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Established Evidence Results

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Below are articles that support specific interventions to advance MCH National Performance Measures (NPMs) and Standardized Measures (SMs). Most interventions contain multiple components as part of a coordinated strategy/approach.

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Displaying records 1 through 16 (16 total).

Boulton, M. J., & Boulton, L. (2017). Modifying self-blame, self-esteem, and disclosure through a cooperative cross-age teaching intervention for bullying among adolescents. Violence and victims, 32(4), 609-626.

Evidence Rating: Emerging Evidence

Intervention Components (click on component to see a list of all articles that use that intervention): YOUTH, Peer-led Mentoring/Support Counseling, CLASSROOM, Peer-led Curricular Activities/Training

Intervention Description: Bullying is common among school students, and some victims hold self-blaming attributions, exhibit low self-esteem, and do not seek social support. A cross-age teaching of social issues intervention was utilized to combat the latter three variables. In small cooperative groups of classmates, participants designed and delivered a lesson to younger students that informed them that bullies not victims are in the wrong, victims have no reason to feel bad about themselves, and that seeking help can be beneficial.

Intervention Results: CATS led to a significant improvement on all 3 dependent variables and changes in self-blame, and separately changes in self-esteem, mediated the positive effect of the intervention on help-seeking.

Conclusion: The theoretical and practical implications of these results were discussed, especially in terms of supporting a highly vulnerable subgroup of adolescents.

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Bradley, C., Day, C., Penney, C., & Michelson, D. (2020). ‘Every day is hard, being outside, but you have to do it for your child’: Mixed-methods formative evaluation of a peer-led parenting intervention for homeless families. Clinical child psychology and psychiatry, 25(4), 860-876.

Evidence Rating: Emerging

Intervention Components (click on component to see a list of all articles that use that intervention): Peer-led Curricular Activities/Training, Family-Based Interventions,

Intervention Description: Adapting the evidence base program 'Empowering Parents, Empowering Communities'

Intervention Results: Thirteen parents completed the programme (including one parent who required two attempts). We found improvements in child behavioural difficulties, parenting knowledge and practices, while parental well-being and social support were unchanged. Participants were highly satisfied overall, with indications that the peer-led model mitigated negative expectancies of services and normalized experiences of parenting in challenging conditions.

Conclusion: Parental self-care and ‘the good enough parent’ were strongly endorsed topics, although some content (e.g. timeout) was deemed impractical. These promising findings warrant further testing under controlled conditions.

Study Design: mixed-methods, formative evaluation

Setting: London, UK

Population of Focus: social workers, public health practitioners

Sample Size: N= 15; Parents living in temporary housing with children aged 2-11years old

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Carlin A, Murphy MH, Nevill A, Gallagher AM. Effects of a peer-led Walking In ScHools intervention (the WISH study) on physical activity levels of adolescent girls: A cluster randomised pilot study. Trials. 2018 Jan 11;19(1):31.

Evidence Rating: Emerging Evidence

Intervention Components (click on component to see a list of all articles that use that intervention): CLASSROOM_SCHOOL, Peer-led Curricular Activities/Training, Extra-Curricular Activities

Intervention Description: Female participants, aged 11-13 years, were recruited from six post-primary schools in Northern Ireland. Participants were randomized by school (cluster) to participate in regular 10-15-min peer-led brisk walks throughout the school week (the WISH study) (n = 101, two schools) or to continue with their usual PA (n = 98, four schools). The primary outcome measure was school-time PA post intervention (week 12), assessed objectively using an Actigraph accelerometer. Secondary outcome measures included anthropometry, cardiorespiratory fitness and psychosocial measures. Changes in PA data between baseline (T0) and end of intervention (week 12) (T1) were analysed using a mixed between-within subjects analysis of variance with one between (group) and one within (time) subjects factor, with two levels.

Intervention Results: Of 199 participants recruited (mean age = 12.4 ± 0.6 years, 27% overweight/obese), 187 had valid accelerometer data for inclusion in subsequent analysis. A significant interaction effect was observed for changes in light intensity PA across the school day (p = 0.003), with those in the intervention increasing their light intensity PA by 8.27 mins/day compared with a decrease of 2.14 mins/day in the control group. No significant interactions were observed for the other PA measures across the intervention. Intervention effects on school-time PA were not sustained four months post intervention.

