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以学校为基础的暴力预防干预措施对残疾儿童是否具有包容性且有效?全球证据的系统评价。

Are school-based violence prevention interventions inclusive and effective for children with disabilities? A systematic review of global evidence.

作者信息

Eldred Emily, Devries Karen, Zinke-Allmang Anja, Mallick Rizwana, Mughis Waliyah, Banks Lena Morgon, Bhatia Amiya

机构信息

Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK.

Department of Social Policy and Intervention, University of Oxford, Oxford, UK.

出版信息

EClinicalMedicine. 2025 Jan 17;80:103060. doi: 10.1016/j.eclinm.2024.103060. eCollection 2025 Feb.

Abstract

BACKGROUND

Children with disabilities are twice as likely to experience violence compared to peers without disabilities. While evaluations of school-based interventions targeting the prevention of violence against children in schools are growing in number, it is unclear whether these interventions are inclusive of, or effective for, children with disabilities.

METHODS

We searched six databases (Medline, Cochrane Library, Embase, Global Health, PsycINFO, Web of Science) and utilised professional networks to identify systematic reviews which included randomised controlled trials (RCTs) of school-based violence prevention interventions up to May 2024. Once we identified our final sample of systematic reviews (n = 29) we hand searched the included papers within these reviews and included all RCTs of school-based violence prevention interventions. We applied criteria to assess disability inclusion and conducted a narrative synthesis of study characteristics, adaptations to intervention and/or data collection design, and effect estimates. We assessed risk of bias using the Cochrane Risk of Bias tool. This review was registered on PROSPERO (CRD42023463384).

FINDINGS

We identified 160 articles of school-based violence prevention interventions. Of these, 13 articles reporting on 10 trials (8.13%) explicitly mentioned disability: 3/10 trials reported on the magnitude of intervention effects among children with disabilities; 4/10 trials mentioned adaptations to research or intervention design to include children with disabilities; 6/10 trials mentioned disability as part of the sample characteristics but did not report further sub-group analysis. 3 trials were effective in reducing violence in schools for children with disabilities, with risk of bias ranging from 'low' (n = 1) to 'some concerns' (n = 2).

INTERPRETATION

Despite growing evidence on how to prevent school violence, there is limited research on the effect of such interventions for children with disabilities. There is a need for future evaluations to stratify effects by disability, conduct disability-inclusive research, and tailor interventions for children with disabilities.

FUNDING

This research was partially funded by the Foreign, Commonwealth and Development Office under the PENDA project (PO8073).

摘要

背景

与无残疾的同龄人相比,残疾儿童遭受暴力的可能性要高出一倍。虽然针对预防校园暴力的校内干预措施的评估数量在不断增加,但尚不清楚这些干预措施是否涵盖残疾儿童,或者对他们是否有效。

方法

我们检索了六个数据库(Medline、Cochrane图书馆、Embase、全球健康、PsycINFO、科学引文索引),并利用专业网络来识别系统评价,这些系统评价纳入了截至2024年5月的校园暴力预防干预措施的随机对照试验(RCT)。一旦确定了我们最终的系统评价样本(n = 29),我们就人工检索了这些评价中包含的论文,并纳入了所有校园暴力预防干预措施的RCT。我们应用标准来评估残疾儿童的纳入情况,并对研究特征、干预措施和/或数据收集设计的调整以及效应估计进行叙述性综合分析。我们使用Cochrane偏倚风险工具评估偏倚风险。本评价已在国际前瞻性系统评价注册库(PROSPERO)上注册(CRD42023463384)。

结果

我们识别出160篇关于校园暴力预防干预措施的文章。其中,13篇文章报告了10项试验(8.13%)明确提到了残疾:10项试验中有3项报告了残疾儿童干预效果的大小;10项试验中有4项提到了对研究或干预设计的调整以纳入残疾儿童;10项试验中有6项提到残疾是样本特征的一部分,但未报告进一步的亚组分析。3项试验在减少残疾儿童校园暴力方面有效,偏倚风险从“低”(n = 1)到“有些担忧”(n = 2)不等。

解读

尽管关于如何预防校园暴力的证据越来越多,但针对此类干预措施对残疾儿童影响的研究仍然有限。未来的评估需要按残疾情况对效果进行分层,开展包含残疾儿童的研究,并为残疾儿童量身定制干预措施。

资金来源

本研究部分由外交、联邦和发展办公室在PENDA项目(PO8073)下资助。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/32c5/11787422/99c5abf8ea7f/gr1.jpg

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