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Brown, E. C., Low, S., Smith, B. H., & Haggerty, K. P. (2011). Outcomes from a school randomized controlled trial of steps to respect: A bullying prevention program. School Psychology Review, 40(3), 423–443. Access Abstract

NPM: 7-1: Child Safety/Injury (0-9 years) 9: Bullying
Intervention Components (click on component to see a list of all articles that use that intervention): CLASSROOM, Adult-led Curricular Activities/Training, SCHOOL, Teacher/Staff Training, School Rules, Identification and Monitoring of/Increased Supervision in Targeted Areas
Intervention Description: Steps to Respect: A Bullying Prevention Program (STR) is a school-based prevention program that is aligned with the social-ecological model of bullying, which views youth behavior as shaped by multiple factors within nested contextual systems (Committee for Children, 2001). The program targets multiple areas of the school environment through intervention components directed at the school, peer, and individual levels (Swearer, Espelage, Vaillancourt, & Hymel, 2010). Schoolwide components are intended to foster a positive school climate and positive norms through teacher and staff training focused on the creation of effective disciplinary policies, improved monitoring of students, and instruction on how to effectively intervene with students involved in bullying situations. Classroom curricula target the upper three elementary grades and are intended to promote socially responsible norms and behavior and increase social-emotional skills. Lessons help students recognize bullying, increase empathy for students that are bullied, build friendship skills to increase protective social connections, improve assertiveness and communication skills to help students deter and report bullying, and teach appropriate bystander responses to bullying. The underlying theory of the STR program is that peer attitudes, norms, and behaviors play an important role in determining and maintaining rates of bullying behavior. Because bullying is a social process strongly influenced by the reactions and behaviors of peers (Atlas & Pepler, 1998), the program seeks to change attitudes about the acceptability of bullying through clearly labeling bullying behavior as unfair and wrong, increasing empathy for students who are bullied, and educating students about their responsibilities as bystanders to bullying. Figure 1 illustrates the social-ecological nature of the program’s theory of change, with intervention components at the individual, peer, and school levels. As shown in this figure, the program is designed to reduce bullying in part through decreasing peer reinforcement of bullying behavior through increased positive bystander behaviors such as ignoring bullying, supporting students who are bullied, intervening to stop bullying incidents, and reporting bullying to school staff.
Conclusion: Results of this study demonstrated significant intervention effects for the prevention of school bullying on 50% of all outcomes examined across the three sources of data. Moreover, intervention effects were found for both proximal and distal outcomes. Following Cohen’s (1988) guidelines for interpreting the magnitude of standardized between-group differences, most observed intervention effect sizes were relatively small (i.e., less than 0.3); however, effects of this magnitude are not unexpected given the short duration (i.e., 1 year) of the study. Long-term follow-up of students in a multiyear longitudinal study, with full dosage and exposure of students to the intervention, might show larger effect sizes (see, for example Frey, Hirschstein, Edstrom, & Snell, 2009). Moreover, increases in normative classroom aggression and related bullying behaviors have been noted during the school year (Frey et al., 2005) and it is important to contextualize intervention effects in light of this normative escalation. Nonetheless, the small effect sizes reported in this study may be seen as a limitation to the practical significance of study findings. Bullying Prevention Outcomes 439 Additional effects of model covariates indicated differences in mean levels of bullying-related behaviors across gender, racial/ ethnic, and age groups. Although not central to aims of the current study, these differences are interesting and support existing literature on the characteristics of students that are associated with bullying. For example, higher rates of bullying perpetration and bullying-related problems among African American, Hispanic, and other minority students are consistent with Graham and Juvonen’s (2002) findings of minority ethnic group differences on aggressive behavior. Higher rates of bullying perpetration found for male students are consistent with Espelage et al. (2004), Nansel et al. (2001), and Seals and Young (2003). Future studies of school bullying prevention program effectiveness should take these differences into consideration and statistically control for them in outcome analyses. In addition to intervention and covariate effects, our results include estimates of intraclass correlations of classroom and school variability to help researchers plan future school-randomized trials of bullying prevention programs. Observed intraclass correlation coefficients indicated that appreciable levels of variation in staff and teacher reported outcomes exist at both classroom and school levels. This suggests that both the classroom and the entire school building are viable, perhaps even necessary, environments for preventive intervention. Consistent with the STR program’s theory of change, we found significant intervention effects on outcome measures from multiple domains of the school environment, including school, peer, and individual student domains. For example, among proximal outcomes, effects on bullying prevention efficacy in the school domain were found in School Antibullying Policies and Strategies (from the SES), and in Teacher/Staff Bullying Prevention and Teacher/Staff Bullying Intervention measures (Student Survey); effects among peers were found in Positive Bystander Behaviors (Student Survey) and Student Bullying Intervention (SES and Student Surveys); and effects among students were found in Social Competency (TASB). Among distal outcomes, intervention efficacy in the school domain was found in School Bullying-Related Problems and Staff Climate (SES measures); and in the student domain for Student Climate (SES and Student Surveys) and Physical Bullying Perpetration (TASB).
Study Design: RCT
Setting: Elementary schools
Target Audience: Students in 3rd–5th grade in 33 California elementary schools
Data Source: Questionnaires responded to by teachers, administrators, and all other support staff. Questionnaires by students.
Sample Size: 2,940 students (17 schools in intervention; 16 schools in control)
Age Range: Not specified

