Efficacy of Bystander Intervention Program in Nursing Students

August 13, 2026 updated by: Seda Er, Istanbul University - Cerrahpasa

The Effect of Bystander Intervention Program on Bystander Efficacy, Behavior and Intent to Help for Dating Violence in Nursing Students

This randomized controlled trial evaluated the effectiveness of a bystander intervention program for dating violence among nursing students. The study was conducted with second-year nursing students at Istanbul University-Cerrahpaşa Florence Nightingale Faculty of Nursing. A total of 84 students were randomized to the intervention and control groups. Due to missing data from one participant in the control group, 83 students were included in the final analysis (intervention group, n=42; control group, n=41). Participants were allocated to the groups using computer-generated randomization. The intervention group received the Bystander Intervention Program, which was developed based on the Bystander Behavior Model and the Theory of Planned Behavior and adapted to the cultural and institutional context. The control group received a single 90-minute educational session on dating violence during the study period. After completion of all outcome assessments, participants in the control group were also offered the Bystander Intervention Program for Dating Violence. Data were collected face-to-face using an Individual Information Form, the Bystander Efficacy Scale, the Intention to Help Scale-Short Version, the Bystander Behavior Scale, and a Program Evaluation Form. Bystander efficacy and intention to help were assessed at baseline, immediately after the intervention, and at two-month follow-up. Bystander behavior was assessed at baseline and at two-month follow-up.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

Dating violence is an important public health concern among young adults and may have adverse physical, psychological, and social consequences. Young people exposed to dating violence may experience difficulties in seeking help or disclosing violence, highlighting the importance of prevention approaches that extend beyond individuals directly involved in violent relationships (Choi et al., 2017; Park & Kim, 2021).

Bystander intervention is a prevention approach that focuses on individuals who witness or become aware of situations involving violence and who may have opportunities to intervene safely. Bystanders may intervene directly or indirectly, and previous studies have reported that bystander-focused programs can influence outcomes including knowledge, attitudes, confidence to intervene, intentions to help, and bystander behaviors (Amar et al., 2015; Jouriles et al., 2018; Peterson et al., 2018).

The intervention evaluated in this study was developed specifically for nursing students and was informed by the Bystander Behavior Model and the Theory of Planned Behavior. The program was adapted to the cultural and institutional context and aimed to strengthen students' ability to recognize dating violence, assume responsibility when intervention is appropriate, identify safe intervention strategies, and provide appropriate support and referral.

Nursing students constitute a relevant population for bystander intervention because they may encounter dating violence both within their peer environments and, as future health professionals, in the care of individuals exposed to violence. Developing their knowledge, confidence, intentions, and behaviors related to safe bystander intervention may therefore be relevant to both violence prevention and future nursing practice.

The study evaluated the Bystander Intervention Program for Dating Violence in a randomized controlled trial among nursing students. The primary outcomes were bystander efficacy, intention to help, and bystander behavior. Bystander efficacy and intention to help were assessed at baseline, immediately after the intervention, and at two-month follow-up; bystander behavior was assessed at baseline and at two-month follow-up.

Study Type

Interventional

Enrollment (Actual)

84

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Turkey (Türkiye)
    • Şişli/Istanbul
      • Istanbul, Şişli/Istanbul, Turkey (Türkiye), 34381
        • Istanbul University-Cerrahpaşa

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Child
  • Adult
  • Older Adult

Accepts Healthy Volunteers

Yes

Description

Inclusion Criteria:

-Being actively enrolled as a student at the nursing faculty of a public university in Istanbul during the 2024-2025 academic year.

Exclusion Criteria:

  • Not being actively enrolled at the nursing faculty during the 2024-2025 academic year due to reasons such as suspension or termination of enrollment, transfer to another institution, or transfer to another academic program.
  • Having a diagnosed mental disorder (e.g., major depression or post-traumatic stress disorder) and/or receiving regular psychiatric treatment.
  • Having previously participated in a seminar, workshop, group activity, conference, congress, training program, or similar educational activity related to dating violence prevention and/or bystander intervention.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

