Peninsula Technology Assessment Group, College of Medicine and Health, University of Exeter, Exeter, UK.
Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, UK.
Prev Sci. 2022 Jan;23(1):1-9. doi: 10.1007/s11121-021-01237-4. Epub 2021 Apr 21.
Whole-school interventions are a promising approach to preventing bullying and aggression while promoting broader health. The main analyses from a trial of the INCLUSIVE whole-school intervention reported reductions in bullying victimisation but not aggression and improved mental well-being. Latent transition analysis can examine how interventions 'move' people between classes defined by multiple outcomes over time. We examined at baseline what classes best defined individuals' bullying, aggression and mental well-being and what effects did the intervention have on movement between classes over time? INCLUSIVE was a two-arm cluster-randomised trial with 20 high schools per arm, with 24-month and 36-month follow-ups. We estimated sequential latent class solutions on baseline data. We then estimated a latent transition model including baseline, 24-month and 36-month follow-up measurements. Our sample comprised 8179 students (4082 control, 4097 intervention arms). At baseline, classes were (1) bullying victims, (2) aggression perpetrators, (3) extreme perpetrators and (4) neither victims nor perpetrators. Control students who were extreme perpetrators were equally likely to stay in this class (27.0% probability) or move to aggression perpetrators (25.0% probability) at 24 months. In the intervention group, fewer extreme perpetrators students remained (5.4%), with more moving to aggression perpetrators (65.1%). More control than intervention extreme perpetrators moved to neither victims nor perpetrators (35.2% vs 17.8%). Between 24 and 36 months, more intervention students moved from aggression perpetrators to neither victims nor perpetrators than controls (30.1% vs 22.3%). Our findings suggest that the intervention had important effects in transitioning students to lower-risk classes.
学校整体干预是预防欺凌和攻击行为，同时促进更广泛健康的有前途的方法。对 INCLUSIVE 学校整体干预试验的主要分析报告称，减少了欺凌受害，但没有减少攻击行为，并且改善了心理健康。潜在转变分析可以研究干预措施如何随着时间的推移将人们在多个结果定义的类别之间“移动”。我们在基线时检查了哪些类别最能定义个人的欺凌、攻击和心理健康，以及干预措施对随着时间的推移在类别之间的移动有什么影响？ INCLUSIVE 是一项两臂集群随机试验，每个臂有 20 所高中，有 24 个月和 36 个月的随访。我们根据基线数据估计了连续潜在类别解决方案。然后，我们估计了一个潜在的转变模型，包括基线、24 个月和 36 个月的随访测量。我们的样本包括 8179 名学生（4082 名对照组，4097 名干预组）。在基线时，类别为（1）欺凌受害者，（2）攻击行为者，（3）极端行为者和（4）既非受害者也非行为者。处于极端行为者类别的对照组学生同样有可能留在该类别（27.0%的概率）或在 24 个月时转移到攻击行为者类别（25.0%的概率）。在干预组中，较少的极端行为者学生留了下来（5.4%），更多的学生转移到攻击行为者（65.1%）。与干预组相比，对照组中更多的极端行为者转移到既非受害者也非行为者（35.2%比 17.8%）。在 24 到 36 个月之间，干预组中从攻击行为者转移到既非受害者也非行为者的学生多于对照组（30.1%比 22.3%）。我们的研究结果表明，干预措施在将学生转移到低风险类别方面具有重要影响。
