Established Evidence Results

Intervention Components (click on component to see a list of all articles that use that intervention): YOUTH, Adult-led Support/Counseling/Remediation, PARENT/FAMILY, Presentation/Meeting/Information Session/Event, Notification/Information Materials (Online Resources, Information Guide), CLASSROOM, Adult-led Curricular Activities/Training, Enforcement of School Rules, SCHOOL, Assembly, Reporting & Response System, Bullying Committee, Teacher/Staff Meeting, Teacher/Staff Training, School Rules, Identification and Monitoring of/Increased Supervision in Targeted Areas, POPULATION-BASED SYSTEMS, COMMUNITY, Media Campaign (Print Materials, Radio, TV)

Intervention Description: To examine the effectiveness of a widely disseminated bullying prevention program.

Intervention Results: Regression analyses controlling for baseline prevalence and school characteristics showed no overall effect on student victimization. However, when stratified by ethnicity/race, reports of relational and physical victimization decreased by 28% (RR = .72, 95% CI: .53-.98) and 37% (RR = .63, 95% CI: .42-.97), respectively, among white students relative to those in comparison schools. No similar effect was found for students of other races/ethnicities; there were no differences by gender or by grade. Students in intervention schools were more likely to perceive other students as actively intervening in bullying incidents, and 6th graders were more likely to feel sorry and want to help victims.

Conclusion: The program had some mixed positive effects varying by gender, ethnicity/race, and grade but no overall effect. Schools implementing the program, especially with a heterogeneous student body, should monitor outcomes and pay particular attention to the impact of culture, race and family influences on student behavior. Future studies of large-scale bullying prevention programs in the community must be rigorously evaluated to ensure they are effective.

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

Setting: US

Population of Focus: Not specified

Data Source: Not specified

Sample Size: Intervention (n=4959) Relational Victimization: Pretest (n=4607); Posttest (n=4480) Physical Victimization: Pretest (n=4531); Posttest (n=4419) Control (n=1559) Relational Victimization: Pretest (n=1408); Posttest (n=1456) Physical Victimization: Pretest (n=1373); Posttest (n=1448)

Age Range: NR

Intervention Components (click on component to see a list of all articles that use that intervention): YOUTH, Adult-led Support/Counseling/Remediation, PARENT/FAMILY, Notification/Information Materials (Online Resources, Information Guide), Presentation/Meeting/Information Session/Event, CLASSROOM, Enforcement of School Rules, SCHOOL, Bullying Committee, Assembly, Reporting & Response System, Teacher/Staff Meeting, Teacher/Staff Training, School Rules, Identification and Monitoring of/Increased Supervision in Targeted Areas, POPULATION-BASED SYSTEMS, COMMUNITY, Media Campaign (Print Materials, Radio, TV)

Intervention Description: This intervention study examined the prevalence of bullying in an urban/suburban middle school and the impact of the Olweus Bullying Prevention Program (OBPP).

Intervention Results: Statistically significant findings were found for 7th grade female students who received 1 year of the OBPP on reports of prevalence of bullying (p = .022) and exclusion by peers (p = .009). In contrast, variability in statistical findings was obtained for 8th grade females and no statistical findings were found for males. Following 1 year of the OBPP, teachers reported statistically significant improvements in their capacity to identify bullying (p = .016), talk to students who bully (p = .024), and talk with students who are bullied (p = .051). Other substantial percentile changes were also noted.

Conclusion: Findings suggest a significant positive impact of the OBPP on 7th grade females and teachers. Other grade and gender findings were inconsistent with previous literature. Recommendations for further research are provided along with implications for school health prevention programming.

Study Design: QE: time-lagged age-equivalent control group

Setting: US

Population of Focus: Not specified

Data Source: Not specified

Sample Size: Intervention (n=112); Control (n=158)

Age Range: NR

Intervention Components (click on component to see a list of all articles that use that intervention): School Rules,

Intervention Description: This study assessed the strength of a sample of school board and secondary school tobacco policies and examined the association with student smoking behaviours.

Intervention Results: The mean school board tobacco policy score was 13.7/40 and the mean secondary school tobacco policy score was 11.3/40. Students were significantly less likely to report current smoking (OR 0.95, 95% CI 0.91-0.99) and more likely to report a supportive school environment (OR 1.06, 95% CI 1.04-1.08) with each four-unit (i.e., 10%) increase in school tobacco policy score.

Conclusion: The vast majority of school board and secondary school tobacco policies were missing components and therefore could not be considered comprehensive. Stronger school tobacco policies may help to reduce student current smoking behaviours.

Study Design: Cross-sectional analysis of COMPASS study (longitudinal cohort of Canadian secondary school students over time)

Setting: 72 secondary schools in Ontario, 9 secondary schools in Albera, Canada

Population of Focus: Researchers, policymakers, and educators

Sample Size: 22696 students from 43 secondary schools and 21 school boards

Age Range: ages 14-18

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

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

Intervention Components (click on component to see a list of all articles that use that intervention): Class Rules, CLASSROOM_SCHOOL

Intervention Description: The objective of this trial was to investigate the impact, value for money and longer-term outcomes of the Good Behaviour Game.

