week, to the intervention sessions; having an outside playground or indoor space in which games could be played, and 35 or more students in the grade-6 class School student participants: enrolled in grade 6 in one of the study schools; informed consent from parent and child; able to read the national language Urdu or provincial language Sindhi
Exclusion criteria
* None
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Peer violence victimisation in the past 4 weeks | assessment 2 years post-baseline | Mean score on the sixteen questions on peer violence victimisation |
| Peer violence perpetration in the past 4 weeks | assessment 2 years post-baseline | Mean score on the sixteen questions on peer violence perpetration |
| Depression | Over last 2 weeks | Score on the 28 items Children's Depression Inventory 2 (CDI 2) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Corporal punishment in the past 4 weeks | 2 years post baseline | Mean score across the 6 questions |
| School performance | 2 years post baseline | Mean score on four items asking about performance in reading, writing, maths and Pakistan studies . Responses per item are 1=fail, 2=average, 3=excellent |
| Gender attitudes (13 items measuring acceptability of spousal violence, girls schooling, male respect for women in decision-making and appropriateness of women's participation) | 2 years post baseline | Mean score |
| Physical punishment at home in past 4 weeks | 2 years post baseline | Based on two items with four response categories. The mean score will be calculated. |
| Days of school missed in last 4 weeks | 2 years post-baseline | Mean |
| preparations for marriage | 2 years post baseline | Based on two questions have you been promised for marriage' and (if so) 'has your family started other preparation for your marriage?' An affirmative response to the latter will be compared to a negative response combined with the category of students who have not been promised in marriage. |
Outcome results
None listed