physical bullying case study

A Systematic Review of Bullying and Victimization Among Adolescents in India

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• Published: 07 September 2020
• Volume 3 , pages 253–269, ( 2021 )

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• Niharika Thakkar   ORCID: orcid.org/0000-0001-8754-6708 1 ,
• Mitch van Geel 1 &
• Paul Vedder 1  

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This study provides a systematic review of literature from India on traditional bullying and victimization among school-going adolescents. A search of bibliographic electronic databases PsycINFO, MEDLINE, ERIC, Web of Science, and PubMed was performed in May 2020. Thirty-seven studies were included in the review. For each study included, the following specifics were examined: (a) methodological characteristics, (b) prevalence estimates of bullying behavior, (c) forms of bullying, (d) risk factors, and (e) consequences of bullying. It was found that bullying happens in India, and some risk factors for bullying and victimization in India are typical to the Indian context. In addition, bullying in India is associated with adverse consequences for both the aggressor and the victim. Many studies on bullying from India should be interpreted cautiously because of problems with data collection processes, instrumentation, and presentation of the findings. Cross-cultural comparisons for prevalence estimates, and longitudinal studies to examine the direction of possible influence between bullying and its correlates need to be conducted, to cater to the large adolescent population of India.

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Bullying is an intentional and repetitive act of physical or psychological aggression, where the aggressor is more powerful than the victim (Olweus 1993 ). Meta-analytic studies have confirmed the marked prevalence of and risk factors associated with bullying perpetration and victimization among children and adolescents in school (Modecki et al. 2014 ). In a recent survey conducted in 79 countries with over 300,000 participants, 30% of the adolescent respondents reported that they had been victims of bullying in the past 30 days (Elgar et al. 2015 ). In India, research on bullying is scarce, certainly in proportion to its population size, as well as socio-cultural diversity (Milfont and Fischer 2010 ; Smith et al. 2018 ). The vast adolescent population provides ample opportunity and resources to further our understanding in the field of bullying. The disparities seen in India in terms of socio-cultural factors such as SES, religion, caste, gender, and color, which have been recognized as typical to the Indian context (Panda and Gupta 2004 ), may aid in breeding an imbalance of power, an underlying element of bullying (Olweus 1993 ). Moreover, given the diverse socio-cultural context of India, and its structural incongruence with western cultures (Charak and Koot 2015 ), literature from western countries may not be generalizable to the Indian population, thus requiring scientific attention to examine the role of these factors specifically in India (Smith et al. 2018 ).

Through the current review, we aim to provide researchers a notion of challenges that need to be addressed in future studies on bullying and victimization in India. Systematic reviews are of importance, because they closely follow a scientific and step-by-step approach, with an aim of limiting systematic errors or bias, and particularly seek to identify, evaluate, and synthesize all relevant studies to elucidate knowledge and advanced understanding of the topic at hand (Petticrew and Roberts 2008 ). The present systematic review focuses on traditional bullying and victimization among adolescents in schools in India, highlighting the following specifics: (a) methodological characteristics of included studies, (b) prevalence estimates of bullying behavior, (c) forms of bullying, (d) risk factors, and (e) consequences of bullying. Specifically, we examine the psychometric properties of the instruments adopted in the included studies from India, as well as methodological characteristics including design and data collection, sample size and sampling procedures of the included studies, and characteristics of bullying behavior distinctive to the Indian context.

Guidelines provided by Arksey and O’Malley ( 2005 ) for conducting systematic reviews were followed in the present study. A systematic search of bibliographic electronic databases PsycINFO, MEDLINE, ERIC, Web of Science, and PubMed was performed in May 2020. The following terms formed the basis of the search strategy: “bullying” OR “peer victim*” OR “bullied” OR “bully” OR “school harassment*” OR “ragging” OR “school violence*” AND “India” OR “Indian” OR “Hindi”. No date limit was set for the search. Our search was not limited to published articles; book chapters, dissertations, unpublished articles, and posters were also eligible. A flow diagram of the search results is provided in Fig. 1 . Only studies that focused on bullying by peers and the resulting victimization at school were included. Articles on online bullying or cyberbullying were excluded. There were too few studies on cyberbullying in India to provide a meaningful analysis, especially when such an analysis should also deal with recent concerns about cyberbullying studies (e.g., Wolke et al. 2017 ). Non-empirical studies that did not include quantifiable data (for instance, book reviews) were excluded as we focus on only empirical research in the current review. Six studies used interviews to gather data; for instance, Kshirsagar et al. ( 2007 ) used Olweus’s ( 1996 ) pre-tested semi-structure interview to collect data on bullying and victimization in their study. The answers to these interviews were quantified and used in statistical analyses, and therefore, we included the articles in the current review. Studies on Indian children who live outside of India were excluded. Because we focused on adolescents in school, the age of students in included studies should range between 10 and 19 years. For studies on students whose ages only partly overlapped with this intended range, we applied the rule that the average age should fall within the intended range and the lowest and highest age should be within 2 years of the intended age limits. Two studies did not provide a definitive age range of the participants included in their study (Patel et al. 2017 ; Schäfer et al. 2018 ); however, the studies indicate that the participants were from grade 8 to 10 (who are typically 12 to 15 years old), thereby qualifying for inclusion in the present review. Three studies did not provide the mean age of the participants in their study though they specify the age range of the participants (Kshirsagar et al. 2007 ; Malik and Mehta 2016 ; Ramya and Kulkarni 2011 ), and because the lower limit or higher limit of the provided age range in these three study fell within 2 years of 11–19 years old, we have included them in the present review. Eventually, 37 studies were included in the final review.

Search results for the systematic review

Methodological Characteristics of Included Studies

Design and data collection.

Of the 37 studies that were included, two were longitudinal studies (Nguyen et al. 2017 ; Thakkar et al. 2020 ), two were experimental studies with pre- and post-test intervention designs (Sharma et al. 2020 ; Shinde et al. 2018 , 2020 ), whereas the others were cross-sectional studies. Seven of the 37 studies used peer-reports, 21 studies used self-reports, two studies used both self- and peer-reports (Chakrabartty and Gupta 2016 ; Thakkar et al. 2020 ), whereas six studies used structured or semi-structured interviews and open-ended questions to collect data on bullying and victimization (Kshirsagar et al. 2007 ; Malhi et al. 2014 , 2015 ; Malik and Mehta 2016 ; Munni and Malhi 2006 ; Ramya and Kulkarni 2011 ). One study used a photo-story method (Skrzypiec et al. 2015 ), where participants were invited to use a photograph or picture to illustrate their opinions or experiences of bullying.

Psychometric Properties

Psychometric properties of the scales or interviewing approaches used in the studies have been reported in 22 of the 37 studies. Four studies reported the reliability and validity of the original scale (Malik and Mehta 2016 ; Menon and Hannah-Fisher 2019 ; Patel et al. 2017 ; Samanta et al. 2012 ), but did not report psychometric properties based on the Indian sample, while five studies reported neither the psychometric properties of the original scale nor its generalizability to the Indian sample (Kshirsagar et al. 2007 ; Maji et al. 2016 ; Sarkhel et al. 2006 ; Sharma et al. 2017 ; Sethi et al. 2019 ). Two studies used a scale developed by the authors of the study; however, psychometric properties were not reported (Kelly et al. 2016 ; Prakash et al. 2017 ). Four studies did not provide a clear description of the method of data collection, and the validity of the approach was not defined (Malhi et al. 2014 , 2015 ; Munni and Malhi 2006 ; Ramya and Kulkarni 2011 ). Seven studies specified that the instrument used to assess bullying behavior was an English language questionnaire, while 10 studies used either existing translations or translations created by the authors of the study, of English scales into Indian regional languages. Two studies used English instruments and orally explained the translation in Punjabi (Lee et al. 2018 ) or translated the difficult words to Hindi (Malik and Mehta 2016 ), and one study used English and Hindi language translations of the scales (Thakkar et al. 2020 ).

Of the 37 studies, 25 studies used a convenience or purposive sampling approach to recruit participants. One study used a proportionate random sampling approach to recruit participants (Kelly et al. 2016 ); one study used a two-stage cluster sampling approach (Swain et al. 2014 ); one used a multi-stage sampling design (Chakrabartty and Gupta 2016 ); six studies reported using a random sampling method for selecting either schools or participants (Kshirsagar et al. 2007 ; Maji et al. 2016 ; Malik and Mehta 2016 ; Nguyen et al. 2017 ; Ramya and Kulkarni 2011 ; Sarkhel et al. 2006 ), but only one of them reported how the school sample was randomized (by draw of lots; Sethi et al. 2019 ). Two studies used a randomized control design to allocate participants to experimental or control groups, where Prakash et al. ( 2017 ) used a cluster randomized control design, and the intervention study by Shinde et al. ( 2018 ) used randomized and masked groups for each of three study groups. One study used a quasi-experimental design, where of the two participating schools, one was randomly assigned to the intervention group, and the other was assigned to the control group (Sharma et al. 2020 ). Of the 37 studies included in the review, 17 studies had a sample size of less than 300 participants, nine studies had a sample size of between 300 and 500 participants, whereas 11 studies had a sample size larger than 500 participants.

The articles widely differed in their statistical reporting practices, and therefore, the amount of statistical information provided in the below sections and Table 1 varies per reported study. Time frames of bullying and victimization prevalence estimates are reported in the below sections if they were specified in the included studies. Percentages are rounded off without decimals.

Prevalence Studies

Eight studies focused on the prevalence of bullying in India, while 14 others provided descriptive statistics or percentages for sample participants that qualified as bullies or victims in their study. Of these, five studies provided the participants with a definition of bullying for peer nomination estimates of bullying and victimization in their research (Goossens et al. 2018 ; Khatri 1996 ; Lee et al. 2018 ; Skrzypiec et al. 2018a ; Thakkar et al. 2020 ). Studies from the same city or region in India were scarce, and reports inconsistent. We found that bullying perpetration estimates ranged from 7% (Thakkar et al. 2020 ) to 31% (Kshirsagar et al. 2007 ), and bullying victimization ranged from 9% (Thakkar et al. 2020 ) to 80% (Maji et al. 2016 ), across studies. For instance, Maji et al. ( 2016 ) found that only 38 of 273 adolescents were not bullied, resulting in a dominant 80% students qualifying as victims of bullying. Next to region differences in prevalence, estimates may be related to the reporter used. Kshirsagar et al. ( 2007 ) found higher prevalence rates for bullying for self-reports than for parent or guardian interviews, whereas Thakkar et al. ( 2020 ) found higher prevalence estimates for bullying and victimization for peer reports than for self-reports. Findings as regards prevalence and other findings or aspects reviewed of each study are reported in Table 1 .

Forms of Bullying

It was observed that name-calling or using bad words were common forms of bullying observed among adolescents next to physical bullying. For instance, Kshirsagar et al. ( 2007 ) reported that the most common types of bullying were teasing and giving discriminatory or offensive labels and nick names to others. Similarly, Malhi et al. ( 2014 ) reported that 16% of their sample were victims of direct bullying or physical bullying and 34% were victims of name-calling. Skrzypiec et al. ( 2015 ) showed that caste-based bullying was reported by students and that for females, sexual harassment or “eve-teasing” was a common occurrence.

Risk Factors for Bullying and Victimization

Thirteen studies from India focus on the risk factors and correlates of bullying and victimization. Risk factors refer to variables that have the potential to increase or decrease the likelihood of bullying behaviors occurring (Olweus 1996 ), whereas correlates of bullying behaviors focus on factors that are significantly associated with, and co-occur with, bullying behaviors. Risk factors for bullying and victimization identified through the review were body weight (Patel et al. 2017 ), religion (Thakkar et al. 2020 ), and age (Malhi et al. 2015 ; Ramya and Kulkarni 2011 ), and factors that were found to be significantly correlated to bullying behaviors were personality traits (neuroticism; Donat et al. 2012 ), academic performance (Patel et al. 2017 ), urban/rural setting (Nguyen et al. 2017 ; Samanta et al. 2012 ), and father’s education level (Sethi et al. 2019 ). Factors that were found to be risks or correlates of bullying behavior in various studies included in the review were caste-system of India (Kelly et al. 2016 ; Sethi et al. 2019 ; Thakkar et al. 2020 ), socio-economic status (Malhi et al. 2015 ; Sethi et al. 2019 ), and gender differences.

Studies focusing on the caste system of India reported contradictory findings ranging from “General” caste students experiencing lower harassment (Kelly et al. 2016 ), “General” caste students experiencing more victimization (Thakkar et al. 2020 ), to no differences between castes (Khatri  1996 ). As regards the role of religion, Thakkar et al. ( 2020 ) reported that non-Hindu children were significantly more likely to classify as victims than Hindu children. For SES, Malhi et al. ( 2015 ) found a significant relationship between SES and victimization, with low SES students scoring higher on physical victimization, whereas high SES students scored higher on relational victimization. For gender comparison, although not fully consistent, most studies within India reported that boys scored higher than girls on bullying perpetration and bullying victimization (Narayanan and Betts 2014 ; Nguyen et al. 2017 ; Patel et al. 2017 ; Pronk et al. 2017 ; Ramya and Kulkarni 2011 ; Sethi et al. 2019 ; Sharma et al. 2017 ; Swain et al. 2014 ). Age was also found to have some, though inconsistent, relationship with bullying behavior in school (Malhi et al. 2015 ; Patel et al. 2017 ; Ramya and Kulkarni 2011 ).

Consequences of Bullying

Being bullied was found to be associated with anxiety, depression, and preferring to stay alone (Kshirsagar et al. 2007 ). Also, bullied children were more likely to report symptoms such as school phobia, vomiting, catastrophizing, self-blaming, and sleep disturbances (Kshirsagar et al. 2007 ; Maji et al. 2016 ). Bully-victims had higher risk of conduct problems, hyperactivity, and academic difficulties, and while bullies were found to be better at academics, they had high self-esteem, and higher risk of hyperactivity and conduct problems (Malhi et al. 2014 ; Sarkhel et al. 2006 ).

Based on the syntheses of studies included in our review, we draw the following conclusions: (a) limitations in methodological characteristics of studies were identified with regard to sampling, instrumentation, data collection processes, and presentation of findings, and thus, conclusions from the included studies must be considered cautiously; (b) bullying happens in India, as it does internationally, though the range of prevalence estimates varies widely across studies; (c) name-calling, using bad words and other forms of relational and social bullying are common in India, and physical bullying is also prevalent; (d) risk factors for bullying and victimization in India show some factors that are typical to the Indian context, for example, caste; and (e) bullying is associated with adverse consequences for both, the aggressor and the victim, in India.

The current review notes that bullying is widely spread in India. However, available prevalence estimates vary largely across India, for bullying perpetration and for victimization. India is a geographically vast country, with enormous differences in regional socio-demographics (Charak and Koot 2015 ), thereby constraining prevalence estimates to stratified regions. Scholars have noted that homogeneity within culture in India, like in many other countries, cannot be assumed (Panda and Gupta 2004 ). Thus, generalizing regional prevalence estimates to be representative across India is questionable, calling attention to the need to conduct cross-regional and cross-cultural comparative studies of bullying behavior within the country.

Furthermore, the type of instruments and their psychometric properties impact the findings of a study (Milfont and Fischer 2010 ), thereby not only making prevalence estimates from studies in the present review questionable but also warranting caution to conclusions. Also, conclusions about similarities or differences between the Indian and Western contexts require that metric invariance first be established to allow cross-ethnic and cross-cultural comparisons (Milfont and Fischer 2010 ). Of the 37 studies included in the present review, 22 studies provided descriptions of the psychometric properties of the instruments used, while 15 studies did not report the properties of instruments in their study raising concerns about comparability across studies in terms of instruments used. Furthermore, most studies on bullying in India adopted a quantitative method of data collection, where only 6 out of the included 37 in the present review used a qualitative approach to collect data for their research. The concerns about validity are increased by the over reliance on self-reports; we found that only 7 of the 37 studies used peer-reports, and 2 studies used self- as well as informant reports. In self-rating procedures, pupils tend to underestimate their aggressive behavior and emphasize prosocial behavior on account of social desirability (Salmivalli et al. 1996 ). There is an urgent need to validate and standardize instruments, with special attention to peer reports that assess bullying behaviors and establish their generalizability to Indian samples, to attain unbiased reports of bullying behavior in India (Sousa and Rojjanasrirat 2011 ).

Furthermore, only few studies included a sample that is sizable enough to provide firm, stable conclusions (Naing et al. 2006 ), and thus, the basis for the generalizability of the reports on the prevalence is very narrow. Ioannidis ( 2005 ) asserted that the smaller the sample sizes in a study, the smaller the power of the study, and consequently the higher the likelihood of the research findings to be affected by bias. Thus, we emphasize the need to conduct more studies across India, with proportional sample sizes for objective, less biased conclusions regarding bullying behavior. Also, the purposive selection of participants in 25 of the 37 included studies poses a potential threat to the validity of findings. In future studies, random sampling approaches should be used to study bullying in India.

Furthermore, we observe that there are only two longitudinal studies from India (Nguyen et al. 2019 ; Thakkar et al. 2020 ). Longitudinal studies help disentangle antecedents and consequents, to estimate the inter-individual variability in intra-individual (or within-person) patterns of change (Curran et al. 2010 ), allowing investigations of the sequence of occurrence of bullying with its risks and outcomes. Additionally, several studies in the present review report the adverse effects of bullying; however, the magnitude of these effects remains unclear. Only two of the 37 included studies were experimental studies with pre- and post-test intervention designs (Sharma et al. 2020 ; Shinde et al. 2018 , 2020 ), which also underlines the urgent need to conduct fundamental indigenous research on the topic of bullying behaviors so that future research focusing on effective and tailor-cut interventions can be modeled for the Indian context. Also, given that most studies included were cross-sectional, cause and effect reasoning for bullying behavior remains elusive in India, and warrants further attention.

Lastly, we emphasize that risk factors of bullying need to be studied in light of the Indian culture to understand its meaning and relevance in the culture (Smith et al. 2018 ). In western literature as well, several recent studies have indicated a growing need to study bullying in relation to its broader socio-cultural context (Graham 2016 ). This is imperative in the Indian context given the contextual-development perspective (Chen and French 2008 ), which suggests that in collectivistic countries like India, context is more likely to affect evaluations of socially acceptable behavior and experiences, rather than individual attributes. Given the diversity and population density of India, considerable disparities and inequalities co-exist between cultures and also within the sub-groups of particular cultures (Panda and Gupta 2004 ). For instance, factors such as caste, dissimilarities between urban and rural youth, and the range of SES as observed in India can help in better, more deeply understanding bullying.

Conclusions and Implications for Future Research

This review contributes valuable findings in the field of bullying and victimization in India. However, it has been noted that conducting research in India comes with its own set of logistical and contextual challenges (Smith et al. 2018 ), and thus, the conclusions drawn through the review must be considered with due caution given methodological limitations of the included studies. The quality of research conducted in India has scope of improvement in terms of methodological rigor, data collection processes, instrumentation, and presentation of the findings.

The present study is limited in capacity as it does not include a report on cyberbullying, and thus, future research on the topic of cyberbullying is necessitated within the Indian context. Furthermore, terms such as “aggression” and “discrimination” were not used as search terms in the current study. However, bullying is a form of aggression, and discrimination could be, in some cases, strongly tied to bullying (Verkuyten and Thijs 2002 ). Future studies should pay more attention to the relations between bullying and discrimination.

In contrast to the large body of research on bullying from western countries where findings have been reproduced with a delimited adolescent population insistently, data from India is scanty. India accommodates the largest adolescent population in the world, providing a potential reservoir of relatively untapped resources that could provide in-depth knowledge of causes and consequences of bullying and victimization. Given its special cultural context, there is considerable scope to scrutinize cultural contexts of bullying behavior in India that could assist in revealing novel insights, such as the role of socio-economic distance between different sects of society in low to middle income countries. Such insights might facilitate the conception of dynamic intervention designs for not only the Indian population but also for western populations. Future studies that compare how bullying happens in the western and Indian context would also help shed further light on this topic.

Study 3 (Correia et al. 2009 ) and 4 (Donat et al. 2012 ) have the same Indian sample in their studies. However, the variables examining correlates and consequences of bullying are different in the studies, and thus for the purpose of our review, we include both studies.

Study 8 by Khatri and Kupersmidt ( 2003 ) is based on a dissertation thesis submitted to University of North Carolina by the first author in 1996. For the purpose of our review, we consider the dissertation and the journal article as one inclusion since the participants as well as bullying reports are the same for both.

Study 19 (Nguyen et al. 2017 ) and 20 (Nguyen et al. 2019 ) have the same Indian sample in their studies. However, the former paper focuses on prevalence and forms of bullying and victimization, whereas the latter one examines psychosocial outcomes of victimization, and thus, we include both studies separately in the present review.

Study 32 includes reports from two articles (Shinde et al. 2018 ; Shinde et al. 2020 ). The studies use an intervention design with the same sample, and include reports after 12-month follow-up and 17-month follow-up of the design, both of which have been reported in point 32 in the present review.

Study 35 (Suresh and Tipandjan 2012 ) uses a retrospective bullying questionnaire with undergraduate college students. As the study focuses on bullying behavior in school retrospectively with adolescents, we included the study in the present review.

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Thakkar, N., van Geel, M. & Vedder, P. A Systematic Review of Bullying and Victimization Among Adolescents in India. Int Journal of Bullying Prevention 3 , 253–269 (2021). https://doi.org/10.1007/s42380-020-00081-4

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Snezana’s story: from being bullied to ending conflicts at school, peer mediators in kosovo (scr 1244) help keep school safe for everyone.

MITROVICA, Kosovo (SCR 1244), 6 September, 2018 - Sixteen-year-old Snezana Dzogovic vividly remembers when her classmates started to bully her. She was in sixth grade at her school in Mitrovica, northern Kosovo (SCR 1244).

“I went ‘into’ myself and did not talk to anyone about it.  I started avoiding school.  My grades fell because I did not go to school. I could not study at home,” she says.

Snezana says the bullying started when she began listening to rock music and dressing differently than the other girls. She liked bands like Nirvana and Guns n’ Roses and she cut her hair short.

Verbal and physical abuse followed. Her classmates would damage her belongings when she wasn’t looking.

One day Snezana came home with her backpack and books ripped and her mother asked her what had happened.

“When I started to talk, my mother felt shocked and embarrassed that I had not shared it before. My mother went to school and spoke to the class teacher, but she (the teacher) avoided resolving the issue,” says Snezana.

Violence, an everyday lesson for millions

According to a new report released by UNICEF today, Violence in Schools: An Everyday Lesson , peer violence, defined as the number of children who report having been bullied in the last month or having been involved in a physical fight in the last year – is a pervasive part of young people’s education around the world.

The report finds that approximately half of all students aged 13 to 15 – 150 million girls and boys – experience peer-violence. This violence exists in every region of the world and in every community.

The report explains that the effects of peer to peer violence are unacceptably high on individual young people as well as society as a whole. Violence decreases self-esteem, reduces attendance, lowers grades and leads many children to drop out of school completely.

From being bullied to mediating conflicts

Snezana explains that during the time she was being bullied, a new group of peer mediators were brought into her school. She had never heard about the group and was admittedly skeptical.

“At first I did not feel comfortable.  I thought it was yet another group that would bully me,” she said.

But this group was different.

The group is organized by UNICEF and partner organization in Kosovo (SCR 1244) DOMOVIK as part of a school-based violence prevention programme. The peer mediators are student volunteers who are trained to resolve conflict at school – often cases of bullying and psychological abuse. They are also trained to refer more serious cases of violence to appropriate officials, including social welfare authorities and the police.

The peer mediators work with school administrators, teachers, the student council as well as psychologists and education specialists.

Snezana decided to join the group. During the first year of being a peer mediator the bullying she was experiencing stopped. She also brought positive changes into other student’s lives. 

“When I joined, I found it to be a wonderful group and started to work on myself,” she says.  “I now put in extra effort when I see a child being bullied, and also suggest the child to join the peer mediation team.”

Over the last five years Snezana has helped end approximately 50 school-based conflicts or cases of bullying. She recalls one particular instance when she convinced two boys who had been fighting that physical conflict would not help.  She explains that she approached the situation as a friend, wanting to listen to both of the boys. 

“That is how it was resolved,” she says.

Another important part of Snezana and the other peer mediator’s work is visiting neighbouring schools and re-enacting cases of bullying. During the reenactments, students learn how to identify bullying and resolve conflict. 

So far, the peer mediation programme has benefitted at least 15,000 students in Kosovo (SCR 1244).

Snezana will never forget the pain of being targeted by bullies, but she says she has moved on.

“I decided to let them know that I was equal to them,” she says about the kids who used to bully her.  “At the end of the day I forgive them because they were children.”

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Bullying in schools: prevalence, bystanders’ reaction and associations with sex and relationships

• Temesgen Demissie Eijigu   ORCID: orcid.org/0000-0001-8846-8844 1 &
• Seleshi Zeleke Teketel 2  

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Bullying and peer victimization are the most pressing social problems affecting the wellbeing of children and adolescents. This study attempts to estimate the prevalence and examine the association of bystander’s sex, her/his relationship with the victim and with the bully, and bystander’s reaction to school bullying in East Gojjam Administrative Zone, Ethiopia.

This study followed an explanatory mixed-method study design. For the quantitative phase, 612 participants were selected using multistage cluster sampling techniques and for qualitative phase, 18 participants were selected using purposive sampling technique. We used self-reported questionnaires and semi-structured interviews to collect data from students attending grades 7, 8, 9, and 10.

This study revealed that 55% of bystanders remained passive while 38% of them defended the victim upon witnessing bullying incidents. Pearson Chi-Square test for independence indicated a significant association between bystanders’ relationship with the victim and/or bully, and bystanders’ reaction. In contrast, sex has no significant association with bystanders’ reaction. The semi-structured interview data also suggested that large number of bystanders most often stood by passively while some of them defended the victim.

The practice of defending among students attending their education in governmental primary and secondary schools in East Gojjam Administrative Zone was low. Close social relationships (being close friends, relatives, and classmates) with the victim and bully were significantly associated with the practice of defending.

Peer Review reports

Bullying and peer victimization are the most pressing social problems affecting the wellbeing of children and adolescents [ 1 ]. Although bullying occurs in many contexts [ 2 ], it is predominantly prevalent within a school setting [ 3 , 4 ]. For instance, over 90% of primary and secondary school students in Australia witnessed verbal bullying, and more than 60% witnessed physical bullying in their schools [ 5 ]. Moreover, a study on the prevalence of being bullied in South Australian schools depicted that approximately one of every two secondary school students experienced victimization by peers while at school [ 3 ].

The problem of violence and bullying is also prevalent in Ethiopia [ 6 , 7 , 8 , 9 , 10 ]. A study in Addis Ababa revealed that 84% of teachers and directors confirmed that violence is a problem in and around primary and secondary schools, mainly targeting girls and smaller children [ 7 ]. Similarly, a national study in Ethiopia revealed that 13.1% and 16.7% of children have been left out and hit by other children, respectively, in their class [ 10 ].

The situation of school bullying in the East Gojjam Zone does not seem an exception. For example, in the 2014 academic year, more than 57% of students in Menkorer High School at Debre Markos Town, the capital of East Gojjam Administrative Zone, experienced physical and sexual violence [ 11 ].

School bullying is viewed as a group phenomenon that, in addition to bullies and victims, involves a large number of bystanders who witness bullying [ 12 , 13 , 14 ]. For instance, two studies in Canada illustrated that peer bystanders were present in more than five out of six bullying episodes [ 13 , 14 ]. Another natural observational research also reported that peers were present closely in nine out of ten bullying episodes [ 13 ]. Although bullying often occurs in the presence of large bystanders who have a high potential to reduce it, most do not intervene to stop it [ 13 , 14 ].