Cross, D., Waters, S., Pearce, N., Shaw, T., Hall, M., Erceg, E., et al. (2012). The Friendly Schools Friendly Families programme: Three-year bullying behaviour outcomes in primary school children. International Journal of Educational Research, 53, 394–406. Access Abstract

NPM: 7-1: Child Safety/Injury (0-9 years) 9: Bullying
Intervention Components (click on component to see a list of all articles that use that intervention): CLASSROOM, Adult-led Curricular Activities/Training, SCHOOL, School Rules, Teacher/Staff Training, PARENT/FAMILY, Training (Parent/Family), Notification/Information Materials (Online Resources, Information Guide), PATIENT/CONSUMER, Educational Material, Motivational Interviewing, Other Education
Intervention Description: The FSFF trial was guided by the conceptual framework (Fig. 1) that addressed the larger social context of a student’s life using a whole-school, system-based approach. The framework suggests ecological, cognitive and psychosocial risk and protective factors that are potentially amenable to change, and that can be regulated or mediated at the school, classroom, family and/or individual levels to reduce bullying. Both the FSFF high and moderate study conditions comprised four levels of intervention; whole-school, classroom, family and individual. Table 1 Friendly Schools Friendly Families study design. Condition Baseline Grades 2, 4 and 6 (March 2002) Intervention 2002 Posttest 1 Grades 2, 4 and 6 (November 2002) Intervention 2003 Posttest 2 Grades 3, 5 and 7 (October 2003) School maintenance of intervention Posttest 3 Grades 4, 6a (October 2004) High O1 X1 O2 X2 O3 X6 O4 Moderate O1 X3 O2 X4 O3 X7 O4 Low O1 X5 O2 X5 O3 X1,2 O4 O1–4 = data collection; X1,2 = high capacity intervention – (whole-school, capacity building and active parent involvement); X3,4 = moderate capacity intervention – (whole-school and capacity building); X5 = low capacity intervention – (standard school programme, brief whole-school intervention and no capacity building support or active parent involvement); X6,7 = high and moderate intervention schools’ maintenance respectively, of the FSFF intervention in follow-up year. a The baseline Grade 6 cohort had moved to secondary school prior to posttest 3 and hence was not assessed. D. Cross et al. / International Journal of Educational Research 53 (2012) 394–406 397 1. The whole-school level activities aimed to: (a) build a positive social climate, positive relations and connectedness between students, school staff and parents; (b) provide effective policies and common understandings and practices to prevent and effectively manage and reduce current bullying; and (c) build school capacity support for implementation through assessment of organizational structures, resources, skills and commitment levels. These outcomes were addressed using detailed whole-school support materials and assessment tools and staff training that suggested modifications to the school’s social, organizational and physical environment (e.g., enhancing supervision levels, availability of student activities during break times, tracking bullying ‘hotspots’) and through the involvement of students’ families. 2. Developmentally appropriate classroom level activities targeted all grade levels from 1 (5–6-year olds) to 7 (12–13-year olds). The activities were designed to complement students’ other social and emotional learning. As used by Olweus (1991), the classroom learning focused on the reciprocal relationship between students who observe bullying, those who are bullied or bully others and their social environment. The learning activities developed common understandings about the nature of bullying, its effects and how it can be discouraged whilst also addressing empathy and social skill building. The activities helped teachers to enhance the positive interactions they have with students using role play, stories, role modelling, skills training and observational learning. All high and moderate intervention schools participated in a 2-h, whole-staff, in-school training to consolidate common understandings about ways to systemically prevent and manage bullying and develop students’ social skills, and their role in teaching the learning activities. 3. The family level activities worked in partnership with parents by building their awareness, attitudes and self-efficacy to role model and help their children to develop social competence and to prevent or respond to bullying. These activities also encouraged school and parent communication and parents’ engagement with the school to reduce student bullying. 4. The individual level activities included selective and indicated activities to support victimized students; to help modify the behaviour of students who bully others; and to facilitate school links with local health professionals with specialist skills. Key school staff were trained to use problem-solving, restorative approaches to prevent and manage bullying incidents, including the Method of Shared Concern (Pikas, 2002).
Conclusion: Notwithstanding these limitations, this research adds to the growing evidence for policy-makers and practitioners that carefully designed whole-school (universal) interventions appear to be able to reduce student bullying victimization and perpetration. It also suggests that interventions that target students in their social context, including their home and school, are more likely to produce positive change than classroom-only approaches. Few previous anti-bullying studies, as reported by Smith et al. (2004), have allowed for comparison of intervention and control conditions for self-reported bullying, and only a few have achieved the effect sizes found in this study. In particular, the Smith et al. (2004) review of 14 school antibullying programmes indicates that, unlike this current study, not one of the eight controlled studies reviewed found significant effects for the behavioural outcome ‘bullying others’. The results of this study suggest to practitioners that positive changes in 9–12-year-old students’ experiences with bullying behaviour (including frequent perpetration and victimization) can be achieved through implementation of a wholeschool programme that includes capacity building and active parent involvement, and that whole-school action to mitigate bullying needs to begin prior to Grade 6, and requires at least two years of implementation to achieve behaviour change. Understanding the social contexts and settings in which young people bully, through the different stages of their development in primary school, is important for practitioners to develop targeted interventions to discourage and ameliorate the effects of bullying. This study followed three cohorts of Grades 2, 4 and 6 students to determine which age groups would benefit developmentally the most, from this whole-school approach. Whilst only the effects of the intervention on the Grades 4 and 6 cohort have been examined in this paper, it seems clear to policy makers that prevention efforts need to begin in schools well before Grade 6 when these behaviours may become more established and reputations are harder to change (Hymel, Wagner, & Butler, 1990). Further research is needed however, to determine the boundary conditions around the effectiveness of the FSFF intervention on different sub-populations and its sensitivity to the developmental needs of students. Through its three treatment group design the FSFF study attempted to determine the relative contribution of capacity building for more targeted parental engagement over and above that typically provided in a comprehensive whole-school programme to reduce bullying. Whereas the reported family implementation of this programme was relatively low, the results from this study concur with Stevens, Bourdeaudhuij, and Van Oost (2001) that bullying prevention programmes do appear to benefit from more intensive efforts within the home environment and increased attention to parental involvement. Further, Ttofi and Farrington’s (2009) meta-analyses of the key elements of anti-bullying programmes highlighted the importance of parent training and informing parents. Whilst this current study focussed on actively informing parents about bullying through and with their children, limited training was provided for parents. Given the possible impact of parent engagement in this study, it may be important for policy makers and practitioners to additionally provide training opportunities for parents, especially in areas such as cyberbullying, to enhance the outcomes achieved in this study. Further research is needed, however, to more fully understand the mechanisms that explain the differences found in this study, and how to increase and sustain the involvement of parents in programmes to reduce school bullying.
Study Design: Group RCT/ Controlled experimental design and random assignment.
Setting: Schools
Target Audience: Students in Grade 4 and Grade 6
Data Source: Students' self-reports; peer nomination reports; teacher and parent reports.
Sample Size: Students from 20 schools. 1,334 students in the high intervention; 1,109 students in the moderate intervention; 1,454 students in the low intervention.
Age Range: Not specified