Conclusion: The intervention increased daily light intensity PA behaviour in these adolescent girls but did not change moderate to vigorous physical activity (MVPA). These findings suggest that a school-based brisk walking intervention may be feasible and can change PA behaviour in the short term, but it is possible that the self-selected walking speeds determined by a peer-leader may not be sufficient to reach MVPA in this age group. Further research is needed to evaluate the potential of school-based brisk walking to contribute to MVPA in adolescent girls.

Study Design: Cluster RCT

Setting: 6 post-primary schools in Northern Ireland

Population of Focus: Girls in participating schools without medical conditions that would limit their participation

Data Source: Accelerometers, BMI, Queens College Step Test (cardiovascular fitness), selfefficacy for PA questionnaire

Sample Size: 6 schools: 101 female students from 2 schools (intervention), 98 female students in 4 schools (control)

Age Range: Ages 11-13

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Connolly J, Josephson W, Schnoll J, et al. Evaluation of a youth-led program for preventing bullying, sexual harassment, and dating aggression in middle schools. J Early Adolesc. 2014:0272431614535090.

Evidence Rating: Evidence Against

Intervention Components (click on component to see a list of all articles that use that intervention): CLASSROOM, Peer-led Curricular Activities/Training

Intervention Description: A YLP to reduce bullying, sexual harassment, and dating aggression was compared experimentally with the board-mandated usual practice (UP).

Intervention Results: Significant improvements were found in knowledge and attitudes in both programs. Students receiving the YLP showed significant reductions in anxiety and maintained their school connectedness (all ps < .05).

Conclusion: The results suggest that youth-led prevention is an effective approach for tackling peer aggression in school settings.

Study Design: Cluster RCT: pretest-posttest

Setting: Canada

Population of Focus: Not specified

Data Source: Not specified

Sample Size: Pretest (N=509): Intervention (n=209); Control (n=300) Posttest (N=447): Intervention (n=183); Control (n=264) Analysis: Intervention (n=183 complete data; n=209 FIML); Control (n=264 complete data; n=300 FIML)

Age Range: 11/14/2022

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Cross D, Shaw T, Hadwen K, et al. Longitudinal impact of the cyber friendly schools program on adolescents’ cyberbullying behavior. Aggress Behav. 2016;42(2):166-180.

Evidence Rating: Evidence Against

Intervention Components (click on component to see a list of all articles that use that intervention): PARENT/FAMILY, Notification/Information Materials (Online Resources, Information Guide), CLASSROOM, Adult-led Curricular Activities/Training, Peer-led Curricular Activities/Training, Training (Parent/Family), SCHOOL, Teacher/Staff Meeting, Teacher/Staff Training, School Rules

Intervention Description: The Cyber Friendly Schools (CFS) group-randomized controlled trial measured the longitudinal impact of a whole-school online cyberbullying prevention and intervention program, developed in partnership with young people.

Intervention Results: The program was associated with significantly greater declines in the odds of involvement in cyber-victimization and perpetration from pre- to the first post-test, but no other differences were evident between the study conditions. However, teachers implemented only one third of the program content.

Conclusion: More work is needed to build teacher capacity and self-efficacy to effectively implement cyberbullying programs. Whole-school cyberbullying interventions implemented in conjunction with other bullying prevention programs may reduce cyber-victimization more than traditional school-based bullying prevention programs alone.

Study Design: Cluster RCT: pretest-posttest

Setting: Australia

Population of Focus: Not specified

Data Source: Not specified

Sample Size: Pretest (N=3382): Intervention (n=1878); Control (n=1504) Posttest 1 (N=2940): Intervention (n=1593); Control (n=1347) Posttest 2 (N=2874): Intervention (n=1582); Control (n=1292)

Age Range: 13-15

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Evans, W., Andrade, E., Pratt, M., Mottern, A., Chavez, S., Calzetta-Raymond, A., & Gu, J. (2020). Peer-to-Peer Social Media as an Effective Prevention Strategy: Quasi-Experimental Evaluation. JMIR mHealth and uHealth, 8(5), e16207. https://doi.org/10.2196/16207

Evidence Rating: Emerging

Intervention Components (click on component to see a list of all articles that use that intervention): Peer-led Curricular Activities/Training,

Intervention Description: Living the Example (LTE) is a program that trains adolescent youth ambassadors to develop and disseminate prevention messages within their own social media networks and through in-school activities. This study aimed to evaluate the effects of exposure to LTE-based social media on students in the youth ambassadors' networks.