In bullying situations, bystanders may take the following four roles: (1) assistants, who join in the bully’s side (2) reinforcers, who encourage bullies (3) passive bystanders, who merely watch what is happening and (4) defenders, who stand up on behalf of victims [ 12 ]. Recent studies proposed three forms of bystander roles as passive bystanders, defenders, and pro-bully/bully supporters/by combining the roles of assistant and reinforcers [ 15 ].

A study in 1220 elementary school children from grades four to six found that low scores on the anti-bullying attitude scale were associated with bullying, assisting the bully, and reinforcing the bully. In contrast, high scores on that scale were related to defending the victim and remaining passive in bullying situations [ 16 ]. Since passive bystanders scored high in anti-bullying attitude and moral disapproval scores of bullying, it is easier to change them to the defenders than assistants and reinforcers. Thus, passive bystanders were the focus of this study. Besides, passive bystanders and defenders account for more than half of the bystanders who could play a key role in reducing bullying. To our knowledge, no previous studies in Ethiopia estimated the extent of defenders and passive bystanders during bullying in primary and general secondary school students. Thus, one of the focuses of this study was to estimate the extent of defending and passive bystanding behaviors during school bullying.

Empirical findings reported gender differences in defending and passive bystanding behavior [ 5 , 17 , 18 , 19 , 20 ]. Several studies revealed that girls are more involved in defending the victim [ 16 , 17 , 20 , 21 , 22 ] and remaining passive in bullying situations than boys, whereas boys were more involved in supporting bullies as assistants and reinforcers than girls [ 16 , 17 , 20 , 23 ]. In addition, some studies have shown a significant association between the gender of the bystander, the gender of the bully, and the victim [ 13 ]. Their findings suggest that boys are more likely to defend when the bully or victim is male, whereas girls are more likely to defend when the bully or victim is female. Likewise, some studies [ 24 , 25 ] documented that students were more likely to defend their same-sex peers than opposite-sex peers. This shows that previous studies emphasized sex differences and how bystanders are more likely to help the same sex victim [ 17 , 18 , 19 ]. They did not answer the question, “To what extent do female and/or male bystanders defend or remain passive upon witnessing a girl victimizing a boy, a boy victimizing a boy, a boy victimizing a girl, and a girl victimizing a girl. Thus, further research is needed to fill these knowledge gaps.

Furthermore, bystanders’ relationships with the victim or bully may also influence defending or passive bystanding behavior [ 26 , 27 ]. These studies revealed that bystanders who had a close relationship with the victim are more likely to help the victim, whereas those who had a close relationship with the perpetrator and no relationship with the victim are more likely to remain passive; sometimes it may even initiate co-bullying [ 26 ]. The motives for co-bullying or non-intervention, were reported to come from fear of friendship loss, perceived peer pressure, or to not disprove the actions of friends.

In the culture of Amhara, when one's close relative or friend is attacked, he/she will not watch the incident passively. At least, he/she is expected to separate the bully and the victim. This strong social bond among Amhara society [ 28 ] makes it reasonable to include bystanders’ relationship with the bully and victim in the study.

Research question

This research planned to answer the following questions:

To what extent do students defend or remain passive during bullying incidents in primary and secondary schools in East Gojjam Administrative Zone?

To what extent do male and female bystanders defend or remain passive upon witnessing a boy victimizing a boy, a boy victimizing a girl, a girl victimizing a girl, and a girl victimizing a boy?

Does the relationship between the bystander and the victim or the bystander and the bully make a difference in the bystander’s reaction?

This study aimed to estimate the prevalence and examine the association between bystander’s sex, her/his relationship with the victim and with the bully, and bystander’s reaction to school bullying in East Gojjam Administrative Zone, Ethiopia.

Study design

This study followed an explanatory sequential mixed methods design [ 29 , 30 ] with quantitative data collection and analysis in the first phase and qualitative data collection and analysis in the second phase. Mixed methods design was selected to other designs since the complex nature of bystanding behaviors during school bullying requires an investigation from multiple ways.

The study was conducted in primary and general secondary schools from Aneded, Debre Markos, Enebesie Sar Medir, Enemay, and Machakel Woredas of East Gojjam Administrative Zone, Amhara National Regional State, Ethiopia. These five Woredas consists of 181 second cycle primary schools (Grades 5–8) and 19 secondary schools (grades 9 and 10). Primary and general secondary schools from Woredas in East Gojjam Administrative Zone were selected due to bullying prevalence and its serious consequences. In addition to familiarity with the language and culture, the researcher works in the study area that may contribute to the study.

Participants and sampling techniques

The quantitative data were drawn from 612 students aged 12–16 years attending five primary schools in grades 7and 8 and five general secondary schools in grades 9 and 10 (see Table 1 ). To select participants for this study, we used a multistage cluster sampling procedure. In the first stage, we subdivided the 19 Woredas of East Gojjam Administrative Zone into five groups based on the number of students’ population from grades 7–10. From each group, we selected one woreda randomly. Then, from each woreda, one general secondary school was chosen randomly. Next, for accessibility and comparison purposes, from all primary schools in the area where the selected general secondary schools were situated, one primary school from each woreda was selected by using lottery method. Then, one class from each grade in each school was selected by applying lottery method. Accordingly, 20 classes of students from both primary and general secondary schools (10 classes each) were invited to participate in the study.

On the other hand, the qualitative data were drawn from 18 participants (9 boys and 9 girls) who witnessed bullying incidents. To select participants, a purposive sampling technique was employed. With the help of school principals, homeroom teachers, and classroom representatives, students who usually defend or passively watch when witnessing bullying incidents were selected. Participants’ age ranged from 14 to 16 years, and more than 22% were from rural areas. Concerning grade level, five students were from grade seven, four students from grade eight, five students from grade nine, and four students from grade ten.

Inclusion and exclusion criteria

All students who were attending grades 7–10 education in 20 classes were included in the study. Those students who witnessed bullying were also included in the study. Those students outside the age range of 12–16 years, who did not witness bullying, and absent from class during data collection were excluded from the study.

Data collection instruments

Questionnaire.

To collect quantitative data, self-report questionnaires have been adapted from previous sources [ 17 ]. To estimate the prevalence and examine the association between bystander’s sex, her/his relationship with the victim and with the bully, and bystander’s reaction to school bullying, participants were asked to recall one particular incident where they witnessed a student/s bullying another student since the beginning of this semester. The items included in the questionnaire were: “Describe in brief the nature of the bullying incident you witnessed,” “When and where the bullying incident happened,” “Describe the characteristics of the victim and the bully (sex, grade, bystander’s relationship with the victim/bully such as close relative, close friend, classmate, a person that I knew but have no close relationship, or person that I did not know),” and “What did you do when you witnessed bullying incident?”.

A bystander was placed into categories of defender, passive bystander, and bully supporter based on his/her reactions to the bullying incident in the school:

If a student answers, “I joined in the bullying when the bully had started it,” “I assisted the bullying by doing something for the bully”, and/or “I giggled, laughed, shouted, or made similar reactions,” s/he is categorized under “bully supporter.”

If a student answers, “I kept looking at the bullying without siding anyone,” “Nothing, I went away from the situation,” and/or “Nothing, I pretended not to notice what was happening,” s/he is categorized under “passive bystander.”

If a student answers, “I tried to help in some way but was not successful,” and/or I tried to help in some way and was successful,” s/he is categorized under “defender.”

The English version of the instrument was translated into the Amharic language by three language experts who have Ph.D. in Teaching Amharic, Linguistic, and Teaching English as a Foreign Language and whose mother tongue was Amharic. The principal investigator of this study synthesized a single version by combining the best cultural translation of each item. The appropriateness of the synthesized translated version was judged by three language experts (two Amharic, one English) and two psychologists. By taking into account the feedback offered by professionals, in view of the study's objectives and reviewed literature, the researcher of this study revised the synthesized translated version of the instrument. An expert from Debre Markos University who had a doctoral degree in Teaching English as a Foreign Language back-translated the synthesized version from Amharic into English. Moreover, the Amharic version of the instrument was submitted to seven psychology instructors of Debre Markos University to assess the instruments' content validity. Based on comments of experts, some items were modified. Finally, the questionnaire was administered to the participants during the period 01–31 January 2019.

Semi-structure interview

The interviews were conducted face to face by the principal investigator from 01 April to 02 May 2019 using semi-structured open-ended items with probing questions. Interviews were conducted at the offices of the counselor, or school director lasted between 30 and 45 min. Students were alone (not accompanied by guardians/parents) when interviews were administered. All interviews were audio-recorded, transcribed, and notes were taken properly. Items in the interview guide include: “If you have witnessed someone being bullied by another student, tell me what happened?”, “How did you feel when you saw bullying happening?”, “What did you do when you witnessed bullying happening? Why?”, “Who else witnessed the bullying situations besides you?”, “What did they do when this was happening?”, “Why do you think they reacted this way?”, “Why do you think that some students defend and others remain silent in bullying incidents?” and “How do you describe boys and girls' engagement in defending or passive bystanding behaviors?”.

Data analysis techniques

Researchers employed percentage to describe the rate of defending and passive bystanding behavior during bullying incidents for data analysis. Chi-square test of independence was used to check the association between bystanders’ sex, their relationship with the victim and with the bully, and their reaction to the bullying incident. Thematic analysis [ 31 ] was used to analyze the qualitative data.

Ethical considerations

Addis Ababa University School of Psychology Ethical Review Committee exempted the study from requiring ethical clearance and suggested collecting letter of permission from the school of Psychology. Accordingly, a letter of permission was collected from the School of Psychology, Addis Ababa University.

Permission letters were submitted to East Gojjam Administrative Zone Education Office. The office itself wrote a letter of permission to school directors. After receiving permission from school directors, students were also asked their willingness to participate in the study. Before data collection, informed assent and passive consent were secured from students and parents, respectively. Students were also informed that they would be free to omit any questions they did not want to answer. The participants were also informed that their identity would not be disclosed to any third party, and the information they provided would be kept confidential.

The extent of defenders, passive bystanders, and bully supporters

Out of 511 participants who reported witnessing a single bullying incident, 55% of bystanders reported being passive bystanders, and 38% of them reported being defenders (see Table 2 ). The Chi-Square test revealed significant differences between the three percentages, x 2 (2, N = 511) = 181.131, p  = 0.000.

In the semi-structured interview, all of the participants agreed that most of the students did not want to defend the victims when witnessing school bullying. For instance, One interviewee stated, “Those who stand and watch victimization were larger than those who defend because they have the interest to see the fight and to know who wins at the end.”

The extent of students involved in defending, passive bystanding, and bully supporting by bully-victim sex

As shown in Table 3 , 39.3% of bystanders witnessed male victimizing male, 33.1% witnessed male victimizing female, 20.2% witnessed female victimizing female, and 7.4% witnessed female victimizing male.

Since the bully support role expected frequencies were less than 5 in more than 8% of the cells [ 32 ], and the purpose of the study focused on defending and passive bystanding behaviors, the bully support role was removed from further analysis (see Table 4 ).

The Chi-Square test revealed no significant association between bully-victim sex and bystander’s reaction, χ 2 (3, N = 475) = 1.956, p  = 0.58, Cramer’s V = 0.06.

The extent to which male and female bystanders defend, or remain passive upon witnessing victimization across bully-victim sex

Tables 5 , 6 , 7 and 8 summarizes that 67.2% of males and 32.8% females had witnessed male victimizing male, 31.2% males, and 68.8% females witnessed male victimizing femalel, 14.4% males and 85.6% females witnessed female victimizing female, and 63.9% males and 36.1% females witnessed female victimizing male.

Among students who witnessed male victimizing male, 40.2% of boys and 38.7% of girls defended victims. Besides, 36% of boys and 49.1% of girls who witnessed male victimizing female helped victims in some way. Regarding students who saw female victimizing female, 46.2% of boys and 35.1% of girls defended victims. Moreover, 30.4% of boys and 53.8% of girls helped victims when witnessing female victimizing male.

The Chi-Square test revealed no significant association between bystander’s sex with victimization across bully-victim sex and bystander’s reaction. The Chi-Square test values were χ 2 (1, N = 189) = 0.001, p  = 0.974, phi  = − 0.014, for students witnessing male victimizing male; χ 2 (1, N = 160) = 1.881, p  = 0.170, phi  = − 0.122, for students witnessing male victimizing female; and χ 2 (1, N = 36) = 1.057, p  = 0.304, phi  = − 0.231, for students witnessing female victimizing male.

The interview data revealed that boys and girls intervened when witnessing school bullying. For instance, Hermela noted, “When male victimizes female, mostly girls hold girls and boys hold boys.” Kidist, a ninth-grade student, also indicated, “When female victimizes female, both boys and girls may intervene.”

The qualitative data demonstrated a dissimilar intervention approach between girls and boys when witnessing male physically victimizing male. Male students, most of the time, defend directly when witnessing male physically victimizing male. On the other hand, girls can participate in defending indirectly by screaming or calling other students or reporting the case to the school authority. For instance, Hermela says, “When male physically attacks male, mostly boys and teachers directly intervene.” Debasu, an eighth-grade student said “If a girl directly intervenes when male is victimized, rumors will spread which show the girl has love affair with the victim.”

The extent of students’ participation in defending and passive bystanding behavior by relationship with the victim or bully

As indicated in Tables 9 and 10 , bystanders were asked to report their relationship with victims and bullies. Among those who reported their relationship with victims and bullies, 3.6% and 3.8% reported to be relatives, 26.7% and 11.6% close friends, 24.6% and 24.2% classmates, 24.6% and 26.3% knew the victim/bully, but have no close relationships, and 20.4% and 34.1% did not know the victim and bully, respectively. Among those who reported their relationship with the victim, 52.9% of relatives, 60.6% of close friends, and 47.8% of classmates defended the victim. Similarly, among those who reported their relationship with the bully, 61.1% of relatives, 49.1% of close friends, and 47% of classmates defended the victim.

The Chi-Square test revealed that there is a significant association between the relationship with the victim and bystander’s reaction, χ 2 (4, 475) = 32.79, p  < 0.001, phi = − 0.263; and between relationship with the bully and bystander’s reaction, χ 2 (4, N = 475) = 9.847, p  = 0.043, phi  = − 0.114.

The qualitative data through interview indicated that bystanders’ close relationship with the victim or/and bully as key determinant of defending upon witnessing school bullying. For instance, Debasu said “I have entered (involved in defending) because both the perpetrators and the victims were my friends.” A grade eight student named Binyam stated, “Students who are relative or close friends…to the victim/bully would not have any role other than separating the bully and the victim.” Hermela also noted that relatives, friends, and teachers are defenders during victimization.

On the other hand, not being a friend of the bully or the victim was reported as a possible reason for bystanders’ passive bystanding. For instance, Hermela mentioned “bystanders’ not being the friend of the bully or the victim as one reason for bystanders to surround and watch bullying events. Had the bystanders been friends of the victim/bully, they would have intervened or they would have called a teacher.”

The extent to which students defend or passively watch during bullying incidents

The findings of this study revealed that a larger proportion of students remained passive upon witnessing school bullying. Fifty five percent of bystanders were involved in passive bystanding behavior, and 38% of them involved in defending behavior.

The interview data also supported the findings of the quantitative data. All participants of the interview reported that many bystanders most often stood by passively, and only some of them defended the victim. Many participants concisely stated that when students in school witness bullying incidents, most of them often stand and observe while a small number of others decide to defend.

These findings are consistent with prior studies [ 14 , 17 ]. For instance, a study conducted on college students who recalled bullying events occurring in junior high school and high school students with the same method reported that 59% of bystanders chose to remain passive upon witnessing bullying situations, and 31% of them were involved in defending on behalf of the victims [ 17 ]. Similar findings were also reported in an observational study conducted in two Toronto school children in Canada [ 14 ]. Even the percentages are very close to the ones this study found.

There are various explanations attributed to the surpassing of passive bystanders to defenders in East Gojjam Administrative Zone. One reason for passivity of bystanders during bullying incidents may involve the gradual decline of helping relationships due to urbanization. In the past, people do not often standby and watch when one individual victimized another. Findings in Yetmen, East Gojjam, revealed that when conflicts arise within and between households, they were usually resolved by neighbors. If neighbors cannot solve the problem, relatives of the two parties consider the problem and try to address it. If this level of conflict resolution fails, the elder of the community get involved [ 28 ]. So, helping each other during an emergency was the norm. Due to urbanization, the norms of helping relationships are changing somehow in the current East Gojjam. Another possible explanation for more passive bystanders to defenders involves fear of revenge. If the perpetrator is older and/or physically stronger than the bystander, the bystanders are more likely to remain passive. Student bystanders may believe that defending on behalf of the victim could lead the older/or stronger bully to attack the defender later. Many other personal and situational factors (e.g., lower level of bystander’s self-efficacy, empathy, lower number of close friends, bullying experiences, high moral disengagement) may also be used to explain greater proportions of passive bystanders to defenders in bullying situations [ 17 , 20 , 22 , 26 , 33 ].

The quantitative findings demonstrated that there were no significant difference between boys and girls in defending and passive bystanding behaviors upon witnessing a boy victimizing a boy, a boy victimizing a girl, and a girl victimizing a boy.

According to the interview data, both boys and girls can intervene when a boy victimizes a boy. But, their style of intervention may differ. Boys may intervene directly when witnessing physical bullying, whereas girls may intervene indirectly. Many participants said that boys, teachers, and adults directly intervene when a boy physically victimizes a boy. One possible reason for the direct intervention of more boys than girls was that if a girl intervenes directly when a boy victimizes a boy, rumors of love between the girl and the victim will spread. In the culture of the study area, having a boyfriend for a girl and a girlfriend for a boy is not a commonly accepted norm at that age level. If they establish such kinds of friendship, they do not disclose it to others. If other students know the relationship, they become the target of the rumor. So as to avoid being the target of the rumor, the girl will decide to use indirect strategies to help the victim.

Another possible explanation for more direct defending of boys than girls in physical bullying was that boys were more often socialized and culturally expected to defend directly than girls. Let alone defending on behalf of the victim, boys are expected to be a winner in any fight by their families and are not accepted by families if beaten up by anyone. If they fail to win the fight, their parents could further beat them. Though girls’ involvement in separating the bully and the victim is less direct, they frequently call defenders by screaming.

The finding also indicated that when a boy victimizes a girl, a girl victimizes a girl, and a girl victimizes a boy, most of the interview participants reported that both boys and girls are engaged in defending. This finding partly contradicts some other findings [ 24 , 25 ]. To explain these findings further, future researches are needed.

The current study revealed that students who were reported to be close friends, classmates, and relatives of the victims appear to defend the victim more than persons who either knew the victim or did not know them. Consistent with the current study, five studies included in one systematic review have examined the association between friendship with students involved in bullying situations and defending [ 33 ]. The studies revealed that youth were more likely to defend when the victimized youth was their friend, relative to a neutral peer. Similarly, some studies [ 26 , 27 ] revealed the association between bystanders’ close relationship with the victim and helping. For example, suppose a bystander is watching one’s own friend being bullied. In that case, the situation evokes more distressing emotions of empathy, sympathy, guilt, or anger and a stronger moral obligation and responsibility to intervene to help one’s friend [ 27 ].

The findings from the interview data also corroborated the quantitative results. The study showed that after bystanders witnessed bullying incidents, they evaluate their relationships (friendship, kinship, and disliking) with the bully, victim, or both before deciding to defend or passively watch the bullying incident. If bystanders witness victims with intimate relationships (friendship and blood relationship), they are more likely to defend the victim. Participants mentioned being close friends, relatives, and teachers with the victim as contributing factors to defending.

The finding that students who were reported to be relatives, close friends, and classmates of the bully appear to defend the victim more than persons who know and those who did not know the bully was unexpected. The qualitative interview also supported this finding. Some interview participants disclosed that having a close relationship with the bully would motivate the bystander to assist the victim. If bystanders are close friends or relatives of the bully, they can enter with confidence to protect the victim believing that the bully will not attack them later. Another possible reason for bystanders who have close relationships with the bully to stop the bully could be the belief that the problem will worsen and affect the whole family and its relatives. However, one participant reported that if bystanders have a close relationship with the bully, they might assist the bully to harm the victim further. Thus, further studies are needed.

Limitations of the study

The current study has some limitations. First, the study participants were limited to young and middle adolescents in East Gojjam Administrative Zone. This could reduce the diversity of the sample and the generalizability of the findings. Had I included adults as well, the findings could have been more generalizable. Second, the quantitative and qualitative findings on defending and passive bystanding behaviors were based on self-report measures. In self-reporting data, study participants may not always provide honest evidences. Third, the current research was cross-sectional, where cause and effect relationships could not be inferred.

Fourth, it is expected that if the perpetrator is older and/or physically stronger than the bystander, the bystander is more likely to remain passive during the incident of bullying. However, the current study did not collect information on age and/or physical differences between bully and bystander. If future studies include age and physical differences between the bystander and the bully, it would have more insights into school bullying literature.

Practice of defending among students attending their education in governmental primary and secondary schools in East Gojjam Administrative Zone was low. Close social relationships (being close friends, relatives, and classmates) with the victim and bully were significantly associated with the practice of defending. The findings of our qualitative study also showed that the number of passive bystanders was larger than defenders during witnessing school bullying; and bystanders’ close relationship with the victim, or/and bully as key determinants of defending.

High prevalence of passive bystanding behavior demand prevention programs that can discourage bullying in schools among bystanders in bullying situations through encouraging defending behavior irrespective of bully-victim sex, and helping bystanders establish close social relationships with the victim or/and bully.

Availability of data and materials

The datasets that support the findings of this study are not publically available at present. The authors need to use the data for further works before data could be made available. Besides, we have not received consent from participants to share the data on the web but, will be available from the corresponding author on reasonable request.

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Acknowledgements

The authors would like to thank Addis Ababa University for its financial support. We would also like to thank teachers at primary and secondary schools in East Gojjam Administrative Zone for their invaluable assistance in collecting data. Finally, we would like to acknowledge principals for facilitating the data collection and all participants of this study for their time and patience in responding to our interviews and questionnaires.

Addis Ababa University financially supported this study. However, the University did not have any role in the design of the study, data collection, and analysis, as well as in the interpretation of data and writing this manuscript.

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TDE has been involved in the study concept and design, data acquisition, drafting the manuscript, administrative, statistical analysis, and interpretation of the data and final proof of the manuscript. SZT has been involved in the study concept and design, technical and study supervision, and manuscript revision. All authors read and approved the final manuscript.

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Eijigu, T.D., Teketel, S.Z. Bullying in schools: prevalence, bystanders’ reaction and associations with sex and relationships. BMC Psychol 9 , 183 (2021). https://doi.org/10.1186/s40359-021-00685-5

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The case of a persistent bully, from victim to perpetrator

by University of South Australia

The new kid, the class clown, the popular kid, the troublemaker, or the loner. We all know children and young people who may be labeled in this way. In fact, many of these stereotypes have been depicted in Hollywood films.

But if your child falls into one of these categories, new University of South Australia research shows that not only may they be at risk of being bullied, but they perhaps, could be engaging in bullying others themselves now or in the future.

In a unique case study published in Pastoral Care in Education , researchers at UniSA's Center for Research in Educational and Social Inclusion have explored the lived experiences of a self-identified persistent bully—a voice that is scarce in literature—to gain a deeper understanding of the factors that may contribute to this anti-social aggressive behavior. The case study was an adult, preservice teacher who voluntarily shared his school-life experiences of bullying for the research.

Through a qualitative, exploratory case study, researchers identified three important social and behavioral "turning points" that served to steer a child toward bullying others, and eventually sustained his bullying behavior. These turning points included:

• Peer rejection and a lack of belonging.
• Striving to belong through bullying.
• Social positioning, status and reputation achieved through bullying.

Each year in Australia, 543,000 perpetrators instigate more than 35 million bullying incidents and almost 25% of students (about 910,000) experience bullying while at school. About 24% of victims are "bully-victims"—both victim and perpetrator of bullying.

UniSA researcher and education expert, Dr. Deborah Green, says the study highlights the acute need to address bullying by focusing and understanding the individual and their motivation.

"Bullying has been researched globally for decades, yet one in four children are still bullied in schools. This equates to more than one incident of bullying every week in every school around Australia," Dr. Green says.

"The trauma associated with bullying is felt both immediately and long after students have completed school, even up to 20 years later. The estimated costs associated with bullying are $2.3 billion.

"Clearly, traditional interventions and sanctions are not working for some students, so it's vital that we look for alternative solutions, particularly for those who persist in bullying others.

"In this study, we've investigated a rarely-heard voice—that of the bully—which revealed some very insightful findings about how and when his behavior changed. We call these turning points as they indicate when a change in behavior occurs. They also represent opportunities for intervention.

"Through this case study, we see how each turning point created a chain reaction of behaviors and responses which ultimately shapes the bullying trajectory, reinforcing the emerging bullying behavior until it was persistent.

"Sadly, although not uncommonly, this child started out as a victim of bullying. Then in an attempt to connect with students he began acting up, demonstrating bullying behaviors to others.

"Ironically, this generated a sense of social standing within his peer group , which led him to detention where he forged a friendship group—the 'detention kids'—and a heightened sense of status and belonging.

"Like all of us, he wanted to feel connected and like he belonged; he wanted a friend. But at each turning point, this need was filled by negative behaviors, rather than positive ones.

"In the end, the only way he knew to engage and connect with his peers was through bullying."

Dr. Green says that this study highlights the need for teachers, counselors, and well-being leaders to reflect on the individual needs of young people who are engaging in persistent bullying and support them in what may have led to this behavior.

"We encourage teachers and counselors to be aware of peer dynamics and social structures of their classes, so that they can better understand and respond to social issues " and call for "this to be further embedded into initial teacher education training," Dr. Green says.

"The negative impact of social rejection on a child's well-being must be recognized sooner, always remembering that the bullying may have started not to inflict harm, but to fill an innate need to connect with others.

"Early intervention and individualized and proactive preventative approaches should foster acceptance, recognition, safety and belonging.

"For some students, bullying appears to be adaptive, meeting an individual's social goals of belonging, status and identity. If we can interrupt the cycle of bullying, we could prevent significant and often lifelong harm for victims and those who engage in bullying."

Provided by University of South Australia

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Please note you do not have access to teaching notes, managing bullying in south african secondary schools: a case study.

International Journal of Educational Management

ISSN : 0951-354X

Article publication date: 13 August 2018

The high prevalence of bullying in South African schools in recent times is a cause for serious concern. Bullying is traumatic and has a painful, corrosive and damaging impact on children, families and society. Hence, curbing the problem before it spirals out of control in secondary schools requires immediate urgent attention from all stakeholders of the school. The purpose of this paper is to report on part of the investigation done for a doctoral thesis (Singh, 2016), which looked at the factors contributing to bullying perpetration in secondary schools and on the basis of the findings, recommend a model that may be used to curb bullying in secondary schools. A qualitative research design was used to investigate the problem through an interview process with participants from secondary schools, as well as a circuit manager from the Uthungulu district of KwaZulu-Natal. The findings confirmed that the problem of bullying emanated at the level of the family, the school and the community. The paper concludes with the provision of a model to manage and curb bullying in these secondary schools.

Design/methodology/approach

A qualitative research approach, in particular a case study design, was selected to give a clear understanding of participants’ views and experiences (Johnson and Christensen, 2011; Mason, 2013). The design involved a social constructivist paradigm, which was primarily concerned with meaning and understanding people’s “lived experiences” and “inner-worlds” in the context of the conditions and circumstances of their lives, which in this particular instance was bullying in secondary schools, occurring within a social context, which was the school (Johnson and Christensen, 2011). Purposeful sampling was used to identify five secondary schools in the Uthungulu district of KwaZulu-Natal where the problem of bullying was most prevalent principals at circuit and district-level meetings complained about the high incidence of bullying perpetration in their schools.