Frey, K. S., Hirschstein, M. K., Edstrom, L. V., & Snell, J. L. (2009). Observed reductions on school bullying, nonbullying aggression, and destructive bystander behavior: A longitudinal evaluation. Journal of Educational Psychology, 101, 466–481. Access Abstract

NPM: 7-1: Child Safety/Injury (0-9 years) 9: Bullying
Intervention Components (click on component to see a list of all articles that use that intervention): CLASSROOM, Adult-led Curricular Activities/Training, SCHOOL, Teacher/Staff Training, Teacher/Staff Meeting, CAREGIVER, Outreach (caregiver), YOUTH, Adult-led Support/Counseling/Remediation, School Rules, Reporting & Response System, Media Campaign (Print Materials, Public Address System, Social Media)
Study Design: Longitudinal study/ Extension of an RCT
Setting: Elementary schools
Target Audience: Students in grades 3–5
Data Source: Surveys by students and teachers, observations on playgrounds.
Sample Size: 624 students (225 students in intervention; 399 students delayed intervention)
Age Range: Not specified

Jenson, J. M., Dieterich, W. A., Brisson, D., Bender, K. A., & Powell, A. (2010). Preventing childhood bullying: Findings and lessons from the Denver Public Schools trial. Research on Social Work Practice, 20, 509–517. Access Abstract