Intervention Results: We found a significant positive effect of LTE exposure on all 8 measured drug use intentions: sell/distribute illegal drugs; smoke cigarettes; drink beer, wine, or liquor when my parents do not know about it; use marijuana; use cocaine, amphetamines, or other illegal drug; use heroin; use synthetic drugs; use any prescription pills without a prescription (all P<.05; odds ratios ranging from 2.12 to 3.71). We also found that boys were more likely than girls to exhibit reduced drug use intentions. We also found reductions in 30-day intentions between the second and third survey waves for all 8 measured drug use variables.

Conclusion: Overall, the results are consistent with and indicate a stronger LTE effect in this study compared with a previous pilot study. LTE appears to offer a protective effect, with exposure to program messages leading to reduced/improved drug use intentions.

Study Design: Cross-sectional design

Setting: USA (Nationwide)

Population of Focus: Researchers, public health professionals, policymakers

Sample Size: 923 9th grade students

Age Range: ages 14-15

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Garandeau CF, Laninga-Wijnen L, Salmivalli C. Effects of the KiVa Anti-Bullying Program on Affective and Cognitive Empathy in Children and Adolescents. J Clin Child Adolesc Psychol. 2022 Jul-Aug;51(4):515-529. doi: 10.1080/15374416.2020.1846541. Epub 2021 Jan 15. PMID: 33448897.

Evidence Rating: Moderate Evidence

Intervention Components (click on component to see a list of all articles that use that intervention): CLASSROOM_SCHOOL, Adult-led Curricular Activities/Training, Multicomponent SchooL-Based Program, Peer-led Curricular Activities/Training

Intervention Description: This study examined the effects of the Finnish anti-bullying program KiVa on changes in self-reported affective and cognitive empathy and tested whether these effects varied depending on students’ gender, initial levels of empathy, peer-reported bullying, and peer-perceived popularity, as well as school type (primary versus secondary school) and classroom bullying norms.

Intervention Results: KiVa had a positive effect on affective empathy, but not cognitive empathy. The effects of the program on both types of empathy did not depend on students' gender, initial levels of empathy, bullying, or popularity, nor on school type or classroom bullying norms.

Conclusion: Findings suggest that KiVa can raise students' affective empathy regardless of students' gender, status, initial empathy, or levels of bullying, and regardless of school type or classroom bullying norms.

Study Design: Pre-post design

Setting: Primary and secondary schools

Population of Focus: Children and adolescents

Sample Size: 15403

Age Range: 8-14

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Houlston C, Smith PK. The impact of a peer counselling scheme to address bullying in an all‐girl london secondary school: A short‐term longitudinal study. Br J Educ Psychol. 2009;79(1):69-86.

Evidence Rating: Emerging Evidence

Intervention Components (click on component to see a list of all articles that use that intervention): YOUTH, Peer-led Mentoring/Support Counseling, CLASSROOM, Adult-led Curricular Activities/Training, SCHOOL, School Rules

Intervention Description: To assess the impact of a peer counselling scheme on peer counsellors and the school community.

Intervention Results: Peer counsellors benefited from their involvement through an acquisition of transferable communication and interpersonal skills, and, compared to age-matched control pupils, had increased social self-esteem. There were no reductions in self-reported bullying and victimization, but in general pupils believed that there was less bullying in school and that the school was doing more about bullying, with year 7 students showing the most positive changes.

Conclusion: Peer-counselling schemes can improve self-esteem of peer supporters, and also impact positively on perceptions of bullying in the school; but impact on actual experiences of bullying is less clear, and there may be problems with the acceptance and use of such programmes by older students.

Study Design: QE: pretest-posttest design

Setting: UK

Population of Focus: Not specified

Data Source: Not specified

Sample Size: Pretest (n =375); Posttest (n=342)

Age Range: 11/14/2022

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Johander E, Turunen T, Garandeau CF, Salmivalli C. Different Approaches to Address Bullying in KiVa Schools: Adherence to Guidelines, Strategies Implemented, and Outcomes Obtained. Prev Sci. 2021 Apr;22(3):299-310. doi: 10.1007/s11121-020-01178-4. Epub 2020 Oct 24. Erratum in: Prev Sci. 2021 Jan 14;: PMID: 33098542; PMCID: PMC8032636.

