Preventing Violence by Teachers Against Children in Sub-Saharan Africa

Study Overview
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Brief Summary
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Violence has severe and long-lasting negative consequences for children's and adolescents' well-being and psychosocial functioning, thereby also hampering communities' and societies' economic growth. Studies show high prevalence of violence by teachers against children in Sub-Saharan Africa, both in countries where violence is lawful as disciplinary measure at school and in countries where it has been officially banned. In addition to legal and structural factors (e. g. stressful working conditions for teachers), attitudes favoring violence against children as an effective and acceptable discipline method and the lack of access to alternative non-violent strategies are likely to contribute to teachers' ongoing use of violence against children. Notwithstanding, there are currently very few school-level interventions to reduce violence by teachers that a) have been scientifically evaluated and b) that focus both on changing attitudes towards violence and on equipping teachers with non-violent discipline strategies. Thus, the present study tests the effectiveness of the preventative intervention Interaction Competencies with Children - for Teachers (ICC-T) in primary and secondary schools in Tanzania, Uganda and Ghana. Previous studies have provided initial evidence on the feasibility and effectiveness of ICC-T to reduce teacher violence in primary and secondary schools in Tanzania and secondary schools in Uganda. This study aims to provide further evidence for the effectiveness of ICC-T to reduce violence and to improve children's functioning (i.e. mental health, well-being, academic performance) across educational settings, societies and cultures.

Detailed Description
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The study is a multi-site cluster randomized controlled trial with schools (clusters) as level of randomization. Multi-stage random sampling will be applied to select three zones per country (Tanzania, Uganda and Ghana) and one district in each zone. In each district, eight public schools will be randomly selected, resulting in a total number of 72 schools (24 per country). Schools will be stratified based on school type (primary or secondary school) and location (rural or urban), leading to 36 sites or cluster pairs (3 countries x 3 zones x 2 school types x 2 locations). In each site, one school will be randomly allocated to the intervention group (that will receive the ICC-T intervention) and one school to the control group (that will receive no intervention). At each school, 40 students (stratified by gender) in the third year of primary school or in the first year of secondary/junior high school and all teachers (expected average number: 20) will be recruited. Thus the final sample will comprise 2880 students and at least 1440 teachers. The study will have three data assessment points: baseline assessment prior to the intervention, the first follow-up assessment six months after the intervention and the second follow-up assessment 18 months after the intervention. In addition, feasibility data will be assessed in the intervention group at the beginning and the end of the intervention. Primary outcome measures are student- and teacher-reported physical and emotional violence by teachers in the past week. Secondary outcome measures include teachers' attitudes towards violence against students, children's emotional and behavioral problems, quality of life, and cognitive functioning.

Official Title
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Reducing Violence by Teachers Against Children: A Multi-Site Cluster Randomized Controlled Trial of Interaction Competencies With Children - for Teachers (ICC-T) in Primary and Secondary Schools in Tanzania, Uganda and Ghana

Conditions
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Violence by Teachers

Intervention / Treatment
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* Behavioral: Interaction Competencies with Children - for Teachers (ICC-T)


Participation Criteria
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Eligibility Criteria
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General: Inclusion Criteria: All: Written informed consent (if underaged by parents (written) & minors themselves (oral or written) Students: Enrollment in class 3 of primary school or in class 1 of secondary school Teachers: All teachers employed at the school Schools: Public schools Mixed-gender schools Day schools At least 40 students in selected class/stream Exclusion criteria: Acute drug or alcohol intoxication Acute psychotic disorder

Ages Eligible for Study
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Minimum Age: 7 Years
Maximum Age: 70 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: ICC-T<br>5.5 days with 8 hours of training for teachers aiming at changing attitudes towards violence and equipping teachers with non-violent discipline strategies | Behavioral: Interaction Competencies with Children - for Teachers (ICC-T)<br>* Core training components include teacher-student interaction, maltreatment prevention, effective discipline strategies, identifying and supporting burdened students and implementation of the training materials into the school setting<br>|
| No Intervention: Monitoring condition<br>No intervention | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change of students' exposure to emotional and physical violence by teachers | The Conflict Tactics Scale (CTS) will be used to assess students' self-reported experiences of emotional and physical violence by teachers at school in the past week. Higher scores indicate higher levels of violence that is used by teachers. A change of exposure to violence in the intervention group is hypothesized. | The CTS will be used at T1 (baseline, prior to intervention), T2 (first follow-up, 6 months after intervention) and T3 (second follow-up, 18 months after intervention). | 
| Change of teachers' use of emotional and physical violence | The Conflict Tactics Scale (CTS) will be used to assess teachers' use of emotional and physical violent discipline measures against students in the past week. Higher scores indicate higher levels of violence that is used by teachers. A change in the use of violence in the intervention group is hypothesized. | The CTS will be used at T1 (baseline, prior to intervention), T2 (first follow-up, 6 months after intervention) and T3 (second follow-up, 18 months after intervention) | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change of teachers' positive attitudes towards emotional and physical violence | Teacher's attitudes towards emotional and physical violence will be assessed with an adapted version of the Conflict Tactic Scale (CTS). Higher scores indicate higher levels of positive attitudes towards violence. A change of positive attitudes towards violence in the intervention group is hypothesized. | The adapted version of CTS will be used at T 1 (baseline, prior to intervention), T2 (first follow-up, 6 months after intervention) and T3 (second follow-up, 18 months after the intervention).) | 
| Change of student's mental health | The Pediatric Symptom Checklist - Youth Report (PSC-Y) will assess students' emotional and behavioral problems. Higher scores indicate higher levels of students' mental health problems. A change of mental health problems in the intervention group hypothesized. | The PSC-Y will be used at T1 (baseline, prior to intervention), T2 (first follow-up, 6 months after intervention) and T3 (second follow-up, 18 months after intervention) | 
| Change of students' quality of life | The KIDSCREEN-10 will assess students' quality of life. Higher scores indicate higher levels of students' quality of life. A change of quality of life in the intervention group is hypothesized. | The KIDSCREEN-10 will be used at T1 (baseline, prior to intervention), T2 (first follow-up, 6 months after intervention) and T3 (second follow-up, 18 months after intervention) ] | 
| Change of students' cognitive functioning | Four tasks implemented in the Android application Psych Lab 101 (Neurobehavioral Systems, 2020) will be used to assess children's cognitive abilities including selective attention, working memory, interference control and cognitive control. Higher scores indicate higher levels of students' cognitive abilities. A stronger improvement of cognitive functioning in the intervention group compared to the control group is hypothesized. | The Psych Lab 101 application will be used at T1 (baseline, prior to intervention), T2 (first follow-up, 6 months after intervention) and T3 (second follow-up, 18 months after intervention) | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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school violence, teacher violence, intervention, teachers, students, primary schools, secondary schools