NPM: 7-1: Child Safety/Injury (0-9 years) 9: Bullying
Intervention Components (click on component to see a list of all articles that use that intervention): CLASSROOM, Adult-led Curricular Activities/Training
Intervention Description: Twelve-month follow-up outcomes from a group-randomized trial (GRT) of a classroom curriculum aimed at preventing bullying and victimization among elementary students in the Denver, Colorado, public school system are presented. Twenty-eight elementary schools were randomly assigned to receive selected modules of Youth Matters (YM), a skills-training curriculum that targets bullying and victimization, or to a no-treatment control group. Linear growth models were fitted to five waves of data collected over 3 years to test the effect of the intervention on the rate of change in self-reported bullying and victimization.
Study Design: Group RCT
Setting: Elementary schools
Target Audience: Students from 28 elementary schools in Denver
Data Source: Student data were collected through classroom surveys conducted in the fall and spring semesters of each academic year.
Sample Size: 876 students (438 from 14 schools in intervention; 438 from 14 schools in control)
Age Range: Not specified

Krueger, L. M. (2010). The implementation of an anti-bullying program to reduce bullying behaviors on elementary school buses. (Doctoral dissertation, Available from the ProQuest Dissertation and Theses database.) Access Abstract

NPM: 7-1: Child Safety/Injury (0-9 years) 9: Bullying
Intervention Components (click on component to see a list of all articles that use that intervention): CLASSROOM, Presentation/meeting/information Session (Classroom), Adult-led Curricular Activities/Training, SCHOOL, Identification and Monitoring of/Increased Supervision in Targeted Areas, PATIENT/CONSUMER, Online Material/Education/Blogging
Intervention Description: This study investigated the effectiveness of an anti-bullying program developed using components of the Take a Stand, Lend a Hand: Stop Bullying Now! resource kit in reducing bullying behaviors on elementary school buses. Video cameras mounted on the interior of the school bus, were utilized to monitor student behavior and thereby determine the effectiveness of the intervention in reducing bullying behavior.
Conclusion: While the results indicated a significant reduction in bullying behaviors for both the control and the experiment group, the reduction was greater for students who participated in the anti-bullying program.
Study Design: RCT
Setting: Elementary schools
Target Audience: Elementary students Grades K–5 in one school who rode the school bus
Data Source: Video recorded student interactions on the school bus.
Sample Size: 47 students
Age Range: Not specified

Roland, E., Bru, E., Midthassel, U. V., & Vaaland, G. S. (2010). The Zero programme against bullying: Effects of the programme in the context of the Norwegian manifesto against bullying. Social Psychology of Education, 13, 41–55. Access Abstract

NPM: 7-1: Child Safety/Injury (0-9 years) 9: Bullying
Intervention Components (click on component to see a list of all articles that use that intervention): CLASSROOM, Adult-led Curricular Activities/Training, YOUTH, Adult-led Support/Counseling/Remediation, CAREGIVER, Outreach (caregiver), SCHOOL, Identification and Monitoring of/Increased Supervision in Targeted Areas
Intervention Description: ‘Zero’ is a programme aimed at reducing bullying in school, which was developed by the Centre for Behavioural Research at the University of Stavanger, Norway. The principle of zero-tolerance of bullying gave the name to the programme. This programme was part of the Norwegian Manifesto Against Bullying that was launched in 2002 by the Government and important stakeholders. The programme starts in May/June and ends in September, approximately 1 year and 4 months later. The implementation strategy draws on a solid body of experience from several countries acknowledging schools’ local contexts and internal processes to change and learning within the organisation (Fullan 2001; Hatton 2001; Marks and Seashore Louis 1999; Perry 2000). Zero thus tries to merge a moderate top-down profile where content is of concern with a moderate bottom-up approach for putting the programme into practice. Involvement of staff, pupils and parents is central to the successful implementation. A project group at each school manages the implementation process. This group consists of the principal, leading teachers, parents and pupils, in accordance with the system’s approach. Each school participating in the Zero programme is organised into a group of three to five schools. The project groups from these schools meet five times during the programme period at seminars organised and led by a trained Zero professional. In addition, all the teachers attend a one-day in-service course on bullying. Besides this, the schools are offered assistance by email or telephone from a Zero professional during the programme period. The programme also contains written material for reference. A teacher’s book (Roland and Vaaland 2003) is essential. The book emphasises measures to prevent or stop bullying, building relationships with and between pupils and parents and cooperation between teachers, parents, pupils and the school administration. A workbook for the pupils’ council, materials for parents’ meetings and a booklet for parents as well as the template for the action plan all form parts of the programme. In addition, a film is available to schools, which demonstrates the methods to stop bullying.
Conclusion: The present study shows that bullying was reduced among pupils in the schools participating in the Zero programme. Moreover, National surveys in spring 2001 and spring 2004 showed a reduction in pupils being victimised in Norway over 3 years. The high profiled national Manifesto Against Bullying started officially in September 2002 and the first period lasted 2 years. The majority of the schools comprising the 2004 national sample reported a substantial increase in anti-bullying work compared to the three-year period before 2001. Interactions between national concern and programme effect are discussed.
Study Design: RCT
Setting: Primary schools
Target Audience: Students in Norwegian primary schools
Data Source: Student surveys/questionnaires
Sample Size: 20,466 students from 146 Norwegian primary schools
Age Range: Not specified