Evidence Rating: Moderate Evidence

Intervention Components (click on component to see a list of all articles that use that intervention): CLASSROOM_SCHOOL, Adult-led Curricular Activities/Training, Multicomponent Schoo-Based Program, Peer-led Curricular Activities/Training

Intervention Description: This study examined the extent to which school personnel implementing the KiVa® antibullying program systematically employed the program-recommended approaches (confronting or non-confronting), used one or the other depending on the bullying case (case-specific approach), or used their own adaptation when talking to perpetrators of bullying, and whether they organized follow-up meetings after such discussions. In addition to investigating adherence to program guidelines, researchers tested how effective these different approaches were in stopping bullying. Finally, this study tested the contribution of follow-up meetings and the number of years KiVa had been implemented in a school to the effectiveness of the interventions, using reports from both school personnel and victimized students.

Intervention Results: The school personnel were more likely to use the confronting approach than the non-confronting approach. Over time, rather than sticking to the two program-recommended approaches, they made adaptations (e.g., combining the two; using their own approach). Two-level regression analyses indicated that the discussions were equally effective, according to both personnel and victimized students, when the confronting, non-confronting, or a case-specific approach had been used.

Conclusion: The discussions were less effective when the personnel used their own adaptation or could not specify the method used. Perceived effectiveness was higher in primary school and when follow-up meetings were organized systematically after each intervention, but unrelated to the number of years KiVa had been implemented.

Study Design: Pre-post design with follow-up

Setting: Primary and secondary schools

Population of Focus: School personnel

Sample Size: 1221 primary and secondary schools

Age Range: n/a

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Kärnä A, Voeten M, Little TD, Alanen E, Poskiparta E, Salmivalli C. Effectiveness of the KiVa antibullying program: Grades 1–3 and 7–9. J Educ Psychol. 2013;105(2):535.

Evidence Rating: Moderate Evidence

Intervention Components (click on component to see a list of all articles that use that intervention): YOUTH, Adult-led Support/Counseling/Remediation, Peer-led Mentoring/Support Counseling, PARENT/FAMILY, Notification/Information Materials (Online Resources, Information Guide), Presentation/Meeting/Information Session/Event, CLASSROOM, Adult-led Curricular Activities/Training, SCHOOL, Reporting & Response System, Teacher/Staff Training, Media Campaign (Print Materials, Public Address System, Social Media)

Intervention Description: This study investigated the effectiveness of the KiVa Antibullying Program in two samples of students, one from Grades 1-3 (7-9 years old, N = 6,927) and the other from Grades 7-9 (13-15 years old, N = 16, 503).

Intervention Results: Multilevel regression analyses revealed that after 9 months of implementation, the intervention had beneficial effects in Grades 1-3 on self-reported victimization and bullying (odds ratios approximately equal to 1.5), with some differential effects by gender. In Grades 7-9, statistically significant positive results were obtained on 5 of 7 criterion variables, but results often depended on gender and sometimes age. The effects were largest for boys' peer reports: bullying, assisting the bully, and reinforcing the bully (Cohen's ds 0.11-0.19).

Conclusion: Overall, the findings from the present study and from a previous study for Grades 4-6 (Karna, Voeten, Little, Poskiparta, Kaljonen, et al., 2011) indicate that the KiVa program is effective in reducing bullying and victimization in Grades 1-6, but the results are more mixed in Grades 7-9. (Contains 1 figure, 7 tables, and 1 footnote.)

Study Design: Cluster RCT: pretest-posttest

Setting: Finland

Population of Focus: Not specified

Data Source: Not specified

Sample Size: Total (n=16503)

Age Range: 13-15

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Nixon CL, Werner NE. Reducing adolescents' involvement with relational aggression: Evaluating the effectiveness of the creating A safe school (CASS) intervention. Psychol Sch. 2010;47(6):606-620.

Evidence Rating: Emerging Evidence

Intervention Components (click on component to see a list of all articles that use that intervention): CLASSROOM, Peer-led Curricular Activities/Training, SCHOOL, Teacher/Staff Training, School Rules, Media Campaign (Print Materials, Public Address System, Social Media)

Intervention Description: This study examined the effectiveness of a comprehensive, school-based intervention program, Creating A Safe School (CASS; The Ophelia Project) designed to reduce relational aggression (RA) and relational victimization (RV).

Intervention Results: Results revealed significant reductions in RA and RV among students who reported initially high levels of involvement. Findings also showed that decreasing approval of RA accounted for a significant amount of variance in changes in RA between pre- and posttest.