This paper highlights the findings in respect of the factors contributing to bullying perpetration in schools and presents a management model to curb bullying in secondary schools in KwaZulu-Natal. Factors contributing to bullying: the findings from the empirical investigation avowed that the three key factors contributing significantly to bullying behaviour are located at the level of the family, the school and the community. First, influence at family level: “60–70 per cent of our learners come from broken homes”. An overwhelming majority of participants in all five secondary schools attributed the escalation of bullying in schools directly to the influence at the family level. Broken homes, poor upbringing, the absence of positive role models and the influence of media violence on learners have had a negative impact on the culture of discipline, teaching and learning in the classroom and the general ethos of schools. Second, influence at school level: “the foremost problem here is peer pressure”. An overwhelming number of participants identified several factors at the school level that contributed to bullying in secondary schools. Learner 3 (School A) highlighted the problem of peer pressure and the need to belong to a group as a critical factor in advancing bullying in schools. Third, influence at community level: “they come from that violent environment”. Participants explained that the absence of after-school programmes and a lack of facilities, particularly in rural communities, misdirected youngsters into engaging in other destructive vices such as forming gangs and indulging in drugs and alcohol, to keep themselves occupied.

Originality/value

Various studies have been conducted in South Africa to understand the phenomenon of bullying and violence in South African schools. While the current body of research highlights the problem of bullying in schools and provides some guidelines on what measures may be adopted to address the problem, the suggested methods are not effective enough, resulting in the problem continuing unabated. This study therefore suggests a model to manage and curb bullying in secondary schools in South Africa.

• South Africa

Steyn, G.M. and Singh, G.D. (2018), "Managing bullying in South African secondary schools: a case study", International Journal of Educational Management , Vol. 32 No. 6, pp. 1029-1040. https://doi.org/10.1108/IJEM-09-2017-0248

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Effectiveness of school‐based programs to reduce bullying perpetration and victimization: An updated systematic review and meta‐analysis

Hannah gaffney.

1 Institute of Criminology, University of Cambridge, Cambridge UK

Maria M. Ttofi

David p. farrington, executive summary/abstract.

Bullying first emerged as an important topic of research in the 1980s in Norway (Olweus), and a recent meta‐analysis shows that these forms of aggression remain prevalent among young people globally (Modecki et al.). Prominent researchers in the field have defined bullying as any aggressive behavior that incorporates three key elements, namely: (1) an intention to harm, (2) repetitive in nature, and (3) a clear power imbalance between perpetrator and victim (Centers for Disease Control and Prevention; Farrington). There are many negative outcomes associated with bullying perpetration, such as: suicidal ideation (Holt et al.), weapon carrying (Valdebenito et al.), drug use (Ttofi et al.), and violence and offending in later life (Ttofi et al.). Bullying victimization too is associated with negative outcomes such as: suicidal ideation (Holt et al.), anxiety, low self‐esteem and loneliness (Hawker& Boulton). Therefore, school bullying is an important target for effective intervention, and should be considered a matter of public health concern.

The objective of this review is to establish whether or not existing school‐based antibullying programs are effective in reducing school‐bullyng behaviors. This report also updates a previous meta‐analysis conducted by Farrington and Ttofi. This earlier review found that antibullying programs are effective in reducing bullying perpetration and victimization and a primary objective of the current report is to update the earlier analysis of 53 evaluations by conducting new searches for evaluations conducted and published since 2009.

Search Methods

Systematic searches were conducted using Boolean combinations of the following keywords: bully*; victim*; bully‐victim; school; intervention; prevention; program*; evaluation; effect*; and anti‐bullying . Searches were conducted on several online databases including, Web of Science, PscyhINFO, EMBASE, EMBASE, DARE, ERIC, Google Scholar, and Scopus. Databases of unpublished reports, such as masters' and doctoral theses (e.g., Proquest) were also searched.

Selection Criteria

Results from systematic searches were screened thoroughly against the following inclusion criteria. To be included in this review, a study must have: (1) described an evaluation of a school‐based antibullying program implemented with school‐age participants; (2) utilized an operational definition of school‐bullying that coincides with existing definitions; (3) measured school‐bullying perpetration and/or victimization using quantitative measures, such as, self‐, peer‐, or teacher‐report questionnaires; and (4) used an experimental or quasi‐experimental design, with one group receiving the intervention and another not receiving the intervention.

Data Collection and Analysis

Of the 19,877 search results, 474 were retained for further screening. The majority of these were excluded, and after multiple waves of screening, 100 evaluations were included in our meta‐analysis. A total of 103 independent effect sizes were estimated and each effect size was corrected for the impact of including clusters in evaluation designs. Included evaluations were conducted using both randomized ( n  = 45; i.e., randomized controlled trials/RCTs) and nonrandomized ( n  = 44; i.e., quasi‐experimental designs with before/after measures; BA/EC) methodologies. All of these studies included measures of bullying outcomes before and after implementation of an intervention. The remaining 14 effect sizes were estimated from evaluations that used age cohort designs. Two models of meta‐analysis are used to report results in our report. All mean effects computed are presented using both the multivariance adjustment model (MVA) and random effects model (RE). The MVA model assigns weights to primary studies in direct proportion to study level sampling error as with the fixed effects model but adjusts the meta‐analytic standard error and confidence intervals for study heterogeneity. The RE model incorporates between‐study heterogeneity into the formula for assigning weights to primary studies. The differences and strengths/limitations of both approaches are discussed in the context of the present data.

Our meta‐analysis identified that bullying programs significantly reduce bullying perpetration (RE: odds ratio [OR] = 1.309; 95% confidence interval [CI]: 1.24–1.38; z  = 9.88; p  < .001) and bullying victimization (RE: OR = 1.244; 95% CI: 1.19–1.31; z  = 8.92; p  < .001), under a random effects model of meta‐analysis. Mean effects were similar across both models of meta‐analysis for bullying perpetration (i.e., MVA: OR = 1,324; 95% CI: 1.27–1.38; z  = 13.4; p  < .001) and bullying victimization (i.e., MVA: OR = 1.248; 95% CI: 1.21–1.29; z  = 12.06; p  < .001). Under both computational models, primary studies were more effective in reducing bullying perpetration than victimization overall. Effect sizes varied across studies, with significant heterogeneity between studies for both bullying perpetration ( Q  = 323.392; df  = 85; p  < .001; I 2  = 73.716) and bullying victimization ( Q  = 387.255; df  = 87; p  < .001; I 2  = 77.534) outcomes. Analyses suggest that publication bias is unlikely. Between‐study heterogeneity was expected, given the large number of studies included, and thus, the number of different programs, methods, measures and samples used.

Authors' Conclusions

We conclude that overall, school‐based antibullying programs are effective in reducing bullying perpetration and bullying victimization, although effect sizes are modest. The impact of evaluation methodology on effect size appears to be weak and does not adequately explain the significant heterogeneity between primary studies. Moreover, the issue of the under‐/over‐estimation of the true treatment effect by different experimental designs and use of self‐reported measures is reviewed. The potential explanations for this are discussed, along with recommendations for future primary evaluations. Avenues for future research are discussed, including the need further explain differences across programs by correlating individual effect sizes with varying program components and varying methodological elements available across these 100 evaluations. Initial findings in the variability of effect sizes across different methodological moderators provide some understanding on the issue of heterogeneity, but future analyses based on further moderator variables are needed.

1. PLAIN LANGUAGE SUMMARY

1.1. interventions to reduce school bullying perpetration and victimization are effective.

Bullying is a ubiquitous form of aggression in schools worldwide. Intervention and prevention programs targeting school bullying perpetration and victimization are effective, yet more research is needed to understand variability in effectiveness.

The main findings of our review are that bullying programs were effective in reducing bullying perpetration outcomes by roughly 18–19% and bullying victimization by roughly 15–16%. There are substantial variations in effects, and the reasons for these variations require further research.

1.2. What is this review about?

Bullying is defined as aggressive behaviors that occur repeatedly over time between two or more individuals. Typically, there is a clear power imbalance between victims and bullies, either socially or physically. Furthermore, bullying behaviors are those that are committed intentionally to harm the victim.

What is the aim of this review?

The aim of this review is to summarise findings from studies of the effectiveness of school‐based antibullying programs in reducing both bullying perpetration and victimization will be reported. The review summarizes 100 studies, with the largest number being from the United States.

1.3. What studies are included?

To be included in this review, primary studies must have evaluated a specific intervention program that targeted bullying perpetration and/or victimization outcomes in school‐aged children, that is, typically between four and 18 years old. Studies must have used two experimental groups of children, one that received the intervention, and one that did not, and applied quantitative measures of bullying behavior (perpetration and/or victimization) that coincided with our operational definition of bullying.

Our final meta‐analytic review includes 100 studies of the effectiveness of antibullying programs. The largest number of studies came from the United States, with most other studies from Canada and Europe.

1.4. What are the findings of this review?

Antibullying programs are effective in reducing bullying perpetration outcomes by roughly 18–19% and bullying victimization by roughly 15–16%.

Variability in the effectiveness of antibullying programs was associated with differences in methodological designs, types of programs and geographical regions. Interventions evaluated using age cohort designs collectively gave the largest overall effect for both bullying perpetration and bullying victimization.

Limitations of the results are similar to those of previous reviews; for example, the reliance of self‐reported measurements of bullying may suggest the change is in reports of bullying perpetration/victimization and not behavioral change.

1.5. What do the findings of this review mean?

The findings indicate that school‐based bullying intervention and prevention programs can be effective in reducing both bullying perpetration and victimization, although the effect is, overall, modest.

The effectiveness of antibullying programs is an important finding with implications for public health and educational policy. However, our review did identify that there are variations in the effectiveness of intervention programs. Future research is needed to explore the reasons for these variations.

1.6. How up‐to‐date is this review?

This report forms an update of an earlier review (Farrington & Ttofi,  2009 ). The review authors searched for studies published up to December 2016.

2. BACKGROUND

Bullying first emerged as an important topic of research in the 1980s, following the tragic suicides of young boys in Norway, the reason for which was attributed to bullying victimization (Olweus,  1993 ). Today, this form of aggressive behavior remains a prevalent problem among young people globally. For example, a recent meta‐analysis of 80 international studies discovered prevalence levels of 34.5% and 36% for bullying perpetration and bullying victimization respectively (Modecki et al.,  2014 ).

Notably, bullying is a matter of public health, impacting the life outcomes of both bullies and victims, in varying ways (Arseneault et al.,  2010 ; Masiello & Schroeder,  2014 ; Ttofi et al.,  2012 ). Given its long‐term effects, it is imperative that effective intervention efforts are put in place in order to alleviate this troubling school phenomenon (Ttofi,  2015 ).

2.1. Defining school bullying

In order to adequately determine which interventions will effectively reduce bullying behaviors, it is important that researchers and educators start by accurately assessing the prevalence of involvement in school bullying (Swearer et al.,  2010 ). There remains some degree of disagreement in relation to definitive cut‐off points for involvement in bullying (Solberg & Olweus,  2003 ; Swearer et al.,  2010 ) and methods utilized for the assessment of bullying (Smith et al.,  2002 ; Swearer et al.,  2010 ). However, there is better agreement in regard to the defining criteria for school bullying.

Prominent researchers in the field have defined bullying as any aggressive behavior that incorporates three core elements, namely: (1) an intention to harm, (2) repetitive in nature, and (3) a clear power imbalance between perpetration and victim (Centers for Disease Control and Prevention,  2014 ; Farrington,  1993 ; Olweus,  1993 ). In other words, bullies are individuals who intend to cause harm to their victims through their actions, over a long period of time. Furthermore, victims of bullying are typically less powerful than bullies, or groups of bullies, and feel that they cannot easily defend themselves. This may be due to a physical or social power imbalance.

There are many forms of bullying, for example, school‐bullying, workplace bullying, sibling bullying and, most recently, cyberbullying. The present review is concerned only with face‐to‐face school‐bullying, namely, bullying that occurs in schools between individuals, usually aged between 4 and 18 years old. In the school context, bullying is a complex social phenomenon, that often does not happen between the bully and victim in isolation (Salmivalli,  2010 ). For example, individuals can be involved in bullying, not only as bullies, victims, or bully‐victims, but also as bystanders, defenders, or reinforcers (Zych et al.,  2017 ).

Cyberbullying is another form of aggressive behaviors that may occur within a school community, and previous research has found a significant overlap between offline (i.e., school‐bullying or face‐to‐face bullying) and online bullying (Baldry et al.,  2017 ). There is currently very little information about the effectiveness of intervention programs designed to reduce cyberbullying or whether school‐based programs that also target face‐to‐face bullying can impact online bullying concurrently.

2.2. The importance of addressing school bullying

School‐bullying is a strong risk marker for several negative behavioral, health, social, and/or emotional problems. A recent comprehensive review of systematic reviews highlighted that the impact of school‐bullying can occur concurrently with perpetration and/or victimization, but also later in life (Zych et al.,  2015 ). Previous studies have found that bullying victimization is often followed by negative mental health outcomes such as: increased suicidal ideation (e.g., Holt et al.,  2015 ); generalized or social anxiety, low self‐esteem and loneliness (e.g., Hawker & Boulton,  2000 ); psychotic symptoms (e.g., van Dam et al.,  2012 ); depression (e.g., Ttofi et al.,  2011a ,  2011b ); sleeping problems (Geel et al.,  2016 ); and other psychosomatic symptoms (Gini & Pozzoli,  2013 ).

Bullying perpetration, on the other hand, has been linked to several negative outcomes such as: suicidal ideation and suicidal attempts (Holt et al.,  2015 ); weapon carrying (Valdebenito et al.,  2018 ); drug use (Ttofi et al.,  2016 ); and violence and offending in later life (Ttofi et al.,  2011b ,  2012 ). Although involvement in school bullying is not necessarily a causal factor for undesirable life outcomes, research has found that there is an apparent association. It may be the case that the experience of school bullying functions as a stepping stone toward undesirable life outcomes (Arseneault et al.,  2010 ).

Moreover, involvement in school bullying, as either a bully or a victim, has been found to correlate with factors such as low academic achievement (Strøm et al.,  2013 ), truancy from school (Gastic,  2008 ), and drug use (Valdebenito et al.,  2015 ). Such factors are common risk factors for youth offending and delinquency (Farrington & Welsh,  2008 ). Therefore, a bullying prevention program could serve as a crime prevention program, as well as a form of promoting public health.

3. OBJECTIVES

It is clear that school bullying is an important target for effective intervention and prevention. Bullying is an ethical problem as well as a developmental one: targeting school bullying facilitates the process of optimal psychological development but it also addresses the question of human rights, especially the rights of the child (Sercombe & Donnelly,  2013 ). The aim of this paper is to provide an up‐to‐date systematic and meta‐analytical exploration of the effectiveness of school‐based antibullying programs. As such, the present report updates an earlier systematic and meta‐analytic review (Farrington & Ttofi, 2009 ; Ttofi & Farrington,  2011 ), by including evidence from an earlier report, and all available evaluations of antibullying programs since 2009.

It is hoped that this new evidence base will assist policy‐makers and practitioners working in the field of bullying prevention. Farrington and Ttofi's ( 2009 ) review concluded that school‐based antibullying programs are effective in reducing both bullying perpetration (OR = 1.36; 95% CI: 1.26–1.47; z  = 7.86; p  < .0001) and bullying victimization (OR = 1.29; 95% CI: 1.18–1.42; z  = 5.61; p  < .0001). Their review had a major impact on the field of bullying intervention and prevention, and in the 9 years that have passed since its publication there has been a wealth of new research.

Therefore, the aim of the present report is to conduct systematic searches for new evaluations of antibullying programs, and also update earlier analysis by including their 53 evaluations.

The initial stage of any meta‐analysis involves conducting a thorough and systematic search of all the existing and relevant literature (Lipsey & Wilson,  2001 ; Littell et al.,  2008 ). Using predetermined keywords and strict inclusion/exclusion criteria, a systematic review aims to identify, screen, appraise, and synthesize all relevant empirical studies (Zych et al.,  2017 ). In this way, systematic bias is avoided.

4.1. Inclusion and exclusion criteria

To be included in the present systematic review, a set of strict inclusion and exclusion criteria were employed to guide searches. These criteria were identical to those used in the previous meta‐analysis (Farrington & Ttofi,  2009 ). Specifically, to be included, primary studies must:

• (1) Describe an evaluation of a school‐based antibullying program implemented with school‐age participants (depending on the site of evaluation, ages may vary between 4 and 18 years of age);
• (2) Utilize an operational definition of school‐bullying that coincides with existing definitions (e.g., CDC,  2014 ; Farrington,  1993 ; Olweus,  1993 );
• (3) Measure school‐bullying perpetration and/or victimization using quantitative measures, such as, self‐, peer‐, or teacher‐report questionnaires; and
• (4) Use an experimental or quasi‐experimental design, with one group receiving the intervention and another (control group) not receiving the intervention. Nonrandomized studies had to measure outcomes before and after the intervention.

As a result, the present systematic review excludes studies that evaluate the effectiveness of intervention programs targeting alternative forms of bullying, such as cyber‐bullying (e.g., Del Rey et al.,  2015 ), general aggression (e.g., Leff et al.,  2010 ), and school violence (e.g., Giesbrecht et al.,  2011 ). Other studies were excluded because they measured bullying‐related nonbehavioral outcomes, for example, “attitudes towards bullying” (e.g., Earhart,  2011 ), or coping strategies for dealing with victimization (e.g., Watson et al.,  2010 ).

In addition, studies conducted with special needs, delinquent, or psychiatric populations were excluded (e.g., Espelage et al.,  2015 ), so that results could be generalizable to the wider mainstream school population. Studies using qualitative measures of effectiveness, such as participant perceptions of the effectiveness of the program (e.g., Fletcher et al.,  2015 ), were also excluded.

4.2. Searches 1

In order to identify potentially includable studies, Boolean searches were conducted using multiple combinations of the following keywords: bully*; victim*; bully‐victim; school; intervention; prevention; program*; evaluation; effect*; and anti‐bullying . A full description of the syntax used is provided in Appendix A.

Searches were conducted on several online databases, including, but not limited to: Web of Science, 2 PsychINFO, EMBASE, DARE, ERIC, and Scopus. Google scholar ( www.scholar.google.co.uk ) was also searched. A full list of databases searched is provided in Table  1 . EBSCOhost was used as a platform to search multiple databases concurrently and such databases are indicated in Table  1 .

Online platforms and databases manually searched

Note: EBSCOhost was used as a platform to search multiple databases concurrently. Such databases are marked with an *.

Databases of unpublished reports (e.g., ProQuest Dissertations and Theses Solutions) were also searched to include gray literature in our review. This should help to minimize potential publication bias linked to larger or significant effect sizes (Easterbrook et al.,  1991 ; McAuley et al.,  2000 ). In addition, evaluation studies included by previous systematic reviews were scanned, based on the name of each program, for additional‐updated evaluation results (i.e., Cantone et al.,  2015 ; Chalamandaris & Piette,  2015 ; Evans et al.,  2014 ; Jiménez‐Barbero et al.,  2012 ,  2016 ).

Studies included in the previous review (Farrington & Ttofi,  2009 ; Ttofi & Farrington,  2011 ), were also included in the present systematic review. Searches for the present review were conducted up to the end of December 2016, 3 for empirical studies published during and since 2009.

4.3. Screening

Our searches of the literature produced approximately 19,877 reports that were screened for eligibility. Based on the title and abstract, a total of 474 primary studies were identified as relevant, were obtained and subjected to further screening. Studies were allocated to six categories based on their relevance to the current meta‐analysis. A description of each category is provided in Table  2 . Screening was undertaken by the first author (H. G.), under the supervision of the second author (M. T.), in a collaborative format. H. G. reviewed eligible studies, and any queries were settled in discussion with M. T.

Relevance scale categories used in screening

The initial wave of screening excluded 258 of these primary studies. At this stage, studies were excluded because they: (1) did not evaluate a specific antibullying program (Category 1; n  = 107); (2) reviewed several different antibullying programs (Category 2; n  = 108); or (3) did not report empirical quantitative data from an evaluation of a specific antibullying program (Category 3; n  = 43).

A second wave of screening excluded a further 133 studies (Category 4; see Table  3 ). Primary studies were excluded at this stage because they: (1) reported irrelevant outcomes; (2) did not have an adequate control group; or (3) did not meet specified methodological criteria. The screening process is described in detail in Figure  1 . In total, 83 studies published since 2009 were included in our updated systematic review (Category 5).

Descriptions of category four studies

Screening of studies

In addition, five studies were identified during searches conducted for a meta‐analytical review of cyberbullying prevention programs (Gaffney et al.,  2018 ). These studies were missed during systematic searches for the current review (i.e., Kaljee et al.,  2017 ; Ortega‐Ruiz et al.,  2012 ; Ostrov et al.,  2015 ; Silva et al.,  2016 ; Solomontos‐Kountouri et al.,  2016 ). One of these studies (i.e., Kaljee et al.,  2017 ) has a publication date outside of the range of our searches. However, it was included because it was available online in 2016.

To provide the most up‐to‐date analysis of school‐based bullying prevention and intervention programs, therefore, a total of 88 newly identified studies are included in the present systematic review.

5. DATA EXTRACTION

After identifying studies eligible for inclusion in the present systematic and meta‐analytical review detailed information about the antibullying programs, sample involved, and evaluation design were extracted from primary studies. The following chapter outlines the coding framework applied in greater detail.

Table  4 also outlines each piece of information extracted. Information was extracted from primary studies under four main headings: (1) Descriptives, (2) Design, (3) Program, and (4) Outcomes. Additionally, the following section outlines information extracted from primary studies in order to create a risk of bias index. Table  5 outlines the items utilized to assess risk of bias for each of the methodological designs included in the present report. Details of the risk of bias results for each study is provided in Appendix B.

Coding framework

Abbreviations: BA/EC, quasi‐experiments with before and after measures of bullying (nonrandomized); exp, experimental group; OBPP, Olweus Bullying Prevention Program; RCT, randomized controlled trial.

Risk of bias tool

Abbreviations: AC, age cohort design; BA/EC, quasi‐experimental design with before and after measures of bullying; RCT, randomized controlled trial.

This procedure was carried out by the first author in consultation with the second and third authors. 4 There were a number of studies from the previous Campbell Collaboration report (i.e., Farrington & Ttofi,  2009 ) for which full texts were unavailable and thus, were excluded from several of the moderator analyses.

5.1. Descriptive

Various pieces of descriptive information were extracted from each of the 100 evaluations included in the present report. Information specific to the evaluation, such as the location or the start/end date, were recorded along with detailed information concerning the sample.

The total sample size and also the n of the relevant experimental and control groups were recorded. Age was extracted in two ways. First, where studies reported the mean age, or the age range (i.e., 8–10 years old) of participants this was recorded. Second, some studies did not report the age in years of participants, but we were able to record the school grade of included samples (i.e., Grades 4–6). Where reported, the % of females and males included in the sample was extracted.

We also coded descriptive information about the publication of the evaluation. Specifically, the type of publication and the publication year was recorded. The former represents a categorical moderator reflected whether or not the evaluation was published via the following channels, in order of hypothesized negative correlation with bias: (1) peer‐reviewed journal article; (2) chapter in an edited book/book; (3) governmental report or similar; (4) correspondence; and (5) unpublished masters or doctoral theses.

Correspondence was included to reflect data obtained from multiple evaluations of the Olweus Bullying Prevention Program (OBPP) sent to the second (M. M. T.) and third (D. P. F.) authors in preparation of their earlier Campbell review. Where evaluation data had been published in multiple formats, we favored the category associated with the least potential bias. For example, Domino ( 2011 ) reported the results of an evaluation of Take the LEAD program in a doctoral dissertation, but later published these results in a peer‐reviewed journal (i.e., Domino,  2013 ). In this scenario, the included study was coded as “article.”

5.2. Design

Included studies were further categorized according to several aspects of the research design used. We coded information regarding both the measures (i.e., instruments to measure bullying behaviors) and research design.

In relation to measurements of bullying, we recorded the timeframe (i.e., past 3 months or “ever”) in which participants were asked to report on experiences of bullying, the type of report used (i.e., self‐, peer‐, or teacher‐report), and data collection points (i.e., baseline, postintervention, 3‐month follow‐up, etc.). We also noted whether the measure was a continuous scale or a global item and whether bullying perpetration, victimization, or both, outcomes were measured.

As for the research design, we recorded information regarding the unit of allocation (or unit of randomization for RCTs; see below), the number of “clusters” included, whether groups were matched at baseline, and the number of experimental or control groups. For example, Elledge et al. ( 2010 ) included multiple control groups: matched controls and nonmatched controls.

Information about the evaluation methodology was also extracted from primary reports. The types of evaluation methodologies included in the present report are now described in further detail.

5.2.1. Evaluation methodology

In order to optimize the comparability of effect sizes, primary studies included in a meta‐analysis should use the same, or at least conceptually similar, research designs (Wilson,  2010 ). Following Farrington and Ttofi's ( 2009 ) criteria, we searched for evaluations using any of the following four research designs:

• (1) Randomized controlled trials (RCTs);
• (2) Before‐after/quasi‐experimental‐control designs (BA/EC);
• (3) Other quasi‐experimental designs; and
• (4) Age cohort designs.

Each of these methodologies varied on four key elements: as randomization of participants (or clusters of participants); use of experimental and control groups; and administration of quantitative bullying measures before and after intervention.

For example, all studies coded as RCT had to include random assignment to experimental conditions (i.e., intervention and control groups) but did not have to use before and after measures of bullying outcomes. RCTs are considered to be the “gold standard” of experimental evaluations (Weisburd et al.,  2001 ). Random assignment of a large number of units is used as a way in which evaluators can also randomize possible confounding variables between groups. As a result, we can infer that any observed differences result from the experimental manipulation (Farrington,  1983 ). The assumption is that randomization ensures that both observed and unobserved variables that may impact the results of an evaluation are also randomly distributed between groups. However, problems may arise if the unit‐of‐allocation, the unit‐of‐randomization, and the unit‐of‐analysis do not align.

Before‐after/quasi‐experimental‐control (BA/EC) designs, are conceptually similar to RCTs, but they do not involve random assignment to experimental conditions. Instead, participants or clusters of participants may be assigned to the intervention or control group on a self‐selected basis (e.g., Menesini et al.,  2012 ), for convenience (e.g., Sapouna et al.,  2010 ), or based on a greater need for intervention (e.g., Losey,  2009 ). Thus, BA/EC designs may be subject to selection biases (Farrington & Petrosino,  2001 ) that may reduce the validity of the results. These can be controlled if outcomes are measured before and after the intervention. Studies coded as BA/EC in the present report all used experimental and control groups but did not randomly assign participants to conditions. They also had to measure bullying outcomes before and after implementation of the intervention.

In contrast, studies categorized in the current review as using “other quasi‐experimental” designs utilized experimental and control conditions, without random assignment, but did not measure bullying behaviors before the intervention. Bullying outcomes were only measured after the implementation of an intervention in these studies. Therefore, selection bias is may be a threat to the internal validity of the results in such designs, which could have possibly attributed to pre‐existing differences between the groups (Farrington, 2003 ). For this reason, a decision was made to omit these designs from this updated meta‐analysis. Thus, relevant evaluations identified in the earlier Campbell Review and any new evaluations (since 2009) using this methodological design were excluded from the new meta‐analyses (see later).

