Preventing Violence Against Children in Schools Study (PVACS)

Preventing Violence Against Children in Schools: Protocol for a Cluster Randomised Controlled Trial of the EmpaTeach Behavioural Intervention in Nyarugusu Refugee Camp

To date, no interventions to prevent violence in refugee camp schools have ever been rigorously evaluated. The primary objective of this project is to test the effectiveness of the Empateach intervention to prevent physical violence from teachers to students in Nyarugusu Refugee Camp, Tanzania. Secondary objectives are to assess the impact of the Empateach intervention on student's depressive symptoms, experience of emotional violence and educational test scores. A two arm cluster RCT with parallel assignment will be conducted.

Study Overview

• Status: Unknown
• Conditions: Child Abuse; Violence; Violence, Physical; Violence Against Children
• Intervention / Treatment: Behavioral: Empateach

Detailed Description

School is one of the most common settings where children may experience violence; and emerging evidence suggests that in some settings, school staff may be one of the most common perpetrator of violence against children.To date, no interventions to prevent violence in refugee camp schools have ever been rigorously evaluated. The primary objective of this project is to test the effectiveness of the Empateach intervention to prevent physical violence from teachers to students in Nyarugusu Refugee Camp, Tanzania. Secondary objectives are to assess the impact of the Empateach intervention on student's depressive symptoms, experience of emotional violence and educational test scores.

The aim of the Empateach intervention is to improve 'student and teacher well-being; self-regulation; teacher classroom management and teacher's use of positive discipline techniques'. Participants in the intervention condition will receive a 10-week group intervention.

A two arm cluster RCT will be conducted, with parallel assignment and an approximately 1:1 allocation ratio. Cross-sectional surveys of students will be conducted at three time points: a baseline, a midline immediately after the 10 week intervention; and an endline 6 months after then end of the intervention. The primary outcome, violence from school staff to students, will be measured using an adapted version of the ICAST-CI.

• Study Type: Interventional
• Enrollment (Anticipated): 2120
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Patricia Henley, PhD; Phone Number: 02079272221; Email: patricia.henley@lshtm.ac.uk

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 9 years and older (Child, Adult, Older Adult)
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• At the school level, all 27 primary and secondary schools in Nyarugusu refugee camp in Tanzania, will be eligible. The intervention is delivered to individual teachers, and all teachers working in included schools will be eligible to receive the intervention. The hypothesized intervention effect will be in all students being taught by participating teachers; however we will measure effects of the intervention in students who are aged 9 years and over. Data will be collected from both students and teachers.
• At the level of individual students, all students who can speak Kirundi or Swahili, and who are capable of providing assent, will be eligible to participate
• At the level of individual teachers, all teachers who can speak Kirundi or Swahili, and who are capable of providing informed consent, will be eligible to participate

Exclusion Criteria:

• there are no exclusion criteria at the School level
• for individual students, those who cannot speak Kirundi or Swahili, or who are not capable of providing assent
• for individual teachers, those who cannot speak Kirundi or Swahili, or who are not capable of providing informed consent

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Prevention
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Empateach Intervention; All teachers in intervention schools will be invited to participate. Participants in the intervention condition will receive Empateach, a 10-week group intervention. Groups meet 14 times for 1-1.5 hour length sessions, which are led by peers. The aim of the Empateach intervention is to improve 'student and teacher well-being; self-regulation; teacher classroom management and teacher's use of positive discipline techniques. The intervention uses cognitive behavioural therapy techniques to change negative thought and behaviour patterns related to corporal punishment. The teachers receive information on alternatives to corporal punishment, planning exercises and reinforcement SMS, and because the intervention is in a group setting, social support to change their behaviours. They discuss their experiences and challenges in group sessions.	Behavioral: Empateach; Empateach is a behavioural intervention for teachers.
No Intervention: Wait-list control; Teachers in wait-list control schools will receive no specific interventions related to violence prevention during the study, but will receive the intervention after the study is over if it is shown to be effective (pending donor funding).

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
physical violence	students' self-reports of physical violence from school staff in the past week, as measured by a modified ICAST-CI	Assessed at 10-week follow-up

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
physical violence	students' self-reports of physical violence from school staff in the past week, as measured by a modified ICAST-CI	Assessed at 6-month follow-up
emotional violence	students' self-reports of emotional violence from school staff, as measured by a modified ICAST-CI	past 1 week; assessed at 10-week and 6-month follow-up
depressive symptoms	students' self-reports of emotional violence from school staff, as measured by a modified ICAST-CI	past 2 weeks; assessed at 10-week and 6-month follow-up
educational performance	test scores on yearly exams	assessed at the end of the school year, about 11-12 months from baseline

Collaborators and Investigators

• Sponsor: London School of Hygiene and Tropical Medicine
• Collaborators: International Rescue Committee; National Institutes of Medical Research, Tanzania; Innovations for Poverty Action, Tanzania; Behavioural Insights Team
• Investigators: Principal Investigator: Karen M Devries, PhD, LSHTM

Publications and helpful links

General Publications

• Fabbri C, Rodrigues K, Leurent B, Allen E, Qiu M, Zuakulu M, Nombo D, Kaemingk M, De Filippo A, Torrats-Espinosa G, Shayo E, Barongo V, Greco G, Tol W, Devries KM. The EmpaTeach intervention for reducing physical violence from teachers to students in Nyarugusu Refugee Camp: A cluster-randomised controlled trial. PLoS Med. 2021 Oct 4;18(10):e1003808. doi: 10.1371/journal.pmed.1003808. eCollection 2021 Oct.
• Devries KM, Fabbri C, Allen E, Barongo V, Shayo E, Greco G, Kaemingk M, Qiu M, Steinacher R, Tol W, Rodrigues K. Preventing violence against children in schools (PVACS): protocol for a cluster randomised controlled trial of the EmpaTeach behavioural intervention in Nyarugusu refugee camp. BMC Public Health. 2019 Oct 15;19(1):1295. doi: 10.1186/s12889-019-7627-y.

Study record dates

Study Major Dates

• Study Start (Anticipated): November 16, 2018
• Primary Completion (Anticipated): December 31, 2019
• Study Completion (Anticipated): July 31, 2020

Study Registration Dates

• First Submitted: November 6, 2018
• First Submitted That Met QC Criteria: November 16, 2018
• First Posted (Actual): November 19, 2018

Study Record Updates

• Last Update Posted (Actual): November 19, 2018
• Last Update Submitted That Met QC Criteria: November 16, 2018
• Last Verified: November 1, 2018

More Information

Terms related to this study

• Keywords: corporal punishment, teacher violence, school violence, sexual violence
• Other Study ID Numbers: 11106

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: UNDECIDED
• IPD Plan Description: We will explore making anonymised data available after the end of the study, subject to UK and Tanzanian regulations.

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No