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Strengthen the Evidence for Maternal and Child Health Programs

New: MCHbest strategies database for sample ESMs

Evidence Tools
MCH Best. NPM 9: Bullying

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Strategy. Ongoing Outreach at Schools

Approach. Collaborate with School Based Health Centers to conduct ongoing meetings, conferences, and webinars to address bullying.

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Overview. Multiple studies have supported the implementation of comprehensive school-based bullying prevention efforts.1 Youth who are bullied are at an increased risk for health and mental health challenges2, School Based Health Centers (SBHCs) are critical partners in bullying prevention.While evidence shows that school-wide interventions (e.g., school rules; media campaigns; teacher/staff trainings) to combat bullying have some effectiveness, they tend to be most effective when implemented in conjunction with other bullying prevention programs. Thus, combining classroom and school level interventions appears to be more effective than implementing either alone. To have effect, school-wide interventions need to be ongoing rather than time-limited.3, 4

Evidence. Emerging Evidence. There is recent evidence that universal strategies such as those implemented in schools (e.g., school rules or teacher/staff training) and/or classrooms (e.g., classroom instruction or class rules) may be somewhat effective. While these results are encouraging, more research is needed for conclusive results. Access the peer-reviewed evidence for school rules, media campaigns, and establishment of classroom rules through the MCH Digital Library. Note: the evidence has found that while targeted interventions (e.g., Zero-Tolerance policies, group treatment for youth who bully, and short-term awareness raising events) are not effective by themselves, when combined with universal interventions (e.g., classroom or school-based), they yield additional benefits. Likewise, combining classroom and school level interventions appears to be more effective than implementing either alone. Thus, multi-tiered approaches have been shown to be the most effective approach in addressing bullying. (Read more about understanding evidence ratings).

Target Audience. Universal: School-wide approach (no other intervention). See above for added benefits of combining with other interventions.

Outcome. Reduced children and adolescents who report being bullied. For detailed outcomes related to each study supporting this strategy, click on the peer-reviewed evidence link above and read the "Intervention Results" for each study.

Examples from the Field. Access descriptions of ESMs across all state/jurisdictions that use this strategy directly or intervention components that align with tis strategy. You can use these ESMs to see how other Title V agencies are addressing the NPM.

Delaware has SBHCs in almost of its public high schools. These SBHC provide a multiude of services, including mental health. Titel V agencies have partnered with SBC to address bullying as a health issue, with a particular focus on mental health impact, not only for the students who are being bullied but for the students who bully others.

The Role of Title V. Title V agencies can support schools that offer comprehensive bullying prevention programming:

Sample ESMs. Using the approach “Collaborate with School Based Health Centers to conduct ongoing meetings, conferences, and webinars to address bullying,” here are sample ESMs you can use as a model for your own measures using the Results-Based Accountability framework (for suggestions on how to develop programs to support this strategy, see The Role of Title V in Adapting Strategies):

QUADRANT 1:
Measuring Quantity of Effort
("What/how much did we do?")

  • Number of School Based Health Center collaborations with MCH staff to conduct meetings, conferences and webinars on bullying and suicide.

QUADRANT 2:
Measuring Quality of Effort
("How well did we do it?")

  • Percent of school based health centers that collaborated with MCH staff to conduct meetings, conferences and webinars on bullying and suicide prevention.

QUADRANT 3:
Measuring Quantity of Effect
("Is anyone better off?")

  • Number of school based health centers that upon completion of meetings, conferences and webinars with MCH staff, reported a decline in reported bullying incidents.

QUADRANT 4:
Measuring Quality of Effect
("How are they better off?")

  • Percent of school based health centers that upon completion of meetings, conferences and webinars with MCH staff, reported a decline in reported bullying incidents.

Note. ESMs become stronger as they move from measuring quantity to measuring quality (moving from Quadrants 1 and 3, respectively, to Quadrants 2 and 4) and from measuring effort to measuring effect (moving from Quadrants 1 and 2, respectively, to Quadrants 3 and 4).

Learn More. Read how to create stronger ESMs and how to measure ESM impact more meaningfully through Results-Based Accountability.


References:

1 National Academies of Science, Engineering, and Medicine. (2016). Preventing Bullying Through Science, Policy, and Practice. Washington, DC: The National Academies Press. doi:10.17226/23482.

2Bogart, L.M., Elliot, M.N., Klein, D.J., Tortolero, S.R., Mrug, S., et al. (2014). Peer Victimization in fifth grade and health in tenth grade. Pediatrics, 133(3), 440-447.

3 Cross, D., Shaw, T., Hadwen, K., Cardoso, P., Slee, P., Roberts, C., Barnes, A. (2016). Longitudinal impact of the Cyber Friendly Schools program on adolescents’ cyberbullying behavior. Aggressive behavior, 42(2), 166-180.

4 Perkins, H. W., Craig, D. W., & Perkins, J. M. (2011). Using social norms to reduce bullying: A research intervention among adolescents in five middle schools. Group Processes & Intergroup Relations, 14(5), 703-722.

This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number U02MC31613, MCH Advanced Education Policy, $3.5 M. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.