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英国威尔士KiVa欺凌预防项目的有效性:一项实用整群随机对照试验的结果

The Effectiveness of the KiVa Bullying Prevention Program in Wales, UK: Results from a Pragmatic Cluster Randomized Controlled Trial.

作者信息

Axford Nick, Bjornstad Gretchen, Clarkson Suzy, Ukoumunne Obioha C, Wrigley Zoe, Matthews Justin, Berry Vashti, Hutchings Judy

机构信息

NIHR ARC South West Peninsula (PenARC), University of Plymouth, Plymouth, UK.

University of Exeter Medical School, University of Exeter, Exeter, UK.

出版信息

Prev Sci. 2020 Jul;21(5):615-626. doi: 10.1007/s11121-020-01103-9.

Abstract

The study evaluated the implementation fidelity and effectiveness of KiVa, an evidence-based program that aims to prevent and address bullying in schools, with a particular emphasis on changing the role of bystanders. The study was a two-arm waitlist control cluster randomized controlled trial in which 22 primary schools (clusters) (N = 3214 students aged 7-11) were allocated using a 1:1 ratio to intervention (KiVa; 11 clusters, n = 1588 students) and a waitlist control (usual school provision; 11 clusters, n = 1892 children)). The trial statistician (but not schools or researchers) remained blind to allocation status. The outcomes were as follows: student-reported victimization (primary outcome) and bullying perpetration; teacher-reported child behavior and emotional well-being; and school absenteeism (administrative records). Implementation fidelity was measured using teacher-completed online records (for class lessons) and independent researcher observations (for school-wide elements). Outcome analyses involved 11 intervention schools (n = 1578 children) and 10 control schools (n = 1636 children). There was no statistically significant effect on the primary outcome of child-reported victimization (adjusted intervention/control OR 0.76; 95% CI 0.55 to 1.06; p = 0.11) or on the secondary outcomes. The impact on victimization was not moderated by child gender, age, or victimization status at baseline. Lesson adherence was good but exposure (lesson length) was lower than the recommended amount, and there was considerable variability in the implementation of whole school elements. The trial found insufficient evidence to conclude that KiVa had an effect on the primary outcome. A larger trial of KiVa in the UK is warranted, however, with attention to issues regarding implementation fidelity. Trial registration: Current Controlled Trials ISRCTN23999021 Date 10-6-13.

摘要

该研究评估了“KiVa”项目的实施保真度和有效性,这是一个旨在预防和解决校园欺凌问题的循证项目,特别强调改变旁观者的角色。该研究是一项双臂等待列表对照整群随机对照试验,其中22所小学(整群)(N = 3214名7至11岁学生)按1:1比例分配到干预组(KiVa;11个整群,n = 1588名学生)和等待列表对照组(常规学校服务;11个整群,n = 1892名儿童)。试验统计学家(而非学校或研究人员)对分配状态保持盲态。结果如下:学生报告的受欺负情况(主要结果)和欺凌行为;教师报告的儿童行为和情绪健康状况;以及学校缺勤情况(行政记录)。实施保真度通过教师完成的在线记录(针对课堂教学)和独立研究人员观察(针对全校范围的内容)来衡量。结果分析涉及11所干预学校(n = 1578名儿童)和10所对照学校(n = 1636名儿童)。对于儿童报告的受欺负这一主要结果(调整后的干预/对照比值比为0.76;95%置信区间为0.55至1.06;p = 0.11)或次要结果均无统计学上的显著影响。对受欺负情况的影响未因儿童性别、年龄或基线时的受欺负状态而有所不同。课程依从性良好,但课时量(课程时长)低于推荐量,并且全校范围内容的实施存在相当大的差异。该试验发现没有足够证据得出KiVa对主要结果有影响的结论。然而,鉴于实施保真度方面的问题,在英国对KiVa进行更大规模的试验是有必要的。试验注册:当前对照试验ISRCTN23999021 日期2013年6月10日

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5333/7305088/ad1878f31640/11121_2020_1103_Fig1_HTML.jpg

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