Development, Acceptability, and Short-Term Outcomes of a Teacher Module for a Brief, Bullying Bystander Intervention for Middle School Students in Rural, Low-Income Communities
Phase: NA
Conditions: Bullying
Sponsor: Boise State University

 
 
Middle School Teacher Module for a Brief Bullying Intervention Program 
NCT06017752 
October 15, 2020 

1.1 Study Title  
 
Middle School Teacher Module for a Brief Bullying Intervention Program 
 
1.5 ClinicalTrials.gov Identifier (e.g., NCT87654321) for this trial, if applicable. 
 
NCT06017752 
 
2.1 Conditions or Focus of Study 
 
Bullying, Mental Health, Teacher-Based Intervention 
 
2.2 Eligibility Criteria  
 
Inclusion Criteria: 
• 
being a middle school teacher at a participating low-income and/or rural school.  
• 
speaks and reads English. 
• 
consents to participate. 
• 
 
Exclusion Criteria: 
• 
speaks and reads only a language other than English. 
• 
does not consent for participation. 
 
2.3 Age Limits 
 
21 years old – no age limit 
 
2.3.a. Inclusion of Individuals Across the Lifespan  
 
Teachers of any age over 21 will be enrolled. The likelihood that teachers are under the age of 21 is very low. 
There is no restriction on older adults participating in this study. Age will be self-reported by participants. 
 
Children will not be included in this study as the purpose of the study is to conduct a needs assessment and 
create a Teacher Module based on feedback from teachers and test the Teacher Module’s acceptability, 
feasibility, and short-term outcomes (e.g., changes in teacher knowledge, attitudes, behavioral intentions).  
 
2.4 Inclusion of Women and Minorities  
 
There are no criteria for exclusion of any sub-population of participants based on ethnic origin, race, gender, or 
disability. Women and minorities will be included in this research. N = 20 participants will be recruited from 
schools in Idaho.  
 
2.5 Recruitment and Retention Plan  
2.5.1. Recruitment and Screening 
Human Subjects oversight will be conducted by Boise State’s IRBs (Boise State IIRB00000924).  All 
recruitment and screening procedures are IRB-approved.  
 
A total of 20 teachers will be recruited from one middle/junior high schools located in a rural, low-income 
community in Idaho. A school liaison will work directly with teachers at the target schools. All teachers of 
grades 6th- 8th meeting inclusion/exclusion criteria will be recruited via an email sent by the school liaison. We 
will continue recruitment at each school until we reach the target sample. Potential participants will be informed 
of the study purposes and procedures, given opportunities to ask questions and have them answered, and 
provide informed consent according to IRB approved guidelines. All participants will provide consent.  
 
 
 

2.5.2. Retention and Adherence 
 
Participants will remain in the study approximately 1.5 hours. The Middle School STAC Teacher Module will 
last approximately 50 minutes and those who consent will be asked to complete questionnaires at baseline and 
immediately post-training.  Teachers will be compensated with a $50 gift card. For the subgroup of participants 
who complete focus groups, participants will remain in the study for one week as the focus groups will take 
place within a week post-training. Teachers who participate in the focus groups will be compensated $50 to 
encourage retention and incentivize participation. 
 
2.7 Study Timeline (PDF) 
 
Study Timeline 
 
Months 
Tasks  
1-3 
4-6 7-9 10-11.5 
Finalize Procedures, Hire and Train Graduate Students 
X 
 
 
Develop STAC Teacher Module, Develop Phase Participant List 
 
X 
X 
 
Participant Recruitment, Administer Teacher Module, Conduct Pre-Post Assessment 
 
 
X 
Focus Groups, Transcribe/Analyze Data, Quantitative Data Analysis and Report Preparation 
 
 
 
X 
 
2.8 Enrollment of First Subject 
1/1/2022 
 
3.1 Protection of Human Subjects  
 
3.1.1. RISKS TO HUMAN SUBJECTS 
 
3.1.1.1. Human Subjects Involvement, Characteristics, and Design:   
The goal of the grant research is to collect pilot data to support an NIMHD STTR/SBIR R41/42 fast-track 
proposal aimed at developing the STAC-T Teacher Module as a companion training to a technology-based 
bullying bystander intervention for middle school students (STAC-T). The subject population for this study are 
teachers of middle school students. 
 