In an age cohort design, students of a particular age X are initially assessed in the 1st year and serve as the control group for the evaluation of an intervention. Then, all students receive the intervention, and different students of the same age X (in the same school, in the 2nd year) serve as the experimental group (see Kärnä et al.,  2013 ). This design, which is largely used in evaluations of the OBPP, deals with some selection effects, since it ensures that experimental and control children are matched on age and school, and it deals with some threats to internal validity (e.g., ageing and maturation). However, this design may be influenced by period and testing effects, and the experimental and control groups may differ on other uncontrolled variables.

Studies employing RCTs, BA/EC, and age cohort designs were included in the present systematic and meta‐analytic review. Because of the potential threat to internal validity, we excluded studies ( n  = 9) in the other quasi‐experimental design category because they are poorly controlled and vulnerable to selection effects. Additionally, the four studies included in the earlier review that used an “other quasi‐experimental” design were excluded from the present systematic review.

5.3. Program

Using a socio‐ecological systems theory framework (Bronfenbrenner, 1979 ) and the previous meta‐analysis (i.e., Farrington & Ttofi,  2009 ) as guidelines, information about the specific intervention program was recorded. General details about the intervention, such as the name of the program (where relevant) and the aim of the intervention (e.g., Silva et al.,  2016 ) were noted along with more detailed information about the antibullying programs.

Intervention components at multiple levels of the socio‐ecological model (i.e., individual, peer, parent, and teacher, etc.) were recorded, such as work with peers, parental involvement, teacher training and whole‐school‐approach. Therefore, a brief description of each antibullying program based on this information is provided in Table  6 .

Systematic review results

In addition to specific program elements included in interventions, we also coded for possible sources of bias in evaluations and intervention development. Conflict of interest (COI) has previously been reported to impact evaluation results of many interventions and is a growing area of interest (COI; Eisner & Humphreys,  2012 ) with studies identified as having higher COI associated with larger overall effect sizes. Eisner and Humphreys outline many other possible sources of COI, such as financial gain to the evaluator, but this information was difficult to obtain for antibullying programs. Thus, a simple indication of potential COI was utilized.

We primarily focused on the overlap between individuals included as author/coauthor on the evaluation study, is also included on previous evaluations of the same program (e.g., NoTrap!; Menesini et al.,  2012 ; Palladino et al.,  2012 ,  2016 ), or is in fact referenced as the developer of that particular program (e.g., Tsiantis et al.,  2013 ). If no reference to a publication relating to the specific program was included, we concluded that the author had developed the program, and thus, the evaluation was deemed high risk.

Program specificity refers to whether the intervention program was specifically targeting bullying outcomes, or if many other outcomes were also included. Targeted programs are suggested to be more effective than generalized programs that aim to reduce many different behaviors in one intervention. Highly specific programs (i.e., those that only included bullying outcomes and very few others) were coded as “high.” Thus, programs that were less specific and included many other outcomes in addition to bullying measures were considered “low.” A third category was created (i.e., “medium”) to include studies that did multiple other outcomes in addition to bullying outcomes, but these additional variables were bullying‐related.

5.4. Outcomes

We also extracted several pieces of statistical information from primary studies that was required for the estimation of effect sizes. Statistics for bullying behaviors, for example, means and standard deviations or sample sizes and percentage of bullies and/or victims, were extracted for experimental and control groups at baseline and immediately postintervention timepoints.

We also coded bullying data for additional follow‐up timepoints where this information was reported by primary studies. Data was extracted and recorded separately for independent samples (i.e., female and male, Palladino et al.,  2016 ; older and younger, Baldry & Farrington, 2001) and different measures. For example, data for both self‐ and peer‐report measures were extracted from Beery and Hunt (2009) and for different forms of bullying (e.g., Frey et al.,  2005 ).

5.5. Risk of bias

As per the Campbell Collaboration reporting guidelines, a risk of bias index was created for the purpose of the present report. The EPOC tool was utilized to assess the risk category of each study on several items relating to the methodological quality of evaluations. Following earlier Campbell review (e.g., Valdebenito et al.,  2018 ) this tool was also used for nonrandomized studies as other risk of bias measurement instruments were considered inappropriate for nonscientific or medical trials.

The following section describes the procedure for addressing risk of bias in the present meta‐analysis. Each primary evaluation was measured on the following items: (1) allocation sequence (AS); (2) Allocation concealment (AC); (3) Baseline equivalence on outcomes (BE); (4) Baseline equivalence on participant characteristics (BC); (5) Incomplete outcome data (ID); (6) Contamination protection (CP); and (7) Selective outcome reporting (SOR). The applicability of these categories for each of the methodological designs included in the present report is outlined in Table  5 . Each study was categorized as being high, low, or unclear (if insufficient information was available) risk on each of these EPOC items.

6. INCLUDED INTERVENTIONS

In total, 67 different school‐based antibullying programs were evaluated by primary studies included in our updated meta‐analysis. Descriptions of each of these interventions is provided in the following section of this report. These narrative reviews of included antibullying programs are based on the best available information provided by the primary studies. Twenty‐one of the evaluated antibullying programs were included (only) in the previous meta‐analysis (Farrington & Ttofi,  2009 ). A number of popular school‐based antibullying programs (n = 7; i.e., Bully Proofing Your School [BPYS], Friendly Schools, KiVa, OBPP, Steps to Respect, ViSC, and Youth Matters) had been re‐evaluated or additional publications since 2009. Hence, the majority of programs evaluated in our updated meta‐analysis ( n  = 40) are new bullying prevention and intervention programs.

The following sections provides detailed summaries of each antibullying program included in our systematic review. Descriptions marked with an * were taken from the previous review (Farrington & Ttofi,  2009 ). To provide the reader with a detailed overview of existing antibullying programs studies subsequently excluded from the meta‐analysis are also included here.

6.1. *Antibullying intervention in Australian secondary schools

This antibullying intervention consisted of several activities that aimed to increase awareness and identification of bullying, to promote empathy for targets of bullying and to provide students with strategies to cope with bullying (Hunt,  2007 , p. 22). The intervention was based on an educational antibullying program, which was delivered by teachers. There was no specific training for teachers. Information about bullying was provided at parent and teacher meetings. Teacher meetings were held in conjunction with regular staff meetings while parent meetings were held after hours. A summary of the information covered at parent meetings was also published in the school newsletter in an attempt to target the wider parent population. Finally, the program includes a 2‐h classroom‐based discussion of bullying (offered by teachers) using activities from an antibullying workbook written by Murphy and Lewers ( 2000 ).

6.2. Anti‐Bullying Pledge Scheme (ABPS)

The ABPS describes a number of local antibullying schemes implemented in UK schools as a result of government recommendations and guidance (Pryce & Frederickson,  2013 ). Schools adopted a declaration of commitment, and intervention components followed a theoretical framework guided by the Theory of Planned Behavior (Ajzen,  1991 ).

The ABPS is a universal prevention program, that aims to reduce the prevalence of bullying perpetration and victimization in schools and increase students' perceptions of safety and support within the school environment (Pryce & Frederickson,  2013 ). Participating schools were assigned a facilitator, referred to as a “pledge supporter,” and a detailed intervention manual. The manual outlined the stages involved in implementing the ABPS program. The stages are as follows:

• Initial meeting with school management and the pledge supporter
• Intervention planning meeting
• School representatives make a declaration of commitment to the intervention
• Staff, student, and parent surveys are circulated
• Results from the surveys were collated and used to tailor intervention components to the individual schools' needs
• Ongoing visits and support from the pledge supporter throughout implementation.

6.3. *Be‐prox program

The Be‐Prox program was specifically designed to tackle bullying and victimization among kindergarten students. According to Alsaker and Valkanover ( 2001 , pp. 177–178), the somewhat higher adult‐children ratio, the interest of preschool teachers in socialization, the greater flexibility as to scheduling and teaching, and the admiration of many preschoolers for their teachers are ideal conditions for the implementation of preventive programs against bully/victim problems. The basic principle of Be‐Prox was to enhance preschool teachers' capacity to handle bully/victim problems (Alsaker,  2004 , p. 291). The program engaged teachers in an intensive focused supervision for approximately 4 months. Central features of Be‐Prox were the emphasis on group discussions, mutual support and co‐operation between consultants and teachers and between teachers and parents (Alsaker,  2004 , pp. 292–293).

The teacher training was provided in six steps (Alsaker,  2004 ; fig. 15.1, p. 292). Initially, teachers were given information about victimization (step 1) and the implications of this information was discussed (step 2). During the third step, specific implementation tasks were introduced and the teachers worked in groups in preparation for the practical implementation (step 4). After this preparation, teachers implemented specific preventive elements in the classroom (step 5) for a specific period of time. After that, teachers met and discussed their experiences of the implementation of the preventive measures (step 6).

In eight meetings over a 4‐month period, issues related to the prevention of bullying were addressed. The main purpose of the first meeting was sensitization. Teachers were asked to describe any possible bully/victim problems in their schools and were then given information about bullying and other types of aggressive behavior. They were also presented with the main principles of the program. The importance of contact between kindergarten teachers and children's parents was also emphasized and teachers were advised to consider the possibility of organizing a meeting with parents. In the second meeting, the importance of setting limits and rules to preschool children was discussed. Teachers were invited to elaborate some behavior codes in their classroom in collaboration with the children and to be ready to present them during the third meeting. Also, as a second homework task, teachers were asked to organize a parent meeting.

During the third meeting, teachers discussed their experiences of implementing classroom rules against bullying. The main focus of this meeting was the need for consistent teacher behavior, the difference between positive and negative sanctioning and the use of basic learning principles in the classroom. The main focus of the fourth session was on the role and responsibility of children who were not involved in bullying and of bystanders in the prevention of victimization. Teachers were asked to draw some kind of personality profiles of passive and aggressive victims and of bullies and to present them to the rest of the group. After this task, teachers were presented with research findings regarding the characteristics of children who were or were not involved in bullying. As a homework task for the next meeting, teachers were asked to systematically observe noninvolved children and to develop some means of involving them in the prevention of victimization.

During the fifth meeting, research‐based information about motor development and body awareness among preschool children was presented to teachers. A discussion between teachers and program researchers of children's self‐perceptions of strength, of peers' perceptions of strengths of victims of bullies, and other motor characteristics of children, aimed to yield important insights. The overall discussion and exchange of information among teachers aimed to promote teachers' understanding about how to change these perceptions within the classroom setting. Specific goals to be achieved within the classroom were clearly set, such as training in empathy and body awareness among children, participation and involvement of noninvolved children and talks with all the children about the situation in their kindergarten. During the sixth meeting, time was given to reflect on the goals formulated at the beginning of the prevention program. Teachers were also given time to discuss their experiences with implementing the goals of the fifth meeting within the classroom settings. The last two meetings followed a similar format, with time given for reflection on goals achieved, problems dealt with, and an overall evaluation of the program.

6.4. *Befriending intervention

Befriending intervention was an antibullying program that relied mainly on a peer support model. The overall aims of the program were: (a) to reduce bullying episodes through developing in bullies an awareness of their own and others' behavior; (b) to enhance children's capacity to offer support to the victims of bullying; (c) to enhance responsibility and involvement on the part of bystanders; and (d) to improve the quality of interpersonal relationships in the class group (Menesini et al.,  2003 , p. 1).

The antibullying intervention was offered in five steps (Menesini et al.,  2003 , p. 5). During the first phase, which targeted the class level (class intervention), several activities were offered aiming to increase children's awareness of prosocial and helping behaviors and to promote positive attitudes toward others. Through work at the class level, the school authorities sensitized and prepared the whole school population for the new service that the school unit was about to implement. In this way, another goal was achieved, namely developing values and attitudes toward “peer support activities” in the whole school population.

During the second phase of the program, the “peer supporters” were selected. Approximately three to four supporters were allocated in each classroom and were selected based on a combination of techniques, such as self‐ and peer‐nominations. These children were then trained in special full‐day sessions or in regular meetings during school time (phase three) so that they knew how to deal with other children and how to facilitate interactions among other children. Teachers and other professionals (psychologists and social workers) took part in these sessions as well. The overall aim of this phase of the antibullying program was to help peer supporters to enhance their listening and communication skills since they would be the mediators in the interactions among children.

During the fourth phase of the program, peer supporters worked in their classes with the assistance and close monitoring of their teachers. The teachers in each class organized “circle meetings” during which the needs of specific children involved in bullying (target children) were identified. Target children were contacted and, after their consent and cooperation, were offered help by the peer supporters. Peer supporters were not only assigned to specific tasks involving the target children but were also supervised by the teachers so that they were given constant feedback on their on‐going work in the class.

During the final phase of the Befriending Intervention, the leading group of peer supporters were involved in training other children in the class, so that more children could be involved in the program (in the transmission of training and passing on the roles).

6.5. *Behavioral program for bullying boys

This program targeted male youth, from a low socio‐economic area, predominately inhabited by individuals of color, involved in bullying. The program was based on the findings of an in‐depth needs assessment within three schools and targeted a specific number of male students aged sixteen who (based on the results of the questionnaire that had been administered) were “considered to be a serious threat to the harmonious functioning of everyday school life” (Meyer & Lesch,  2000 , p. 59). The theoretical basis of the program could be found in the Social Interactional Model for the development of aggression (Meyer & Lesch,  2000 , p. 61) and involved a behavioral approach for tackling the problem of bullying. The program was implemented by psychology students for ten nonconsecutive weeks, with 20‐h‐long sessions held twice weekly at the school, during school hours.

The components of the 17‐session behavioral program included homework tasks, modeling, self‐observation, role‐plays, and a token economy system for reinforcing positive behaviors. According to the program designers “the chief contingency for behavioral change was the token economy system, using Wonderland Games tokens, chocolates and cinema tickets as reward for non‐bullying behavior” (Meyer & Lesch,  2000 , p. 62). Each participant was monitored by himself and by a “buddy” who was selected in each session prior to the monitoring. Each session included an opportunity for feedback on the students' progress in the week, a discussion of a relevant applied topic, role‐playing, games, and drawing. The program designers pointed out the limitations of the intervention strategy. As they indicate (Meyer & Lesch,  2000 , p. 67) “the program was too short and structured to address the issues that were disclosed in sessions, as the severity of the nature of the aggression in the schools and vast social problems was seriously underestimated.”

6.6. Beyond the Hurt

Sutherland ( 2010 ) implemented the Beyond the Hurt program, a peer‐led school‐based bullying intervention and prevention program, developed by the Red Cross. Beyond the Hurt is a high school program and emphasizes education, prevention and intervention to reduce prevalence of bullying perpetration and victimization. Sutherland ( 2010 , p. 84) describes the four key components of the intervention: (1) education and training of peer facilitators, (2) in‐class presentations given by peer facilitators, (3) teacher workshops, and (4) online training material for teachers and community members.

This peer‐led program trains and educates select peer facilitators, who become the implementers of the intervention program within participating schools. These students are guided by a teacher and Red Cross professional throughout training and implementation of class presentations highlighting several bullying‐related issues. The overarching aim of the Beyond the Hurt program is to create a positive school and class climate in which students are encouraged to develop and maintain healthy prosocial relationships, and bullying perpetration and victimization are not supported. The program aims to promote antibullying attitudes among participants and encourage empathy and prosocial support for victims of bullying.

6.7. *Bulli and Pupe

Bulli and Pupe was an intervention program concerned with bullying and family violence. The program, developed by Baldry (2001), was “directed towards the individual and peer group, and aimed to enhance awareness about violence and its negative effects” (Baldry & Farrington,  2004 , p. 3). The intervention package consisted of three videos and a booklet divided into three parts; each video was linked to one part of the booklet. Each part of the booklet was meant to take the form of an interactive lesson where professionals, experienced in school and juvenile processes, discussed three issues according to the structure of the manual.

The first part of the booklet, entitled “Bullying among peers,” emphasized teen violence among peers. The booklet presented vignettes and graphics that reported research findings on bullying in an attempt to raise students' awareness of this issue. The corresponding video showed teenagers talking about bullying based on their own experiences and judgments. The second part of the booklet, entitled “Children witnessing domestic violence,” analyzed the effects of domestic violence on children and the repercussions for school achievement and peer relations. In the accompanying video, children in a shelter for battered women were presented, talking about their personal experiences and emotions. Finally, the third part of the booklet, entitled “Cycle of violence,” dealt with the long‐term effects of violence on adults who were victims of violence in their childhood. The corresponding video consisted of an interview conducted with a 19‐year old boy who had a violent father.

The program was in the first place delivered in 3 days by experts who, together with teachers, discussed about bullying, read the booklet and analyzed its content. The program was taken over by teachers who once a week created a facilitation group and allowed children to discuss any problems they encountered with their peers. The program was more effective with secondary students because it required its participants to have good interpersonal and cognitive skills (Baldry & Farrington,  2004 , p. 4).

6.8. The Bully Prevention Challenge Course Curriculum (BPCCC)

Battey ( 2009 ) implemented the BPCCC (Haggas,  2006 ) to students over two 45 min classes, on 4 days of one school week. The program was implemented by trained facilitators, whom included the schools' physical education/health teacher. The program commenced by providing participants with name tags and organizing some warm‐up physical activities. Next, the physical education/health teacher provided participants with information about bullying, such as, identifying and addressing bullying, who to talk to and where to seek support. Subsequent group discussions focused on empathy and understanding each other's differences. Audience participation activities also required the students to engage to represent the number of students whom had been a victim or bully.

6.9. Bully Proofing Your School

“Bully‐Proofing Your School” was a comprehensive, school‐based intervention program for the prevention of bullying (Menard & Grotpeter,  2014 ; Menard et al.,  2008 ; Toner,  2010 ). The program involved three major components: (1) heightened awareness of the problem of bullying, involving a questionnaire to measure the extent of bullying and the creation of classroom rules related to zero tolerance for bullying; (2) teaching students protective skills for dealing with bullying, resistance to victimization and providing assistance to potential victims by teaching assertiveness skills; and (3) creation of a positive school climate where students were encouraged to work as positive and supportive bystanders (Menard et al.,  2008 , p. 7).

The primary targets of BPYS were elementary and middle school students. School staff were involved as both secondary targets of intervention (since changes in their behavior was a requirement for the construction of a positive antibullying school environment) and as agents delivering the intervention to students. Teachers were given information and strategies to help them recognize bullying incidents among their students and how to effectively deal with these behaviors (Menard & Grotpeter,  2014 ).

The intervention in the classes consisted of a classroom curriculum, which included seven sessions of approximately 30–40 min. Each session was delivered by a teacher or by mental health staff. After completion of the classroom curriculum materials, teachers were encouraged to hold weekly classroom meetings during which students could be helped to reflect on their behaviors. Parents were offered information through newsletters. Individual parents of students involved in bullying as either perpetrators or victims were given consultation (Menard & Grotpeter,  2014 ).

6.10. Chinese antibullying intervention

Ju et al. ( 2009 ) implemented an antibullying program in a Chinese primary school employing an action research framework. There were two main aims of this intervention program. First, the program aimed to reduce bullying perpetration and victimization both on students' way to, and from, school. Second, the study aimed to investigate practical intervention elements that could be applied nationwide to Chinese primary school children (Ju et al.,  2009 ).

The initial step in this intervention was the training of teachers on the fundamental principles of action research. This training program targeted the following components of educational research: (1) research methodology in education; (2) knowledge of school bullying; (3) components of action research; and (4) intervention skills, such as brainstorming and role‐playing. Second, a 5‐week intervention program was designed and implemented by teachers in classrooms. Components that targeted both victims and bullies specifically were also incorporated into the intervention.

6.11. The Confident Kids program

The Confident Kids program is an antibullying intervention designed for early adolescent males who were experiencing anxiety as a result of being bullied at school (Berry & Hunt,  2009 ). The foundations of the program lie in cognitive‐behavioral therapy, employing both anxiety management techniques and antibullying elements. Based on the “Cool Kids Program” (Lyneham et al., 2003), this intervention program aims to reduce bullying victimization by targeting factors that increase the likelihood of victimization. Therefore, this program focuses primarily on issues such as: self‐esteem, coping strategies; social skills; emotional regulation; and internalizing behaviors.

The program was implemented over a period of 8 weeks, and included student and parent involvement. Students participated in weekly group sessions led by a team of assistant and qualified clinical psychologists. These sessions incorporated a combination of tasks including: skill demonstration; role‐playing; and group discussion. Homework was allocated after each session and participants were encouraged to apply skills acquired in real‐life settings between each session.

Sessions covered a variety of issues, including both cognitive‐behavioral anxiety management techniques and antibullying information. Seven core sessions focused on the following topics: psycho‐education; cognitive restructuring (2 sessions); graded exposure; adaptive coping strategies; improving social skills; and self‐esteem. A final session targeted relapse prevention and provided a general overview of the skills learned throughout the program. Parents participated in sessions that ran parallel to the student program. Group discussions targeted the strategies being taught to student participants and also possible parent factors that could influence effectiveness of intervention for their children, for example, parental anxiety.

6.12. Cyberprogram 2.0

Cyberprogram 2.0 is a cyberbullying intervention program that also incorporates elements on school bullying (Garaigordobil & Martínez‐Valderrey,  2015 ). The intervention is delivered over 19 sessions, and outlines the following four main goals:

• To outline and conceptualize bullying and cyberbullying, including identifying the different roles involved (e.g., bullies, victims, and bystanders).
• To illustrate the consequences of bullying and cyberbullying for all those involved
• To develop coping strategies in order to reduce bullying and cyberbullying behaviors.
• Developing positive social and emotional skills, such as empathy, active listening, anger management, conflict resolution strategies, and diversity tolerance.

A wide range of activities and techniques are used, such as, role‐playing, brainstorming, case studies, and guided discussion. The Cyberprogram 2.0 intervention followed a specific methodological framework, employing four key components for implementation. They are as follows: (1) inter‐session constancy: intervention was delivered in weekly 1‐h sessions; (2) spatial‐temporal constancy: intervention was delivered in the same place and at the same time each week; (3) constancy of adult facilitator: intervention was implemented by the same adult, who same psycho‐pedagogical training, each week; and (4) constancy in the session structure: sessions being with group instruction and activities. There is then a following reflection phase that is led by the adult.

6.13. Daphne III

Daphne III was an international antibullying initiative implemented and developed in association with numerous organizations. In this study (Papacosta et al., 2014), school antibullying programs were coordinated in Cyprus by the Association for the Psychosocial Health of Children and Adolescents (APHCA). Other influential “partners” included the Cyprus Ministry of Health, mental health services, Department of Child and Adolescent Psychiatry, Ministry of Education and Culture, and Educational Psychology services. Organizations from other European countries included: Child Line [ Vsi Vaiku Linija ], in Lithuania, and Nicolaus Copericus University, in Poland, were also involved.

The overarching aim of this initiative was to educate 5th and 6th grade primary school students about bullying, and the many different forms it can take (Papacosta et al., 2014). Teachers implemented the program in their classrooms, and were trained by psychology and mental health professionals. There were eleven workshops involved in the program that followed a structured curriculum manual. This manual also provided schools with suggestions and recommendations on ways in with they could prevent, and intervene in, bullying situations.

6.14. *Dare to Care: BPYS program

“Dare to Care; Bully Proofing Your School” was a modification of the “Bully Proofing Your School” program (Beran et al.,  2004 , p. 103), which in turn was modeled on the Olweus Program. This antibullying program placed emphasis on clinical support to victims and perpetrators of bullying in the form of individual and group counseling. It also enabled collaboration with community services. The essence of the program was to encourage accountability for creating solutions among all parties involved in the education system (Beran et al.,  2004 , p. 104).

The program included several steps. Program facilitators provided to school personnel information and training on issues related to bullying in schools (in a full‐day professional development workshop). This workshop aimed to ensure that the program principles would be reflected in the overall curriculum and would be sustained over time. Information was also given to parents. Then, students, parents and school staff collaborated in the development of a school antibullying policy. This policy had the aim of identifying caring and aggressive behaviors and consequences of those behaviors, but with a focus on reparation rather than punishment. The antibullying policy was posted throughout the school. Finally, the program involved the implementation, on behalf of the teachers, of a classroom curriculum that educated children about the nature of bullying and strategies to avoid victimization. The curriculum included discussion, role‐plays, artwork, books, videos and skits presented to school staff, parents, and other children.

6.15. Defeat Bullying

The Defeat Bullying program is a curriculum‐based antibullying program that was published by the National Society for prevention of Cruelty to Children (NSPCC, UK) in 2007 (Herrick,  2012 ). The program materials were available to download online, as part of a nationwide campaign to reduce bullying perpetration and victimization in UK schools. The overarching aim of the Defect Bullying program is to raise awareness and improve attitudes toward bullying, educate about bullying‐related feelings and emotions, and to develop effective intervention and conflict resolution strategies (Herrick,  2012 , p. 85). Based on social identity theory (Tajfel & Turner,  1979 ), the program aims to establish an in‐class antibullying norm, so that students will be encouraged to adopt this norm, and thus, reduce levels of bullying perpetration and victimization.

There are five key lessons implemented throughout the program, and each incorporates a range of individual, class and group activities (Herrick,  2012 ). The lessons cover the following five themes: (1) understanding attitudes and values toward bullying; (2) educating about the feelings that occur as a result of bullying; (3) embracing diversity; (4) safety awareness; and (5) encouraging bystanders to get involved in antibullying strategies. The available intervention materials were also reviewed by groups of teachers, and any necessary amendments were incorporated. For example, Herrick ( 2012 ) describes that following teacher discussion groups, homework assignments relating to each lesson were developed and implemented. Parents of participating students were also invited to attend an antibullying workshop led by the researcher.

6.16. *Dutch antibullying program

The antibullying initiative in the Netherlands was inspired by the Olweus program (Fekkes et al.,  2006 , p. 639). The program was specifically designed to tackle bullying behavior by involving teachers, parents and students. It offered a 2‐day training session for teachers in order to inform them about bullying behavior and to instruct them about how to deal with bullying incidents in schools. During the intervention period, teachers had access to the training staff for additional advice. Intervention schools were supported by an external organization named KPC, which specialized in training school staff and in assisting schools in setting up new curricula and guidelines. The core intervention program included: (1) antibullying training for teachers, (2) a bullying survey, (3) antibullying rules and a written antibullying school policy, (4) increased intensity of surveillance, and (5) information meetings or parents.

During the intervention, there was careful dissemination of the antibullying program to intervention schools. Also, the researchers provided information about the number of intervention and control schools, which have used the above‐mentioned elements of intervention. Finally, intervention schools were supplied with the booklet “Bullying in schools: how to deal with it” and with a “Bullying Test,” a computerized questionnaire that children could complete anonymously in the classroom.

6.17. Dutch Skills for Life

The Skills for Life program is a Dutch universal school‐based behavioral and health prevention program for adolescents aged 13–16 years old (Diekstra,  1996 ; Gravesteijn & Diekstra,  2013 ). The program targets prosocial behavior, self‐awareness, social awareness, self‐control, interpersonal skills, and ethical decision making to reduce behavioral and health problems (Fekkes et al.,  2016 ). The program is based on social learning theory and Rational Emotive Behavioral Therapy. As a result, the program aims to reduce bullying by enabling students to learn from each other in a classroom setting through behavioral modeling.

The program is implemented by teachers, who attend two 3‐day training workshops prior to implementation and receive “booster” training sessions throughout the intervention (Fekkes et al.,  2016 ). The intervention is comprised of 25 lessons that are delivered over the course of two academic years. First, four lessons address awareness and handling of thoughts and feelings. Skills such as interpersonal problem solving, emotional regulation, and critical thinking are targeted. There are twelve additional lessons in the 1st year, and nine more lessons in the 2nd year of implementation. These generally focus on skills that are applicable to particular behavioral or health experiences. For example, lessons are aimed at: dealing with bullying; setting and respecting boundaries; substance use; norms and values; friendships; sexuality; suicidal ideation; and conflicts with peers and/or teachers. Various activities are utilized throughout the program, including, active enactment, DVDs, role play, discussion and feedback.