Intervention Results: There was no evidence that the Good Behaviour Game improved any outcomes (hypothesis 1). The only significant subgroup moderator effect identified was contrary to expectations: at-risk boys in Good Behaviour Game schools reported higher rates of bullying (hypothesis 2). The moderating effect of the amount of time spent playing the Good Behaviour Game was unclear; in the context of both moderate (≥ 1030 minutes over 2 years) and high (≥ 1348 minutes over 2 years) intervention compliance, there were significant reductions in children’s psychological well-being, but also significant reductions in their school absence (hypothesis 3). The only medium-term intervention effect was for peer and social support at 24 months, but this was in a negative direction (hypothesis 4). After disaggregating within- and between-individual effects, we found no temporal within-individual associations between children’s mental health and their academic attainment (hypothesis 5). Last, our cost–consequences analysis indicated that the Good Behaviour Game does not provide value for money (hypothesis 6).

Conclusion: The Good Behaviour Game cannot be recommended based on the findings reported here.

Intervention Components (click on component to see a list of all articles that use that intervention): School Rules,

Intervention Description: This study assessed how a multidimensional STP, as perceived by students and staff, was associated with adolescent smoking over time in six European cities. STP stands for School Tobacco Policy, which refers to a set of regulations and guidelines implemented by schools to promote a smoke-free environment and reduce adolescent smoking. STPs typically include rules and regulations related to smoking on school premises, tobacco advertising, and the sale of tobacco products to minors.

Intervention Results: Greater STP enforcement, as perceived by students, was associated with lower odds of weekly smoking (OR:0.93, 95%CI:0.89-0.97) and of smoking on school premises (OR:0.80, 95%CI:0.72-0.90). Higher total STP scores were associated with lower odds of smoking on school premises (OR:0.76, 95%CI:0.67-0.86), but not of smoking just outside premises or smoking weekly. Greater increases in STP scores over time were associated with lower odds of smoking on school premises in 2016 (OR:0.65, 95%CI:0.47-0.89).

Conclusion: This study concluded that comprehensive, well-enforced school tobacco policies (STPs) can be effective in reducing adolescent smoking prevalence in school environments. The study's conclusions highlight the importance of STP enforcement, communication, and comprehensiveness in reducing adolescent smoking, and suggest that strengthening STPs may contribute to reducing adolescent smoking in school settings. The study also emphasizes the need for schools to adopt comprehensive policies that extend to the surroundings of their premises, indicating the potential benefits of extending STPs to school entrances and close surroundings to further reduce adolescent smoking visibility.

Study Design: Longitudinal observational design

Setting: 6 European cities (Specific locations not mentioned)

Population of Focus: Researchers, public health professionals, policymakers

Sample Size: 38 schools in 6 European countries

Age Range: ages 14-16

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

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

Intervention Components (click on component to see a list of all articles that use that intervention): Enforcement of School Rules, School Rules, Assessment,

Intervention Description: the study compares the proportions of provisional enrollment, medical and non-medical exemptions, and required vaccine receipt before and after the new regulations were implemented. Moving the vaccination requirement from 8 months to 5 days.

Intervention Results: The study found that after the reduced provisional period was introduced at the beginning of the 2017/18 school year, the statewide rate of provisional enrollment at kindergarten and seventh grade immediately decreased from 11.1% to 2.5% (a 77% relative decrease) 6 [Page 6]. The study also found that the percent of students entering kindergarten and seventh grade not up-to-date on vaccination decreased from 14.1% in 2016/17 to 6.1% in 2017/18 6 [Page 6]. Among kindergartners, following the provisional period reduction, there were increases in uptake of ≥2 doses of MMR (measles-mumps-rubella) vaccine and 2 doses of the Varicella vaccine. Among 7th graders, the largest improvements were seen for the first MCV (meningococcal vaccine) dose and first Tdap/TD (Tetanus and diphtheria) vaccine dose 6 [Page 6]. The study also found that the new regulations in Pennsylvania are accomplishing the goal of increasing the proportion of students who are up-to-date or in compliance with requirements for vaccines at the beginning of the school year without a significant increase in exemption rates 9 [Page 9].

Conclusion: The study concludes that the new regulations in Pennsylvania are accomplishing the goal of increasing the proportion of students who are up-to-date or in compliance with requirements for vaccines at the beginning of the school year without a significant increase in exemption rates 6 [Page 9]. The study also suggests that vaccination policies/regulations that focus on children who have started, but not completed, required vaccine series have shown to be an effective approach to increase vaccination rates at school entry 9 [Page 9]. However, the persistence of high provisional enrollment in some counties points to additional barriers to this goal in some schools and regions

Study Design: retrospective analysis of vaccination data collected from school districts in Pennsylvania from the 2014/15 school year through the 2017/18 school year for kindergartners and 7th graders

Setting: The study was conducted in Pennsylvania, United States.

