The Good Schools Toolkit to prevent violence against children in Ugandan primary schools: study protocol for a cluster randomised controlled trial

Karen M Devries, Elizabeth Allen, Jennifer C Child, Eddy Walakira, Jenny Parkes, Diana Elbourne, Charlotte Watts, Dipak Naker, Karen M Devries, Elizabeth Allen, Jennifer C Child, Eddy Walakira, Jenny Parkes, Diana Elbourne, Charlotte Watts, Dipak Naker

Abstract

Background: We aim to evaluate the effectiveness of the Good School Toolkit, developed by Raising Voices, in preventing violence against children attending school and in improving child mental health and educational outcomes.

Methods/design: We are conducting a two-arm cluster randomised controlled trial with parallel assignment in Luwero District, Uganda. We will also conduct a qualitative study, a process evaluation and an economic evaluation. A total of 42 schools, representative of Luwero District, Uganda, were allocated to receive the Toolkit plus implementation support, or were allocated to a wait-list control condition. Our main analysis will involve a cross-sectional comparison of the prevalence of past-week violence from school staff as reported by children in intervention and control primary schools at follow-up.At least 60 children per school and all school staff members will be interviewed at follow-up. Data collection involves a combination of mobile phone-based, interviewer-completed questionnaires and paper-and-pen educational tests. Survey instruments include the ISPCAN Child Abuse Screening Tools to assess experiences of violence; the Strengths and Difficulties Questionnaire to measure symptoms of common childhood mental disorders; and word recognition, reading comprehension, spelling, arithmetic and sustained attention tests adapted from an intervention trial in Kenya.

Discussion: To our knowledge, this is the first study to rigorously investigate the effects of any intervention to prevent violence from school staff to children in primary school in a low-income setting. We hope the results will be informative across the African region and in other settings.

Trial registration: clinicaltrials.gov NCT01678846.

Figures

Figure 1
Figure 1
Trial timeline.