6.18. Dynamic Approach to School Improvement (DASI)

The DASI (Kyriakides, Creemers, Papastylianou, et al.,  2014 ; Kyriakides, Creemers, Muijs, et al.,  2014 ) was a whole‐school approach to bullying prevention implemented in several European countries, such as: Cyprus, Greece, UK, Belgium and the Netherlands. This approach draws factors from the educational effectiveness model (Creemers & Kyriakides,  2008 ,  2012 ). The intervention targets specific school factors, that is, (1) school teaching policy, (2) school learning environment, and (3) school evaluation. This framework was previously found to improve academic achievement (e.g., Kyriakides,  2008 ).

At the beginning of the intervention, the research team held training for participating school staff. The theoretical framework was introduced, and a detailed manual was provided. The aim of the handbook was to facilitate school stakeholders to develop strategies and action plans that were specific to the schools' needs (Kyriakides, Creemers, Papastylianou, et al.,  2014 ). Support was offered to each school by the research team throughout the process.

Teacher surveys were distributed prior to implementation in order to highlight specific areas that needed improvement. The next phase of the intervention involved school stakeholders coming together to form cooperative committees with representatives of parents, students, and teachers. These committees then collaborated to develop action plans and strategies to address specific problems in their schools. Committees formulated plans to implement particular intervention components that best suited their specific needs. Therefore, the schools participating did not necessarily implement the same intervention components or activities. Schools were required to retain log books of activities undertaken.

Kyriakides, Creemers, and Papastylianou, et al. ( 2014 ) provide an outline of the intervention components implemented in one experimental school involved in their trial. For example, the following are identified as essential elements implemented in order to reduce bullying:

• “Student behavior outside the classroom”—involves developing clear and efficient antibullying policy, increased teacher vigilance in bullying “hot spots” and effective supervision of students.
• Improved school learning environment
• “Rewarding good behavior”—enforcing a system that acts as a nonpunitive approach to antibullying, by motivating students to behave in a prosocial manner.
• “Collaboration and interaction between teachers”—encouraging teachers to work together and communicate effectively about bullying issues in their schools.
• Other intervention components, including, encouraging and supporting peer bystanders; identifying and support “at risk” and vulnerable students; and creating student‐made videos about bullying issues.

6.19. *Ecological antibullying program

The Ecological antibullying program examined peer group and school environment processes “utilizing a systemic interactional model with evaluations at each level of intervention” (Rahey & Craig,  2002 , p. 283). The overall aim of the program was the creation of a supportive and safe school environment in which firm limits against bullying were established. The specific goals of the program included raising awareness of the problem of bullying, increasing empathy, encouraging peers to speak against bullying and formulating clear rules against bullying.

The 12‐week program was based on the “Bully Proofing Your School” program which was designed to increase the understanding of bullying and decrease the incidence of bullying (Rahey & Craig,  2002 , p. 285). The program elements included a psycho‐educational component implemented within each classroom, a peer mediation component and specialized groups for children involved in bullying.

At the school‐wide level, the psycho‐educational program was implemented by psychology students who received training sessions and manuals prior to intervention. Prior to the program, at a school assembly the program was introduced to students. The assembly signaled the formal beginning of the intervention. The classroom programs involved interactive educational approaches such as role playing and puppet techniques. The topics addressed were bullying and victimization, conflict resolution, empathy, listening skills and individual differences (Rahey & Craig,  2002 , p. 286).

Individual programs for children involved in bullying were also part of the intervention. The relevant sessions consisted of social skills, listening, empathy training and supportive counseling. Each weekly session lasted 45 min. The program also included intervention at the teacher level. Teacher programs consisted of meetings with teachers to discuss bullying, intervention approaches, and student support for those directly involved in bullying. During the intervention, the program coordinators met with principals and teachers to offer support.

6.20. Emotional Literacy Intervention

Knowler and Frederickson ( 2013 ) evaluated the effectiveness of an emotional literacy intervention targeted on bullying behaviors to reduce bullying victimization in UK schools. Selected schools were previously implementing the Social and Emotional Aspects of Learning (SEAL; Department for Education and Skills,  2005 ) program. One of the themes included in the SEAL program is “Say no to bullying” (Knowler & Frederickson,  2013 ), however the overall program aims to improve students' social relationships, motivation, learning strategies, and holistic school improvement.

The specific emotional literacy intervention implemented and evaluated by Knowler and Frederickson ( 2013 ) involved teaching emotional literacy skills to small groups of students (Faupel,  2003 ). In the current evaluation, the intervention was delivered to groups of “low emotional literacy” and “high emotional literacy” groups distinguished by scores above, or below, median scores on the Emotional Literacy assessment‐pupil form (ELA‐PF; Faupel,  2003 ). The intervention program employed 12 weekly lessons and was implemented by trained teaching aids (Knowler & Frederickson,  2013 ). The program consisted of four main concepts: (1) self‐awareness, (2) self‐regulation, (3) empathy, and (4) social skills. Lessons employed a variation of behavioral and cognitive‐behavioral elements (Faupel,  2003 ).

6.21. Empathy training program

This intervention program was developed for children identified as bullies and aimed to increase their empathetic skills in order to reduce their bullying behaviors (Şahin,  2012 ). The empathy training program was implemented over eleven 75‐min sessions that were based on a curriculum lesson plan developed by the author. Several cognitive techniques were utilized throughout the program, such as: recognizing, evaluating and naming feelings; diadtic, experimental, modeling and role‐playing, in order to improve the students' cognitive abilities in relation to empathy. Each lesson required the students to work together to develop a slogan that emulated the content of the session. The following is an outline of the first 4 weekly lessons, and the associated slogan developed, (for a full outline see: Şahin,  2012 , p. 1327; Table  2 ).

Slogan: Be kind, loving and forgiving to each other to lead a happy life .

Slogan: Living without the awareness of feelings is like driving a car with its brakes on .

Slogan: One who claims to know everything about the universe but nothing about himself, actually knows nothing .

Slogan: We can look at the same thing but view it differently .

6.22. *Expect respect

Expect Respect was a school‐based program that aimed to promote awareness and effective responses to bullying and sexual harassment. The project was developed by Safe Place, the sole provider of comprehensive sexual and domestic violence prevention and intervention services in Austin, Texas (Rosenbluth et al.,  2004 , p. 211). The program targeted the involvement of all members of the school community in recognizing and responding to bullying and sexual harassment. The overall project design was inspired by the work of Olweus (Rosenbluth et al.,  2004 , p. 212). Expect Respect consisted of five core program components, namely a classroom curriculum, staff training, policy development, parent education and support services.

The classroom curriculum was based on 12 weekly sessions adapted from a specific manual called “Bullyproof: a teachers” guide on teasing and bullying for use with fourth and fifth grade students' (Whitaker et al.,  2004 , p. 330). The Bullyproof curriculum was designed to be taught in conjunction with literature typically read by fourth and fifth graders. Although the antibullying curriculum was designed to be implemented by teachers, within the framework of the Expect Respect program, it was jointly led by Safe Place Staff and teachers or school counselors (Whitaker et al.,  2004 , p. 331). The curriculum aimed to increase the ability and willingness of bystanders to intervene in bullying situations, thus reducing the social acceptability of bullying and sexual harassment. The Bullyproof lessons included writing assignments, role‐plays of how to intervene in bullying situations, class discussions and so on.

With regard to the staff training, a 6‐h training was provided to project staff, counselors, and fifth grade teachers. The training was given by the author of the specific manual and aimed to prepare school personnel to respond effectively to bullying incidents. In addition, 3‐h training sessions were provided once per semester for all personnel, including bus drivers, cafeteria workers, hall monitors and office staff. The training presentation included research on bullying and sexual harassment; strategies to enhance mutual respect among students; practice in using lessons from the curriculum; and methods for integrating the lessons into other subject areas including language arts and health.

School administrators were encouraged to develop an antibullying policy (policy development) in their school to ensure consistent responses by all staff members to incidents of bullying and sexual harassment. Principals were expected to present the policy to school staff, students and parents. In order to facilitate the overall procedure of policy development, Expect Respect staff provided an initial policy template to school administrators (Whitaker et al.,  2004 , p. 332) and each school was encouraged to expand this initial policy in accordance with the specific needs of their unit.

The Expect Respect program also included parent training. Educational presentations were offered to parents, twice a year, providing information about the project. The information given to parents through these meetings (as well as through parent newsletters sent home) was aimed at enhancing parents' strategies to help children involved in bullying as bullies, victims, bully‐victims, or bystanders.

Further support services were provided such as continuous assistance of school counselors by Safe Place staff. School counselors were given a specialized session on how to deal with students who were repeatedly involved in bullying as either perpetrators or victims. They were also provided with a comprehensive resource manual containing reading and resource materials on bullying, sexual harassment and domestic violence.

6.23. fairplayer.manual

The fairplayer.manual is a structured, curriculum‐based antibullying program for Grade 7–9 students (Bull et al.,  2009 ; Wölfer & Scheithauer,  2014 ). The overarching aim of the intervention is to reduce bullying and relational aggression by improving students' social and moral competencies. The program focuses on raising awareness, changing attitudes, and encouraging bystander intervention.

The program is implemented over 15‐weekly 90 min lessons, and can be delivered either by trained teachers (Bull et al.,  2009 ), or psychologists (Wölfer & Scheithauer,  2014 ). Intervention lessons employ cognitive‐behavioral techniques and target nine specific topics. The first introductory lesson introduces the program to students, and class antibullying rules are developed. Two following lessons are concerned with raising awareness about bullying‐related issues, such as, the various forms of bullying and the consequences associated with perpetration and victimization. One lesson subsequently focuses on improving students' understanding of their own and peers' feelings. A further two lessons highlight the numerous participant roles involved in bullying, for example, bullies, victims, outsiders (i.e., noninvolved), assistants, and re‐inforcers (Wölfer & Scheithauer,  2014 ). The latter roles describe different forms of bystanders, those who witness bullying and allow it to happen and those who reinforce bullying behaviors. Social dynamics in the classroom is also addressed in one intervention session. By addressing the different dynamics, networks and norms socially in the class, this lesson aims to improve the classroom climate and encourage co‐operation among students. Another intervention lesson models and promotes bystander intervention in order to encourage noninvolved children to become actively engaged with intervening in bullying situations that they may witness.

Following these core awareness‐raising and knowledge‐improving lessons, participating students undertake five social skill‐training session s. These lessons focus on developing social, emotional, and moral skills of participants, in order to combat bullying. Perspective taking, empathy, and moral dilemmas are just some of the issues that are included. Diversity is the topic addressed in one of the following lessons, where students learn to respect and appreciate diversity. Finally, a concluding lesson brings together all of the issues covered by the intervention and demonstrates ways in which participants can utilize skills and knowledge in their everyday lives.

6.24. FearNot!

The FearNot! (Fun with Empathetic Agents to achieve Novel Outcomes in Teaching; Sapouna et al.,  2010 ) was an immersive learning intervention that aimed to reduce bullying victimization. Students from British and German primary schools participated in the virtual learning program for weekly 30‐min sessions over the course of three consecutive weeks. Participating schools were required to have adequate computer facilities in order to be able to run the program.

During intervention sessions bullying scenarios were enacted by male and female 3D animated characters. The content of these scenarios reflected the characters' genders, for example, scenarios involving male characters included more incidents of physical bullying, whereas female characters demonstrated more relational bullying. Following each of the bullying episodes, participants were asked to interact and provide the animated victim of bullying with a suitable coping strategy to prevent future victimization. The program then enabled students to see the outcomes of their suggested strategy. In some circumstances, the animated victim of bullying responded that they did not feel emotionally adequate enough to carry out the suggested coping strategy (e.g., not strong enough to stand up to the bully).

Based on previous research (e.g., Kochenderfer & Ladd,  2000 ), students were then provided with an indication of how successful their proposed coping mechanism would be in real‐world bullying scenarios. For example, students were provided with a score on a scale of zero (never successful) to ten (always successful; Sapouna et al.,  2010 ). In addition to the computerized program, teachers in intervention schools were provided with a detailed intervention manual. However, during the FearNot! program, teachers were instructed only to assist students with issues of comprehension, and not to guide them on suitable responses to the bullying scenarios.

6.25. Fourth R

The Fourth R: Strategies for Healthy Youth Relationships is a dating violence prevention program that targeted bullying perpetration and victimization as secondary outcomes (Cissner & Ayoub,  2014 ). This curriculum‐based intervention program was based on social learning theory (Bandura,  1978 ), and was implemented in classrooms by trained teachers during health and physical education classes. Participating teachers completed an intensive 1‐day training session that provided them with the skills to implement the program effectively. Detailed manuals and lesson outlines/materials were provided, and the Fourth R curriculum was integrated into existing health and physical education curricula.

The Fourth R was designed as a 21‐lesson curriculum that incorporates a variety of activities and lessons. Role‐playing, individual, pair and group work, and detailed examples/scenarios of conflict are examples of Fourth R‐style tasks. Program lessons were categorized into the following 3 units: (1) Personal Safety and Injury Prevention; (2) Healthy Growth and Sexuality; and (3) Substance Use and Abuse. Each unit consisted of seven 45‐min lessons. The Fourth R was also designed to be implemented in either gender‐segregated or co‐ed classrooms.

6.26. *Friendly Schools Project

“Friendly Schools” was a theoretically grounded program. Its educational techniques (e.g., role modeling, drama activities, skills training, etc.) were based on notions derived from Social Cognitive theory, the Health Belief Model and Problem Behavior theory (Cross et al.,  2004 ,  2011 ). An interesting aspect of this program is that it was based on the results of a systematic review (Cross et al.,  2004 , p. 187), which provided a set of key elements to be included in the final intervention strategy. The program targeted bullying at three levels: (a) the whole‐school community, (b) the students' families, and (c) the fourth and fifth grade students and their teachers.

With regard to the whole‐school intervention component, in each school, a Friendly Schools Committee was organized with key individuals (e.g., a parent representative, a school psychologist, a school nurse, teaching staff) who could co‐ordinate and successfully sustain the antibullying initiative. Each committee was provided with a 4‐h training, designed to build members' capacity to address bullying. Each member was provided with a specific strategy manual. The manual was a step‐by‐step guide on how to implement the antibullying initiative. It included among others the Pikas “Method of Shared Concern” and the “No Blame” approach (Cross et al.,  2011 ; Pikas,  2002 ).

With regard to the family intervention component, this included home activities linked to each classroom‐learning activity. Parents were also provided with 16 skills‐based newsletter items (eight for each year of the intervention) that aimed to provide research information on bullying as well as advice to parents on what to do if their child was a perpetrator or a victim of bullying behavior.

Moving on to the Grade 4 and 5 classroom curricula, the Friendly Schools curriculum consisted of nine learning activities per year. The curriculum was offered by trained teachers in three blocks of three 60‐min lessons, over a three‐school‐term period. The learning activities aimed to promote awareness of what was bullying behavior; to help students to become assertive and talk about bullying with teachers and parents; and to promote peer and adult discouragement of bullying behavior.

Finally, the Friendly Schools program offered manuals to teachers. The teacher manuals were designed to be entirely self‐contained so as to maximize the likelihood of teacher implementation. Friendly Schools project staff also provided teacher training (a 6‐h course) for all intervention teachers.

6.27. *Granada antibullying program

This program was a pilot antibullying program with the following aims: (a) to establish children's involvement in bullying within different participant roles/categories; (b) to reduce the number of students involved in the phenomenon as bullies, victims and bully‐victims; (c) to increase the number of students who are categorized as noninvolved in bullying, through the enhancement of prosocial skills; and (d) to identify the threats to fidelity of the program and establish the validity of the pilot program with the possibility of replicating it in future (Martin et al.,  2005 , p. 376). Forty‐nine sixth graders from one Spanish primary school in Granada participated in the program.

The program designers gathered information about the social, educational and economic background of the school, of the students' families and the community in general. That was done during 3 meetings/seminars of 3 h each. Parents, teachers and members of the educational team attended those meetings. Through these meetings, it was established that the program should target interpersonal relationships of the children. It was decided that the program would be curriculum‐based as part of the normal program of the school. It was decided that the program would be implemented by one of the researchers because the teachers did not have enough qualifications to do it and because of lack of time and resources for teacher training. Parents and teachers were provided with information about bullying (a dossier/file) that they could use to discuss the problem of bullying with children. Also, teachers could attend the intervention program so that later they would be able to implement it by themselves. Parents were invited to attend some talks on bullying that would be given by the implementation team so that the program could be continued outside the school. The program was implemented for 5 months at the classroom level (30 sessions; 3 sessions per week with one tutor, i.e., one of the evaluators).

During the first 5 sessions, the tutor informed the children about peer bullying. Topics covered in the first 5 sessions involved issues such as concept of bullying, types of bullying, how to identify it, individual and group differences in bullying, and classroom rules against bullying. From the 6th to the 21st sessions, the program emphasis was on the emotional and social abilities of the children. Several topics were covered such as: identification and expression of emotions during bullying situations; communication abilities; ability to pose questions; ability of children to give and receive complements and complaints; ability to say no in life; ability to ask for a change of behavior; and ability to solve interpersonal problems. From the 17th to the 21st sessions, the program placed emphasis on mediation.

From the 22nd to the 25th sessions, the program emphasis was on human rights. Several topics were covered such as: freedom and equality, respect of private life, respect for other people's belongings, and respect for others' opinions. Similarly, from the 26th to 30th sessions, the emphasis was on moral education. During the whole program (sessions 1–30), there was also an emphasis on the inhibition of impulsivity and enhancement of reflexivity. For the enhancement of reflexivity, the program designers used a specific program called “Programa de Intervencion para Aumentar la Attention y la Reflixividad” [PIAAR] developed by Gargallo (2000) (see Martin et al.,  2005 , p. 378). This focuses on cognitive techniques that aim to inhibit impulsivity and enhance self‐control. The program also included role‐playing, peer mediation, guided discussion, brainstorming, and drawings.

The authors acknowledge several problems with the implementation of the program such as: little involvement by parents and teachers; implementation of the program lessons during recess time or during the physical education program; lack of time to cover all the topics; no second follow‐up because of difficulties of following the children; problems with the size and selection of the sample; the instrument they used; and possible contamination of results because of the way they categorized the children (Martin et al.,  2005 , p. 382). These pitfalls could easily be spotted. For example, the evaluators indicate that they implemented the program with the most aggressive sixth graders who had the worst interpersonal problems (Martin et al.,  2005 , p. 738). This made it difficult to know whether any changes in bullying in the experimental condition were attributable to the effectiveness of the program or to regression to the mean. Also, even though they distributed a self‐report questionnaire, they categorized children based on those questionnaires only after teachers' suggestions.

6.28. *Greek antibullying program (1)

The Greek antibullying initiative was a 4‐week intervention program that aimed to minimize both bullying and victimization. The conceptual framework of the Greek antibullying program was based on the theoretical model proposed by Salmivalli in 1999 (Andreou et al.,  2007 , p. 696), according to which changing an individual's behavior (e.g., the bully's behavior) entailed motivating not only the particular person but also the rest of the group members (participant roles' approach).

The program was embedded within the wider curriculum of the fourth‐, fifth‐, and sixth‐grade classrooms and consisted of eight instructional hours, each hour corresponding to one curricular activity. The curricular activities were presented to students by their classroom teachers who received training beforehand. The teacher training consisted of five 4‐h meetings and aimed to increase awareness of the bullying problem and its seriousness as well as to raise teachers' self‐efficacy in implementing the program (Andreou et al.,  2007 , p. 697).

The Greek antibullying curriculum was divided into three parts in accordance with the three main theoretical axes proposed by Salmivalli in 1999, namely: (1) awareness‐raising; (2) self‐reflection; and (3) commitment to new behaviors (Andreou et al.,  2007 , pp. 697–698).

In line with the first axis (awareness‐raising), small‐group and whole‐class discussions were conducted (over three instructional hours) that aimed to increase students' awareness of the bullying problem. Corresponding materials included a real snap‐shot from the playground, a story entitled “A new friend” and students' own drawings. In line with the second theoretical axis (self‐reflection), two instructional hours involving classroom discussions were conducted. These discussions placed emphasis on the participant roles that students took in the bullying process. Corresponding materials involved each students' completion of open‐ended sentences. Through this activity students were intended to reflect on critical issues around the causes, benefits, feelings, and consequences of adopting different roles. In line with the final axis (commitment to new behaviors), three instructional hours of small‐group and whole‐class discussions were conducted concerning different ways of approaching or solving the peer‐conflict situation and the formulation of class rules. Corresponding materials involved an open‐ended comic‐strip for group completion to find a solution to the bullying situation presented in the relevant story.

6.29. Greek antibullying program (2)

This antibullying program was implemented in Greek elementary schools during the academic year 2011/2012 (Tsiantis et al.,  2013 ). The school‐based program incorporated many elements and was implemented by teachers. Participating teachers attended a 2‐day training seminar before implementation began. A teacher's manual (Tsiantis,  2011 ) was also provided and outlined the detailed and systematic procedures involved in the intervention. Throughout the program teachers were provided with additional support from two mental health professionals whom acted as program co‐ordinators.

The program comprised of 11 weekly workshops that were implemented for two 45‐min class periods (90‐min in total). Class activities included group discussions, games and the formation and signing of class antibullying rules (Tsiantis et al.,  2013 ). Parent meetings were also organized to increase parent participation with the intervention. The first meeting provided parents with information about the intervention program and bullying issues. During the second parent session, students presented the achievements they had made during the intervention.

6.30. Inclusive

The INCLUSIVE program is a whole‐school restorative approach to bullying prevention and intervention (Bonnell et al.,  2015 ). The program involves creating an “action group” within each participating school in order to combat bullying. These groups are comprised of a minimum of six students and six members of staff, with at least one representative from senior management, teaching, support, and pastoral staff. Each action group is appointed an external expert facilitator for the duration of the intervention. It is the facilitators' role to provide ongoing support and training to each member of the action group. Action groups were required to meet regularly throughout the intervention year, approximately once every half term.

The INCLUSIVE intervention was designed to include several core standardized intervention components, including staff training in restorative practices, and a student social and emotional skills curriculum. However, the program also allows for schools to adapt the intervention according to school‐specific needs. These needs were established using a needs assessment survey distributed to year 8 students prior to commencement of the intervention. This survey aimed to establish student views on bullying and aggression in their schools, while providing information regarding school engagement and connectedness, perceptions of safety/risks, social support and social skills, relationships, and teaching in personal, social and health (PSHE) classes. Results of the needs assessment survey were then employed by the action group to tailor the INCLUSIVE intervention to target specific needs. The action groups also utilized this information to review and improve schools' existing policies, procedures and schemes (e.g., peer mediation and “buddying” schemes).

In relation to the core components of the INCLUSIVE intervention, all school staff were provided with introductory training in restorative practices by their affiliated expert facilitator. A minimum of twenty school staff were also required to attend intensive training provided by a specialist training provider. Restorative practices, such as “Circle Time,” were taught to staff to improve school climate and student‐staff communication. This technique involves teachers and staff sitting together in a circle discussing various emotional, social, and curricular issues. Each member of the circle is considered a valued contributor, and all inputs are treated equally. Circle time aims to support student communication and promote positive relationships. Another restorative technique used in the INCLUSIVE program was “formal conferencing,” which aimed to deal with serious bullying and aggressive incidents directly. Formal conferencing involves bringing together teachers, parents and students to establish appropriate punishment and ways in which the harm caused can be repaired. This approach emphasizes a nonjudgmental and inclusive environment so that both victims and perpetrators of bullying and/or aggression are involved.

Year 8 students also completed 5–10 h of social and emotional skills training throughout the process of the INCLUSIVE intervention. These lessons were based on the Gatehouse Project curriculum and could be delivered as either stand‐alone modules or integrated into existing academic curriculums. Modules covered included: (1) Establishing respectful relationships; (2) Emotion management; (3) Understanding and creating trusting relationships; (4) Exploring others' needs and avoiding conflict; and (5) Maintaining and repairing relationships.

6.31. *KiVa

The name of this project is an acronym of the expression “Kiusaamista Vastaan” which means “against bullying.” The word “kiva” in Finnish means “nice” and this is why this acronym was chosen for the specific antibullying initiative in Finland. Regarding the overall perspective of the program, the KiVa project included a universal and an indicated intervention (Kärnä et al.,  2011a ,  2011b ,  2013 ; Nocentini & Menesini, 2016; Salmivalli et al., 2007). The universal intervention referred to efforts made to influence the group norms while the indicated intervention referred to the way in which specific cases were handled in schools through individual and group discussions between the teacher and the students involved (Salmivalli et al., 2007, p. 6).

The KiVa program included a large variety of concrete materials for students, teachers, and parents. It also utilized the Internet and virtual learning environments (e.g., computer games against bullying) aiming in this way to enhance students' attitudes against bullying. Also, students received their own personal user ID, which they could use as a password before the completion of each web‐based questionnaire on bullying. KiVa included 20‐h student lessons, which were carried out by student teachers. The lessons involved discussions, group work, short films about bullying, and role‐playing exercises. After each lesson, a class rule was adopted, based on the central theme of the lesson.

A unique feature of the KiVa program was the use of an antibullying computer game. The game involved five levels and the teacher always activated the next level of the game after the relevant lesson was completed. Students were able to begin using the game after the third lesson; the second level of the program was played after the fifth lesson, and so on until the end of the school year. Each level of the computer game included three components that were named as “I know,” “I can,” and “I do.” In the first component, students were informed about basic facts on bullying. In the second component, the “I can”‐component, students moved around in the virtual school and faced different challenging bullying incidents. Finally, the third component was used to encourage students to make use of their knowledge and skills in real life situations.

Another important element of the KiVa project was the teacher training. Teachers were also provided with vests that they could use during playtime while supervising the school yard. This simple technique aimed to enhance teachers' visibility in the schoolyard and to signal that bullying was taken seriously in the school. Also, all teachers carrying out the KiVa program could seek advice from a web‐based discussion forum, where they could share experiences and ideas about bullying with other colleagues.

Within the school framework, the program also facilitated the use of a peer support group for victims of bullying. The classroom teacher was expected to arrange a group with 2–4 classmates—those who were pro‐social and had high status in the class—who were expected to provide support to victimized students, thus sustaining healthy peer relationships. An interesting element in the KiVa program is that it incorporated both punitive and nonblame approaches when dealing with perpetrators of bullying. Half of the school teams were instructed to use more punitive approaches (e.g., what you have done is wrong and it has to stop right now) while the rest of the school teams were instructed to use no‐blame approaches in their discussions with children (e.g., “your classmate is also having a hard time and this is why he behaves like that; what could we do to help him?”). There was also co‐operative group work among experts when dealing with children involved in bullying.

Finally, the KiVa program involved parents. A parents' guide was sent to the home and provided information about bullying and advice on how parents could be involved to reduce this problem. Information nights for parents were also organized and provided.

6.32. Lead Peace Intervention

The Lead Peace intervention is based on a resiliency conceptual framework (Resnik,  2000 ), thus, aims to reduce youth problem behaviors using an assets‐based approach (Harpin,  2011 ; Sieving & Widome,  2008 ). The intervention was developed as a school‐based “service learning and health education” program to reduce risk of violence and school failure in middle school students (Sieving, 2006). Developed from the Points of Light Youth Leadership curriculum for 9th to 12th grade students (Sieving, 2006), the program was adapted for use with Grade 6–8 students (Harpin,  2011 ).