Sapouna, M., Wolke, D., Vannini, N., Watson, S., Woods, S., Schneider, W., et al. (2010). Virtual learning intervention to reduce bullying victimization in primary school: A controlled trial. Journal of Child Psychology and Psychiatry, 51(1), 104–112. Access Abstract

NPM: 7-1: Child Safety/Injury (0-9 years) 9: Bullying
Intervention Components (click on component to see a list of all articles that use that intervention): CLASSROOM, Adult-led Curricular Activities/Training
Intervention Description: One thousand, one hundred twenty-nine children (mean age 8.9 years) in 27 primary schools across the UK and Germany were assigned to the FearNot! intervention or the waiting control condition. The program consisted of three sessions, each lasting approximately 30 minutes over a three-week period. The participants were assessed on self-report measures of victimization before and one and four weeks after the intervention or the normal curriculum period.
Conclusion: Conclusions: A virtual learning intervention designed to help children experience effective strategies for dealing with bullying had a short-term effect on escaping victimization for a priori identified victims, and a short-term overall prevention effect for UK children. Keywords: Anti-bullying intervention, victimization, virtual learning, controlled trial. Abbreviation: FearNot!: Fun with Empathic Agents to achieve Novel Outcomes in Teaching.
Study Design: Quasi-experimental
Setting: Primary schools
Target Audience: School children from 27 primary schools in the UK and Germany
Data Source: The participants were assessed on self-report measures of victimization.
Sample Size: 1,129 school children (455 intervention, 487 control)
Age Range: Not specified

Waasdorp, T. E., Bradshaw, C. P., & Leaf, P. J. (2012). The impact of schoolwide positive behavioral interventions and supports on bullying and peer rejection. Archives of Pediatric and Adolescent Medicine, 166(2), 149–156. Access Abstract

NPM: 7-1: Child Safety/Injury (0-9 years) 9: Bullying
Intervention Components (click on component to see a list of all articles that use that intervention): SCHOOL, Reporting & Response System, School Rules, CLASSROOM, Class Rules, Enforcement of School Rules, Identification and Monitoring of/Increased Supervision in Targeted Areas, Media Campaign (Print Materials, Public Address System, Social Media)
Intervention Description: Participants Data involved 12 344 children (52.9% male, 45.1% African American, 46.1% white) followed up longitudinally across 4 school years. Intervention A randomized controlled effectiveness trial of SWPBIS. Outcome Measures Reports from teachers on bully-related behaviors were assessed through the Teacher Observation of Classroom Adaptation–Checklist.
Conclusion: The results indicated that SWPBIS has a significant effect on teachers' reports of children's involvement in bullying as victims and perpetrators. The findings were considered in light of other outcomes for students, staff, and the school environment, and they suggest that SWPBIS may help address the increasing national concerns related to school bullying by improving school climate.
Study Design: Longitudinal study/Randomized controlled effectiveness trial
Setting: Elementary schools
Target Audience: Students from 37 public elementary schools in Maryland
Data Source: Reports from teachers on bullyingrelated behaviors were assessed through the Teacher Observation of Classroom Adaptation–Checklist (TOCA-C).
Sample Size: 12,334 children (6,614 students from 21 schools in the intervention; 51,24 students from 16 schools in control)
Age Range: Not specified

Williford, A., Boulton, A., Noland, B., Little, T. D., Karna, A., & Salmivalli, C. (2012). Effects of the KiVa anti-bullying program on adolescents' depression, anxiety, and perception of peers. Journal of Abnormal Child Psychology, 40, 289–300. Access Abstract