Population of Focus: Researchers, scholars, healthcare professionals, and individuals with an interest in biomedical and health-related topics.

Sample Size: The study analyzed vaccination data reported to the Pennsylvania Department of Health for all students in kindergarten and seventh grade in the state during the 2016/17 and 2017/18 school years.

Age Range: 5/13/2024

Intervention Components (click on component to see a list of all articles that use that intervention): YOUTH, Adult-led Support/Counseling/Remediation, PARENT/FAMILY, CLASSROOM, Adult-led Curricular Activities/Training, Enforcement of School Rules, Notification/Information Materials (Online Resources, Information Guide), SCHOOL, Bullying Committee, Reporting & Response System, Teacher/Staff Training, School Rules, POPULATION-BASED SYSTEMS, COMMUNITY, Media Campaign (Print Materials, Radio, TV), Presentation

Intervention Description: The goal of this large population-based initiative was to reduce bullying by producing a quantifiable change in school climate using an established program and standardized measurement tool.

Intervention Results: After 1 to 2 years of program implementation, across cohorts, there were reductions in student self-reports of bullying others, and improvements in student perceptions of adults' responsiveness, and students' attitudes about bullying.

Conclusion: This initiative reaffirms the efficacy of the OBPP, emphasizes the importance of an identified coalition, and highlights several positive outcomes. It is recommended that the OBPP be implemented through the establishment of community partnerships and coalitions as consistent with the public health model.

Study Design: QE: pretest-posttest age-equivalent cohort

Setting: US

Population of Focus: Not specified

Data Source: Not specified

Sample Size: HALT! Schools Cohort 1: Middle school (n=0); High school (n=999) Cohort 2: Middle school (n=12972); High school (n=7436) PA CARES Schools: Middle school (n=9899); High School (n=6048)

Age Range: NR

Intervention Components (click on component to see a list of all articles that use that intervention): YOUTH, Adult-led Support/Counseling/Remediation, PARENT/FAMILY, Presentation/Meeting/Information Session/Event, CLASSROOM, Adult-led Curricular Activities/Training, Class Rules, SCHOOL, Teacher/Staff Meeting, Teacher/Staff Training, School Rules

Intervention Description: The purpose of the present study was to evaluate behavioural effectiveness of a school-based anti-bullying approach within Flemish schools. In addition, specific attention was given to the relationship between outcome findings and external support.

Intervention Results: The findings regarding the effects of the school-based anti-bullying intervention programme on the extent of bullying and victimisation showed a mixed pattern of positive changes in primary schools and zero outcomes in secondary schools. The findings regarding the effects of external support revealed limited outcomes.

Conclusion: The outcomes of the evaluation study confirm that a school-based anti-bullying intervention strategy can be effective in reducing problems with bullying, especially within primary schools. It was argued that the developmental characteristics of secondary school students interfered with the programme outcomes. In addition, the findings revealed no extra effects of specific training sessions.

Study Design: Cluster RCT: pretest-posttest

Setting: Belgium

Population of Focus: Not specified

Data Source: Not specified

Sample Size: Treatment with Support (n=284) Treatment without Support (n=277) Control (n=151)

Age Range: NR

Intervention Components (click on component to see a list of all articles that use that intervention): SCHOOL, School Rules, YOUTH, Adult-led Support/Counseling/Remediation, Reporting & Response System

Intervention Description: A tobacco prevention curriculum comprising social and health consequences of tobacco use and training in refusal skills was introduced. Smoking control policies for schools was encouraged. Children in intervention schools wrote letters to their fathers to ask them to quit smoking and monitored their smoking behavior. At baseline, 68.8% of father in the intervention group smoked and 65.6% of father in the control group smoked.

Intervention Results: At follow-up the scores of students in the intervention group were significantly higher than both the reference group follow-up scores and the intervention group baseline scores. The reported smoking rate for fathers in the intervention group decreased from 68.8% to 60.7% (p<0.05) while the reported rate remained approximately the same among fathers in the reference group. Approximately 90% of the father in the intervention group who were smokers reported to have quit smoking for at least 10 days. The 6-month cessation rate for fathers in the intervention group was 11.7% compared with 0.2% in the reference group.

Conclusion: The findings suggest that school-based tobacco use prevention curricula and policies are effective in increasing knowledge among students about the health consequences of tobacco use.

Study Design: Control trial

Setting: Community (school)

Population of Focus: Children in grades 1-7 from 23 primary schools and their fathers

Data Source: Self-reported questionnaires.

Sample Size: 20,382 children with 10,395 in the intervention group and 9987 in the control group

Age Range: Not specified