The core curriculum targets factors on three levels: (1) environmental (e.g., adult resources and supports, family norms and behaviors, peer norms and behaviors, school/community opportunities and social connectedness); (2) personal (e.g., attitudes, beliefs, perceived norms, emotional distress); and (3) behavioral (e.g., social and emotional skills, coping behaviors, school performance). The program aims to reduce risky health and social behaviors (e.g., interpersonal aggression, physical fighting, bullying) in order to promote positive and reduce risky behaviors. The curriculum is implemented for 3 years, and can be delivered in two “doses”: (1) Lead Peace program (basic)—includes 15–20 intervention lessons each year; or (2) Lead Peace plus program—includes 30 intervention lessons, 15–20 additional community service hours, and health education and family outreach activities.

6.33. Lunch Buddy Mentoring program

The Lunch Buddy mentoring program was a school‐based antibullying program that aimed to reduce bullying victimization in elementary school children (Elledge et al.,  2010 ). The program was based on previous research that suggests youth mentoring can be utilized as an effective prevention technique (Dortch, 2000). In comparison to peer‐mentoring antibullying program, the Lunch Buddy program employed college student mentors based on prior success of college student mentoring aggressive children (Cavell & Hughes,  2000 ).

Mentors were provided with training prior to implementation of the program and participated in weekly meetings throughout the program. Children were identified as potential participants using a self‐ and teacher‐report victimization index. The self‐report School Experiences Questionnaire (Kochenderfer & Ladd,  2000 ) and teacher ratings of child victimization due to physical, verbal and relational aggressive were combined to create this index. School principals also collaborated with counselors to identify potentially suitable candidates. Eligible participants were then matched with same‐sex college student mentors, based on the availability of mentors during the mentees scheduled lunchtimes. Mentors visited the mentees twice a week, over the course of 5–6 months. During these visits mentors were required to sit with their mentee and their peers during lunchtime. Each mentor was also required to complete a log sheet after each visit.

6.34. Media Heroes

Chaux et al. ( 2016 ) evaluated the effectiveness of the cyberbullying prevention program “Media Heroes” [ Medienhelden ] on reports of traditional school bullying. The Media Heroes program is based theoretically on the Theory of Planned Behavior (Ajzen,  1991 ) and the social context of participant roles in bullying (Salmivalli,  2010 ). The program aims to reduce cyberbullying perpetration by enhancing empathy, increasing awareness and knowledge about what constitutes cyberbullying, the safety risks associated with Internet activity, and by providing assertive and useful methods in which bystanders can intervene in cyberbullying (Chaux et al.,  2016 ).

There are two versions of Media Heroes: (1) a short version implemented over four 90‐min lessons that take place in one school day; and (2) a long version that is implemented over 15‐weekly 45‐min lessons (Schultze‐Krumbholz et al.,  2012 ). Intervention activities include, role‐playing, class debates, news and film content, group learning and student‐parent presentations (Chaux et al.,  2016 ). Measures of both traditional‐ and cyber‐bullying were implemented in this evaluation, due to the significant overlap in the prevalence of these behaviors.

6.35. NoTrap!

Noncadiamointrappola (Let's Not Fall into a Trap), or NoTrap!, is a web‐based antibullying program that has been developed, implemented and refined over several studies (Menesini et al.,  2012 ; Palladino et al.,  2012 ,  2016 ). Initially implemented in two Italian schools in 2008, the program involves students actively engaging in the development of a website promoting antibullying (Menesini et al.,  2012 ). A selected number of students per school are provided with training and enroll as online peer‐educators. These students acted as online moderators of an antibullying forum, regulating discussion threads and responding to users' questions and concerns (Menesini et al.,  2012 ). In addition, peer‐educators also conducted face‐to‐face awareness raising workshops and meetings with their classmates, to highlight the key issues surrounding traditional‐ and cyber‐bullying (Palladino et al.,  2016 ).

Subsequent editions of the NoTrap! program incorporated additional elements based on findings from previous evaluations. For example, Palladino et al. ( 2012 ) placed more emphasis on: (1) victims' roles and victim support, (2) involving bystanders, (3) greater involvement of teachers in antibullying activities, and (3) creation of a Facebook group to supplement online materials. The third revision of the NoTrap! program incorporated standardization of the face‐to‐face antibullying activities led by peer educators (Palladino et al.,  2016 ). New peer‐led activities involved group work that targeted empathy and problem‐solving skills (Palladino et al.,  2016 ).

6.36. *Olweus Bullying Prevention Program

The OBPP was a multilevel program aiming at targeting the individual, the school, the classroom and the community level. Apart from marked mass‐media publicity, the program started with a 1‐day school conference during which the problem of bullying was addressed between school staff, students, and parents. This signaled the formal commencement of the intervention. Two different types of materials were produced: a handbook or manual for teachers (entitled “Olweus” core program against bullying and antisocial behavior') and a folder with information for parents and families. The program also included: (1) CD‐program that was used for assessing and analyzing the data obtained at the pre‐test period, so that school‐specific interventions could then be implemented; (2) a video on bullying; (3) the Revised Olweus Bully/Victim Questionnaire and (4) the book “Bullying at school: what we know and what we can do.”

The antibullying measures mainly targeted three different levels of intervention: the school, the classroom and the individual. At the school level, the intervention included:

• Meetings among teachers to discuss ways of improving peer‐relations; staff discussion groups.
• Parent/teacher meetings to discuss the issue of bullying.
• Increased supervision during recess and lunchtime.
• Improvement of playground facilities so that children have better places to play during recess time.
• Questionnaire surveys.
• The formation of a coordinating group.

At the classroom level the intervention included:

• Students were given information about the issue of bullying and were actively involved in devising class rules against bullying.
• Classroom activities for students included role‐playing situations that could help students learn how to deal better with bullying.
• Class rules against bullying.
• Class meetings with students.
• Meetings with the parents of the class.

At the individual level the intervention included:

• Talks with bullies and their parents and enforcement of nonhostile, nonphysical sanctions.
• Talks with victims, providing support and providing assertiveness skills training to help them learn how to successfully deal with bullying; also, talks with the parents of victims.
• Talks with children not involved to make them become effective helpers.

An interesting feature of the OBPP is that it offered guided information about what schools should do at both the intervention and the maintenance period. The Olweus program demands significant commitment from the school during the 'introductory period' which covers a period of about 18 months. Later the methodology acquired by the staff and the routines decided by the school may be maintained using less resources … Yet, even for the maintenance period, the program offers a point by point description of what the school should do to continue its work against bullying in accordance with Olweus methodology (Olweus, 2004c, p. 1). Also, at the school level training was offered to the whole school staff, with additional training provided to the coordinators and key personnel. These were responsible for coordinating the overall antibullying initiative in their school. The program also included cooperation among experts and teachers (e.g., psychologists) who worked with children involved in bullying.

6.37. Positive Action program

The Positive Action Program is a generalized school‐based “well‐being” program (Lewis et al.,  2013 ). The program targets both distal (e.g., school climate and teacher classroom management) and proximal (e.g., students' thoughts, feelings, and self‐efficacy) facets are targeted in order to impact a range of health‐ and behavioral‐related outcomes (Li et al.,  2011 ). The program is based on three core elements.

First, the Positive Action philosophy. Based on the theory of self‐concept (Combs,  1962 ; Purkey,  1970 ; Purkey & Novak,  1996 ) and a Positive Psychology (Frederickson, 2000; Seligman & Csikszentmihalyi,  2000 ) approach, the philosophy emphasizes positive feelings about the self, to encourage positive behaviors toward others (Flay & Allerd,  2010 ). Second, the Thoughts‐Actions‐Feelings Circle concept is used throughout the program to illustrate the reinforcing cycle of thoughts, feelings and actions. This is delivered to outline that positive thoughts lead to positive actions, positive actions in turn lead to positive feelings, which then reinforce positive thoughts. Third, a strict six‐unit curriculum that involves daily lessons, interactive learning and social‐emotional skill development.

The PA curriculum is designed to be adapted for kindergarten to Grade 12 students, and is based on six key concepts: (1) self‐concept; (2) social and emotional positive actions for managing oneself responsibly; (3) positive actions relating to a healthy body and mind; (4) honesty with oneself; (5) getting along with others; and (6) continuous self‐improvement (Lewis et al.,  2013 ). The intervention program also involves teacher, parent/family and community training. Schools implementing the PA program receive support from developers throughout implementation by training, manuals, school‐wide climate development, counselors, family classes, and individual consultations for staff with a PA implementation coordinator.

6.38. Preventure and Adventure CBT

The Preventure and Adventure intervention programs were part of two 2 year longitudinal projects that targeted adolescent alcohol use and bullying behaviors (Topper,  2011 ). Intervention components were primarily personality‐targeted cognitive behavioral therapy (CBT) for “high risk” students. Participants were screened prior to taking part in the intervention for four individual personality domains: (1) hopelessness; (2) anxiety‐sensitivity; (3) sensation seeking; and (4) impulsivity. Students who were classified as being “high risk” on any of the four domains were invited to participate, and assigned to one of four potential intervention workshops. These intervention sessions were CBT‐based and were aimed at each of the four personality domains. Thus, a student who scored highly on the impulsivity measure was assigned to the impulsivity‐focused CBT session. For participants that scored above the mean on multiple measures, they were assigned to the session that corresponded to the personality domain that they deviated the most from standardized scores.

High risk students in each school were randomly assigned to either the intervention or control condition, as were “low risk” students, for comparison. The Preventure study took place between 2005 and 2007, and either a chartered counseling psychology, an experienced special needs teacher, or a master‐level research assistant implemented intervention workshops. In comparison, the Adventure study took place between 2007 and 2009, and although the intervention sessions followed the same procedure, they were implemented by trained teachers in each school.

6.39. *Pro‐ACT+E program

Pro‐ACT+E was a universal, multidimensional program that aimed to prevent bullying in secondary schools (Sprober et al., 2006). It involved a cognitive‐behavioral approach to the problem of bullying and victimization by building up prosocial behavior. The program was universal: it did not involve specific work with perpetrators or victims of bullying. However, it included both teacher and parent training and a 2‐h classroom discussion with students about violence problems. The program offered curriculum materials that aimed to increase awareness in relation to the problem of bullying and placed emphasis on specific issues such as classroom management and classroom rules against bullying.

6.40. *Progetto Pontassieve

The program was delivered in a period of 3 years, and it consisted of two main parts. During the 1st two years it was delivered more at the school level whereas the 3rd year was more at the class and individual level (Ciucci & Smorti,  1998 ). During the 1st year a training course for teachers took place addressing psychosocial risks for children and bully‐victim problems. At the end of the training, a study was conducted to reveal how serious was the problem of bullying and what were its characteristics. The 2nd year of the intervention included a counseling service for each individual who was affected by bullying.

The intervention took place in the 3rd year and was based on the use of two different methods: Quality Circles, where pupils had to cooperate to find practical solutions to their problems, with the use of the Interpersonal Process Recall which consisted of the recording of one Quality Circle and discussion about it. The other method used was Role Playing conducted in small groups with subsequent class discussions, which helped students to examine possible strategies to face and overtake bullying problems. The aims of both of these methods were to make students aware that they could intervene in an efficient way to reduce bullying.

6.41. *Project Ploughshares for Peace

Project Ploughshares Puppets for Peace (P4 program) was an antibullying program that aimed to educate elementary school students about bullying and conflict resolution (Beran & Shapiro,  2005 , p. 703). The P4 program used puppets and a 30‐min script. Using three‐feet, hand‐and‐rod puppets, two puppeteers enacted a story that involved direct and indirect bullying, as well as a successful resolution to this scenario. These behaviors occurred among two female puppets and a male puppet friend.

After watching the play, students were invited to identify the bullying behaviors. During the discussion, four main strategies—presented as “4 Footsteps”—to deal with bullying were suggested to pupils: (1) ignore, (2) say stop, (3) walk away, and (4) get help. The show took approximately 45 min and aimed to increase children's awareness about which behaviors could be categorized as bullying and to show various strategies that children who were bullied and/or who witnessed bullying could use to discourage it (Beran & Shapiro,  2005 , p. 703).

6.42. Rational Emotive Behavioral Education (REBE) and ViSC

Trip et al. ( 2015 ) implemented a dual program consisting of REBE (Trip & Bora,  2010 ) and ViSC social competence (Strohmeier et al.,  2012 ) elements. These components were combined to address both social and emotional factors involved in bullying and positive youth development (PYD). This program approaches bullying from a sociological perspective, including factors on the individual, family, peer, classroom, and school levels (Espelage & Horne,  2008 ; Swearer & Espelage,  2011 ).

ViSC social competence program is a systemic approach to antibullying that targets students, teachers and parents (Strohmeier et al.,  2012 ). Implemented by teachers in the classroom, the program comprises several intervention units that aim to: (1) foster empathy and perspective training, (2) enhance responsibility, and (3) improve students' behavioral responses to bullying (Trip et al.,  2015 , p. 733).

REBE elements employed by Trip et al. ( 2015 ) on the other hand, target specific elements of aggression that are lacking in the ViSC units. Based on the theory of Rational Emotive Behavioral Therapy (Ellis,  1962 ), the REBE elements of the intervention program target the difference between desire and reality (Trip & Bora,  2010 ) and anger. The REBE program activities target specific elements of anger, specifically, anger triggers, personal experiences of anger and the consequences of anger (Trip et al.,  2015 ).

6.43. Restorative Whole‐school Approach (RWsA)

The RWsA (Hopkins,  2004 ; Morrison,  2002 ) was a school‐based antibullying initiative that employs a restorative justice inspired philosophy. Hence, the program focuses on creating a positive school environment to prevent bullying in the long‐term, rather than a short‐term disciplinary and punishment approach (Wong et al.,  2011 ). The program had three core goals: (1) to create a positive and harmonious school learning environment; (2) implement an interactive classroom curriculum; and (3) encourage an effective partnership between teachers, students, parents and relevant professionals.

A whole‐school antibullying nonpunitive ethos and policy is implemented as the core of the intervention (Wong et al.,  2011 ). This policy aims to establish a positive school environment in order to combat bullying‐related risk factors. The curriculum lessons incorporated elements on various issues, including, empathy, assertiveness, coping, problem‐solving, and conflict resolution.

6.44. Resourceful Adolescent Program (RAP)

The RAP is a classroom‐based CBT intervention designed for adolescents aged 12–15 years of age (Stallard et al.,  2013 ). The program is a depression prevention program, however, bullying problems were included as secondary outcomes. The program incorporates a detailed manual and student workbooks, and was implemented over nine sessions, of approximately 50–60 min each. The core components include: psycho‐education, helpful thinking, identifying personal strengths, keeping calm, problem solving, support networks, and keeping the peace. The program was designed to flexible and adaptable to participating schools' varying busy timetables.

6.45. *S.S. Grin

The Social Skills Group Intervention (S.S. GRIN) was a school‐based program that aimed to help children enhance their social skills. S.S. GRIN was designed as a social‐skills training intervention for peer‐rejected, victimized, and socially anxious children. It could be applied to an array of problems that are social in nature (e.g., aggression, low self‐esteem, depression, social anxiety, social withdrawal) not just bullying (DeRosier & Marcus,  2005 , p. 140). The authors argued that the program went beyond the most common social‐skills training (De Rosier & Marcus, 2005, p. 141) by emphasizing the cognitive aspects of relations and emotions. That is, children were not only taught prosocial skills, but they were also taught, on the cognitive level, how to identify negative perceptions and behaviors in an effort to help children to regulate their own emotions as well as enhance their coping skills.

Overall, the program was a combination of social‐learning and cognitive‐behavioral techniques, used to help children build social skills and positive relationships with peers. It was a highly structured, manualized program (DeRosier,  2004 , p. 197) with a number of sessions containing scripts and activities to undertake. Each session included didactic instruction combined with active practice such as role‐playing, modeling and hands‐on activities (De Rosier, 2004, p. 197). The children participated in group sessions for eight consecutive weeks. Each session lasted approximately an hour. The groups were led by each school's counselor and an intern, who were trained and supervised by one of the program instructors (De Rosier & Marcus, 2005, p. 143).

6.46. School‐based Drama program

This school‐based antibullying program was based on drama (Owens & Barber,  1998 ) and social cognitive theories (Bandura,  1978 ). The main aim of this project was to design and implement a drama‐based program to improve social relationships and social/emotional well‐being in children, which in turn may help to reduce bullying (Joronen et al.,  2011 ). Targeted concepts included: empathy; social competence; student‐teacher interaction; child–parent interaction; and recognition of values/emotions.

This program was developed by the combined efforts of researchers, drama experts and teachers. It was implemented in‐class by trained teachers and school nurses over a period of 6 months. Teachers and school nurses attended a 2‐day seminar and received two drama handbooks, however, there was no manual or fixed program outline provided. Support was provided through email communication between teachers and researchers for the duration of program implementation. Teachers conducted one drama session per month with their class. These sessions covered a variety of topics, including, bullying, friendship, loss of a friend, supporting a bullied peer, tolerance, and child abuse.

6.47. School‐wide Positive Behavioral Interventions and Supports (SWPBIS)

SWPBIS was a universal behavioral intervention program that targets school‐level factors in order to improve school climate and promote positive student and staff behaviors (Waasdorp et al.,  2012 ). Instead of following a specific antibullying curriculum, SWPBIS aimed to reduce bullying by targeting schools' discipline and behavioral management strategies. A SWPBIS team in each school organized and facilitated the intervention implementation.

These teams were responsible for developing a set of “positive expectations” for the school. These were a number of statements that outlined what the school expected in relation to student and staff behavior, for example, “be responsible, respectful, and ready to learn” (Waasdorp et al.,  2012 , p. 150). Posters highlighting the expectation statements were then displayed all around participating schools, both in classrooms and outside of classrooms, and are positively reinforced using reward systems. Furthermore, data from student surveys and discipline referrals were employed throughout the intervention to inform teachers of potential bullying “hot spots” that require increased supervision and monitoring. School staff also received training on classroom management and how to respond consistently and effectively to bullying. Additionally, students identified as being “high risk” or vulnerable to bullying behaviors or victimization were provided with selective intensive intervention.

6.48. School bus antibullying intervention

This intervention program was a universal antibullying program designed to reduce the prevalence of bullying behaviors on school buses (Krueger,  2010 ). The program was purposefully developed and utilizes materials and content from the “Take a Stand, Lend a Hand, Stop Bullying Now!” tools that are available free of charge.

The intervention was implemented with elementary school children over five consecutive days, during the final 20‐min of the school day. Lessons were delivered by the school's social worker and principal to two groups (kindergarten to 2nd grade students, and 3rd to 5th grade students) of participants. The program followed this format from days 2–5, however, on day 1, all participants completed the introductory lesson together. The school‐bus antibullying program primarily utilized DVD materials from the “Take a Stand” content. These video clips depicted cartoon characters engaging in different bullying scenarios.

On day 1 (i.e., the introductory lesson) an overview of school bullying and related issues, including bystander intervention, was provided to participants. The associated DVD clip depicted a male character physically bullying another child in the playground while other students watched. Participants then discussed the clip in groups, and were introduced to the “Three Steps to Stop Bullying Chart.” This technique involves three steps, Stop, Help , and Tell , that bystanders can take if they witness bullying.

On each subsequent day, a new DVD clip was shown to participants and the Stop, Help , and Tell concepts were revisited. The school's social worker or principal led discussion groups by posing questions to the students concerning the feelings and emotions experienced by the victim of bullying, potential coping strategies that the victim could use, and possible bystander behaviors. Participants also shared their previous experiences with similar situations. Furthermore, using the Stop, Help , and Tell paradigm, participants brainstormed potential ways to tell a bully to stop behaving in a certain manner, ways to help the victim and appropriate trusted adults that they can tell about the situation.

6.49. Second Step

The Second Step: Student Success Through Prevention is a middle school Social‐Emotional Learning (SEL) program that aims to reduce bullying, peer victimization, physical aggression, homophobic name‐calling and sexual violence (Espelage et al.,  2013 ,  2015 ). The intervention curriculum is taught in‐class by trained teachers. Lessons are interactive and engaging, requiring students to take part in whole‐class, small group and individual work. A take home task is also given after each lesson to reinforce skills learned. DVDs are also used to accompany and enrich lesson content.

The 6th grade Second Step curriculum involves 15 weekly lessons on various social and emotional skills and bullying‐related topics. The following outlines the curriculum: (1) empathy and communication—five lessons; (2) bullying—two lessons; (3) emotion regulation (e.g., coping with stress)—three lessons; (4) problem‐solving—two lessons; and (5) substance abuse prevention—four lessons.

Each lesson has clearly outlined learning objectives to reduce problem behaviors and increase prosocial behaviors. For example, lessons on bullying target the peer context by increasing knowledge, improving attitudes, and encouraging bystander intervention in order to reduce bullying perpetration and victimization. Students are educated about the differences between types of bullying, importance and responsibilities of bystanders in preventing bullying and a number of positive bystander behaviors are modeled. The 7th grade Second Step curriculum involves a similar lesson structure, with some slight changes. The intervention is delivered over 13 weekly lessons, and cyber‐bullying and sexual harassment issues are incorporated into bullying modules.

6.50. Shared Concern

Wurf ( 2012 ) assessed the effectiveness of the whole‐school approach to bullying intervention and prevention, with a particular emphasis on Pikas' ( 2002 ) nonpunitive method of shared concern. The Pikas method of Shared Concern is a teacher, or counselor, implemented intervention, that is divided into five key stages. First, the intervener identifies the students involved in bullying and talks with them individually. These discussions aim to provide nonpunitive and constructive options for both bullies and victims (Wurf,  2012 ). The second and third stages involve providing empathy and ongoing support to the victims of bullying. Finally, the fourth stage incorporates a mediation session between bullies and victim(s). A conflict resolution approach to prevent bullying is agreed upon and implemented by all involved. The fifth and final stage occurs during the follow‐up period, whereby the teacher or counselor monitors the involved students to ensure that the bullying has stopped.

6.51. *Short Intensive Intervention in Czechoslovakia

The antibullying intervention in Czechoslovakia was inspired by the OBPP and borrowed elements from it, such as the Olweus videocassette on bullying (Rican et al.,  1996 , p. 399). The Olweus bullying questionnaire was used to measure several aspects of bullying within the schools. A peer nomination technique was also used to identify bully and victim scores. The relevant results from both measurement scales were presented to teachers in the intervention schools to increase awareness of the problem of bullying. The program researchers discussed with the teachers “possibilities of an individual approach to the bullies as well as to the victims” (Rican et al.,  1996 , p. 399).

As another intervention element, teachers were instructed to introduce relevant ethical aspects into the curriculum where possible: the ideal of knighthood was suggested for history classes and the ideal of consideration for the weak was introduced in sentences used for dictation and analysis (Rican et al.,  1996 , p. 400). Another element of the intervention involved the use of a method called “class charter.” Specifically, children were asked to indicate how they would like their teachers and other classmates to behave toward them as well as how students should behave toward teachers and among themselves. The final aim of this classroom activity was the construction of a set of rules and principles, which was then signed by all pupils in the classroom and placed there in a visible position. Finally, the Olweus video‐cassette on bullying was shown to children and was used as a means of promoting the antibullying idea in the school.

6.52. *Short Video Intervention

This antibullying strategy, involved a single viewing of an antibullying video, entitled Sticks and Stones, and aimed to examine its effects on secondary school students' views of, and involvement in, bullying. The program aimed to examine both attitudes toward bullying and the actual behavior since “it would not be unreasonable to propose that these attitudes will influence actual behavior” (Boulton & Flemington,  1996 , p. 334). The program involved only one school that had no prior antibullying policy.

The video presented pupils (either in groups or on their own) talking about bullying, their views about this phenomenon and their personal experiences of bullying. The video also involved a number of bullying scenes (see Boulton & Flemington,  1996 , p. 337 for examples).

6.53. Social and Emotional Training (SET) intervention

This intervention program was a school‐based SET mental health program for Swedish school children (Kimber et al.,  2008 ). The SET program was primarily focused on mental health, but also targeted other aspects of participants' lives, such as bullying. Both internalizing and externalizing aspects of child mental health are addressed.

Trained teachers delivered the program over the course of two academic years. Intensity of program implementation varied according to the age of students. Junior students (i.e., grades 1–5) received the program in 45‐min sessions twice a week, while senior students (i.e., grades 6–9) completed one 45‐min session per week. Program developers provided each participating teacher with detail manuals for implementing the program with each grade and grade‐specific student workbooks. Role‐playing and modeling tasks covered many themes, including: social problem solving; conflict management; dealing with strong emotions; and resisting peer pressure. Teachers were also supervised once a month during the 1st year of implementation, and students were encouraged to practice skills both at school and at home.

6.54. Social Norms Project

Lishak ( 2011 ) implemented an antibullying program based on social norms theory (Perkins,  2003 ) with middle school students. The program was implemented over a period of 12 weeks and was developed based on student responses to an anonymous web‐based survey and student discipline and suspension reports (Lishak,  2011 ). Student surveys collected information regarding perceptions of bullying in the school and results were then relayed to participants via weekly lessons, assemblies, posters, and media content throughout the school. Data from school discipline, suspension and visitation logs were collated to estimate the prevalence of bullying and school violence.

6.55. *Social Skills Training (STT) program

STT was a program specifically designed to support “chronic victims” of bullying (Fox & Boulton,  2003 , p. 237). The general aim of the program was to help children improve their social skills, therefore reducing a child's individual risk of victimization (Fox & Boulton, 2003 , p. 234). The program involved an 8‐week course during which children learnt how to use both problem‐solving and relaxation skills, how to think positively, how to modify their nonverbal behavior and how to use some verbal strategies such as “fogging” and “mirroring” (Fox & Boulton,  2003 , p. 235).

During the program, victims of bullying were gathered in groups of five to ten and were exposed to the aims of the program for 1 h/week. Two trainers delivered the 1‐h sessions throughout the program. The 1st week was dedicated to children introducing each other and listening each other's problem. The next two sessions dealt with issues of friendship and aimed to help children form strong friendships (e.g., having conversations; asking to join in), while the fourth session dealt with issues of body language: teaching children how to modify their nonverbal behavior in a way that would protect them from being victimized. During the fifth session children learned how to be assertive while in the next two sessions children were taught how to deal with the bully. The eighth session signaled the end of the program.

6.56. *SPC and CAPSLE program

This evaluation compared the effects of two intervention packages with a treatment‐as‐usual condition (Fonagy et al.,  2009 ). Nine schools were randomly allocated to the two experimental and one control (treatment‐as‐usual) conditions after a stratified allocation procedure, which was used to stratify schools based on the percentage of low‐income students (indicated by students' free‐ and reduced‐lunch status). In the experimental conditions, the full intervention was offered for 2 years (the efficacy phase) with a limited 3rd year of intervention (the maintenance phase).

The first experimental condition involved a “School Psychiatric Consultation” (SPC), a manualized protocol that aims to address mental health issues of children with disruptive behavioral problems, internalizing problems, or poor academic performance. SPC was a school‐level intervention focused on individual children. Three child psychiatry residents, supervised biweekly by a senior child psychiatrist, delivered mental health consultation following the SPC manual for 4 h/week. The psychiatric residents attended weekly school resource meetings and consulted directly with teachers, parents and other school personnel, through classroom observations and meetings, providing 140 consultations for 65 students in year 1 and 97 consultations for 45 students in year 2.