NPM: 7-1: Child Safety/Injury (0-9 years) 9: Bullying
Intervention Components (click on component to see a list of all articles that use that intervention): CLASSROOM, Adult-led Curricular Activities/Training, YOUTH, Adult-led Support/Counseling/Remediation
Intervention Description: In the fall of 2006, letters describing KiVa were sent to 3,418 schools in Finland. The letter included information about the objectives of KiVa and an enrollment form. A total of 275 schools enrolled in the study, and 78 of them were stratified by province and language, and then randomly assigned to the intervention or control condition. Of these 78 schools, 429 classrooms from grades 3–5 (grades 4–6 during the implementation of KiVa) were included. A consent form was sent to parents of students in the participating schools. Excluding those who were not consented, the final sample size for the analyses was 7,741 students (3,685 in the control condition and 4,056 in the intervention condition). Of the respondents, 50.6% were girls and 49.4% were boys; the average age was 11.2 years (SD = 0.90). Most students were native Finns (i.e. Caucasian), with the proportion of immigrants being 2.1%. Data were collected at three separate time points over the course of two academic years: in May 2007, December 2007/January 2008, and May 2008. At each wave of data collection, teachers administered online questionnaires to students during regular school hours. Teachers were provided with instructions for questionnaire administration approximately 2 weeks prior to data collection. Students completed the questionnaire during school hours in each school’s computer lab. A definition of bullying as defined in Olweus’s (1996) bully/victim questionnaire was provided at the beginning of the survey. Scale and item order were randomized to prevent any order effects (See Salmivalli et al. 2010 and Kärnä et al. 2011 for details on protocols).
Conclusion: Overall, students in KiVa evidenced more positive outcomes over time as compared to controls. Therefore, these findings suggest that KiVa was able to retard negative developmental changes associated with bullying such as increases in distrust of their peers. Additionally, positive developmental change observed in both study conditions (reductions in anxiety) was accelerated for students receiving KiVa.
Study Design: Longitudinal study/ RCT
Setting: Schools
Target Audience: School children in Finland
Data Source: Online questionnaires filled out by students.
Sample Size: 429 classrooms of Grade 4–6 students
Age Range: Not specified

Ahlers-Schmidt, C. R., Schunn, C., Dempsy, M., & Blackon, S. (2014-A). Evaluation of community baby showers to promote safe sleep. Kansas Journal of Medicine, 7, 1–5. Access Abstract

NPM: 7-1: Child Safety/Injury (0-9 years) 5: Safe Sleep
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), Training (Parent/Family), CAREGIVER, Education/Training (caregiver), Educational Material (caregiver), Provision of Safe Sleep Item
Intervention Description: The purpose was to describe participants’ knowledge and intentions regarding safe sleep following a Community Baby Shower.
Conclusion: Our Baby Showers were attended by the target audience, who exhibited high levels of safe sleep knowledge, and stated intentions to utilize most safe sleep recommendations following the Shower. However, some participants were resistant to following at least some of the recommendations. Additional venues and other educational strategies may be needed to maximize the uptake of these recommendations.
Study Design: Survey following Baby Shower
Setting: Community Baby Showers
Target Audience: 60% AA women
Data Source: Survey
Sample Size: 364 participants
Age Range: Infant

Ahlers-Schmidt, C. R., Kuhlmann, S., Kuchlmann, Z., Schunn, C., & Rosell, J. (2014-B). To improve safe-sleep practices, more emphasis should be placed on removing unsafe items from the crib. Clinical Pediatrics, 53(13), 1285–1287. Access Abstract

NPM: 7-1: Child Safety/Injury (0-9 years) 5: Safe Sleep
Intervention Components (click on component to see a list of all articles that use that intervention): PROVIDER/PRACTICE, Provider Training/Education, Educational Material (Provider)
Intervention Description: A Safe Sleep Toolkit was developed to improve consistency in safe sleep communication between health providers and parents. The toolkit was implemented at two resident physician clinics, obstetric and pediatric, and included: 1) parent checklist regarding sleep position, location, environment, and intentions to share information; 2) a brief health care provider script; and 3) nationally available resources.
Study Design: Completion of checklist at clinic visit
Setting: Obstetric and pediatric clinics
Target Audience: Expectant and new parents
Data Source: Checklist
Sample Size: 309 parents
Age Range: Infant

Ahlers-Schmidt, C. R., Schunn, C., Nguyen, M., Nimeskern Miller, J., Rabea Ilahe, R., & Kuhlmann, S. (2015). Does providing infant caregivers with a wearable blanket increase safe sleep practices? A randomized controlled trial. Clinical Pediatrics. doi:10.1177/0009922815572077. Access Abstract

NPM: 7-1: Child Safety/Injury (0-9 years) 5: Safe Sleep
Intervention Components (click on component to see a list of all articles that use that intervention): PARENT/FAMILY, Presentation/Meeting/Information Session/Event, CAREGIVER, Provision of Safe Sleep Item
Intervention Description: The purpose of this study was to test the effectiveness of a wearable blanket versus a control item to increase safe sleep practices among parents at a pediatric resident clinic.
Study Design: RCT
Setting: Pediatric continuity clinic that serves mostly state-insured patients.
Target Audience: Parents of infants
Data Source: Survey at baseline and 2-month clinic visit
Sample Size: 152 participants
Age Range: Infant

Canter, J., Rao, V., Patrick, P. A., Alpan, G., & Altman, R. L. (2015). The impact of a hospital-based educational video on maternal perceptions and planned practices of infant safe sleep. Journal for Specialists in Pediatric Nursing. doi:10.1111/jspn. 12114. Access Abstract

