Established Evidence Results

Intervention Components (click on component to see a list of all articles that use that intervention): Presentation/meeting/information Session (Classroom), CLASSROOM_SCHOOL, Extra-Curricular Activities

Intervention Description: This study assesses the effectiveness and implementation fidelity of the ACT Out! Social Issue Theater program, a 1-hour psychodramatic intervention by professional actors; it also measures students' receptiveness to the intervention.

Intervention Results: Intervention fidelity was uniformly excellent (>96% adherence), and students were highly receptive to the program. However, trial results did not support the hypothesis that the intervention would increase participants' social-emotional competence. The intervention's impact on bullying was complicated to interpret and included some evidence of small interaction effects (reduced cyberbullying victimization and increased physical bullying perpetration). Additionally, pooled within-group reductions were also observed and discussed but were not appropriate for causal attribution.

Conclusion: This study found no superiority for a 1-hour ACT Out! intervention compared to treatment as usual for social-emotional competence or offline bullying, but some evidence of a small effect for cyberbullying. On the basis of these results and the within-group effects, as a next step, we encourage research into whether the ACT Out! intervention may engender a bystander effect not amenable to randomization by classroom. Therefore, we recommend a larger trial of the ACT Out! intervention that focuses specifically on cyberbullying, measures bystander behavior, is randomized by school, and is controlled for extant bullying prevention efforts at each school.

Intervention Components (click on component to see a list of all articles that use that intervention): Communication Tools, Presentation/meeting/information Session (Classroom),

Intervention Description: The intervention in the study involved engaging adolescents with anti-smoking motivational messages and forming repeated implementation intentions on how to refuse offers of cigarettes. The intervention consisted of eight sessions, each led by a teacher and designed to be matched in duration and frequency across the intervention and control conditions. The sessions took place separately to data collection in classroom time and were designed to be age-appropriate and engaging. During these sessions, adolescents engaged with motivational materials (anti-smoking messages or pro-homework messages) and completed implementation intention sheets related to the target behavior (not smoking in the intervention condition; completing homework in the control condition)

Intervention Results: Schools were randomly allocated (September–October 2012) to intervention (n = 25) or control (n = 23). At follow-up, among 6,155 baseline never smokers from 45 retained schools, ever smoking was significantly lower (RR = 0.83, 95% CI [0.71, 0.97], p = .016) in intervention (29.3%) compared with control (35.8%) and remained so controlling for demographics. Similar patterns observed for any smoking in last 30 days. Less consistent effects were observed for regular smoking and breath carbon monoxide levels. Economic analysis yielded an ICER of $134 per ever smoker avoided at age 15–16 years.

Conclusion: This pragmatic trial supports the use of repeated implementation intentions about how to refuse the offer of a cigarette plus antismoking messages as an effective and cost-effective intervention to reduce smoking initiation in adolescents.

Study Design: Cluster randomized controlled trial

Setting: 36 Secondary schools in the UK

Population of Focus: Researchers, public health professionals, educators, policymakers

Sample Size: Roughly 3672 adolescents

Age Range: ages 11-14 at baseline, 15-16 at follow up

Intervention Components (click on component to see a list of all articles that use that intervention): CLASSROOM_SCHOOL, Comprehensive School-Based PA Program, Presentation/meeting/information Session (Classroom), Physically Active Classrooms, Multicomponent School-Based Program

Intervention Description: “GiochiAmo” is an innovative randomized field trial which aims to educate children aged about nutrition, physical activity, smoking and alcohol. Each primary school class worked on a different theme. Particularly, the project is structured in two sequential phases: a lesson for each theme followed by several game sessions during the next three months.

Intervention Results: A total number of 74 and 76 children participated in the physical activity and nutrition interventions. NTs was 4.17 (SD: 2.23) before and 5.03 (SD: 2.79) after the intervention (P = 0.005). PAs was 27.4 (SD: 9.6) before and 30.5 (SD: 10.7) after the intervention (P = 0.003). No significant differences were obtained comparing males and females for all scores. Ds was 0.86 for nutrition and 3.1 for physical activity. Univariate analysis of Delta scores obtained no significant differences.

