Bullying of Child, Child Behavior Disorders, Interpersonal Relations, Mental Health, Prevention and Control, School Health Services, Social Behavior
Conditions
Keywords
Bullying Prevention, Psychosocial Skills, Elementary Education, Health Education, Student Well-Being, Cluster Randomized Trial, TEAL Program, School Climate, Public Health Intervention
Brief summary
This study, titled APACHES, is a cluster randomized controlled trial aimed at evaluating the effectiveness of a school-based prevention program, Tous Épanouis à l'École (TEAL), conducted by healthcare students as part of their mandatory public health service curriculum. The TEAL program consists of five interactive sessions focused on developing psychosocial skills (e.g., communication, empathy, collaboration) among elementary school students (grades CE2-CM1-CM2) in the Grenoble Academy. The primary objective is to assess whether the program reduces the prevalence of bullying behaviors (victims and/or aggressors) compared to standard preventive actions on unrelated themes. The study involves 36 classrooms across 18 schools, with data collected at three time points: before, one month after, and four months after the intervention. Secondary objectives include evaluating social proximity, altruistic behaviors, and qualitative perceptions from students, teachers, and facilitators.
Detailed description
Bullying is a critical public health issue with severe consequences for children's psychological development, academic success, and long-term health outcomes. The APACHES study evaluates the effectiveness of the TEAL program, a psychosocial skills training intervention tailored to reduce bullying behaviors and improve classroom climate. The intervention will be delivered by healthcare students (from medicine, midwifery, pharmacy, and nursing) as part of their Service Sanitaire curriculum. The study follows a pragmatic design with a cluster randomized controlled methodology. Classrooms in participating schools are randomized into two groups: an intervention group receiving the TEAL program and a control group undergoing alternative health education sessions. The TEAL program is structured around active and participatory learning, including sessions on emotional awareness, communication, empathy, and collective problem-solving. A total of 900 students from 36 classrooms (approximately 450 per group) will participate. Objectives Primary Objective: To determine whether the TEAL program reduces the prevalence of bullying (victims and/or aggressors) by comparing baseline and follow-up outcomes. Secondary Objectives: To explore improvements in social proximity, altruistic behaviors, and psychosocial skills; to collect qualitative feedback from students, facilitators, and teachers about the intervention. Data Collection and Outcomes Quantitative data will be collected using validated questionnaires (e.g., Revised Bully/Victim Questionnaire) administered at three time points: pre-intervention (T1), one month post-intervention (T2), and four months post-intervention (T3). Secondary outcomes, including social proximity and altruism, will also be assessed. Qualitative data will be gathered through interviews and focus groups to evaluate participants' experiences and perceptions. Significance This study aims to address a pressing public health need by leveraging healthcare students' involvement in primary prevention. If effective, the TEAL program could be scaled nationally across France, contributing to the broader goal of improving psychosocial environments in schools and mitigating the long-term effects of bullying.
Interventions
BEHAVIORALTous Épanouis à l'École (TEAL Program)
The TEAL Program is a structured, five-session behavioral intervention targeting psychosocial skill development in children. Delivered by healthcare students in elementary school classrooms, the program includes interactive activities designed to improve communication, empathy, social proximity, and prosocial behaviors. The intervention aims to reduce bullying behaviors (victims and aggressors) and enhance classroom climate. Each session is guided by a detailed manual and includes active participation from students and their teachers.
BEHAVIORALStandard Health Education Sessions
This intervention consists of five sessions on general health topics unrelated to bullying, such as nutrition, sleep hygiene, and physical activity. The sessions are facilitated by healthcare students as part of their Service Sanitaire training. These sessions provide a comparable structure and duration to the TEAL program but do not address bullying prevention.
Sponsors
Université Lumière Lyon 2
University Grenoble Alps
Maison des Sciences de l'Homme et de la société
Grenoble Academy
University Hospital, Grenoble
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
NONE
Masking description
Although the study is open-label for participants, care providers, and investigators, the statistician conducting the data analysis will remain blinded to group allocation. This ensures unbiased interpretation of the results.
Intervention model description
This is a cluster randomized controlled trial where classrooms are randomized into two groups: the intervention group receives the TEAL program, and the control group participates in unrelated health education sessions.
Eligibility
Sex/Gender
ALL
Age
8 Years to 11 Years
Healthy volunteers
Yes
Inclusion criteria
* Students enrolled in grades CE2, CM1, or CM2 in participating schools. * Parents or legal guardians have provided signed informed consent for their child to participate in the study. * The child is available to attend all scheduled intervention sessions.
Exclusion criteria
* Students whose parents or legal guardians have not provided signed informed consent. * Students with medical or behavioral conditions that might prevent full participation in the sessions (e.g., requiring additional support not available during the study). * Students not attending the school on a regular basis.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Prevalence of Bullying Behaviors (Victims and/or Aggressors) | Change from baseline (T1) to one month after the intervention (T2). | The proportion of students identified as victims, aggressors, or victim-aggressors based on the Revised Bully/Victim Questionnaire (rBVQ). Measured at three time points: before the intervention (T1), one month after the intervention (T2), and four months after the intervention (T3). |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in Psychosocial Skills | Change from baseline (T1) to one month after the intervention (T2). | Improvement in psychosocial skills such as empathy, communication, and emotional regulation, measured via a validated psychosocial skill scale. Changes are assessed at T1, T2, and T3. |
| Change in Altruistic Behaviors | Change from baseline (T1) to one month after the intervention (T2). | Improvement in students' altruistic behaviors, assessed using the French version of the Child Altruism Scale (20 items). Measurements occur at T1, T2, and T3. |
| Change in Social Proximity Score | Change from baseline (T1) to one month after the intervention (T2). | Assessment of the social proximity among students using a validated scale. The change in scores will be measured at T1, T2, and T3 to evaluate the intervention's impact on fostering closer social relationships. |
| Perception of the Intervention by Elementary School Teachers (Interviews) | Collected one month after the intervention (T2) | Feedback from teachers in the TEAL group on the program's impact on classroom dynamics, bullying behaviors, and overall implementation. Data are collected through semi-structured interviews. |
| Perception of the Intervention by Students (Interviews) | Collected one month after the intervention (T2) | Qualitative feedback from children in the TEAL group on their experiences with the program, including perceived benefits, engagement, and understanding of key themes. Data are collected via semi-structured interviews. |
| Perception of the Intervention by Healthcare Students (Focus Groups) | Collected one month after the intervention (T2) | Exploration of the perceptions and experiences of healthcare students who facilitated the TEAL program, gathered through focus groups. Topics include perceived impact, challenges, and learning outcomes from the intervention. |
Countries
France
Outcome results
None listed