JMIR Publications

ABSTRACT

Background:

Violence against children (VAC) in schools is a global public health problem. There is growing evidence that school-based interventions can be effective in reducing VAC in schools. However, there is little evidence about the long-term impact of such interventions. The Good School Toolkit, developed by Raising Voices, a Uganda-based non-profit organisation, is a whole-school violence prevention intervention that aims to change the operational culture of primary schools. In 2014, the Toolkit was evaluated through a cluster randomised controlled trial (Good Schools Study, GSS) and found to reduce teacher-on-student and student-on-student violence.

Objective:

This protocol describes quantitative analyses to explore longer-term outcomes of the Toolkit intervention among adolescents in Uganda, including the extent to which it is associated with peer-violence victimisation (primary outcome) and secondary outcomes: peer-violence perpetration; intimate-partner violence; acceptance of teacher-violence; equitable gender attitudes; agency; self-regulation; peer connectedness; social assets; psychological assets and retention in school.

Methods:

This is a non-randomised quasi-experimental 4-year follow-up study of adolescents who attended the 42 GSS primary schools in 2014. 21 schools initiated the Toolkit intervention during the GSS trial from 2012, and 19 schools initiated the intervention after the trial (during the scale-up phase) from 2015. Two schools did not implement the intervention. Students in the final school grade (Primary 7) during 2014 are expected to have left school prior to Toolkit scale-up in the 19 primary schools. Wave 1 data were collected in 2014 from 3431 grade Primary 5 to Primary 7 school students aged 11-14 years; these students were followed up in 2018-19 when aged 16-19 years and invited to participate in the Wave 2 survey. Data were collected in face-to-face interviews by trained Ugandan field researchers. Toolkit exposure groups are defined based on exposure during the GSS trial (from 2012), later during scale-up (from 2015), or not exposed including those expected to have completed Primary 7 prior to Toolkit scaled-up or from the two schools that did not implement the Toolkit. Associations between outcomes at Wave 2 and Toolkit exposure groups will be analysed using mixed-effect multivariable logistic and linear regression models for binary and continuous outcomes respectively. This analysis is exploratory and aims to generate hypotheses on if, and under what circumstances, the Toolkit influences later adolescent outcomes.

Results:

NA

Conclusions:

To our knowledge, this is the first long-term follow-up study of adolescents exposed to a school-based violence-prevention intervention in sub-Saharan Africa. If the intervention reduces violence and improves other outcomes in later adolescence, then this study supports primary school interventions as key to achieving long-term population impacts. Pattern of effects will inform where reinforced or additional interventions are needed. Clinical Trial: This study is a long-term follow up of participants in the Good Schools Study (NCT01678846, clinicaltrials.gov) funded under the Contexts of Violence in Adolescence Cohort (CoVAC) Study, MR/R002827/1.