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

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Experimental Group
Participants in this group received the Bystander Intervention Program for Dating Violence. The program was developed based on the Bystander Behavior Model and the Theory of Planned Behavior and was adapted to the cultural and institutional context. It aimed to improve nursing students' knowledge and skills for recognizing dating violence and responding safely as bystanders. The program was delivered to second-year nursing students at Istanbul University-Cerrahpaşa Florence Nightingale Faculty of Nursing.
Behavioral: Bystander Intervention Program for Dating Violence
The Bystander Intervention Program for Dating Violence was delivered face-to-face as a one-day workshop (10:00-17:00) consisting of five sessions, each lasting approximately 60-90 minutes. The sessions addressed: (1) dating violence and its types; (2) risk factors and consequences of dating violence; (3) bystander intervention and barriers to intervention; (4) bystander intervention strategies; and (5) self-care for bystanders witnessing dating violence. The program was based on the Bystander Behavior Model and the Theory of Planned Behavior and was adapted to the cultural and institutional context. PowerPoint presentations, videos, interactive scenarios, and group discussions were used during the workshop.
Active Comparator: Control Group
Participants in the control group received a single-session educational program on dating violence during the same week as the intervention group. The session addressed dating violence and its types, causes, myths related to dating violence, the cycle of violence, consequences of dating violence, and prevention. The session lasted 90 minutes. After completion of the experimental phase and all outcome assessments, participants in the control group were also offered the five-session Bystander Intervention Program for Dating Violence for ethical and educational equity considerations.
Behavioral: Dating Violence Education
Participants in the control group received a single 90-minute face-to-face educational session on dating violence. The session covered dating violence and its types, causes of dating violence, myths related to dating violence and the cycle of violence, consequences of dating violence, and prevention of dating violence. The session was delivered during the same study period as the Bystander Intervention Program provided to the experimental group.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Bystander Efficacy Scale
Time Frame: Baseline (within one week before the intervention), immediately after completion of the intervention, and at two-month follow-up.
The scale used to assess bystander effectiveness was developed by Banyard et al. The scale includes 18 items. The participant is expected to indicate his/her degree of confidence by writing a whole number between 0-100 to indicate how confident he/she is that he/she can perform the behaviors specified in the scale. The calculation is made by averaging all items and the scale has no cut-off point. High scores indicate a high degree of confidence. In the study conducted by Banyard et al. (2014), the Cronbach's alpha value of the scale was .93 and the mean was 72.60.
Baseline (within one week before the intervention), immediately after completion of the intervention, and at two-month follow-up.
Intention to Help Scale-Short Version
Time Frame: Baseline (within one week before the intervention), immediately after completion of the intervention, and at two-month follow-up.
The scale, which assesses the likelihood or willingness of participants to engage in various helping behaviors, was developed by Banyard et al. (2014). There are two separate subscales by creating separate but parallel items and it consists of 18 items in total. Participants are expected to rate their likelihood of performing the behaviors using a 5-point Likert-type scale. The scale is calculated by averaging the answers given to the items. High scores indicate that the individual is more likely to engage in helping behavior. Cronbach's alpha value for the short version of the scale was .93 (Banyard et al. 2014).
Baseline (within one week before the intervention), immediately after completion of the intervention, and at two-month follow-up.
Bystander Behavior Scale (For Friends)
Time Frame: Baseline (within one week before the intervention) and at two-month follow-up.
The scale used to determine the spectator behavior of the participants in the last 2 months was developed by Banyard et al. The scale has 44 items and includes only spectator behaviors towards friends. The scale consists of 4 factors. Participants are expected to mark "Yes", "No" and "Did not meet" for the fulfillment of each item. In the evaluation, each no sign is calculated as 0 points and each yes sign is calculated as 1 point. The items that individuals said they did not encounter are not included in the scoring and the calculation is made by taking the average of the answers given to the other items. Higher scores indicate the types of bystander behavior reported by more people. Cronbach's alpha value for the short version of the scale was .971 (Banyard et al. 2014).
Baseline (within one week before the intervention) and at two-month follow-up.

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Istanbul University - Cerrahpasa

Collaborators

The Scientific and Technological Research Council of Türkiye (TUBITAK)

Investigators

  • Study Chair: Sevim Buzlu, PhD,RN, Istanbul University - Cerrahpasa

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Helpful Links

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

December 10, 2024

Primary Completion (Actual)

February 10, 2025

Study Completion (Actual)

February 10, 2025

Study Registration Dates

First Submitted

December 2, 2023

First Submitted That Met QC Criteria

December 11, 2023

First Posted (Actual)

December 20, 2023

Study Record Updates

Last Update Posted (Actual)

August 17, 2026

Last Update Submitted That Met QC Criteria

August 13, 2026

Last Verified

August 1, 2026

More Information

Terms related to this study

Keywords

Other Study ID Numbers

  • IU-Cerrahpaşa (IUC)
  • 324K026 (Other Grant/Funding Number: TUBITAK)

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

IPD Plan Description

Individual participant data will not be made publicly available to protect participant confidentiality and privacy. Aggregate study findings will be reported in scientific publications.

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

product manufactured in and exported from the U.S.

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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