Bullying
Conditions
Brief summary
Given the limited impact of existing school-based interventions and the time associated with implementing them during school time, more efficient and effective intervention methods are needed. Programs that can be delivered to middle school youth irrespective of whether they are attending school physically or virtually may be especially relevant as school boundaries become more fluid. BullyDown addresses this critical need by providing a scalable program that could be quickly and cost-effectively disseminated nationally.
Interventions
BEHAVIORALBullyDown
BullyDown is an 8 week, text messaging-based prevention program aimed to prevent bullying behaviors among middle school-aged youth. Message content is based upon the social-emotional learning model.
BEHAVIORALAttention-matched control
The attention-matched control will receive the messages for the same number of days as the intervention. Content will talk about 'healthy lifestyle' topics, such as fitness and healthy social media use.
Sponsors
University of North Carolina, Chapel Hill
Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)
Center for Innovative Public Health Research
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
SINGLE (Subject)
Masking description
Youth assigned to the control group will receive message written to seem as if it is intervention content (i.e., address bullying behaviors).
Intervention model description
Youth will be randomized to either the intervention or control group.
Eligibility
Sex/Gender
ALL
Age
12 Years to 14 Years
Healthy volunteers
Yes
Inclusion criteria
Participants will: be enrolled in one of our partner schools, be in middle school (i.e., 7th or 8th grade) or between the ages of 12-14 years of age, be English-speaking, own their own cell phone, intend to have the same cell phone number for at least 3 months (this may or may not apply, depending on the number of youth who meet this criterion), and provide informed written assent. Non-English speakers and youth who do not have the reading ability to complete the screener are not eligible. Youth recruited from schools will also be required to have parental permission.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Feasibility: Recruitment Rate | Recruitment period | If at least 75% of eligible participants assent to participate, this will be supportive of a hypothesis of feasibility. Note that a youth could assent and not be randomized if they did not complete the baseline survey. |
| Acceptability of the Intervention | Intervention end, 9 weeks after program enrollment | Youth were asked: How likely are you to recommend BullyDown to other people your age? Answers were collected on a 5-point Likert scale. The response option ranged from 1-5, with higher values reflecting greater acceptability. An average score of 4 or higher was deemed supportive of program acceptability. |
| Feasibility: Retention at 3-month Follow-up | 21 weeks post-randomization, 3 months after the 9-week program ended | A retention rate of 80% or higher was deemed to be supportive of a hypothesis of feasibility |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Feasibility: Retention Rate at Program End | 9 weeks post-randomization | A retention rate of 80% or higher was deemed supportive of a hypothesis of feasibility. |
Other
| Measure | Time frame | Description |
|---|---|---|
| Scores of Bystanding Behavior in the Intervention Versus Control Group | Responses provided at the program end survey, 9 weeks after they were randomized | Bystander intentions are measured using the 5-item University of Illinois Willingness to Intervene scale. Each of the items is measured on a 4-point Likert scale, resulting in a sum that ranges from 5 - 20. A higher score reflects a greater willingness to intervene. |
| Rates of Bullying Perpetration in the Intervention Versus Control Group | Reported bullying perpetration behavior in the past 30 days at the end of the 9 week program | Bullying behaviors towards other youth the same age 3 or more times in the past 30 days |
| Rates of Aggressive Behavior in the Intervention Versus Control Group | Reported aggressive behavior in the past 30 days at the end of the 9 week program | Youth who report aggressive acts towards others 1-2 times in the past 30 days |
Countries
United States
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| BullyDown Intervention BullyDown: BullyDown is an 8 week, text messaging-based prevention program aimed to prevent bullying behaviors among middle school-aged youth. Message content is based upon the social-emotional learning model. | 71 |
| Healthy Lifestyle Control Attention-matched control: The attention-matched control will receive the messages for the same number of days as the intervention. Content will talk about 'healthy lifestyle' topics, such as fitness and healthy social media use. | 67 |
| Total | 138 |
Baseline characteristics
| Characteristic | BullyDown Intervention | Healthy Lifestyle Control | Total |
|---|---|---|---|
| Age, Categorical <=18 years | 71 Participants | 67 Participants | 138 Participants |
| Age, Categorical >=65 years | 0 Participants | 0 Participants | 0 Participants |
| Age, Categorical Between 18 and 65 years | 0 Participants | 0 Participants | 0 Participants |
| Aggression perpetration | 24 Participants | 22 Participants | 46 Participants |
| Bullying perpetration | 9 Participants | 11 Participants | 20 Participants |
| Bystander behavior | 14.7 units on a scale STANDARD_DEVIATION 2.4 | 15.3 units on a scale STANDARD_DEVIATION 2.7 | 15.0 units on a scale STANDARD_DEVIATION 2.5 |
| Ethnicity (NIH/OMB) Hispanic or Latino | 54 Participants | 50 Participants | 104 Participants |
| Ethnicity (NIH/OMB) Not Hispanic or Latino | 17 Participants | 14 Participants | 31 Participants |
