School of Nursing and Midwifery, Aga Khan University , Karachi City, Pakistan.
College of Nursing, Texas Woman's University , Denton, TX, USA.
Glob Health Action. 2020 Dec 31;13(1):1836604. doi: 10.1080/16549716.2020.1836604.
Peer violence is common globally, but a little researched topic in low-and middle-income countries. This study presents the evaluation of a two-year randomized controlled trial of a structured play-based life-skills intervention implemented in schools in Hyderabad, Pakistan.
To determine the impact of the intervention on school-based peer violence (victimization and perpetration) and depression among school children.
40 single-sex public schools were randomized into two study arms (20 per arm 10 of each sex). A total of 1752 grade 6 students (929 from intervention and 823 from control schools) were enrolled in the trial. The two-year intervention was a biweekly structured game led by a coach followed by critical reflection and discussion for 30 minutes. Primary outcomes (exposure to peer violence exhibited through victimization and perpetration and depression) were evaluated using generalized linear-mixed models.
Of the enrolled children (N = 1752) 91% provided data for analysis. There were significant decreases in self-reported peer violence victimization, perpetration and depression. For peer violence victimization, the reductions in the intervention and control arms were: 33.3% versus 27.8% for boys and 58.5% versus 21.3% for girls. For peer violence perpetration, the reductions were: 25.3% versus 11.1% for boys and 55.6% versus 27.6% for girls in the intervention and control arms, respectively. There were significant drops in mean depression scores (boys 7.2% versus 4.8% intervention and control and girls 9.5% versus 5.6% intervention and control).
A well-designed and implemented play-based life-skills intervention delivered in public schools in Pakistan is able to effect a significant reduction in peer violence.
同伴暴力在全球范围内很常见，但在中低收入国家却是一个研究较少的课题。本研究介绍了在巴基斯坦海得拉巴的学校实施的为期两年的基于结构性游戏的生活技能干预的随机对照试验评估结果。
确定该干预措施对学校同伴暴力（受害和施暴）和在校儿童抑郁的影响。
将 40 所单性别公立学校随机分为两组（每组 20 所，每性别 10 所）。共有 1752 名六年级学生（干预组 929 名，对照组 823 名）参加了试验。为期两年的干预措施是由一名教练每隔两周带领一次的结构化游戏，然后进行 30 分钟的批判性反思和讨论。主要结局（通过受害和施暴表现出的同伴暴力暴露以及抑郁）使用广义线性混合模型进行评估。
在纳入的儿童（N=1752）中，有 91%提供了分析数据。自我报告的同伴暴力受害、施暴和抑郁均显著减少。对于同伴暴力受害，干预组和对照组的减少幅度分别为：男孩 33.3%比 27.8%，女孩 58.5%比 21.3%。对于同伴暴力施暴，干预组和对照组的减少幅度分别为：男孩 25.3%比 11.1%，女孩 55.6%比 27.6%。男孩的平均抑郁评分显著下降（干预组 7.2%，对照组 4.8%），女孩的平均抑郁评分也显著下降（干预组 9.5%，对照组 5.6%）。
在巴基斯坦公立学校实施的精心设计和实施的基于游戏的生活技能干预措施能够显著减少同伴暴力。