Conclusion: These results provide initial evidence of the effectiveness of the CASS intervention model in reducing RA among early adolescents.

Study Design: Quasi-experiment study: pretestposttest

Setting: US

Population of Focus: Not specified

Data Source: Not specified

Sample Size: N=405

Age Range: Mean: 11.4

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Palladino BE, Nocentini A, Menesini E. Evidence‐based intervention against bullying and cyberbullying: Evaluation of the NoTrap! program in two independent trials. Aggress Behav. 2016;42(2):194-206.

Evidence Rating: Emerging Evidence

Intervention Components (click on component to see a list of all articles that use that intervention): YOUTH, Peer-led Mentoring/Support Counseling, CLASSROOM, Presentation/meeting/information Session (Classroom), Peer-led Curricular Activities/Training, SCHOOL, Assembly, Media Campaign (Print Materials, Public Address System, Social Media), POPULATION-BASED SYSTEMS, COMMUNITY, Event, Presentation

Intervention Description: The NoTrap! (Noncadiamointrappola!) program is a school-based intervention, which utilizes a peer-led approach to prevent and combat both traditional bullying and cyberbullying. The aim of the present study was to evaluate the efficacy of the third Edition of the program in accordance with the recent criteria for evidence-based interventions.

Intervention Results: Towards this aim, two quasi-experimental trials involving adolescents (age M = 14.91, SD = .98) attending their first year at different high schools were conducted. In Trial 1 (control group, n = 171; experimental group, n = 451), latent growth curve models for data from pre-, middle- and post-tests showed that intervention significantly predicted change over time in all the target variables (victimization, bullying, cybervictimization, and cyberbullying). Specifically, target variables were stable for the control group but decreased significantly over time for the experimental group. Long-term effects at the follow up 6 months later were also found. In Trial 2 (control group, n = 227; experimental group, n = 234), the moderating effect of gender was examined and there was a reported decrease in bullying and cyberbullying over time (pre- and post-test) in the experimental group but not the control group, and this decrease was similar for boys and girls.

Conclusion: The significant improvement in target variables in trials of the third edition, compared to the non-significant improvements found for the first and second editions, suggests that the new/modified components may have improved the efficacy of the program.

Study Design: QE: pretest-posttest non-equivalent control group

Setting: Italy

Population of Focus: Not specified

Data Source: Not specified

Sample Size: Total (n=375) Intervention (n=231); Control (n=144)

Age Range: 14-18

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Peterson L, Rigby K. Countering bullying at an Australian secondary school with students as helpers. J Adolesc. 1999;22(4):481-492.

Evidence Rating: Emerging Evidence

Intervention Components (click on component to see a list of all articles that use that intervention): YOUTH, Adult-led Support/Counseling/Remediation, Peer-led Mentoring/Support Counseling, CLASSROOM, Peer-led Curricular Activities/Training, SCHOOL, Assembly, Reporting & Response System, Teacher/Staff Training, School Rules, Media Campaign (Print Materials, Public Address System, Social Media)

Intervention Description: To counter bullying at an Australian coeducational secondary school, staff and students co-operated in developing and implementing appropriate policies and procedures.

Intervention Results: Questionnaires assessing the incidence of bullying and related attitudes were completed by students in Years 7, 9, 10 and 11 in 1995 and again in 1997. Significant reductions in levels of victimization were recorded for Year 7 students only. Significantly increased support for anti-bullying initiatives was found among senior students (Years 10 and 11)

Conclusion: Anti-bullying activities directed and undertaken by students themselves received most approval from peers.

Study Design: QE: pretest-posttest

Setting: Australia

Population of Focus: Not specified

Data Source: Not specified

Sample Size: NR (The school has a total of ~1200 students; 4 of the 5 grades included in the study)

Age Range: NR

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Ross, A., & Kurka, J. M. (2022). Predictors of active transportation among Safe Routes to School participants in Arizona: impacts of distance and income. Journal of school health, 92(3), 282-292.

Evidence Rating: Scientifically Rigorous

Intervention Components (click on component to see a list of all articles that use that intervention): CLASSROOM_SCHOOL, Peer-led Curricular Activities/Training, Adult-led Curricular Activities/Training, Multicomponent School-Based Program

Intervention Description: Using active transportation to (or from) school (ATS), or non-motorized modes of travel such as walking ot biking, holds promising potential to increase the health of children and adolescents. Individual- and school-level predictors of ATS were examined using data from parent surveys (N = 11,100) of students in grades 3-8 attending 112 schools in Arizona (United States) administering Safe Routes to School (SRTS) programs between 2007 and 2018. Multilevel logistic models were estimated to predict the likelihood of students using active (walking or biking) versus inactive travel (riding bus or car) to and from school, and across distance and school-level income categories.

