Nurse-Led ROOTS-Soft Skills Intervention for Bullying Prevention

December 4, 2025 updated by: Universitas Padjadjaran

The Effect of the Nurse-Led ROOTS Program and Soft Skills Training on Emotional Regulation to Prevent Bullying in High School Students in Bandung City: A Quasi-Experimental

This study aims to evaluate the effect of a nurse-led intervention combining the ROOTS program and soft skills training on emotional regulation and bullying prevention among high school students in Bandung, Indonesia. Bullying remains a major concern in schools and is closely linked to emotional difficulties, poor coping skills, and limited empathy. Strengthening students' emotional regulation is an evidence-based strategy to reduce aggressive behaviors and promote safer school environments.

In this study, trained school nurses will deliver an integrated intervention consisting of sessions on identifying emotions, managing stress, developing empathy, communicating effectively, and resolving conflicts. The program is designed to help students better understand their emotions, control impulsive reactions, and build positive relationships with peers. These skills are expected to reduce the risk of bullying-both as perpetrators and as victims.

The research uses a quasi-experimental design involving two high schools in Bandung. One school will receive the nurse-led intervention, while the comparison school will continue routine school activities. Students who meet inclusion criteria and provide consent/assent will participate in pre- and post-intervention assessments. The primary outcome is improvement in emotional regulation scores. Secondary outcomes include bullying behavior, empathy, and student perceptions of the school climate.

All activities will follow ethical guidelines, including confidentiality, voluntary participation, and the right to withdraw at any time. The study seeks to provide evidence on how nurses can contribute to mental health promotion in schools and support sustainable, school-based bullying prevention strategies.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

This study investigates a structured, nurse-led intervention that integrates the ROOTS program with soft skills training to enhance emotional regulation as a strategy to prevent bullying among adolescents. The intervention consists of multiple structured sessions delivered over several weeks, focusing on emotional awareness, stress management, empathy development, communication strategies, and problem-solving skills. The program was adapted for Indonesian high school students and aligned with the role of school nurses in mental health promotion.

A quasi-experimental non-randomized design will be used. Two high schools in Bandung will participate: one serving as the intervention site and the other as the comparison site. Participants will be students in grades 10-11 who consent to join the study. Pre-intervention assessments will measure emotional regulation (primary outcome) and bullying behaviors, empathy, and school climate (secondary outcomes). After the intervention sessions are completed, the same measures will be reassessed.

The study aims to generate evidence on the feasibility and effectiveness of a nurse-led emotional and social skills program delivered in school settings. Findings are expected to inform future mental health strategies, support the integration of nurses into school-based preventive services, and contribute practical recommendations for bullying prevention policies.

Study Type

Interventional

Enrollment (Actual)

100

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

  • Indonesia
    • West Java
      • Bandung, West Java, Indonesia, 40184
        • SMA Al Marwah and MAN Kota Bandung

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

Accepts Healthy Volunteers

No

Description

Inclusion Criteria

  • Adolescents aged 14-18 years
  • Enrolled in participating secondary schools
  • Willing to provide assent, with parental/guardian consent
  • Able to understand and communicate in the local language (e.g., Indonesian or English)
  • Identified as having mild to moderate difficulties in emotional regulation or at risk for anxiety/depression based on school screening Exclusion Criteria
  • Severe psychiatric conditions requiring immediate clinical intervention (e.g., psychosis, severe depression with suicidal intent)
  • Currently receiving structured psychological or psychiatric treatment for emotional regulation or mental health conditions
  • Cognitive or developmental disabilities that would prevent meaningful participation in group activities
  • Non-consent from parent/guardian or the participant

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: Non-Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Intervention Group
Participants receive the Nurse-Led ROOTS Program combined with Soft Skills Training. This eight-week program, facilitated by the school nurse and a teacher, includes peer-led leadership activities, emotion regulation exercises, assertive communication, cognitive reappraisal, and empathy training to prevent bullying and improve emotional regulation.
Behavioral: Nurse-Led ROOTS Program and Soft Skills Training

A structured, eight-week program delivered once per week (60-90 minutes/session) by the school nurse and supported by teachers. Core components include:

Program orientation and group norms

Peer leadership and assertive communication

Emotional awareness and labeling

Expression management and self-control

Cognitive reappraisal exercises

Empathy and perspective-taking

Peer-led positive values campaign

Reflection, feedback, and skill consolidation
No Intervention: Control Group
Participants in this arm will receive standard care provided at the school without additional psychological intervention.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Emotional Regulation
Time Frame: Pre-intervention (week 0) and post-intervention (week 8)
Emotional regulation ability is measured using the Emotion Regulation Questionnaire for Children and Adolescents (ERQ-CA), a 10-item instrument rated on a 5-point Likert scale ranging from 1 (strongly disagree) to 5 (strongly agree). The total score ranges from 10 to 50, with higher total scores indicating better overall emotional regulation ability. Changes in the total ERQ-CA score from pre-intervention (week 0) to post-intervention (week 8) are used to evaluate the extent to which the intervention improves participants' capacity to manage and express their emotions adaptively.
Pre-intervention (week 0) and post-intervention (week 8)

Collaborators and Investigators

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

Sponsor

Universitas Padjadjaran

Investigators

  • Principal Investigator: Iyus Yosep, Universitas Padjadjaran

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)

July 1, 2025

Primary Completion (Actual)

September 30, 2025

Study Completion (Actual)

October 5, 2025

Study Registration Dates

First Submitted

November 22, 2025

First Submitted That Met QC Criteria

November 22, 2025

First Posted (Estimated)

December 3, 2025

Study Record Updates

Last Update Posted (Actual)

December 12, 2025

Last Update Submitted That Met QC Criteria

December 4, 2025

Last Verified

November 1, 2025

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • NURS-202511.01

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

IPD Plan Description

Individual participant data (IPD) will not be shared. The dataset contains sensitive mental health information from adolescents, and institutional policies prohibit the release of such de-identified data to external researchers.

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

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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