The EmpaTeach intervention for reducing physical violence from teachers to students in Nyarugusu Refugee Camp: A cluster-randomised controlled trial.
The EmpaTeach intervention for reducing physical violence from teachers to students in Nyarugusu Refugee Camp: A cluster-randomised controlled trial.
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DOI：
10.1371/journal.pmed.1003808
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发表时间：
2021-10
期刊：
影响因子：
15.8
通讯作者：
Devries KM
中科院分区：
文献类型：
--
作者：
Fabbri C;Rodrigues K;Leurent B;Allen E;Qiu M;Zuakulu M;Nombo D;Kaemingk M;De Filippo A;Torrats-Espinosa G;Shayo E;Barongo V;Greco G;Tol W;Devries KM
以学校为基础的暴力预防干预措施为减少儿童遭受教师暴力的经历提供了巨大的潜力，但在全球范围内得到严格评估的很少，据我们所知，在人道主义环境中也没有。我们测试了EmpaTeach干预措施是否可以减少坦桑尼亚尼亚卢古苏难民营的教师对学生的身体暴力。我们进行了一项平行分配的双臂随机对照试验。对尼亚卢古苏难民营所有27所小学和中学的完整样本进行了接触，并同意参加研究。符合条件的学生和教师分别在2018年11月/12月、2019年5月/6月和2020年1月/2月参加了横断面基线、中线和终线调查。14所学校被随机分配接受2019年1月至3月实施的针对教师的暴力预防干预；13所学校组成了等待名单控制组。EmpaTeach干预使用共鸣建立练习和小组工作来装备教师自我调节、替代纪律技巧和课堂管理策略。由于干预的性质，分配没有被隐瞒。主要结果是学生自我报告的来自教师的身体暴力经历，使用ISPCAN儿童虐待筛查工具-儿童机构的修订版在中线进行评估。次要结果包括学生报告的情绪暴力、抑郁症状和学校出勤率。分析是通过意向处理，使用根据分层因素调整的通用估计方程。没有学校离开这项研究。在1866名(80%)随机抽样的学生中，总共有1,493人参加了基线调查；在基线调查中，54.1%的学生报告了学校工作人员过去一周的身体暴力行为。总体而言，1,978名学生中有1,619人(81.9%)参加了中线调查，2,032名学生中有1,617人(79.6%)参加了Endline调查。过去一周的中线暴力发生率在干预组(48.6%)和对照学校(53.0%)无统计学差异(P=0.106)。未检测到对二次结局的影响。在实施干预期间，全营范围内的教育政策变化导致14.7%的干预组教师接受了压缩版的干预，但探索性分析表明，学校层面对干预的坚持程度对我们的主要结果没有影响。主要的研究限制包括营地中学校的数量很少，这限制了统计能力来发现干预组和控制组之间的微小差异。我们也没有评估我们结果测量的重测可靠性，面试者被揭穿了干预分配的秘密。没有证据表明EmpaTeach干预措施有效地减少了教师对尼亚卢古苏难民营中小学生的身体暴力。需要进一步研究，以制定和测试干预措施，以防止人道主义环境中的教师暴力。ClinicalTrials.gov(NCT03745573)在一项整群随机对照试验中，Camilla Fabbria博士和他的同事调查了EmpaTeach干预措施是否可以减少坦桑尼亚尼亚卢古苏难民营教师对学生的身体暴力。学校内外的暴力行为普遍存在，教师是对学生实施暴力的最常见的肇事者之一。在人道主义环境中，普遍的不安全以及学生和教师的创伤史可能会加剧暴力的风险。尽管如此，防止教师暴力侵害儿童的干预措施很少在随机对照试验中得到严格测试，据我们所知，在人道主义环境中也没有。我们进行了一项整群随机对照试验，以测试一项简短的基于学校的同伴主导的行为干预，以减少教师在坦桑尼亚尼亚卢古苏难民营对学生使用身体和情感暴力的情况。干预包括为期10周的12次会议，内容包括建立同理心的练习和小组工作，以学习和实践自我调节技术、积极的纪律方法和促进福祉的战略。在干预实施后2个月和10个月，我们没有发现任何证据表明干预降低了暴力水平。我们没有发现证据表明干预在改善儿童的身体或情感暴力体验方面是有效的，这可能是由于设计、交付和背景因素的组合。需要进一步研究，以测试哪些干预内容和交付战略可以有效地减少人道主义环境中的校园暴力。
School-based violence prevention interventions offer enormous potential to reduce children’s experience of violence perpetrated by teachers, but few have been rigorously evaluated globally and, to the best of our knowledge, none in humanitarian settings. We tested whether the EmpaTeach intervention could reduce physical violence from teachers to students in Nyarugusu Refugee Camp, Tanzania. We conducted a 2-arm cluster-randomised controlled trial with parallel assignment. A complete sample of all 27 primary and secondary schools in Nyarugusu Refugee Camp were approached and agreed to participate in the study. Eligible students and teachers participated in cross-sectional baseline, midline, and endline surveys in November/December 2018, May/June 2019, and January/February 2020, respectively. Fourteen schools were randomly assigned to receive a violence prevention intervention targeted at teachers implemented in January–March 2019; 13 formed a wait-list control group. The EmpaTeach intervention used empathy-building exercises and group work to equip teachers with self-regulation, alternative discipline techniques, and classroom management strategies. Allocation was not concealed due to the nature of the intervention. The primary outcome was students’ self-reported experience of physical violence from teachers, assessed at midline using a modified version of the ISPCAN Child Abuse Screening Tool–Child Institutional. Secondary outcomes included student reports of emotional violence, depressive symptoms, and school attendance. Analyses were by intention to treat, using generalised estimating equations adjusted for stratification factors. No schools