The second experimental condition involved the implementation of CAPSLE (“Creating a Peaceful School Learning Environment”), a manualized psychodynamic approach addressing the cocreated relationship between bullies, victims and bystanders. In contrast to SPC, CAPSLE represents a whole‐school intervention approach. It aimed to modify the educational and disciplinary school climate. A CAPSLE team drawn from school staff in the pilot project led implementation in the two intervention years using a training manual. In year 1, teachers received a day of group training, students received nine sessions of self‐defense training, and the CAPSLE team consulted with school staff monthly. Year 2 started with a school‐wide half‐day refresher self‐defense course, and consultation continued with counselors, teachers and adult/peer mentor programs. In year 3 (the maintenance phase), self‐defense training continued as in year 2.

CAPSLE includes several antibullying materials that can be used by teachers such as a Teacher Discipline Manual (used in the teacher training), a Student Workbook, Buttons and Magnets and Patches (used as a way of reinforcing of desirable student behavior), Parent Warning Notes (notifying parents about specific problem behavior of the child) as well as antibullying videos that can be used during the physical education lessons (and videos that can be used by parents). CAPSLE also includes the Gentle Warrior Program, a 12‐week curriculum specifically designed for physical education teachers. For CAPSLE, intervention fidelity was assessed using a teacher self‐report measure that required teachers to state the frequency with which various CAPSLE program components were implemented.

6.57. Standard CBT and CBT plus media program

This intervention program combined elements of standardized CBT and DVD bullying‐related materials in order to reduce bullying perpetration and victimization among elementary school children (McLaughlin,  2009 ). The standardized CBT lessons were delivered by a trained counselor, and focused on bullying and aggression relation issues. Two experimental groups were employed, one of which received only the CBT lessons, and the other completed the CBT lessons and were shown the bullying DVDs.

The program was implemented over 4 weekly lessons that followed a strict outline. In week 1, the lesson focused on defining bullying, identifying bullying roles and different forms of bullying, and exploring the possible characteristics of bullies, victims, and bystanders. Week 2's lesson was concerned with establishing the consequences of bullying for all those involved, including the bully, victim and bystanders. Empathy for victims of bullying was also developed. Activities included creating feeling lists, and participating in role plays. Lesson three aimed to promote bystander intervention by developing awareness and knowledge of appropriate responses to bullying, suitable ways to intervene, and promoting assertiveness. Classes are taught using educational and informative posters. The final lesson, in week 4, aimed to outline the gender differences in bullying, why these occur, and ways to combat gender‐specific forms of bullying. In their classes, students establish class antibullying rules and are taught about the support available in school to stop bullying.

In addition, students in the CBT + media experimental group watched three DVDs that highlighted the issues outlined in the weekly lessons. The DVDs that were shown are as follow: (1) Let's Get Real , which shows young people talking about their personal experiences of bullying; (2) The Deepest Hurt , that depicts girls role‐playing various scenarios of relational aggression; and (3) The Broken Toy , a dramatization of the damage bullying can cause. Following the videos, students engaged in group discussions led by the counselor about the issues illustrated in each DVD.

6.58. *Stare bene a scuola: Progetto di prevensione del bullismo

This intervention was based on the curriculum activities and the whole school approach because it tried to involve all people in a school (Gini et al.,  2003 ). The program was delivered to 6 schools and included several activities. Teachers were first trained in 3 days on “cooperative learning” and in particular on the Jigsaw technique. Teachers then had an on‐going supervision once every 15 days. The intervention in the class lasted 4 months with two meetings a week. The intervention was directed toward the following areas: (1) awareness of the body and what it feels; (2) emotional awareness; and (3) bullying awareness. These areas were dealt with in each of the sessions, starting from the first one. For each thematic area, several activities were conducted and several methods were used.

6.59. Start Strong

“Start Strong: Building Healthy Teen Relationships” was a school‐based curriculum focused teen dating‐violence prevention program (Williams et al.,  2015 ). The program was implemented over 2 years in four experimental schools (that implemented the program) and four comparison schools (that did not implement the program). Schools were matched based on: school size, percentage of students eligible for free school lunches, race/ethnicity, and socioeconomic status. The effectiveness of the program was measured for outcomes that included the perpetration and victimization of teen dating‐violence, bullying and sexual harassment.

6.60. *Steps to Respect

The Step to Respect program aimed to tackle bullying by: (1) increasing staff awareness; (2) fostering socially responsible beliefs; and (3) teaching social‐emotional skills so as to promote healthy relationships (Frey et al.,  2005 , p. 481). The program included staff and family training manuals, a program guide and lesson‐based curricula for third‐ through sixth‐grade classrooms (Hirschstein & Frey,  2007 , p. 7).

Components at a whole school level consisted of an antibullying policy and procedures, staff training and parent meetings, all aiming at sharing understanding of bullying and its consequences and increasing adult awareness, monitoring, and involvement. At the classroom level, the proposed activities consisted of teaching friendship skills, emotion regulation skills, identifying types of bullying, teaching prevention strategies and peer group discussion. The aim was to improve peer relations and reduce the risk of victimization, assess level of safety and recognize, report and refuse bullying. At the individual level, students involved in bullying were approached and coached based on the “Four‐A Responses”: affirm behavior, ask questions, assess immediate safety and act.

The S to R training manual consisted of an instructional session for all school staff and two in‐depth training sessions for counselors, administrators, and teachers. There were also videos accompanying the program. With regard to staff training, there were two levels of training: all school staff received an overview of the program goals and principal aspects of the program (program guide). Teachers, counselors, and administrators received additional training in how to coach students involved in bullying, based on behavioral skills training, cooperative learning and role‐playing.

The student curriculum comprised skills and literature‐based lessons delivered by third‐ through sixth‐grade teachers during a 12–14‐week period. The intervention consisted of 10 semi‐scripted skills lessons with topics such as joining groups, distinguishing reporting from tattling and being a responsible bystander.

Finally, with regard to the parent intervention, administrators informed parents about the program and the school's antibullying policy and procedures. Parents could also benefit from other resources such as letters provided to them and newsletters describing whole‐school antibullying activities undertaken at school.

6.61. Strengths in Motion (SIM)

The SIM (Rawana et al.,  2011 ) program was a strength‐based whole school antibullying intervention. There were several components involved in the program, all of which centered around a strength‐based approach. This technique involves highlighting and enhancing individuals' strengths in order to develop positive mental health (Duckworth et al.,  2005 ). In the context of the present evaluation, Rawana et al. ( 2011 ) requested that each participating school allocated one room as a designated intervention resource room. In the first instance, this room acted as a “Good Start Centre” (p. 287) where new students to the school were provided with two half‐day orientation sessions prior to starting school. Part of these orientation sessions was individualized strength assessments. It was predicted that by providing new students with guidance on how to best use their strengths to integrate successfully into school life the likelihood of future bullying and victimization would be reduced.

The second use of the intervention room was as a “Cool Down & Prevention,” where students experiencing behavioral or emotional problems could go to calm down. Staff were on hand to prevent the behaviors from escalating and offer helpful advice. The room also acted as an alternative to suspension from school, whereby students could be mandated to spend a certain number of days in the “Good Choices Room.” An ambassador's club for students identified as being at high risk for bullying perpetration or victimization was also held in the resource room. Finally, mental health professionals provided student and parent workshops and staff received tailored training on the strength‐based approach to bullying prevention and intervention.

6.62. Take the LEAD (TTL)

The TTL (Domino,  2011 ,  2013 ) program was designed to increase the social competencies of participants in order to reduce bullying behaviors. The intervention is based on SEL and PYD theories.

Various social and emotional skills are targeted during the 16‐weekly lesson curriculum, including: (1) Self‐awareness; (2) Self‐management; (3) Social‐awareness; (4) Relationship skills; (5) Decision making; (6) Problem solving; and (7) Leadership. Trained teachers taught TTL lessons during normal class periods on a weekly basis. Participating teachers were trained on the skill‐based curriculum by the developers of the TTL program. During training, teachers were taught about specific learning objectives and goals of the intervention program, and also about the lesson plans and activities involved in “Take the LEAD.” Information evenings for parent were also held as part of the TTL intervention and aimed to raise parents' awareness of key social‐emotional issues.

Each of the sixteen TTL lessons involved specific learning objectives and goals. Lessons involved a combination of knowledge and skill development and an application component, so that participants were given the opportunity to apply skills in real‐world settings. For example, the “Communication skills” lesson aimed to “explore elements of communication that enhance interpersonal skills and foster positive relationships (Domino,  2013 , p. 432). During this lesson students brainstormed ideas about effective and positive communication techniques and were then required to practice these skills (e.g., eye contact, active listening and showing empathy) in pairs. Finally, participants were required to practice these techniques in an interview with a classmate, and later with a parent.

6.63. *Toronto antibullying program

The Toronto antibullying program was inspired by the OBPP (Pepler et al.,  2004 , p. 125). It was based on the understanding that bullying is a problem that extends far beyond the individual children; it involved the peer group and the teachers, as well as the parents of children (Pepler et al.,  2004 , p. 127). The program included several preventive elements implemented at the school, parent, and classroom levels, as well as additional work with specific students involved in bullying as perpetrators or victims.

The level of implementation of the program varied across the intervention schools. However, in all intervention schools three critical elements were found: staff training, codes of behavior and improved playground supervision. At the school level an emphasis was placed on developing a positive code of behavior among students, engaging teachers, and promoting positive playground interactions. At the parent level, information nights were held during which parents were informed about the problem of bullying in their school. Also, information about the program and its objectives was sent home. At the classroom level, children were involved in developing classroom rules against bullying. Further classroom activities aimed to change students' attitudes and to promote healthy relationships among peers. At the individual level, children involved in bullying as perpetrators or victims received specialized intervention through consultation and though engaging their parents. Follow‐up monitoring of these cases helped school authorities to establish that bullying incidents were terminated or discontinued.

6.64. *Transtheoretical‐based Tailored antibullying program

This antibullying initiative involved “transtheoretical‐based tailored programs that provided individualized and interactive computer interventions to populations of middle and high school students involved in bullying as bullies, victims and/or passive bystanders” (Evers et al.,  2007 , p. 398). The intervention involved only three 30‐min computer sessions during the school year for the students and a 10‐page manual for staff and parents with optional activities. According to the program designers, the transtheoretical model is “a theory of behavior change that applies particular change processes like decision‐making and reinforcement to help individuals progress at particular stages of change” (Evers et al.,  2007 , p. 398).

Intervention materials included the “Build Respect, Stop Bullying” program, which is a multicomponent, internet‐based computer system (Evers et al.,  2007 , p. 402). Students initiated the program by running a multimedia CD which brought them to the program website. Students could use the program by creating a login name based on personal information and a password. Once the students registered for the program, logged in and consented to be involved in the intervention study, they were given instructions on how to proceed. This multi‐media program also included short movies (videos) of students giving testimonials about bullying (Evers et al.,  2007 , p. 403).

Other elements of the program included: (1) a 10‐page family guide, sent to children's homes, which provided brief information about the multi‐media program and its relation to the antibullying initiative; and (2) a 10‐page staff guide, which included general information about bullying and how to support student change, classroom activities and information on how to work with parents. Teachers were not provided with any training.

6.65. Utrecht Healthy Schools

The Utrecht Healthy Schools program was a comprehensive educational program that targeted adolescent health behaviors (Busch et al.,  2013 ). The integrated program aims to improve various different health‐related behaviors exhibited by Dutch secondary school students, such as, nutrition, exercise, sexual health, substance and alcohol use, smoking behaviors, bullying, and excessive use of television, gaming and Internet use. The program was implemented as a whole‐school approach and consisted of five key components.

First, participating schools implemented a “healthy school” policy outlining a zero‐tolerance attitude toward risky or violent behaviors, such as alcohol use, smoking or bullying. Second, the program aimed to create a healthy school environment by offering healthy options in the canteen, removing vending machines, ensuring proper sports facilities, hosting alcohol‐free school parties and implementing a smoke‐free school yard. In the third instance, the program aimed to involve parents in intervention activities by providing parent workshops and/or take‐home activities for students. Finally, curriculum materials focused on personal skill development and the program aimed to incorporate public health services into the intervention program.

6.66. *Viennese Social Competence Training program (ViSC)

The ViSC aimed to provide students “with systematic theoretically‐based guidance in becoming responsible and competent actors in conflict situations” (Atria & Spiel,  2007 ; Yanagida et al.,  2019 ). It was specifically designed for disadvantaged adolescents aged fifteen to nineteen who were considered at risk for future problems (Atria & Spiel,  2007 , p. 179). The theoretical basis of the programs drew its main ideas from social information processing theory and from research that approached the problem of bullying as a group phenomenon (Gollwitzer et al.,  2006 , p. 126).

The ViSC program consisted of thirteen lessons which were divided into three phases: (1) impulses and group dynamics; (2) reflection; and (3) action. The first phase, entitled “impulses and group dynamics,” consisted of six lessons and the main aim was to enhance students' competence in dealing with critical situations by teaching them how to look at social situations from different perspectives using vignette stories, discussions and role‐plays. The second phase, reflection , involved one lesson during which pupils reflected on what had been learned in the first phase of the program.

The last phase, action , consisted of six lessons during which the trainer asked students to define how they wanted to benefit from the remaining lessons. The trainer collected students' individual ideas, evaluated them and—along with the students—put them in practice in alignment with the global goal of the program: enhancing pupils' social competence. The third phase of the program was flexible and it could involve several projects suggested by pupils such as a movie production, a work of art, the organization of a party, and so on. This flexibility was allowed and was, in fact, a main feature of ViSC because organizing such projects “involves a variety of critical situations, in which alternative, nonaggressive response options can be probed, rehearsed, and evaluated for success” (Gollwitzer et al.,  2006 , p. 126).

Based on the design of the program, the training of students was conducted by specialist trainers, not their teachers. The trainers participated in instruction workshops and were also supervised during the training by the ViSC developers' team at the University of Vienna (Gollwitzer et al.,  2006 , p. 127). According to the principles of the program, it was essential for the trainer to avoid receiving any information about individual students offered by teachers; students' assessments should be based on standardized diagnostic measures (Atria & Spiel,  2007 , p. 184). Moreover, the training was conducted during regular class time and teachers were advised to attend the lessons, so that the program was taken seriously by the students. ViSC has been implemented and evaluated three times: by Gollwitzer (2005), by Atria and Spiel ( 2007 ) and by Gollwitzer et al. ( 2006 ).

6.67. Youth‐led program

The Youth‐led program (YLP; Connolly et al.,  2015 ) was a generalized middle school violence prevention program. This program was developed by a community agency, and involved training high school students to lead violence prevention workshops with middle school students in order to increase the latter's knowledge and attitudes of peer aggression and victimization.

Experienced mental health professionals were employed to select and supervise male and female high school students that would become “youth leaders.” These students received training in afterschool sessions on skills and knowledge of peer aggression. Topics covered included bullying perpetration and victimization, but also peer aggression, violence, and harassment.

The final sessions of this training required the youth leaders to create two individualized presentations; one covering bullying and the other discussing general aggression. Mixed gender pairs of youth leaders then conducted these presentations in middle school classrooms under the supervision of a mental health worker. These presentations lasted for approximately 45 min each.

6.68. *Youth Matters

The Youth Matters program used “a curricular and a modified systemic approach to bullying prevention” (Jenson & Dieterich,  2007 , p. 287). The aim of the curriculum was to strengthen peer and school norms against antisocial behaviors by addressing critical issues (issue modules) such as the difference between teasing and bullying, building empathy, risks and norms surrounding aggression and so on. The curriculum also aimed to promote skills (skill modules; structured skills training sessions) that students could use in order to stay safe at school, cope with bullying, enhance their social skills and improve their peer relationships. To address systemic issues associated with bullying, curriculum modules terminated with the development of classroom or school‐wide projects, which placed emphasis on the negative consequences of bullying for students.

The curriculum consisted of 10‐session modules. Each module included a 30–40‐page story, the content of which was directly linked to the structured skills training sessions. When looking at the implementation of the program, all curriculum materials were “language sensitive”: translated into Spanish for use in the three Spanish‐speaking classrooms included in the evaluation. Youth Matters curriculum modules were offered to fourth and fifth graders. According to Jenson and Dieterich ( 2007 , p. 287), grades 4 and 5 were selected “based on an appropriate fit between developmental ability and curricula.”

The Youth Matters program was based on a theoretically grounded curriculum. The curriculum was based on theoretical constructs derived from the Social Development Model. The latter integrated perspectives from three theories (i.e., social control theory, social learning theory and differential association theory) and proposed that four factors inhibit the development of antisocial development in children. These were: (1) bonding or attachment to family, schools and positive peers; (2) belief in the shared values or norms of the above‐mentioned social units; (3) external constraints or consistent standards against antisocial behavior; and (4) social, cognitive and emotional skills that can be seen as protective tools for children to solve problems and perform adequately in social situations. The Youth Matters curriculum addressed each of these four core areas.

6.69. Zero program

The Zero antibullying program is based on the idea that bullying is predominately a version of proactive aggression (Roland et al.,  2010 ). The program aims to create a school environment that prevents these forms of proactive aggression. The intervention places the majority of responsibility for bullying prevention and intervention with the adults within the school environment (Roland et al.,  2010 ). School staff were required to define clear standards of positive prosocial behavior among the students and to ensure that these standards are met. Thus, the adults within the school context adhere to a “zero tolerance” policy toward bullying. Another key feature of the intervention is that students are instructed to treat all school property appropriately and respectfully and the intervention philosophy is carried into classroom activities and standards also.

During the intervention, class teachers engage their respective classes in active discussions about issues relating to bullying in adherence with the intervention guidelines. The preventative function of the Zero program takes both a direct and indirect approach (Roland & Galloway,  2004 ). Teachers are also expected to be vigilant and visible in school corridors and playgrounds during nonclass time and follow intervention procedures when dealing with specific instances of bullying (Roland et al.,  2010 ). When particular instances of bullying are identified, the victim is first approached and takes part in a few sessions with trained staff being comforted and assured. Parental involvement also occurs at this point. Finally, the perpetrators are invited to attend meetings and conflict resolution occurs under a restorative justice model.

6.70. Zippy's Friends

Zippy's Friends is a universal school‐based program for children aged 6–8 years old (Holen et al.,  2013 ; Mishara & Ystgaard,  2006 ). The overarching aim of the program is to develop and improve participants' coping strategies in order to reduce and prevent psychological problems. Zippy' Friends has been funded by the global suicide prevention organization “Befrienders International,” and is now distributed internationally by the nonprofit group “Partnership for Children.”

The intervention is delivered over the course of 24 weekly lessons, that are implemented by classroom teachers. The program is based around six stories of the imaginary character “Zippy,” three children, and their families and friends. A structured curriculum outline for each lesson allows participants to engage and discuss the various themes that emerge in each of the stories. Themes that are incorporated include: emotions; communication; friendships; conflict resolution; loss and change.

Teachers are provided with a detailed manual for the program and are required to guide their classrooms through the intervention while also encouraging active engagement with the content. Typical activities that are involved in the Zippy's friends program include: drawing, role‐playing, performing exercises, play and dialogue.

7. RESULTS OF SYSTEMATIC REVIEW

In addition to the newly identified studies ( n  = 88), primary evaluations ( n  = 53) discovered by Farrington and Ttofi ( 2009 ) are also included in the present systematic review, giving a total of 141 studies. However, this updated systematic review has excluded evaluations that used an “other” experimental‐control design ( n  = 13). Next, a detailed explanation is provided about studies which were excluded from the current review and justifications for this decision.

7.1. Studies excluded because of missing information

A certain amount of statistical information is needed in order to produce meaningful effect sizes in a meta‐analysis. We estimated an antibullying program's effectiveness as the difference between the experimental and control groups on bullying outcomes, either measured as the percentage of bullies/nonbullies or victims/nonvictims or based on mean scores on measurement instruments before and after implementation of the intervention.

However, 21 studies identified by our systematic review did not present sufficient effect size information, and so the primary authors of these publications were contacted. We were able to obtain relevant information for the majority of these studies, but three authors were unable to provide required statistics and seven did not respond to our email communication.

Thus, 10 studies had to be excluded from our meta‐analysis because of a lack of information regarding quantitative outcomes. These relate to: Gradinger et al. ( 2015 ); Harpin ( 2011 ); Kyriakides et al. ( 2014 ); Lewis et al. ( 2013 ); Lishak ( 2011 ); Low and Van Ryzin ( 2014 ); van der Ploeg et al. ( 2016 ); Sahin (2012); Schroeder et al. ( 2012 ); and Wurf (2010). In the previous review by Farrington and Ttofi ( 2009 ), 44 out of 53 evaluations provided sufficient information on quantitative outcomes.

7.2. Studies excluded because of nonindependent samples

One further stipulation of a meta‐analysis is that the final samples must be independent of one another (Borenstein et al.,  2009 ; Ellis,  2010 ). Overlapping samples are statistically dependent, and thus the variance of the summary effect size produced by the meta‐analysis would be under‐estimated (Wilson,  2010 ). Therefore, before conducting our meta‐analysis we ensured that all samples were independent of one another.

This issue of nonindependent samples was particularly relevant for the multiple evaluations of the KiVa antibullying program. Our thorough systematic searches identified 16 potentially includable studies presenting evaluation data from implementation of the KiVa program (i.e., Ahtola et al.,  2012 ,  2013 ; Garandeau, Lee, et al.,  2014 , Garandeau, Poskiparta, et al.,  2014 ; Haataja et al.,  2014 ; Hutchings & Clarkson,  2015 ; Kärnä et al.,  2011a ,  2011b ,  2013 ; Nocentini & Menesini,  2015 ; Noland,  2011 ; Sainio et al.,  2012 ; Salmivalli et al.,  2012 ; Williford et al.,  2012 ,  2013 ; Yang & Salmivalli,  2015 ). For a description of each of these studies, see Table  7 .

Description of KiVa studies

* Included in meta‐analysis.

However, following further screening, only four of the aforementioned studies were subsequently included in the systematic and meta‐analytic review (i.e., Kärnä et al.,  2011a ,  2011b ,  2013 ; Nocentini & Menesini, 2016). These four studies presented independent results of the KiVa program from the initial nationwide evaluation in Finland. Kärnä et al. ( 2011a ) used an age cohort design with adjacent cohorts and reported the initial results from the nationwide implementation in Finland. Second, Kärnä et al. ( 2011b ) reported the results from the RCT with Finnish students in grades 4–6, and Kärnä et al. ( 2013 ) reported results for students in grades 1–3 and 7–9. In addition, Nocentini and Menesini (2016) reported the results of the implementation and evaluation of KiVa in Italian schools. The remaining 12 publications relating to the KiVa program utilized data from the RCT evaluation in Finland (i.e., Kärnä et al.,  2013 or Kärnä et al.,  2011b ) but explored different facets of the program's effectiveness.

Four studies identified in our systematic searches replaced evaluations included in the earlier review. For example: (1) Menard and Grotpeter ( 2014 ) was a continuation of the Menard et al. ( 2008 ) evaluation; (2) Cross et al. ( 2011 ) was a republication of the Cross et al. ( 2004 ) evaluation included in the previous review; (3) Jenson et al. ( 2013 ) and Jenson et al. ( 2010 ) presented data from additional follow‐up points to the Jenson et al. ( 2007 ) evaluation; and (4) Frey et al. ( 2009 ) used an age cohort design to evaluate follow‐up effects from the earlier Frey et al. ( 2005 ) study. In cases such as these, the most recent publication, or the publication with the most statistical information, was included in the meta‐analysis.

Ten studies (published both before and since 2009) were identified as reporting the effectiveness of an antibullying program from the same sample, or were repeat publications of earlier studies (e.g., DeRosier,  2004 and DeRosier & Marcus,  2005 ; Domino,  2011 and Domino,  2013 ; Espelage et al.,  2013 and Espelage et al.,  2015 ; Jenson et al.,  2013 and Jenson et al.,  2010 ; and Menesini et al.,  2012 ; Study 2 and Palladino et al.,  2012 ). In these instances, the most recent publications were selected, and as a result, five studies were excluded from the meta‐analysis.

7.3. Included studies

Therefore, 128 studies are included. Table  5 summarizes the intervention programs and methodological components of the 79 newly identified studies that are included in the present systematic review. For details of the remaining 49 studies please refer to Farrington and Ttofi ( 2009 ).

7.4. Moderator analysis

The following moderators were selected a priori for further analysis, under the descriptive label (i.e., location of intervention, publication type, publication year), design label (i.e., evaluation method and unit of allocation/randomization), and the program heading (i.e., name of intervention, COI, and program specificity). Results of these moderator analyses analogous to the analysis of variance (ANOVA) are presented in Sections 8.5.1 to 8.5.7 of the present report.

7.4.1. Evaluation method

The primary moderator chosen for further analysis was evaluation method. Specifically, whether the evaluation was conducted using a RCT, quasi‐experimental with before and after measures (BA/EC) or age cohort (AC) design.

Overall, in relation to bullying perpetration outcomes, 36 evaluations used RCT designs, 31 used BA/EC designs and 14 used age cohort designs. However, due to some evaluations reporting data for multiple independent samples, a total of 40 effect sizes were estimated for bullying perpetration outcomes from RCT designs. A further 36 were estimated from BA/EC designs and 14 effect sizes came from evaluations using age cohort designs.

For bullying victimization outcomes, overall, 33 evaluations used RCT designs that gave 37 independent effect sizes for bullying victimization and 37 evaluations used BA/EC designs and gave 42 independent effect sizes. Similar to perpetration outcomes, 14 evaluations used age cohort designs to evaluate the effect of antibullying programs on bullying victimization outcomes.

7.4.2. Location of intervention

Evaluations included in the present analysis were conducted in many different countries around the world. However, there were only a few countries in which multiple evaluations of antibullying programs had been published.

Specifically, in the following countries only one evaluation was included in the present report: Austria (i.e., Yanagida et al.,  2019 ); Brazil (i.e., Silva et al.,  2016 ); China (i.e., Ju et al., 2009); Czechoslovakia (modern day Czech Republic and Solvakia; i.e., Rican et al.,  1996 ); Hong Kong (i.e., Wong et al.,  2011 ); Ireland (O'Moore and Milton,  2004 ); Malaysia (i.e., Yaakub et al.,  2010 ); Romania (i.e., Trip et al.,  2015 ); Sweden (i.e., Kimber et al.,  2008 ); Switzerland (Alsaker & Valkanover,  2001 ); South Africa (Meyer & Lesch,  2000 ); and Zambia (Kaljee et al.,  2017 ).

If these evaluations were to be included in further moderator analysis, we would be examining the differences based on only one sample and effect size. Therefore, moderator analysis was conducted only between locations in which multiple evaluations of antibullying programs had been conducted.

So, of the 100 evaluations included in our meta‐analysis of school‐based antibullying programs, the majority (80 for perpetration, 84 for victimization) were conducted in one of 12 different countries. With respect to bullying perpetration outcomes, these countries were as follows: Australia ( n  = 2); Canada ( n  = 6); Cyprus ( n  = 3); Finland ( n  = 6); Germany ( n  = 5); Greece ( n  = 2); Italy ( n  = 11); Netherlands ( n  = 3); Norway ( n  = 8); Spain ( n  = 3); UK ( n  = 4); and United States ( n  = 26). With respect to bullying victimization outcomes, these countries were as follows: Australia ( n  = 3); Canada ( n  = 7); Cyprus ( n  = 3); Finland ( n  = 6); Germany ( n  = 4); Greece ( n  = 2); Italy ( n  = 10); the Netherlands ( n  = 3); Norway ( n  = 7); Spain ( n  = 3); UK ( n  = 6); and United States ( n  = 28).