3.1.1.2. Study Procedures:   
 
One middle school in a rural, low-income community in Idaho (N=20) will test the STAC Teacher Module to 
evaluate program acceptability, feasibility, changes in knowledge, confidence, attitudes about bullying, and 
self-efficacy, and intention to use the teacher STAC strategies. Outcomes of knowledge, confidence, attitudes, 
and self-efficacy will be tested immediately before and after the STAC Teacher Module training session. 
Program acceptability and intentions to use the strategies will be measured immediately after the STAC 
Teacher Module Training. All teachers of students in grades 6, 7, and 8 will be invited to participate. 
Recruitment will continue until sample size is met. Teachers who provide informed consent will be invited to 
participate in the study during evening hours in an auditorium provided by the school where participants can sit 
far enough apart from each other so that others cannot see their answers to surveys. Teachers will be provided 
a unique study ID number and will complete the baseline assessment. Immediately after completing the 
baseline assessment (10-15 minutes), teachers will participate in the STAC Teacher Module training (50 
minutes). Participants will then complete an immediate post-training assessment (10-15 minutes). Data 
collection and training will occur in person although we do have the ability to conduct sessions remotely if 
needed following similar procedures we have used during COVID-19. Baseline Assessment: Teachers will 
complete a survey assessing knowledge, confidence, attitudes about bullying, self-efficacy, and demographic 
characteristics. Immediate-Post Assessment: Immediately following the STAC Teacher Module training, 
teachers will complete a survey assessing acceptability of the STAC Teacher Module, knowledge, confidence, 
attitudes about bullying, self-efficacy, and intentions to use the STAC teacher strategies. Teachers will be 
randomly selected to participate in focus groups which will occur within a week post-training. In three focus 
groups with teachers of middle school students (6-8 per group; N=12-16), participants will be asked to talk 
about the content of the training, as well as asked about current practices, school needs and interest in the 
future for a technology-based, bullying parent intervention, and challenges and barriers to use. The focus 
groups will be led by research staff trained in focus group moderation, encouraging open non-judgmental 

discussion. Focus groups will be conducted in-person although we do have the ability to conduct sessions 
remotely if needed following similar procedures we have used during COVID-19. Focus groups will be 
audiotaped, transcribed, and analyzed using NVivo. Summary reports will be prepared and reviewed to finalize 
the content of the STAC Teacher Module. 
 
3.1.1.3. Study Materials:  
Data from the focus groups and testing of acceptability, feasibility, and short-term outcomes will be collected in 
the form of handwritten notes, audio recordings, computer files, transcriptions, and questionnaires. Discussions 
will be recorded, transcribed, and analyzed using NVivo qualitative data analysis software.  
 
Data will be obtained specifically for research purposes and will be kept confidential with access limited to the 
PI and specific project staff. All data will be kept in locked files. 
 
3.1.1.4. Potential Risks:   
There are minimal risks associated with participation in this study. Any potential psychological risks posed by the 
research are primarily related to the sensitivity of the topic of bullying.  Participants may also be hesitant or 
uncomfortable discussing their opinions regarding the STAC Teacher Module. Participants will be allowed to 
withdraw if they are uncomfortable with providing any of this information. Their responses will in no way be 
shared with anyone except project staff (i.e., kept confidential). Responses to the questions will be coded to 
protect confidentiality, and participants may choose not to answer questions. All survey datawill be confidential, 
accessed only by research staff on this project and stored in locked files. Data converted to computer files will 
be stored on a secure network server and password protected. Participants will be told that they do not have to 
answer questions if they are uncomfortable and can terminate the training session at any time they wish.  
 
Responses to survey questions would not reasonably place the subjects at risk of criminal or civil liability or be 
damaging to the subjects' financial standing, employability, or reputation. 
 
