Adolescent Mental Health, Bullying Behavior, Emotional Regulation Difficulties
Conditions
Keywords
Bullying Prevention, Emotional Regulation, Empathy, High School Students, Nurse-Led Intervention
Brief summary
This study aims to evaluate the effect of a nurse-led intervention combining the ROOTS program and soft skills training on emotional regulation and bullying prevention among high school students in Bandung, Indonesia. Bullying remains a major concern in schools and is closely linked to emotional difficulties, poor coping skills, and limited empathy. Strengthening students' emotional regulation is an evidence-based strategy to reduce aggressive behaviors and promote safer school environments. In this study, trained school nurses will deliver an integrated intervention consisting of sessions on identifying emotions, managing stress, developing empathy, communicating effectively, and resolving conflicts. The program is designed to help students better understand their emotions, control impulsive reactions, and build positive relationships with peers. These skills are expected to reduce the risk of bullying-both as perpetrators and as victims. The research uses a quasi-experimental design involving two high schools in Bandung. One school will receive the nurse-led intervention, while the comparison school will continue routine school activities. Students who meet inclusion criteria and provide consent/assent will participate in pre- and post-intervention assessments. The primary outcome is improvement in emotional regulation scores. Secondary outcomes include bullying behavior, empathy, and student perceptions of the school climate. All activities will follow ethical guidelines, including confidentiality, voluntary participation, and the right to withdraw at any time. The study seeks to provide evidence on how nurses can contribute to mental health promotion in schools and support sustainable, school-based bullying prevention strategies.
Detailed description
This study investigates a structured, nurse-led intervention that integrates the ROOTS program with soft skills training to enhance emotional regulation as a strategy to prevent bullying among adolescents. The intervention consists of multiple structured sessions delivered over several weeks, focusing on emotional awareness, stress management, empathy development, communication strategies, and problem-solving skills. The program was adapted for Indonesian high school students and aligned with the role of school nurses in mental health promotion. A quasi-experimental non-randomized design will be used. Two high schools in Bandung will participate: one serving as the intervention site and the other as the comparison site. Participants will be students in grades 10-11 who consent to join the study. Pre-intervention assessments will measure emotional regulation (primary outcome) and bullying behaviors, empathy, and school climate (secondary outcomes). After the intervention sessions are completed, the same measures will be reassessed. The study aims to generate evidence on the feasibility and effectiveness of a nurse-led emotional and social skills program delivered in school settings. Findings are expected to inform future mental health strategies, support the integration of nurses into school-based preventive services, and contribute practical recommendations for bullying prevention policies.
Interventions
BEHAVIORALNurse-Led ROOTS Program and Soft Skills Training
A structured, eight-week program delivered once per week (60-90 minutes/session) by the school nurse and supported by teachers. Core components include: Program orientation and group norms Peer leadership and assertive communication Emotional awareness and labeling Expression management and self-control Cognitive reappraisal exercises Empathy and perspective-taking Peer-led positive values campaign Reflection, feedback, and skill consolidation
Sponsors
Universitas Padjadjaran
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
SINGLE (Outcomes Assessor)
Masking description
Participants and school staff are aware of group allocation, but outcome assessors are blinded to minimize measurement bias.
Intervention model description
Students are assigned to either the intervention group receiving the ROOTS and Soft Skills sessions or a control group receiving school-as-usual activities. The intervention lasts 8 weeks with pre- and post-assessments.
Eligibility
Sex/Gender
ALL
Age
14 Years to 18 Years
Healthy volunteers
No
Inclusion criteria
* Adolescents aged 14-18 years * Enrolled in participating secondary schools * Willing to provide assent, with parental/guardian consent * Able to understand and communicate in the local language (e.g., Indonesian or English) * Identified as having mild to moderate difficulties in emotional regulation or at risk for anxiety/depression based on school screening
Exclusion criteria
* Severe psychiatric conditions requiring immediate clinical intervention (e.g., psychosis, severe depression with suicidal intent) * Currently receiving structured psychological or psychiatric treatment for emotional regulation or mental health conditions * Cognitive or developmental disabilities that would prevent meaningful participation in group activities * Non-consent from parent/guardian or the participant
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Emotional Regulation | Pre-intervention (week 0) and post-intervention (week 8) | Emotional regulation ability is measured using the Emotion Regulation Questionnaire for Children and Adolescents (ERQ-CA), a 10-item instrument rated on a 5-point Likert scale ranging from 1 (strongly disagree) to 5 (strongly agree). The total score ranges from 10 to 50, with higher total scores indicating better overall emotional regulation ability. Changes in the total ERQ-CA score from pre-intervention (week 0) to post-intervention (week 8) are used to evaluate the extent to which the intervention improves participants' capacity to manage and express their emotions adaptively. |
Countries
Indonesia
Outcome results
None listed