Delivering an effective violence prevention intervention at scale: testing an alternative delivery model for the Good...

Almost no evidence exists on effectively delivering school violence prevention interventions at scale. The Good School Toolkit (GST), developed by Uganda-based non-governmental organisation (NGO) Raising Voices, is an effective whole-school violence prevention intervention when delivered by NGO staff. This study aimed to determine whether GST, delivered via a scalable delivery model using Regional Resource Persons (RRPs), is effective in changing teachers' attitudes towards violence and improving perceptions of school operational culture.A pre-post study was conducted in 95 schools across Uganda, randomly selected from 1000 schools implementing GST via RRPs. All schools had the opportunity to implement GST. Teachers participated in cross-sectional baseline (February-April 2022) and endline (September-October 2023) surveys. Primary outcomes were acceptance of physical discipline and markers of school operational culture. We fitted mixed-effects linear regression models to examine changes in outcomes over time and influence of GST exposure.Analyses showed that each unit increase in GST exposure was associated with an increase of 0.59 (95% CI 0.49 to 0.69, p<0.001) in teachers' perception of school operational culture, and 0.12 (95% CI 0.09 to 0.14, p<0.001) in perceptions of staff and student involvement in school operations. Although mean acceptance of physical discipline increased over time (β=0.51, 95% CI 0.27 to 0.76, p<0.001)-likely attributable to changes in schools post-COVID-19-each unit increase in GST exposure corresponded to an attenuation in acceptance by 0.06 (95% CI -0.12 to 0.00, p=0.046). Teachers reporting higher exposure to GST were also less likely to report using past year physical violence (OR=0.92, 95% CI 0.89 to 0.96, p<0.001).This study is the first in the Global South to evaluate a new delivery model for implementing an evidence-based violence prevention intervention at scale. GST delivered via RRPs mitigated an increased acceptance of physical discipline and was associated with improvements in school operational culture and reduced teacher physical violence, highlighting the promise of the RRP delivery model for implementing GST.