3.1.2  ADEQUACY OF PROTECTION AGAINST RISKS  
3.1.2.1. Informed Consent: Human Subjects oversight will be conducted by the Boise State University IRB 
(DHHS IRB Reg. No.00000924; FWA No.00000097).   
 
All consenting procedures are IRB-approved. The IRB will review and approve any modification to subject 
materials (including recruitment emails, letters, consent forms, assent forms, survey instruments) and data 
management procedures prior to study implementation. 
 
Project staff will provide participants with IRB-approved consent forms that will describe the purpose of the 
project, risks and benefits. The consent will occur in person and will be administered by a member of the 
research team. Project staff will provide participants with copies of their signed IRB-approved consent forms 
that will describe the purpose of the project, risks and benefits, and selection criteria. Participants will be 
informed that they have a right to withdraw from the study at any time. No additional data will be collected from 
participants who decide to withdraw; however, the information collected prior to withdrawal will remain in the 
study. 
 
Responses to focus group or survey questions will not reasonably place participants at risk of criminal or civil 
liability or be damaging to the financial standing, employability, or reputation of subjects. Participants will be 
informed that they have a right to withdraw from the study at any time and there will be no penalty for non-
participation.  
 
All data management, analysis and reporting activities will be conducted by project staff. All notes and printed 
data collection forms will be stored in locked cabinets; all electronic data files will be stored on secure network 
servers behind computer firewalls, with routine backup. All identifiers for participants will be stored in secure 
files and behind computer firewalls. Participant names and study identification numbers will be recorded and 
stored separately from the research data files. Data forms will be labeled only with participant identification 
number. Results of analyses will be shared in aggregate form only.  
 
 

3.1.2.2. Protection Against Risk.  
To minimize potential psychological risk, all focus group facilitators will establish ground rules for discussion 
that includes an open, non-evaluative exchange of comments and ideas. All surveys and data collection forms 
will be IRB-approved and employed under the supervision of senior project staff. Participants will be told that 
they do not have to answer any questions which make them uncomfortable and may terminate their 
participation at any time they wish.   
 
The data collected on this project will be obtained with the survey questions and focus group procedures. 
Notes, surveys, audio recordings, and data will be accessible only by research personnel. Responses to focus 
group or survey questions would not reasonably place the subjects at risk of criminal or civil liability or be 
damaging to the subjects' financial standing, employability, or reputation.  
 
Additionally, all data and other information for this study will be maintained confidentially. To protect against 
risks posed by a potential loss of confidentiality, we will take the following steps. First, participants will be 
assured that they are free to refrain from answering any questions they do not wish to answer. Second, all data 
will be identified only by a PIN, which will be randomly generated for study purposed. Third, a master list of 
names and code numbers will be stored in locked file cabinets under the supervision of the PI and will be 
available only to research staff on this project. Next, graduate student research assistants will receive training 
on the importance of confidentiality and all personnel will complete the required NIH training in protection of 
human research participants and will sign confidentiality statements. Completed questionnaires will be stored 
in a locked file cabinet under the supervision of the PI. Data will also be retained on computers with restricted 
and password protected access, without links to the master code list. All data based on this research will be 
reported in aggregate form. No individual respondents will be identified.  
 
3.1.3.  Potential Benefits of the Proposed Research to Participants and Others 
Potential benefits for all participants will be the knowledge that one has helped in development of an 
intervention that teaches teachers how to support students who witness bullying, to reduce both bullying and 
the negative emotional consequences for both targets and bystanders. Also, participants will have the 
opportunity to make a difference at their school and view themselves as advocates for students in their school 
community, which can result in positive feelings. Additionally, teachers will be compensated with a $50 gift card 
for participation in data collection and the teacher training and $50 for their participation in focus groups. 
 