Intervention Results: Student grade, parent education, asking permission to use ATS, perceived health and school support for ATS, distance, and school income were predictive of ATS. The impact of demographic factors persisted across distances of ½ mile or less and at low- and medium-income schools but diminished as distance and income increased. Asking permission and perceived school support persisted across levels of distance and income, while perceiving ATS as healthy was significant only for distances under 1 mile.

Conclusion: SRTS programs should continue promoting health benefits and school support for ATS. SRTS may be particularly effective at low- and medium-income schools and among families living within ½ mile distances.

Study Design: Program evaluation

Setting: Schools in Arizona administering Safe Routes to School programs

Population of Focus: Parents of students in grades 3-8 at 112 schools who completed a Safe Routes to School Parent Survey between 2007 and 2018

Sample Size: 11,100 parent surveys

Age Range: N/A

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Salmivalli C. Peer-led intervention campaign against school bullying: Who considered it useful, who benefited? Educ Res. 2001;43(3):263-278.

Evidence Rating: Emerging Evidence

Intervention Components (click on component to see a list of all articles that use that intervention): CLASSROOM, Peer-led Curricular Activities/Training, SCHOOL, Assembly, Media Campaign (Print Materials, Public Address System, Social Media)

Intervention Description: Effects of a peer-led intervention campaign against school bullying, carried out by eight peer counsellors, were studied in an upper-level comprehensive school in southern Finland.

Intervention Results: The results showed that the campaign was especially effective among girls. This was most clearly shown by decreases in both self- and peer-reported bullying, as well as an increase in 'power attitudes', i.e. attitude items reflecting the students' self-perceived potential and willingness to influence bullying problems in their class. Among boys, on the other hand, there was a slight decrease in self-reported bullying, not confirmed by peer reports and, unfortunately, there was an increase in pro-bullying attitudes, such as 'bullying might be fun sometimes'. Evaluating the campaign, girls also perceived it as more beneficial and more effective than boys did.

Conclusion: Most students who reported being bullied before the intervention were satisfied with the campaign and thought it was helpful.

Study Design: QE: pretest-posttest

Setting: Finland

Population of Focus: Not specified

Data Source: Not specified

Sample Size: Total (n=196) Analysis (n=144)

Age Range: ~13-15

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Swaim RC, Kelly K. Efficacy of a randomized trial of a community and school-based anti-violence media intervention among small-town middle school youth. Prev Sci. 2008;9(3):202- 214.

Evidence Rating: Moderate Evidence

Intervention Components (click on component to see a list of all articles that use that intervention): CLASSROOM, Peer-led Curricular Activities/Training, SCHOOL, Assembly, Media Campaign (Print Materials, Public Address System, Social Media), POPULATION-BASED SYSTEMS, COMMUNITY, Training, Event, Media Campaign (Print Materials, Radio, TV), Distribution of Promotional Items (Classroom/School), Distribution of Promotional Items (Community)

Intervention Description: In a community randomized controlled trial, intervention middle school students from small towns were exposed to a community and school-based anti-violence intervention ("Resolve It, Solve It").

Intervention Results: Students in the intervention group reported a significantly higher rate of decline in verbal victimization compared to control students. The difference was only significant among males. For physical victimization, the decline in the intervention group compared to the control group was in the expected direction but did not reach statistical significance (p=0.069). This near significant difference was accounted for by males.

Conclusion: These results suggest that a media and reinforcing community intervention led by older peers can alter rates of growth for some measures of violence and associated factors among small-town youth. Further research is indicated to determine how different campaign messages influence students by sex.

Study Design: Cluster RCT: pretest-posttest

Setting: US

Population of Focus: Not specified

Data Source: Not specified

Sample Size: Total (n=1492) Intervention (n=712); Control (n=780)

Age Range: NR

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The MCH Digital Library is one of six special collections at Geogetown University, the nation's oldest Jesuit institution of higher education. It is supported in part by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under award number U02MC31613, MCH Advanced Education Policy with an award of $700,000/year. The library is also supported through foundation and univerity funding. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.