Preventing Peer Violence Against Children: Methods and Baseline Data of a Cluster Randomized Controlled Trial in
Judith McFarlane1, Rozina Karmaliani2, Hussain Maqbool Ahmed Khuwaja2
1Texas Woman's University College of Nursing, Houston, Texas, USA. jmcfarlane@twu.edu.
Insights
Peer violence is a global issue affecting youth. A school-based play intervention in Pakistan aims to reduce violence and improve mental health among children, with high rates of victimization and perpetration observed at baseline.
Area of Science:
- Public Health
- Child Development
- Mental Health Research
Background:
- Violence against children is a global public health concern impacting development, education, and health.
- Youth violence is linked to increased morbidity, mortality, and perpetration of violence against women later in life.
- This study addresses the need for evidence-based interventions to mitigate youth violence and its consequences.
Purpose of the Study:
- To describe the intervention, design, methods, and baseline findings of a trial evaluating a school-based play intervention.
- To assess the impact of the intervention on reducing peer violence and enhancing mental health in Pakistani youth.
- To provide insights into implementing and evaluating such programs in challenging socio-political contexts.
Main Methods:
- A cluster randomized controlled trial involving 6th-grade students in 40 schools in Hyderabad, Pakistan.
- Utilized Multidimensional Peer-Victimization and Peer Perpetration Scales and Children's Depression Inventory 2 (CDI 2) for outcome measurement.
- Investigator-derived scales assessed domestic violence; intervention specifics, logistics, ethics, and fidelity management were detailed.
Main Results:
- 1,752 youth were enrolled at baseline; high rates of victimization (94% boys, 85% girls) and perpetration (85% boys, 66% girls) were reported.
- Boys reported higher depression, negative mood, lower self-esteem, and more interpersonal/emotional problems than girls.
- Baseline data highlight the significant prevalence of peer violence and associated mental health challenges in the study population.
Conclusions:
- High prevalence of youth violence perpetration and victimization necessitates effective prevention strategies.
- Evaluating a play-based intervention using a randomized controlled design offers a robust approach to identify evidence-informed solutions.
- This research contributes to scalable and sustainable interventions for reducing youth violence and improving well-being.
Background:
Violence against and among children is a global public health problem that annually affects 50% of youth worldwide with major impacts on child development, education, and health including increased probability of major causes of morbidity and mortality in adulthood. It is also associated with the experience of and perpetration of later violence against women. The aim of this article is to describe the intervention, study design, methods, and baseline findings of a cluster randomized controlled trial underway in Pakistan to evaluate a school-based play intervention aiming to reduce peer violence and enhance mental health.
Methods:
A cluster randomized controlled design is being conducted with boys and girls in grade 6 in 40 schools in Hyderabad, Pakistan, over a period of 2 years. The Multidimensional Peer-Victimization and Peer Perpetration Scales and the Children's Depression Inventory 2 (CDI 2) are being used to measure the primary outcomes while investigator-derived scales are being used to assess domestic violence within the family. Specifics of the intervention, field logistics, ethical, and fidelity management issues employed to test the program's impact on school age youth in a volatile and politically unstable country form this report.
Baseline Results:
A total of 1,752 school-age youth were enrolled and interviewed at baseline. Over the preceding 4 weeks, 94% of the boys and 85% of the girls reported 1 or more occurrences of victimization, and 85% of the boys and 66% of the girls reported 1 or more acts of perpetration. Boys reported more depression compared with girls, as well as higher negative mood and self-esteem scores and more interpersonal and emotional problems.
Interpretation:
Globally, prevalence of youth violence perpetration and victimization is high and associated with poor physical and emotional health. Applying a randomized controlled design to evaluate a peer violence prevention program built on a firm infrastructure and that is ready for scale-up and sustainability will make an important contribution to identifying evidence-informed interventions that can reduce youth victimization and perpetration.
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