3.1.4. Importance of the Knowledge to be Gained   
The development and implementation of bullying intervention programs for middle school students has the 
potential for reducing the serious public health problem of bullying and the negative associated consequences. 
Given the relatively high rates of bullying in middle school and the relationship between bullying and the 
development of socio-emotional problems, dissemination of efficacious intervention programs has the potential 
for significant societal benefits. Although current school-wide bullying programs can be effective, both time- 
and labor-intensive resources required for program implementation pose significant barriers for schools, 
particularly in low-income and rural communities. Further, few anti-bullying programs provide teacher 
education, and those that do are rarely interactive and do not focus on supporting bystanders. Thus, 
developing a STAC Teacher Module has the potential to enhance the efficacy of the STAC intervention, 
thereby further reducing bullying and the associated negative consequences for both targets and bystanders. 
 
3.3 Data and Safety Monitoring Plan (PDF) 
A data safety and monitoring plan will be implemented for this project, following well-established procedures. 
We will not set up an independent Data Safety and Monitoring Board because this study is very low risk, does 
not include use of therapeutics, and psychological risk is not anticipated.  
 
We will maintain strict confidentiality of participants in the project’s registration system, provide only ID 
numbers in data files, and ensure quality control using standard data management routines. We will work to 
maximize participation to minimize missing data. We will use standard data management procedures. Files 
connecting data with IDs will be kept confidential.  
 
Study progress will be monitored monthly by the PI and Co-PI. All critical events will be reviewed by the 
Investigators to ensure that our methods have not been intrusive or disruptive. The Co-PI will examine the 

quality of data input throughout the data collection period, following standard quality control and assurance 
procedures. Analyses of the data will be performed by the Co-PI at the conclusion of the baseline data 
collection period to assess distributional assumptions and the success of randomization.  
 
The PI is responsible for reporting all adverse events to the IRB. Only Grade 1 events are expected on this 
trial. Thus, adverse events will be reported annually, as required by DHHS. This report will be reviewed by the 
IRB. Any action taken by the IRB or project investigators resulting in a temporary or permanent suspension of 
the trial will be communicated immediately by the PI to the NIH grant program officer. 
 
 
3.4 Will a Data and Safety Monitoring Board be appointed for this study? 
Yes ☐ No ☒ 
 
3.5 Overall Structure of the Study Team 
 
The research project will be conducted by a research team at Boise State University (Boise State). Drs. Aida 
Midgett, Principal Investigator (PI) and Diana Doumas, Co- Principal Investigator (Co-PI) will ensure that the 
research project is in compliance with human subjects requirements and will work to build consensus on 
administrative and scientific decisions that must be made during planning and execution of the protocol. Drs. 
Midgett and Doumas will work collaboratively with Boise State business office staff on budgeting and 
operational issues.  
 
4.1 Study Design 
4.1.a. Detailed Description 
 
National statistics indicate bullying peaks in middle school, with approximately 28.0% of middle school students 
reporting bullying victimization and 33.0% reporting being cyberbullied. Among middle school students, bullying 
victimization and witnessing bullying as a bystander are associated with a wide range of mental health risks. 
Rural youth and youth in low-income communities are particularly vulnerable to bullying. Students in rural 
communities report higher rates of bullying and bullying victimization than those in urban areas and students in 
low-income households report the highest rates of bullying, physical bullying, bullying-related injury, and 
cyberbullying across income categories. Although comprehensive, school-wide bullying programs can be 
effective in reducing bullying, both time- and labor-intensive resources required for program implementation 
pose significant barriers for schools, particularly in low-income and rural communities. Brief interventions that 
reduce barriers for implementation to address health disparities are needed to reduce bullying and its negative 
consequences among students in rural and low-income communities.     
 
To address barriers to program implementation, the PI developed a brief bullying bystander intervention, 
STAC, using four strategies: Stealing the Show, Turning it Over, Accompanying Others, and Coaching 
Compassion. Research conducted in rural and low-income communities indicates STAC is effective in reducing 
bullying perpetration, victimization, and negative mental health consequences for bystanders who witness 
bullying.  Although initially developed as an in-person brief intervention, the research team is currently adapting 
STAC to a technology-based format (STAC-T) to further reduce implementation barriers for schools in rural 
and low-income communities. Research indicates there is a need for technology-based bullying bystander 
interventions at these schools and that schools in these communities have the interest and infrastructure to 
adopt STAC-T once developed. 
 
