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Randomized Controlled Trial
. 2017 Mar 28;5(1):115-137.
doi: 10.9745/GHSP-D-16-00215. Print 2017 Mar 24.

Preventing Peer Violence Against Children: Methods and Baseline Data of a Cluster Randomized Controlled Trial in Pakistan

Judith McFarlane  1 , Rozina Karmaliani  2 , Hussain Maqbool Ahmed Khuwaja  2 , Saleema Gulzar  2 , Rozina Somani  2 , Tazeen Saeed Ali  2 , Yasmeen H Somani  2 , Shireen Shehzad Bhamani  2 , Ryan D Krone  3 , Rene M Paulson  3 , Atta Muhammad  4 , Rachel Jewkes  5
Affiliations
Randomized Controlled Trial

Preventing Peer Violence Against Children: Methods and Baseline Data of a Cluster Randomized Controlled Trial in Pakistan

Judith McFarlane et al. Glob Health Sci Pract. .

Abstract

Background: Violence against and among children is a global public health problem that annually affects 50% of youth worldwide with major impacts on child development, education, and health including increased probability of major causes of morbidity and mortality in adulthood. It is also associated with the experience of and perpetration of later violence against women. The aim of this article is to describe the intervention, study design, methods, and baseline findings of a cluster randomized controlled trial underway in Pakistan to evaluate a school-based play intervention aiming to reduce peer violence and enhance mental health.

Methods: A cluster randomized controlled design is being conducted with boys and girls in grade 6 in 40 schools in Hyderabad, Pakistan, over a period of 2 years. The Multidimensional Peer-Victimization and Peer Perpetration Scales and the Children's Depression Inventory 2 (CDI 2) are being used to measure the primary outcomes while investigator-derived scales are being used to assess domestic violence within the family. Specifics of the intervention, field logistics, ethical, and fidelity management issues employed to test the program's impact on school age youth in a volatile and politically unstable country form this report.

Baseline results: A total of 1,752 school-age youth were enrolled and interviewed at baseline. Over the preceding 4 weeks, 94% of the boys and 85% of the girls reported 1 or more occurrences of victimization, and 85% of the boys and 66% of the girls reported 1 or more acts of perpetration. Boys reported more depression compared with girls, as well as higher negative mood and self-esteem scores and more interpersonal and emotional problems.

Interpretation: Globally, prevalence of youth violence perpetration and victimization is high and associated with poor physical and emotional health. Applying a randomized controlled design to evaluate a peer violence prevention program built on a firm infrastructure and that is ready for scale-up and sustainability will make an important contribution to identifying evidence-informed interventions that can reduce youth victimization and perpetration.

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Figures

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Students in Pakistan engage in the Right To Play curriculum through games and activities twice weekly.
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The Right To Play intervention in Pakistan encouraged girls' engagement in sports by holding tournaments and community events.
FIGURE
FIGURE
Percentage of Participants Exposed to Low-Violence and High-Violence Peer Perpetration and Victimization Using CDC Cutoffsa by Study Arm and Gender, Hyderabad, Pakistan, 2016
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The Right To Play program in Pakistan focuses on 4 areas of child and youth development including physical, cognitive, social, and emotional components. At baseline, boys reported more depression and interpersonal and emotional problems than girls.
See this image and copyright information in PMC

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