References

    1. Pinheiro PS. World Report on Violence Against Children. New York: United Nations; 2006.
    1. Youssef R, Attia M, Kamel M. Children experiencing violence. II: Prevalence and determinants of corporal punishment in schools. Child Abuse Negl. 1998;22:975–985. doi: 10.1016/S0145-2134(98)00084-2.
    1. Mahmoud A, Ayanniyi A, Salman M. Observations of teachers in Ilorin, Nigeria on their practices of corporal punishment that are potentially injurious to their pupils’ eyes. Ann Afr Med. 2011;10:150–154. doi: 10.4103/1596-3519.82075.
    1. Naker D. Violence Against Children: The Voices of Ugandan Children and Adults. Kampala: Raising Voices, Save the Children Uganda; 2006.
    1. Leach F, Humphreys S. Gender violence in schools: taking the ‘girls-as-victims’ discourse forward. Gend Dev. 2007;15:51–65. doi: 10.1080/13552070601179003.
    1. Leach F, Fiscian V, Kadzamira E, Lemani E, Machakanja P. Educational Paper No. 54. London: Department for International Development; 2003. An Investigative Study of the Abuse of Girls in African Schools.
    1. Muhanguzi FK. Gender and sexual vulnerability of young women in Africa: experiences of young girls in secondary schools in Uganda. Cult Health Sex. 2011;13:713–725. doi: 10.1080/13691058.2011.571290.
    1. Ackard DM, Eisenberg ME, Neumark-Sztainer D. Long-term impact of adolescent dating violence on the behavioral and psychological health of male and female youth. J Pediatr. 2007;151:476–481. doi: 10.1016/j.jpeds.2007.04.034.
    1. Kendler KS, Karkowski LM, Prescott CA. Causal relationship between stressful life events and the onset of major depression. Am J Psychiatry. 1999;156:837–841.
    1. Devries KM, Watts C, Yoshihama M, Kiss L, Schraiber LB, Deyessa N, Heise L, Durand J, Mbwambo J, Jansen H, Berhane Y, Ellsberg M, Garcia-Moreno C. WHO Multi-Country Study Team. Violence against women is strongly associated with suicide attempts: evidence from the WHO multi-country study on women’s health and domestic violence against women. Soc Sci Med. 2011;73:79–86. doi: 10.1016/j.socscimed.2011.05.006.
    1. Dube SR, Anda RF, Felitti VJ, Chapman DP, Williamson DF, Giles WH. Childhood abuse, household dysfunction, and the risk of attempted suicide throughout the life span. Findings from the adverse childhood experiences study. JAMA. 2001;286:3089–3096. doi: 10.1001/jama.286.24.3089.
    1. Foshee VA, Benefield TS, Ennett ST, Bauman KE, Suchindran C. Longitudinal predictors of serious physical and sexual dating violence victimization during adolescence. Prev Med. 2004;39:1007–1016. doi: 10.1016/j.ypmed.2004.04.014.
    1. Gilbert R, Widom CS, Browne K, Fergusson D, Webb E, Janson S. Burden and consequences of child maltreatment in high-income countries. Lancet. 2009;373:68–81. doi: 10.1016/S0140-6736(08)61706-7.
    1. McCabe K, Lucchini SE, Hough RL, Yeh M, Hazen A. The relation between violence exposure and conduct problems among adolescents: a prospective study. Am J Orthopsychiatry. 2005;75:575–584.
    1. Fang X, Massetti GM, Ouyang L, Grosse SD, Mercy JA. Attention-deficit/hyperactivity disorder, conduct disorder, and young adult intimate partner violence. Arch Gen Psychiatry. 2010;67:1179–1186. doi: 10.1001/archgenpsychiatry.2010.137.
    1. Boden JM, Horwood LJ, Fergusson DM. Exposure to childhood sexual and physical abuse and subsequent educational achievement outcomes. Child Abuse Negl. 2007;31:1101–1114. doi: 10.1016/j.chiabu.2007.03.022.
    1. Randolph MK, Gold CA. Child sexual abuse prevention: Evaluation of a teacher training program. Sch Psychol Rev. 1994;23:485–495.
    1. Zwi K, Woolfenden SR, Wheeler DM, O’brien TA, Tait P, Williams KW. School-based education programmes for the prevention of child sexual abuse. Cochrane Database Syst Rev. 2007;3 CD004380.
    1. Vreeman RC, Carroll AE. A systematic review of school-based interventions to prevent bullying. Arch Pediatr Adolesc Med. 2007;161:77–88.
    1. Farrington DP, Ttofi MM. School-Based Programs to Reduce Bullying and Victimization. Campbell Systematic Reviews. 2009;6 doi: 10.4073/csr.2009.6.
    1. Totten DM, Quigley P, Morgan M. Safe School Study. Ottawa: Canadian Public Health Association/Youth Services Bureau of Ottawa and National Crime Prevention Strategy of Canada; 2005.
    1. Baker-Henningham H, Walker S, Powell C, Gardner JM. A pilot study of the Incredible Years Teacher Training programme and a curriculum unit on social and emotional skills in community pre-schools in Jamaica. Child Care Health Dev. 2009;1:1–13.
    1. United Nations Children‘s Fund. Child Friendly Schools Programming: Global Evaluation Report. New York: United Nations Children‘s Fund; 2009.
    1. Patel V, Flisher AJ, Nikapota A, Malhotra S. Promoting child and adolescent mental health in low and middle income countries. J Child Psychol Psychiatry. 2008;49:313–334. doi: 10.1111/j.1469-7610.2007.01824.x.
    1. Abraham C, Michie S. A taxonomy of behavior change techniques used in interventions. Health Psychol. 2008;27:379–387.
    1. Jewkes R. et al.Impact of stepping stones on incidence of HIV and HSV-2 and sexual behaviour in rural South Africa: cluster randomised controlled trial. BMJ. 2008;337:a506. doi: 10.1136/bmj.a506.
    1. Webster-Stratton C. Quality Training, Supervision, Ongoing Monitoring, and Agency Support: Key Ingredients to Implementing The Incredible Years Programs with Fidelity. Washington: University of Washington; 2004.
    1. Prochaska JO, Velicer WF. The transtheoretical model of health behavior change. Am J Health Promot. 1997;12:38–48. doi: 10.4278/0890-1171-12.1.38.
    1. Twa-Twa JM, Oketcho S. Global School Based Student Health Survey 2003: Uganda Country Report. Kampala, Uganda: Ministry of Health, School Health Section and Ministry of Education and Sports; 2005.
    1. International Society for the Prevention of Child Abuse and Neglect. The ISPCAN Child Abuse Screening Tool- Child Version.
    1. Garcia-Moreno CJ, Ellsberg H, Heise M, Watts L. WHO Multi-Country Study on Womens Health an Domestic Violence against women. Geneva: WHO; 2005.
    1. Brooker S, Okello G, Njagi K, Dubeck MM, Halliday KE, Inyega H, Jukes MC. Improving educational achievement and anemia of school children: design of a cluster randomized trial of school-based malaria prevention and enhanced literacy instruction in Kenya. Trials. 2010;11:93. doi: 10.1186/1745-6215-11-93.
    1. Goodman R, Ford T, Simmons H, Gatward R, Meltzer H. Using the strengths and difficulties questionnaire (SDQ) to screen for child psychiatric disorders in a community sample. Br J Psychiatry. 2000;177:534–539. doi: 10.1192/bjp.177.6.534.
    1. Hayes R, Moulton L. Cluster Randomised Trials, Interdisciplinary Statistics Series. Boca Raton: Chapman & Hall; 2009.

Source: PubMed

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