Middle school students indicate that school bullying occurs most often in the classroom, accounting for 42.3% 
of all school bullying incidences. However, national data indicate that only approximately half (51.7%) of middle 
school students report bullying to an adult at school, with report prevalence declining from sixth grade (57.2%) 
to eighth grade (47%). Although students report bullying to teachers more often than to any other adult at 
school, reporting behavior is influenced by a student’s perception of teachers’ responses to bullying. Students 
are more likely to report when they believe teachers will intervene, effectively handle the situation, and 
reward students’ efforts when they report or intervene in bullying. In addition, students’ future reporting 
behavior is influenced by how teachers respond to students’ initial reporting. Students are less likely to report 
bullying and rates of bullying are higher in the classroom when students perceive that teachers have low self-

efficacy in handling bullying situations. As such, it is important for teachers to demonstrate comfort with and 
confidence in handling bullying situations. Training teachers to effectively respond to bullying and to encourage 
and support students who report and intervene in bullying are important components of bullying programs 
aimed at increasing student bystander intervention.  
 
The overall project goal is to develop the content for a STAC Teacher Module. The project will be completed in 
11.5 months and will consist of two stages: (1) content development and (2) testing of program acceptability, 
feasibility, and short-term outcomes. The primary outcomes are increases in knowledge and confidence, 
changes in bullying attitudes, increases in self-efficacy to manage bullying, and intentions to use the teacher 
strategies. The secondary outcomes are related to program acceptability. Teachers will complete baseline and 
immediate post-intervention assessments. 
 
The proposed project is a first step in developing the STAC-T Teacher Module. This project will provide the 
pilot data needed to support a NIMHD STTR/SBIR R41/42 fast-track proposal aimed at developing the STAC-T 
Teacher Module for middle schools in rural and low-income communities. The aims of the pilot study are to: 
(1) Develop the content for the Teacher Module. Our previous research with school personnel and the 
bullying literature will guide the creation of the Teacher Module content.   
(2) Assess the feasibility, acceptability, and immediate outcomes (e.g., knowledge, attitudes, self-
efficacy, and behavioral intentions) of the STAC-T Teacher Module. We will conduct a quantitative study 
with teachers (N = 20) from one middle school, assessing program acceptability and post-training outcomes 
through survey data; a subgroup of teachers (N = 12-16) will participate in focus groups, providing feedback 
about content, feasibility, and acceptability of the Parent Module for schools in rural, low-income communities.  
 
A mixed-methods approach will be utilized; 20 teachers will be recruited from one public middle school located 
in a rural, low-income community in Idaho. All teachers of students in grades 6th- 8th meeting 
inclusion/exclusion criteria will be recruited through an email r sent by the school liaison and asked to sign up 
to participate. We will continue recruitment until we reach the target sample. The email will explain the study 
and include a survey link to sign up for participation, as well as a project phone number and email address. 
Teachers will be invited to participate in the study in the evening at the school. Teachers who provide consent 
will be provided a unique study ID number and will complete the baseline assessment. Immediately after 
completing the baseline assessment, teachers will complete the Teacher Module training. Following the 
training, teachers will complete the follow-up assessment. Baseline assessments include a survey assessing 
knowledge, confidence, attitudes, self-efficacy, and demographic characteristics. Immediately following the 
STAC Teacher training, teachers will complete a survey assessing acceptability of the training, knowledge, 
confidence, attitudes, self-efficacy, and behavioral intentions to use the STAC teacher strategies.  
 
Study consents and assessments will be collected via paper-pencil format. All data will be input into SPSS; 
data will be de-identified and stored in Boise State’s secured database. Boise State’s protocols for quality 
assurance (valid ranges; internal consistency checks, etc.) will ensure high quality data.  
 