Conclusion: The present results confirm the effectiveness of 'GiochiAMO' to change nutrition and physical activity behavior.

Study Design: Single arm, cluster field trial (c-RCT)

Setting: Public primary schools

Population of Focus: Second and third grade students in primary school

Data Source: Student self-report

Sample Size: 150 students

Age Range: Ages 6-9

Intervention Components (click on component to see a list of all articles that use that intervention): CLASSROOM_SCHOOL, Homework/Extra Credit, Presentation/meeting/information Session (Classroom), Adult-led Curricular Activities/Training

Intervention Description: A total of 675 children aged 7-10 years from 16 New Zealand primary schools participated in the Healthy Homework study. Schools were randomised into intervention and control groups (1:1 allocation). Intervention schools implemented an 8-week applied homework and in-class teaching module designed to increase physical activity and improve dietary patterns. Physical activity was the primary outcome measure, and was assessed using two sealed pedometers that monitored school- and home-based activity separately. Secondary outcome measures included screen-based sedentary time and selected dietary patterns assessed via parental proxy questionnaire. In addition, height, weight, and waist circumference were measured to obtain body mass index (BMI) and waist-to-height ratio (WHtR). All measurements were taken at baseline (T0), immediately post-intervention (T1), and 6-months post-intervention (T2). Changes in outcome measures over time were estimated using generalised linear mixed models (GLMMs) that adjusted for fixed (group, age, sex, group x time) and random (subjects nested within schools) effects. Intervention effects were also quantified using GLMMs adjusted for baseline values.

Intervention Results: Significant intervention effects were observed for weekday physical activity at home (T1 [P < 0.001] and T2 [P = 0.019]), weekend physical activity (T1 [P < 0.001] and T2 [P < 0.001]), BMI (T2 only [P = 0.020]) and fruit consumption (T1 only [P = 0.036]). Additional analyses revealed that the greatest improvements in physical activity occurred in children from the most socioeconomically deprived schools. No consistent effects on sedentary time, WHtR, or other dietary patterns were observed.

Conclusion: A compulsory health-related homework programme resulted in substantial and consistent increases in children's physical activity - particularly outside of school and on weekends - with limited effects on body size and fruit consumption. Overall, our findings support the integration of compulsory home-focused strategies for improving health behaviours into primary education curricula.

Study Design: Cluster RCT

Setting: Primary schools in Auckland or Dunedin

Population of Focus: 3rd-5th year students

Data Source: Pedometers, questionnaires (diet, television and computer usage), anthropometrics

Sample Size: 675 students from 16 schools

Age Range: Ages 7-10

Intervention Components (click on component to see a list of all articles that use that intervention): Adult-led Curricular Activities/Training, Presentation/meeting/information Session (Classroom), Education on Disease/Condition

Intervention Description: Implementation of a translated and adapted version of a Canadian mental health literacy curriculum called "The Mental Health and High School Curriculum Guide (MHC)" Delivered in six modules over 1 day on topics like destigmatization, mental health/illness, specific disorders, lived experiences, help-seeking, and positive mental health Includes individual and group activities using printed materials, videos, presentation slides etc. Implemented by teachers and a school counselor Incorporated personal stories from mental health experts with lived experience (in-person in 2 classes, via video in 3 classes)

Intervention Results: Data from 188 students was eligible for analysis. The analysis of the baseline data reveals a high comparability of the two groups in terms of demographics, and initial mental health knowledge and help-seeking efficacy scores. ANOVA results showed significant improvements for the intervention group having a large effect size for mental health knowledge (f = 0.574, p < 0.001, partial η2 = 0.25) and a medium effect size for help-seeking efficacy (f = 0.311, p < 0.001, partial η2 = 0.09).