| Ethnicity (NIH/OMB) Unknown or Not Reported | 0 Participants | 3 Participants | 3 Participants |
| Race (NIH/OMB) American Indian or Alaska Native | 2 Participants | 1 Participants | 3 Participants |
| Race (NIH/OMB) Asian | 3 Participants | 0 Participants | 3 Participants |
| Race (NIH/OMB) Black or African American | 9 Participants | 8 Participants | 17 Participants |
| Race (NIH/OMB) More than one race | 3 Participants | 6 Participants | 9 Participants |
| Race (NIH/OMB) Native Hawaiian or Other Pacific Islander | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Unknown or Not Reported | 13 Participants | 11 Participants | 24 Participants |
| Race (NIH/OMB) White | 41 Participants | 41 Participants | 82 Participants |
| Sex/Gender, Customized Boys | 21 Participants | 16 Participants | 37 Participants |
| Sex/Gender, Customized Declined to answer | 8 Participants | 4 Participants | 12 Participants |
| Sex/Gender, Customized Girls | 38 Participants | 41 Participants | 79 Participants |
| Sex/Gender, Customized Nonbinary youth | 4 Participants | 6 Participants | 10 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | 0 / 71 | 0 / 67 |
| other Total, other adverse events | 0 / 71 | 0 / 67 |
| serious Total, serious adverse events | 0 / 71 | 0 / 67 |
Outcome results
Primary
Acceptability of the Intervention
Youth were asked: How likely are you to recommend BullyDown to other people your age? Answers were collected on a 5-point Likert scale. The response option ranged from 1-5, with higher values reflecting greater acceptability. An average score of 4 or higher was deemed supportive of program acceptability.
Time frame: Intervention end, 9 weeks after program enrollment
Population: Youth who provided data at the program end survey were included in the analyses.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Overall Number of Participants Recruited | Acceptability of the Intervention | 3.7 Average score on a 5-point likert scale | Standard Deviation 1.1 |
| Healthy lifestyle control | Acceptability of the Intervention | 3.6 Average score on a 5-point likert scale | Standard Deviation 1 |
Primary
Feasibility: Recruitment Rate
If at least 75% of eligible participants assent to participate, this will be supportive of a hypothesis of feasibility. Note that a youth could assent and not be randomized if they did not complete the baseline survey.
Time frame: Recruitment period
Population: 474 youth were identified as eligible.
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| Overall Number of Participants Recruited | Feasibility: Recruitment Rate | 202 Participants |
Primary
Feasibility: Retention at 3-month Follow-up
A retention rate of 80% or higher was deemed to be supportive of a hypothesis of feasibility
Time frame: 21 weeks post-randomization, 3 months after the 9-week program ended
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| Overall Number of Participants Recruited | Feasibility: Retention at 3-month Follow-up | 48 Participants |
| Healthy lifestyle control | Feasibility: Retention at 3-month Follow-up | 49 Participants |
Secondary
Feasibility: Retention Rate at Program End
A retention rate of 80% or higher was deemed supportive of a hypothesis of feasibility.
Time frame: 9 weeks post-randomization
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| Overall Number of Participants Recruited | Feasibility: Retention Rate at Program End | 59 Participants |
| Healthy lifestyle control | Feasibility: Retention Rate at Program End | 56 Participants |
Other Pre-specified
Rates of Aggressive Behavior in the Intervention Versus Control Group
Youth who report aggressive acts towards others 1-2 times in the past 30 days
Time frame: Reported aggressive behavior in the past 30 days at the end of the 9 week program
Population: Youth who provided data at the program end survey were included in the analyses.
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| Overall Number of Participants Recruited | Rates of Aggressive Behavior in the Intervention Versus Control Group | 15 Participants |
| Healthy lifestyle control | Rates of Aggressive Behavior in the Intervention Versus Control Group | 14 Participants |
Other Pre-specified
Rates of Bullying Perpetration in the Intervention Versus Control Group
Bullying behaviors towards other youth the same age 3 or more times in the past 30 days
Time frame: Reported bullying perpetration behavior in the past 30 days at the end of the 9 week program
Population: Youth who provided data at the program end survey were included in the analyses.
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| Overall Number of Participants Recruited | Rates of Bullying Perpetration in the Intervention Versus Control Group | 7 Participants |
| Healthy lifestyle control | Rates of Bullying Perpetration in the Intervention Versus Control Group | 7 Participants |
Other Pre-specified
Scores of Bystanding Behavior in the Intervention Versus Control Group
Bystander intentions are measured using the 5-item University of Illinois Willingness to Intervene scale. Each of the items is measured on a 4-point Likert scale, resulting in a sum that ranges from 5 - 20. A higher score reflects a greater willingness to intervene.
Time frame: Responses provided at the program end survey, 9 weeks after they were randomized
Population: Youth who provided data at the program end survey were included in the analyses.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Overall Number of Participants Recruited | Scores of Bystanding Behavior in the Intervention Versus Control Group | 14.7 units on a scale | Standard Deviation 2.9 |
| Healthy lifestyle control | Scores of Bystanding Behavior in the Intervention Versus Control Group | 15.0 units on a scale | Standard Deviation 3.1 |