4.1.b. Primary Purpose 
Prevention 
 
4.1.c. Interventions 
Type: 
 
Behavioral  
 
Name: (up to 200 characters) 
 
STAC-T Teacher Module 
 
Description: (up to 1000 characters) 
 
Teacher-based bullying intervention 
 

 
 
4.1.d. Study Phase 
Phase 1 
 
Is this an NIH-defined Phase III clinical trial? 
Device and behavioral intervention studies may select “Yes” here even if the answer above is “Other”. 
Yes ☐ No ☒ 
 
4.1.e. Intervention Model  
Single Group 
 
4.1.f. Masking 
If yes: 
Choose an item. 
 
4.1.g. Allocation 
N/A 
 
4.2 Outcome Measures 
 
Type  
Primary  
 
Name 
Teacher-Advocates Pre- and Post-Scale (TAPPS)  
 
Time Frame 
Baseline assessment, immediate post-assessment 
 
Brief Description: 
An 11-item questionnaire measuring teacher knowledge of bullying, knowledge of the teacher STAC strategies, 
and teacher confidence to supporting students to intervene in bullying situations.  
 
Type  
Primary  
 
Name 
National Education Association Bullying Survey  
 
Time Frame 
Baseline assessment, immediate post-assessment 
 
Brief Description: 
This questionnaire has items that measure comfort managing bullying (4 items on a 4-point likert scale), and 
teachers’ self-efficacy in handling bullying situations (2 items on a 4-point likert scale).   
 
Type  
Primary  
 
Name 
Teacher’s Attitudes about Bullying Questionnaire 
Time Frame 
Baseline assessment, immediate post-assessment 
 
Brief Description: 
The subscale to measure confidence in Managing Bullying was used. This included 3 items rated on a 5-point 

Likert Scale. 
 
 
Type  
Primary  
 
Name 
Intention to Use Teacher STAC Strategies   
 
Time Frame 
Immediate post-assessment 
 
Brief Description: 
Questions rating teacher intention to use each teacher STAC strategy was measured using four items rated on 
a 5-point Likert scale. Questions asked teachers the following: How likely are you to support students using 
these strategies to intervene in bullying in the future? a) Stealing the Show—support students using humor or 
distraction to get the attention away from the bullying situation, b) Turning it Over—support a student who 
reported bullying to you or supporting students to report to a principal or SRO, c) Accompanying Others—
support students who reach out to the student who was the target of bullying, or d) Coaching Compassion—
support students who help the student who bullied develop empathy for the target. 
 
Type  
Secondary  
 
Name 
Acceptability Survey 
 
Time Frame 
Immediate post-assessment 
 
Brief Description: 
An 8-item questionnaire measuring acceptability and relevance of the Teacher Module. Items were ranked on 
a 4-point Likert scale.  
 
Type  
Secondary  
 
Name 
Qualitative questions 
 
Time Frame 
Immediate post-assessment 
 
Brief Description: 
Brief open-end questions that ask how helpful the program was, how the liked program was, and whether the 
user has any suggested changes to the program. 
 
4.3 Statistical Analysis Plan 
 
The primary outcomes are detecting positive changes in knowledge acquisition and confidence, attitudes about 
bullying, self-efficacy regarding bullying, and intention to use of the STAC teacher strategies. The secondary 
outcomes are program acceptability.  A total of 20 teachers within one school provides at least 80% power to 
detect a difference in baseline and immediate follow-up corresponding to a medium effect size (e.g., Cohen’s d 
= .5) with a 5% type I error probability. We propose planning for 20 teachers. 
 
We will evaluate whether the STAC Teacher Module increases knowledge and confidence, changes attitudes 
about bullying, and increases self-efficacy from baseline to immediate follow-up, as well as intention to use the 

STAC teacher strategies at the immediate follow-up. We will also evaluate acceptability at the immediate 
follow-up. Means, SDs, and percentages will be used to describe the primary and secondary outcomes.  
 
Quantitative data from the questionnaires will be analyzed using SPSS (version 28.0; IBM Corp). Before 
conducting the statistical analyses, the data will be examined for outliers and normality. We will conduct a 
series of paired-sample t tests to evaluate changes from pretest to posttest measurements. Qualitative 
summary reports will also be prepared.