Conclusion: The first-time application and evaluation of an adapted mental health literacy school curriculum shows significant increases in mental health knowledge and help-seeking efficacy, two core dimensions of mental health literacy, among 10th grade students in Germany. Further studies are needed to confirm these results as well as have a more in-depth analysis on the interrelations of the different dimensions of mental health knowledge and help-seeking practices.

Study Design: Quasi-experimental pre-post evaluation with a control group

Setting: Secondary schools in Germany

Population of Focus: 10th grade students

Sample Size: 188

Age Range: 14-17 years old

Intervention Components (click on component to see a list of all articles that use that intervention): Multicomponent School-Based Program, Presentation/meeting/information Session (Classroom), CLASSROOM_SCHOOL, Intensive Therapy, PATIENT_CONSUMER

Intervention Description: To examine the secondary effects of a personality-targeted intervention on bullying and harms among adolescent victims and bullies.

Intervention Results: There was no significant intervention effect for bullying victimization or perpetration in the total sample. In the subsample, mixed models showed greater reductions in victimization (b = -0.208, 95% CI -0.4104 to -0.002, p < .05), suicidal ideation (b = -0.130, 95% CI -0.225 to -0.034, p < .01), and emotional symptoms (b = -0.263, 95% CI -0.466 to -0.061, p < .05) among high-risk victims in Preventure versus control schools. Conduct problems (b = -0.292, 95% CI -0.554 to -0.030, p < .05) showed greater reductions among high-risk bullies in Preventure versus control schools, and suicidal ideation showed greater reductions among high-risk female bullies in Preventure versus control schools (b = -0.820, 95% CI -1.198 to -0.442, p < .001).

Conclusion: The findings support targeting personality in bullying prevention.

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)

Intervention Description: This paper reports on the evaluation of a peer support model implemented in two Italian secondary middle schools as an anti-bullying intervention.

Intervention Results: The results of this short-term study highlight the fact that a befriending intervention had a positive effect on the experimental classes, preventing the increase of negative behaviours and attitudes reported in the group that did not receive the intervention. The findings that related to the pro-bullying roles and to the role of outsiders are particularly relevant since these roles remained stable or decreased in the experimental group, whereas they clearly increased in the control group. The opposite trend was registered for children's pro-victim attitude, which shows a decrease in the control sample and good stability in the experimental group.

Conclusion: On the whole, the intervention seemed to prevent the escalation of negative behaviours and attitudes that often develop spontaneously in young people of this age.

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

Setting: Italy

Population of Focus: Not specified

Data Source: Not specified

Sample Size: Intervention (n=178); Control (n=115)

Age Range: 11/14/2022

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), SCHOOL, Assembly, Media Campaign (Print Materials, Public Address System, Social Media), POPULATION-BASED SYSTEMS, COMMUNITY, Event, Outreach

Intervention Description: An investigation of whether and to what extent a peer-led model is able to counteract mechanisms underlying bullying in peer groups, seeking clarification of divergence in reported results on the efficacy of peer-led models.

Intervention Results: Two studies were carried out in Italy within a project tackling bullying and cyberbullying in secondary schools. In the first study (n= 386), concerning the first phase of the project, a significant decrease was found only for cyberbullying, most of all for male peer educators. For the second study (n= 375) the model was improved and significant effects were found for several participating groups (peer educators and the experimental classes), who exhibited a decrease in bullying, victimization, and cybervictimization.

Conclusion: Results suggest that peer educators can act as agents of change in the broader context.

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

Setting: Italy

Population of Focus: Not specified

Data Source: Not specified

Sample Size: Study 1: Intervention 1 (n=126); Intervention 2 (n=63); Control (n=47) Study 2: Intervention (n=231); Control (n=144)

Age Range: 14-20

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

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), SCHOOL, Assembly, Media Campaign (Print Materials, Public Address System, Social Media), POPULATION-BASED SYSTEMS, COMMUNITY, Event, Presentation

Intervention Description: The aim of the present study is to describe and evaluate an ongoing peer-led model against bullying and cyberbullying carried out with Italian adolescents.