NPM: 7-1: Child Safety/Injury (0-9 years) 5: Safe Sleep
Intervention Components (click on component to see a list of all articles that use that intervention): PARENT/FAMILY, Presentation/Meeting/Information Session/Event, Notification/Information Materials (Online Resources, Information Guide)
Intervention Description: To evaluate whether an educational video would impact infant sleep practices among new mothers.
Conclusion: Given the potentially fatal consequence of unsafe sleep, a brief video provided by nursing staff can be a prudent component of new parent education.
Study Design: Before-and-after study design (with historical and concurrent controls and a 2-month prospective intervention)
Setting: Maternity ward
Target Audience: Parents of newborns
Data Source: Self-administered survey
Sample Size: Intervention n=43 Control n=49
Age Range: Infant

Goodstein, M. H., Bell, T., & Krugman, S. D. (2015). Improving infant sleep safety through a comprehensive hospital-based program. Clinical Pediatrics, 54(3), 212–221. Access Abstract

NPM: 7-1: Child Safety/Injury (0-9 years) 5: Safe Sleep
Intervention Components (click on component to see a list of all articles that use that intervention): HOSPITAL, PARENT/FAMILY, Notification/Information Materials (Online Resources, Information Guide), Training (Parent/Family), CAREGIVER, Education/Training (caregiver), Educational Material (caregiver), Sleep Environment Modification, PROVIDER/PRACTICE, Provider Training/Education, Educational Material (Provider), Nurse/Nurse Practitioner, Guideline Change and Implementation
Intervention Description: We evaluated a comprehensive hospital-based infant safe sleep education program on parental education and safe sleep behaviors in the home using a cross-sectional survey of new parents at hospital discharge (HD) and 4-month follow-up (F/U).
Conclusion: Reinforcing the infant sleep safety message through intensive hospital-based education improves parental compliance with sudden infant death syndrome risk reduction guidelines.
Study Design: Quasi-experimental nonequivalent control group design
Setting: Hospital, postpartum maternity units
Target Audience: Nurses + New parents
Data Source: Cross-sectional survey of parents at time of hospital discharge and at 4-month well-child visit
Sample Size: 1,092 in hospital sample 490 at 4-month follow-up
Age Range: Infant

Mason, B., Ahlers-Schmidt, C. R., & Schunn, C. (2013). Improving safe sleep environments for well newborns in the hospital setting. Clinical Pediatrics, 52(10), 969–975. Access Abstract

NPM: 7-1: Child Safety/Injury (0-9 years) 5: Safe Sleep
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), PROVIDER/PRACTICE, Nurse/Nurse Practitioner, Provider Training/Education, Educational Material (Provider)
Intervention Description: The purpose of this study was to improve sleep position and environment in the hospital.
Conclusion: Using a multifaceted approach significantly improved infant safe sleep practice in the hospital setting.
Study Design: Pre-post intervention
Setting: Wesley Medical Center postpartum units
Target Audience: Nursing staff and mothers of infants
Data Source: Observation of sleep environment in hospital; follow-up parent survey
Sample Size: Baseline in hospital n=144 Post-intervention in hospital n=249 Parent survey n=101
Age Range: Infant

Shaefer, S. J., Herman, S. E., Frank, S. J., Adkins, M., & Terhaar, M. (2010). Translating infant safe sleep evidence into nursing practice. Journal of Obstetric, Gynecologic, and Neonatal Nursing, 39(6), 618–626. Access Abstract

NPM: 7-1: Child Safety/Injury (0-9 years) 5: Safe Sleep
Intervention Components (click on component to see a list of all articles that use that intervention): PROVIDER/PRACTICE, CAREGIVER, Educational Material (caregiver), Provider Training/Education, Nurse/Nurse Practitioner, HOSPITAL, Quality Improvement, Policy/Guideline (Hospital)
Intervention Description: The authors describe a 4-year demonstration project (2004-2007) to reduce infant deaths related to sleep environments by changing attitudes and practices among nurses who work with African American parents and caregivers in urban Michigan hospitals.
Conclusion: Following the policy change effort, nurses changed their behavior and placed infants on the back to sleep.
Study Design: QE: pretest-posttest
Setting: 7 maternity wards in urban hospitals in MI
Target Audience: Nursing staff and parents
Data Source: Crib audit; infant observation
Sample Size: Baseline: n=579 Follow-up: n=692
Age Range: Infant

Voos, K. C., Terreros, A., Larimore, P., Leick-Rude, M. K., & Park, N. (2015). Implementing safe sleep practices in a neonatal intensive care unit. The Journal of Maternal-Fetal Neonatal Medicine. Doi:10.3109/14767058.2014.964679. Access Abstract