left the study. In total, 1,493 of the 1,866 (80%) randomly sampled students approached for participation took part in the baseline survey; at baseline 54.1% of students reported past-week physical violence from school staff. In total, 1,619 of 1,978 students (81.9%) took part in the midline survey, and 1,617 of 2,032 students (79.6%) participated at endline. Prevalence of past-week violence at midline was not statistically different in intervention (408 of 839 students, 48.6%) and control schools (412 of 777 students, 53.0%; risk ratio = 0.91, 95% CI 0.80 to 1.02, p = 0.106). No effect was detected on secondary outcomes. A camp-wide educational policy change during intervention implementation resulted in 14.7% of teachers in the intervention arm receiving a compressed version of the intervention, but exploratory analyses showed no difference in our primary outcome by school-level adherence to the intervention. Main study limitations included the small number of schools in the camp, which limited statistical power to detect small differences between intervention and control groups. We also did not assess the test–retest reliability of our outcome measures, and interviewers were unmasked to intervention allocation. There was no evidence that the EmpaTeach intervention effectively reduced physical violence from teachers towards primary or secondary school students in Nyarugusu Refugee Camp. Further research is needed to develop and test interventions to prevent teacher violence in humanitarian settings. clinicaltrials.gov (NCT03745573) In a cluster-randomised controlled trial, Dr. Camilla Fabbria and colleagues investigate whether the EmpaTeach intervention could reduce physical violence from teachers to students in Nyarugusu Refugee Camp, Tanzania. Violence in and around schools is widespread, and teachers are among the most frequent perpetrators of violence against students. In humanitarian settings, widespread insecurity and students’ and teachers’ histories of trauma may exacerbate the risk of violence. Despite this, few interventions to prevent violence against children from teachers have been rigorously tested in randomised controlled trials, and none to our knowledge in humanitarian settings. We conducted a cluster-randomised controlled trial to test a brief school-based peer-led behavioural intervention to reduce teachers’ use of physical and emotional violence against students in Nyarugusu Refugee Camp, Tanzania. The intervention consisted of 12 sessions delivered over 10 weeks, covering empathy-building exercises and group work to learn and practice self-regulation techniques, positive disciplinary methods, and strategies to promote well-being. We found no evidence that the intervention reduced levels of violence at 2 and 10 months after the intervention implementation. We did not find evidence that the intervention was effective in improving children’s experiences of physical or emotional violence, and this could be due to a combination of design, delivery, and contextual factors. Further research is needed to test what intervention components and delivery strategies can be effective to reduce school-based violence in humanitarian settings.
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影响因子：
2.6
作者：
Karmaliani R;McFarlane J;Khuwaja HMA;Somani Y;Shehzad S;Saeed Ali T;Asad N;Chirwa ED;Jewkes R
通讯作者：
Jewkes R
过去一年对儿童的暴力行为的全球流行：系统的审查和最低估计。
影响因子：
8
作者：
Hillis S;Mercy J;Amobi A;Kress H
通讯作者：
Kress H
DOI：
10.1016/s2214-109x(21)00002-4
发表时间：
2021-04
期刊：
The Lancet. Global health
影响因子：
--
作者：
Baker-Henningham H;Bowers M;Francis T;Vera-Hernández M;Walker SP
通讯作者：
Walker SP
影响因子：
8
作者：
Devries, Karen M.;Child, Jennifer C.;Naker, Dipak
通讯作者：
Naker, Dipak
影响因子：
1.2
作者：
FELSON, RB
通讯作者：
FELSON, RB