Intervention Results: Results showed a significant decrease in the experimental group as compared to the control group for all the variables except for cyberbullying. Besides, in the experimental group we found a significant increase in adaptive coping strategies like problem solving and a significant decrease in maladaptive coping strategies like avoidance: these changes mediate the changes in the behavioural variables. In particular, the decrease in avoidance predicts the decrease in victimization and cybervictimization for peer educators and for the other students in the experimental classes whereas the increase in problem solving predicts the decrease in cyberbullying only in the peer educators group.

Conclusion: Results are discussed following recent reviews on evidence based efficacy of peer led models.

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

Setting: Italy

Population of Focus: Not specified

Data Source: Not specified

Sample Size: Trial 1: Intervention (n=451); Control (n=171) Trial 2: Intervention (n=234); Control (n=227)

Age Range: Mean: ~16.23

Intervention Components (click on component to see a list of all articles that use that intervention): Presentation/meeting/information Session (Classroom), Distribution of Promotional Items (Classroom/School), CLASSROOM_SCHOOL

Intervention Description: This study aims to implement and evaluate an educational intervention on bullying prevention among junior high school students in Shantou, China.

Intervention Results: The results showed that the intervention group's awareness of bullying (percentage of the students who knew bullying very well, male: before vs. after intervention: 16.3% vs. 37.6%, P < 0.001; female: before vs. after intervention: 11.8% vs. 38.8%, P < 0.01), and the female students' acceptance of anti-bullying education (before vs. after intervention: 89.3% vs. 97.6%, P < 0.05) was improved after intervention. The incidence of cyber victimization (male: 32.3% vs. 18.5%, P < 0.05; female: 22.4 to 7.0%, P < 0.01) was also reduced in the intervention group, with the reduction in the incidence of social (19.4% vs. 8.7%, P < 0.05), verbal (40.9% vs. 27.2%, P < 0.05) victimization, and peer (36.6% vs. 20.7%, P < 0.05) and social bullying (11.8% vs. 2.2%, P < 0.01) among male students after intervention.

Conclusion: This educational intervention was the first important step to develop effective intervention strategies for bullying prevention among junior high school students in China.

Intervention Components (click on component to see a list of all articles that use that intervention): Presentation/meeting/information Session (Classroom), Adult-led Support/Counseling/Remediation, CLASSROOM_SCHOOL, YOUTH

Intervention Description: The current effectiveness trial evaluated the combination of a whole-school program designed to prevent bullying perpetration and victimization together with a targeted intervention for at-risk students, teaching them individual and dyadic strategies to reduce their anxiety and manage victimization, allowing schools some latitude to implement programs as they typically would.

Intervention Results: Victimization decreased significantly and similarly across all four conditions at 12 and 24 months following baseline. Similar reductions and failure to discriminate conditions were found on other key constructs: anxiety; bullying perpetration; and depression.

Conclusion: Possible reasons for the failure to demonstrate victimization prevention differences and lessons learned from this large, effectiveness trial are considered.

Intervention Components (click on component to see a list of all articles that use that intervention): Presentation/meeting/information Session (Classroom), CLASSROOM_SCHOOL

Intervention Description: The purpose of this study was to develop a social and emotional competence enhancement (SECE) program as an intervention for adolescents who bully, and to investigate its effects on school bullying behavior and mental health.

Intervention Results: The effects of this program were significant with regard to group-by-time interaction effects on social competence, emotional regulation, empathy, and school bullying behavior at the 1-month follow-up.

Conclusion: The results indicate that the SECE program was effective at reducing school bullying behavior in adolescents who bully. School and community-based mental health professionals can provide feasible interventions that can be used in the short term to reduce school bullying behavior in adolescents who bully.