NPM: 7-1: Child Safety/Injury (0-9 years) 5: Safe Sleep
Intervention Components (click on component to see a list of all articles that use that intervention): HOSPITAL, Policy/Guideline (Hospital), Quality Improvement, Continuing Education of Hospital Providers, Sleep Environment Modification, PROVIDER/PRACTICE, Nurse/Nurse Practitioner, Provider Training/Education, CAREGIVER, Educational Material (caregiver)
Intervention Description: The dual aims of this project were to develop a safe sleep educational model for our neonatal intensive care unit (NICU), and to increase the percentage of eligible infants in a safe sleep environment.
Conclusion: With formal staff and family education, optional wearable blanket, and data sharing, safe sleep compliance increased and patient safety improved.
Study Design: QE: pretest-posttest
Setting: NICU
Target Audience: Neonatal nurses; staff Parents of newborns
Data Source: Crib audit/infant observation
Sample Size: 28 families at baseline 26 families at follow-up
Age Range: Infant

Bulzacchelli MT, Gielen AC, Shields WC, McDonald EM, Frattaroli S. (2009) Parental safety-related knowledge and practices associated with visiting a mobile safety center in a low income urban population. Family and Community Health 2009;32(2):147–58. Access Abstract

NPM: 7-1: Child Safety/Injury (0-9 years)
Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Educational Material, Community-Based Group Education, COMMUNITY, Community Events, Outreach, Presentation, Visual Display (Community), Visual Display (Hospital), Distribution of Promotional Items (Classroom/School), Distribution of Promotional Items (Community)
Intervention Description: A mobile safety center (MSC) provided education and reduced-cost safety products to low-income urban families. We evaluated uptake of this service under 3 different conditions, and safety-related knowledge and behavior associated with visiting the MSC among 210 families.
Conclusion: This study provides very modest evidence of a positive impact of the MSC when its services are provided at a community health center.
Study Design: Quasiexperimental
Setting: Community (well child clinics)
Target Audience: Parent or guardian of child between 1 month and 7 years of age visiting a pediatric clinic at a community health center serving low-income urban families for a well-child appointment; English speaking; not having previously visited the MSC
Data Source: Baseline assessment on participants' current injury prevention behaviors; follow-up assessment on perceptions regarding the injury prevention information they received, a 9-item scale assessing the persuasiveness of the intervention materials; and a brief telephone survey re: experience with and reactions to the intervention
Sample Size: Visitors to clinic on M/W/F when the mobile van was present: group 1 (96) (prescribed) were escorted to the van after their appointment; group 2 (98) (optional) were given a flyer and encouraged to visit but not escorted to it
Age Range: 1 month - 7 years

Hendrickson, S. G., Williams, J., & Acee, T. W. (2008). Immigrant Hispanic mothers’ participation in a dual-site safety intervention. Hispanic Health Care International, 6(2), 71–79. Access Abstract

NPM: 7-1: Child Safety/Injury (0-9 years)
Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Home Visits, CAREGIVER, Home Visit (caregiver), PARENT/FAMILY, Notification/Information Materials (Online Resources, Information Guide), Training (Parent/Family), PROVIDER/PRACTICE, Community Health Workers (CHWs), Educational Material, Other Person-to-Person Education
Intervention Description: Improving the health of children is an international goal (UNICEF, 2007). Barriers to the achievement of this goal are still documented in poor and underserved communities (Collins, 2006). This exploratory intervention study sought to better understand pediatric home injury risk in immigrant Hispanic families in Texas and New Mexico.
Conclusion: Policy implications impact immigrants in ways communities must investigate and assess.
Study Design: Experimental
Setting: Community (home visits)
Target Audience: Spanish-speaking mothers of children aged 1-4 years, at or below poverty level
Data Source: Self-reporting questionnaires; observations; checklists of home hazards
Sample Size: 30 intervention; 30 comparison group
Age Range: 1-4 years of age

Kendrick D., Mulvaney C., Watson M. (2009b). Does targeting injury prevention towards families in disadvantaged areas reduce inequalities in safety practices?, Health Education Research. 24:32-41. Access Abstract

NPM: 7-1: Child Safety/Injury (0-9 years)
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), Consultation (Parent/Family), CAREGIVER, Education/Training (caregiver), Educational Material (caregiver), Assessment (caregiver)
Intervention Description: This study examines the effect of a home safety intervention on reducing inequalities in safety practices using a secondary analysis of data from a randomized controlled trial.
Conclusion: Other strategies will be required to reduce inequalities especially in relation to functioning smoke alarms.
Study Design: RCT
Setting: Community (home visits)
Target Audience: Families with children less than five years of age, living in deprived areas in Nottingham
Data Source: Questionnaires
Sample Size: 1000 (988) intervention; 1000 (980) control
Age Range: Under 5 years of age

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This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number U02MC31613, MCH Advanced Education Policy, $3.5 M. 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.