7.4.3. Publication type and year

Overall, the majority of evaluations were published in peer‐reviewed journal articles, for both bullying perpetration ( n  = 67) and bullying victimization ( n  = 72) outcomes. Two evaluations were published in chapters of edited books and both reported effects of a program on both bullying victimization and perpetration. No evaluations identified were published as entire books. Moreover, 12 unpublished dissertations were identified that published evaluation data for bullying perpetration and bullying victimization outcomes. Data was also retrieved for both outcomes from three governmental reports. Four of the effect sizes included in the present report were estimated from data emailed to authors (M. M. T. and D. P. F.) in preparation of the previous Campbell report (i.e., Farrington & Ttofi,  2009 ).

We also categorized included evaluations according to whether they were included in the previous report (i.e., “2009” studies), or only included in the present report (i.e., “2016” studies). In relation to bullying perpetration outcomes, 37 studies were coded as 2009 studies and 53 studies were coded as 2016 studies. Similarly, more studies were coded as 2016 ( n  = 54) studies in comparison to 2009 ( n  = 39) studies for bullying victimization outcomes.

7.4.4. Intervention program

We found that very few specific antibullying programs had been implemented and evaluated more than once using independent samples. Sixty‐five different school‐based bullying intervention and prevention programs were included in our meta‐analysis, but only eight were repeatedly evaluated. Moderator analysis with respect to the specific intervention program therefore, focused on programs that had been repeatedly evaluated.

In relation to reducing bullying perpetration outcomes the intervention programs thus included in our moderator analysis were: BPYS ( n  = 3; e.g., Menard & Grotpeter,  2014 ); fairplayer.manual ( n  = 2; e.g., Bull et al.,  2009 ); KiVa ( n  = 6; Kärnä et al.,  2011b ); NoTrap! ( n  = 4; e.g., Menesini et al.,  2012 ); Second Step ( n  = 3; e.g., Espelage et al.,  2015 ); Steps to Respect ( n  = 2; e.g., Frey et al.,  2005 ); ViSC ( n  = 5; e.g., Yanagida et al.,  2019 ).

Similarly, these interventions were included in our moderator analysis in relation to bullying victimization outcomes with the exception of the fairplayer.manual program. This intervention was evaluated twice only in relation to bullying perpetration outcomes.

Additionally, multiple evaluations of the OBPP were included in our meta‐analysis. Overall, 12 independent evaluations of this intervention were included in our analysis in relation to bullying perpetration and victimization outcomes. These are included in our moderator analysis as a collective subgroup and also as further subgroups. Evaluations of the OBPP conducted in the United States (perpetration n  = 6; victimization n  = 7) and those conducted in Norway (perpetration n  = 5; victimization n  = 5) were included in the moderator analysis separately. There was one evaluation of the OBPP conducted in Malaysia is included in the overall category ( n  = 12).

7.4.5. Unit of allocation/randomization

Systematic review findings showed that one consistent issue with included intervention programs was that the unit of allocation of participants, or clusters of participants, was different to the unit of analysis in most evaluations. Age cohort designs were omitted from this moderator analysis as the unit of allocation was largely unclear due to the logistics of this experimental design.

The majority of RCT and BA/EC evaluations assigned schools to experimental conditions (perpetration n  = 44; victimization n  = 47) yet the unit of analysis was individual students. A number of evaluations (perpetration n  = 19; victimization n  = 15) assigned classes to experimental conditions yet the unit of analysis was individual students. Less than 10 evaluations (perpetration n  = 7; victimization n  = 9) included assigned students to experimental and control conditions. One study randomly assigned districts to experimental conditions, and information was not available for five studies in relation to bullying perpetration outcomes and four studies in relation to bullying victimization.

7.4.6. Conflict of interest

In the present report, 40 studies were categorized as high COI. A large number of studies (perpetration n  = 36; victimization n  = 39) were considered low COI, and 14 were categorized as possible COI. Information concerning COI was unavailable for 4 evaluations in relation to bullying perpetration outcomes.

7.4.7. Program specificity

Overall, a small number ( n  = 11) of studies included in our analysis were coded as low on the program specificity variable. The vast majority of evaluations were considered highly specific (i.e., were mostly concerned with only bullying behavioral outcomes; n  = 59). Additionally, 18 studies were categorized as medium in relation to specificity, where extra outcome variables were measured but these variables were related to bullying (e.g., school climate).

7.5. Risk of bias analysis

Figure  2 presents the results of the risk of bias analysis for each of the items on the EPOC tool and the additional items we included. The following section describes each of these categories in more detail, with examples of high‐ and low‐risk studies included. The main limitation in assessing risk of bias was the lack of information reported by primary studies. Thus, while the best effort was made to categorize each primary evaluation as being high or low risk, a large number of studies were recorded as “unclear” risk.

Risk of bias analysis results. AC, allocation concealment; AS, allocation sequence; BC, baseline equivalence on participant characteristics; BE, baseline equivalence on outcomes; BOA, blind outcome assessment; COI, conflict of interest; CP, contamination protection; ID, incomplete outcome data; SOR, selected outcome reporting

As seen in Figure  2 , the fewest studies were considered unclear risk on CP and selected outcome reporting. Furthermore, a large number of studies were considered low risk on these items.

For the purpose of analysis, the categories high, unclear, and low risk were transformed into scores of 3, 2, and 0 respectively. A continuous “risk of bias” variable was then estimated as the sum total of scores on each of the EPOC items. As such, the lowest possible score a study could be given was zero and the maximum score was 24.

Descriptive statistical analysis identified that risk of bias scores ranged from 0 to 17, with a mean score of 9.62. Meta‐regression analysis was conducted to assess the relationship between risk of bias and effect sizes. The result of this analysis is included in Section  7 of this report. The following sections provide more detail about each of the risk categories.

7.5.1. Allocation sequence

AS refers to the way in which participants, or clusters of participants, were assigned to experimental conditions. For example, low‐risk studies were those where a random number generator or another randomization software was used. In total, 30 studies were categorized as high risk on the AS item. Moreover, 29 studies were low risk and 32 were unclear risk.

7.5.2. Allocation concealment

AC item refers to whether the method of allocation was concealed from participants or not. In total, 36 studies were categorized as high risk on the AC item. A further 19 studies were considered low risk, and 34 were unclear risk.

7.5.3. Baseline equivalence: Outcome

Baseline equivalence refers to the comparability of experimental and control participants before the intervention has taken place. This item specifically refers to equivalence on relevant outcomes, in this case, school bullying perpetration and victimization. When experimental and control participants are not statistically significant at baseline then we can be more certain that any changes are a result of the intervention. Overall, 14 studies were categorized as high risk on the baseline equivalence on bullying outcomes item. A total of 54 studies were low risk and 21 were unclear risk.

7.5.4. Baseline equivalence: Characteristics

Similarly, baseline equivalence on participant characteristics increases the chance that any change is a result of the intervention, and not a confounding variable such as differential participant characteristics at baseline. Overall, 15 studies were categorized as high risk on the baseline equivalence in participant characteristics item, 64 studies were low risk, and 11 were unclear risk.

7.5.5. Incomplete outcome data

Included evaluations were required to incorporate pre‐ and post‐intervention measures of bullying (except if randomization was used). However, because of this, it is likely that there will be some attrition in primary studies. The incomplete outcome data item referred to the risk associated with differential attrition between experimental groups and/or ways in which attrition and missing cases were dealt with by primary studies. Twelve studies were categorized as high risk on the incomplete outcome data item. Additionally, 48 studies were low risk and 29 were unclear risk.

7.5.6. Blind outcome assessment

This item assesses the risk associated with any bias which may arise if outcome measurements are not conducted blindly. In other words, if the individual, or individuals, who administer and collect the measurement instruments are aware of the experimental conditions of participants at the time of measurement. Overall, 27 studies were categorized as high risk on the BOA item. Twenty studies were low risk and 43 were unclear risk.

7.5.7. Contamination protection

Risk of contamination occurs when there is a possibility that experimental and control participants may interact or encounter one another during the course of the evaluation. Thus, the effects of the intervention may “spill over” to control students and impact the results of the evaluation. In our analysis, 35 studies were categorized as high risk on the CP item, 47 studies were low risk, and 9 were unclear risk.

7.5.8. Selective outcome reporting

SOR occurs when the outcomes reported in an evaluation study differ from the outcomes of interest proposed originally. For example, if a trial protocol proposed different outcomes than those actually reported in the publication of the trial results. Two studies were categorized as high risk on the SOR item. Eighty‐four studies were low risk, and three were unclear risk.

8. META‐ANALYSIS

After accounting for missing information, studies excluded because of their methodology (i.e., “other experimental‐control” designs), and studies with overlapping samples, a total of 41 studies were excluded from the meta‐analysis. Thus, a total of 100 studies were eligible for inclusion in our meta‐analysis. Table  8 outlines the raw data from these studies used to estimate effect sizes. The Comprehensive Meta‐Analysis (CMA) software was used to estimate all summary effect sizes in the present meta‐analysis.

Raw data from included evaluations

Abbreviations: A, after; B, before; C, control; E, experimental; M , mean; N , sample size; n , group sample size.

8.1. Effect sizes

A meta‐analysis aims to estimate comparable effect sizes from multiple primary studies. The choice of effect size depends on how statistical information is reported by primary studies (Borenstein et al.,  2009 ). In meta‐analyses such as this one, the data is largely presented in continuous (e.g., means, standard deviations, sample sizes) or dichotomous (e.g., prevalence or percentages) forms (Wilson,  2010 ). Thus, primary effect sizes estimated were Cohen's d and Odds Ratios.

As previously mentioned, we aimed to estimate one effect size for each independent sample included in primary studies. Therefore, where studies reported results separately for male and female participants, or primary and secondary school students, one effect size was calculated for each group.

For primary studies that presented results as percentages or frequencies of participants identifying as either bullies or victims, the odds ratio (OR) effect size was estimated. The ORs for before and after intervention time‐points were calculated independently. The CMA™ software that we used to analyze effect sizes in the present report did not allow us to enter raw data for before and after time‐points for primary studies that reported dichotomous outcomes separately. Thus, we were unable to use this software to calculate a pre‐post intervention estimate for these studies. Hence, these calculations were carried out manually, 5 by the first author, using the method outlined by Farrington and Ttofi ( 2009 ).

Cohen's d was estimated for primary studies when results were reported in the form of continuous data. Cohen's d is estimated as the difference between experimental and control means divided by the pooled standard deviation (Wilson,  2010 , p. 184). Effects were assigned a positive direction in cases where bullying was less in the experimental group compared to the control group or where the reduction in bullying outcomes was larger in the experimental group in comparison to the change in the control group. Following this logic, a negative effect was found when there was: (1) a larger reduction in the control group compared to the experimental group; or (2) there was no change or increase in bullying perpetration/victimization in the experimental group but a reduction or smaller increase in the control group.

For comparability, all effect sizes were converted to ODs. Summary mean effects for bullying perpetration, bullying victimization, and for each of the moderator subgroup are thus reported as odds ratios. In the present review, odds ratios greater than one represent a positive, or desirable, intervention effect. Namely, a reduction of bullying in the experimental group, that is comparably larger than the change in bullying in the control group. Therefore, the change is attributed to have occurred because of the intervention program. Similarly, odds ratios less than one represent a negative, or undesirable, intervention effect and odds ratios that equal one represents a null effect.

8.2. Corrections for clustering

As the present review aims to evaluate the effectiveness of school‐based antibullying programs, cluster‐randomized trials were included. Clustering is a common phenomenon in educational evaluations (Donner & Klar,  2002 ), and occurs when “clusters,” not individuals, are randomly assigned to experimental conditions (Higgins et al.,  2011 ). In other words, primary studies sometimes assigned classes or schools to intervention and control conditions, rather than individual students.

Often this approach is utilized in evaluation studies to reduce treatment contamination and increase administrative convenience (Donner et al.,  2001 ). However, one of the main issues with incorporating cluster‐randomized trials in a meta‐analysis is that participants within a cluster are likely to be more homogeneous than participants in another cluster (Higgins et al.,  2011 ). Thus, the variance of estimates of treatment effectiveness will be under‐estimated (Donner & Klar,  2002 , p. 2974). Clustering could occur for several reasons in studies included in the present report. For example: (1) classes of children, not individual children, were e randomized to intervention or control condition; (2) the intervention was implemented at the classroom level (i.e., to a class or group of children at one time); or (3) the intervention was targeted at teachers, who were trained to implement the intervention in their respective classrooms.

Therefore, effect sizes in the present meta‐analysis were corrected for the inclusion of clusters in primary studies. This is achieved by estimating a design effect:

where M represents the mean cluster size in each study (e.g., the mean number of students per classroom 6 ) and the ICC is the intraclass correlation coefficient.

The ICC is rarely reported by primary studies (Higgins et al.,  2011 ; Valdebenito et al.,  2018 ). Based on Murray and Blitse ( 2003 ), and subsequently the strategy followed by Farrington and Ttofi ( 2009 ), an ICC of 0.025 was assumed in the current meta‐analysis. The variances of effect sizes were then multiplied by this design effect estimated for each study. In the present meta‐analysis, there were only four studies where corrections for clustering were not required. Three studies (i.e., Berry & Hunt,  2009 ; Knowler & Frederickson,  2013 ; Meyer & Lesch,  2000 ) randomly assigned participants to experimental conditions, and Elledge et al. ( 2010 ) described an intervention that was not implemented in a classroom (i.e., the intervention occurred in one‐on‐one sessions with victims of bullying).

8.3. Computational models

The results of our meta‐analysis are presented using two different models. First, we will report the results as estimated using a random effects model that weights studies, largely in proportion to the between‐study variance and accounting for sampling error, thus allowing for the natural variation that occurs between primary studies (Borenstein et al.,  2009 ). We also present the results under the MVA model (Jones, 2005; Farrington & Welsh,  2013 ). which uses the same estimation of a mean effect size as the fixed effects model in that it assigns greater weight to larger evaluations, but also accounts for the between‐study heterogeneity. The MVA model takes account of the heterogeneity of effect sizes to fit the data exactly and yields the same mean effect size as a fixed effect model, but with and increased confidence interval. 7

Farrington and Welsh ( 2013 ) have argued that larger evaluations should be given more weight, and that adding to the variance of effect sizes in order to reduce the heterogeneity is not an optimal method of estimating the weighted mean effect size. When there is considerable heterogeneity in effect sizes, all studies tend to be given much the same weighting in a random effects model. Therefore, several effect sizes from independent samples in one study (e.g., a multisite evaluation) will have a greater weight in the random effects model than in the fixed effects model.

Comparing six models of estimating mean effect sizes for the impact on CCTV on crime rate, Farrington and Welsh ( 2013 ) found that five of the six models produced very similar mean odds ratio effect sizes, with the exception of the random effects model. In this case the random effects model estimated a much higher mean odds ratio (Farrington & Welsh,  2013 , p. 11).

The MVA model is suggested as an alternative approach that overcomes the issues of the random effects model. This technique can be seen as an adjustment to the fixed effects model and combines both the strengths of the fixed effects model (i.e., larger studies = larger weights) and the random effects model (i.e., adjusting for highly probable between‐study variance), and has been used in several meta‐analyses from both the behavioral sciences (e.g., Portnoy & Farrington,  2015 ; Ttofi et al.,  2016 ; Zych, Baldry, et al.,  2019 ; Zych, Viejo, et al.,  2019 ) and medical sciences, where this is known as the “Shore adjustment” (e.g., Ayieko et al.,  2014 ; Carlos‐Wallace et al.,  2016 ; Erren et al.,  2009 ; Steinmaus et al.,  2008 ).

A full review of the strengths and limitations of this model is beyond the scope of the current review. Therefore, in our current meta‐analysis we report mean effect sizes for the impact of antibullying programs on bullying perpetration and bullying victimization using both the random effects model and the MVA model. In later sections, we discuss the differences in the weighted mean effect sizes according to the model chosen.

8.4. Moderator analysis

In traditional empirical research when one wishes to compare two mean values to evaluate the difference between two participants, or two groups of participants, a t test is the standard statistical test. In meta‐analysis, we want to compare subgroups of studies rather than sub‐groups of individuals, so the analysis is slightly different. We followed guidelines provided by noted meta‐analysts for this type of analysis (Borenstein et al.,  2009 ; Lipsey & Wilson,  2001 ).

Our approach involved two steps: (1) computing the mean effect and variance for each subgroup; and (2) comparing the mean effects between subgroups (Borenstein et al.,  2009 , p. 152). This approach has been used previously by researchers to conduct similar analyses (e.g., Kaminski et al.,  2008 ; Ttofi & Farrington,  2011 ).

Comparing the mean effect sizes for subgroups involves a method that is analogous to a one‐way ANOVA in primary research (Hedges,  1982 ; Lipsey & Wilson,  2001 ; Wilson, 2002). The meta‐analyst creates mutually exclusive categories of primary studies and then compares the between‐studies ( Q B ) and the within‐studies ( Q W ) variance.

The between‐studies heterogeneity is the value used to evaluate whether the difference between subgroups is statistically significant (i.e., whether the difference in weighted mean effect sizes for subgroups is, at least partially, explained by the relevant intervention component). Similar to a one‐way analysis of variance, this approach partitions the variance and compares the variability between‐groups. The following formula is used to estimate the Q B :

The degrees of freedom for the between‐studies heterogeneity is estimated as j  − 1 and the statistical significance is determined using a χ 2 distribution. As Q B is estimated using the weights assigned to observed effect sizes, the value will vary between the fixed effects model and the random effects model. Q B is not reported for comparisons of subgroups with very unequal numbers of studies (e.g., location of the evaluation). Under the MVA model, the heterogeneity between groups is estimated by dividing the fixed effects Q B by Q/df . The present report presents results from moderator analysis under both the random effects and MVA models.

8.5. Meta‐regression analysis

CMA™ version 3 software was used to conduct meta‐regression analysis to explore the relationship between continuous moderator variables and perpetration and victimization outcomes. Weighted regression analysis (Lipsey & Wilson,  2001 ) were used to explore which moderators were independently related to school bullying perpetration and victimization. Meta‐regression analyses were only conducted for continuous moderator variables.

Meta‐regression analyses were computed under a fixed effects model, and the standard error of regression coefficients were adjusted using the MVA model. The Q and df of Q for the mean summary effect sizes for subgroups were used to adjust the standard error to reflect between‐study variance.

9. RESULTS OF META‐ANALYSIS

In total, 100 studies were included in our meta‐analysis of the effectiveness of school‐based antibullying programs. From these evaluations, we were able to estimate 103 independent effect sizes. These are presented for bullying perpetration and bullying victimization outcomes in Tables  8 and  9 , respectively. The majority of these effect sizes were estimated from studies that used RCT designs ( n  = 45 effect sizes) or BA/EC designs ( n  = 44 effect sizes). We estimated the remaining 14 effect sizes from age cohort designs.

Meta‐analysis results: School‐bullying perpetration outcomes

Abbreviations: BA/EC, before‐after/experimental control designs; CI, confidence intervals; MVA, multiplicative variance adjustment; OR, odds ratio; RCT, randomized controlled trial; Sig, statistically significant.

9.1. School‐bullying perpetration outcomes

Overall, we found that antibullying programs significantly reduced bullying perpetration under both computational models of meta‐analysis. The effect sizes for each evaluation are presented in Table  9 . The mean summary effect sizes were similar under both the multivariance adjustment model (MVA: OR = 1.324; 95% CI 1.27–1.38; z  = 13.4; p  < .001; I 2  = 81.42) and the random effects model (RE: OR = 1.309; 95% CI: 1.24–1.38; z  = 9.88; p  < 0.001; τ 2  = 0.044).

This result indicates that participants in primary studies who received an antibullying intervention were less likely to report engaging in bullying others after completing the program in comparison to control students who did not partake in the program.

Analysis of the funnel plot (Figure  3 ) suggests that publication bias is not present, as studies are symmetrically distributed around the mean effect size. In addition, point estimates did not vary using Duval and Tweedie's trim and fill procedure under a random effects model (in both cases: OR = 1.308; 95% CI 1.240–1.380). Based on these results, it was reasonable to assume that publication bias was not likely.

Publication bias analysis: school‐bullying perpetration

9.2. School‐bullying victimization outcomes

Overall, we found that antibullying programs significantly reduced bullying victimization under both computational models of meta‐analysis. The effect sizes for each evaluation are presented in Table  10 . The mean summary effect sizes were very similar under both the multivariance adjustment model (MVA: OR = 1.248; 95% CI 1.21–1.29; z  = 12.06; p  < .001; I 2  = 78.327) and the random effects model (RE: OR = 1.244; 95% CI: 1.19–1.31; z  = 8.92; p  < 0.001; τ 2  = 0.032).

Meta‐analysis results: School‐bullying victimization outcomes

This result suggests that students who participated in an antibullying program were significantly less likely to report being bullied by others after receiving the intervention in comparison to students who did not receive the intervention.

The funnel plot in Figure  4 indicates that no publication bias is present in analysis of bullying victimization effect sizes, as the studies fall symmetrically around the mean effect size. Duval and Tweedie's trim and fill procedure highlighted some minor differences between observed effect sizes (OR = 1.245; 95% CI 1.186–1.306; Q  = 460.97) and adjusted effect sizes (OR = 1.241; 95% CI 1.182–1.303; Q  = 473.43). However, this difference is negligible. Based on these results, it was reasonable to assume that publication bias was not likely.

Publication bias analysis: school‐bullying victimization

9.3. Analysis of heterogeneity

In a meta‐analysis, heterogeneity ( Q ) is the between‐study spurious variance that occurs partly because of true variation in effect sizes, but also as a result of random error (Borenstein et al.,  2009 ). Heterogeneity is estimated as the excess variation that exists when we compare the total amount of between‐study variance and within‐study random error.

In the present meta‐analysis, there was significant heterogeneity between studies for both bullying perpetration ( Q  = 323.392; df  = 85; p  < 0.001; I 2  = 73.716) and bullying victimization ( Q  = 387.255; df  = 87; p  < 0.001; I 2  = 77.534) outcomes. Multiple moderator analyses were conducted to explore possible explanations for this heterogeneity.

9.4. Risk of bias analysis

Scores on each of the risk of bias items were summed to estimate a total risk of bias score. This continuous variable was then used to examine the relationship between effectiveness and risk of bias in meta‐regression models.

For perpetration outcomes, risk of bias was not associated with effect size under a random effects model of meta‐regression ( b  = 0.003; SE  = 0.006; z  = 0.50; p  = .621) or under the MVA model ( b  = 0.014; SE  = 0.014; z  = 1.01; p  = .156). Similarly, risk of bias scores did not significantly predict bullying victimization effect sizes under a random effects meta‐regression ( b  = 0.007; SE  = 0.005; z  = 1.30; p  = .195) or the MVA model ( b  = 0.012; SE  = 0.012; z  = 1.006; p  = .157).

9.5. Moderator analyses 8

9.5.1. evaluation method.

Our meta‐analysis further investigated the effectiveness of antibullying programs in relation to the methodological designs used by evaluation studies. The breakdown of results by methodological design is also shown in Tables  9 and  10 for bullying perpetration and victimization outcomes respectively.

Primary studies employing age cohort designs associated with the largest effect sizes for both bullying perpetration (OR = 1.474; 95% CI, 1.39–1.56; p  < .001) and bullying victimization (OR = 1.302; 95% CI, 1.230–1.378; p  < .001) under a random effects model. Similarly, AC studies were associated with the largest effect sizes under the MVA model also (perpetration OR = 1.422; 95% CI, 1.36–1.46; p  < .001) and victimization OR = 1.289; 95% CI, 1.29–1.35; p  < .001).

Under the MVA model of meta‐analysis, mean effect sizes were the same for RCT evaluations (OR = 1.171; 95% CI, 1.08–1.27; p  < .001) and BA/EC evaluations (OR = 1.170; 95% CI, 1.05–1.31; p  = .005) for bullying perpetration outcomes. Moreover, the differences between RCT evaluations (OR = 1.117; 95% CI, 1.03–1.22; p  = .01) and BA/EC evaluations (OR = 1.188; 95% CI, 1.07–1.33; p  = .002) were marginal for bullying victimization outcomes under the MVA model.

In relation to bullying victimization outcomes, before‐after/experimental‐control designs gave the second largest mean effect size (OR = 1.225; 95% CI, 1.085–1.383; p  = 0.001), followed by RCTs (OR = 1.210; 95% CI, 1.091–1.342; p  < .001) under a random effects model. However, the result was the opposite for bullying perpetration outcomes under a random effects model (RCT: OR = 1.244; 95% CI, 1.123–1.379; p  < .001; BA/EC: OR = 1.187; 95% CI, 1.044–1.350; p  = 0.009).

Due to the marginal differences and lack of clear pattern in which method was associated with the largest effect sizes (between RCT and BA/EC) further moderator analysis was not conducted.

9.5.2. Location of intervention

Mean effects for bullying perpetration and bullying victimization outcomes are presented graphically in Figures  5 and  6 , respectively. Table  11 outlines the mean effects for each of the 12 countries for both bullying perpetration and victimization outcomes under both the MVA model and the random effects model.

Forest plot of effect size by location: school‐bullying perpetration

Forest plot of effect sizes by location: school‐bullying victimization

Moderator analyses results: Location of evaluation

Evaluations conducted in Greece were associated with the largest effect sizes for bullying perpetration outcomes, followed by Norway, Italy, United States, and Finland under the MVA model of meta‐analysis. Evaluations conducted in Italy were associated with the largest mean effect sizes in relation to bullying victimization, followed by Spain, Norway, United States, and Finland under the MVA model of meta‐analysis. Additionally, evaluations conducted in Germany and the UK gave significant mean effects when computed using the MVA model.

Under the random effects model, Greek evaluations were similarly associated with the largest effect sizes for bullying perpetration, followed by Spanish and Norwegian evaluations. Evaluations conducted in Italy and the United States were also associated with significant mean effects for reductions in bullying perpetration. In relation to bullying victimization, evaluations conducted in Spain and Italy were associated with very similar mean effect sizes and were the largest of the 12 effect sizes, followed by evaluations conducted in Norway. Evaluations conducted in Australia were also associated with significant mean effects in reducing bullying victimization ( p  < .05) and evaluations conducted in Finland and the United States were nearly statistically significant ( p  = .05 and p  = .06, respectively) under the random effects model.

Due to the large number of different countries and the unequal number of studies in each location, further subgroup analyses were not conducted.

9.5.3. Publication type and year

Table  12 outlines the mean summary effect sizes for each of the publication type moderators for bullying perpetration and victimization outcomes. Evaluations for which data was received via email correspondence from evaluators gave the largest mean effect sizes for both bullying perpetration and bullying victimization. Differences in the mean effect sizes for evaluations reported via unpublished dissertations, either masters or doctoral theses, gave the smallest mean effect sizes for both bullying perpetration and victimization outcomes. Subgroup analysis was not conducted further using these categorizations due to the imbalance in numbers of evaluations in each category (i.e., evaluations were overwhelmingly published in peer‐reviewed journal article format).

Moderator analyses results: Publication type

However, additional analysis was conducted to examine any potential differences between peer reviewed and nonpeer reviewed evaluations. Therefore, the above categories were collapsed, and evaluations reported by dissertation, chapter, correspondence and governmental reports (perpetration n  = 23; victimization n  = 21) were compared to evaluations published via peer‐reviewed journal article.

Under the MVA model, non‐peer‐reviewed evaluations gave a larger (OR = 1.493; 95% CI, 1.266–1.761; p  < .001) mean effect size than peer‐reviewed evaluations (see Table  11 ). Moreover, moderator analysis indicated that the difference was statistically significant ( Q B  = 12.861; df  = 1; p  < .001). However, under the random effects model, both groups gave similar effect sizes for bullying perpetration outcomes, and the difference between peer‐reviewed (see Table  11 ) and non‐peer‐reviewed (OR = 1.309; 95% CI, 1.137–1.508; p  < .001) was not statistically significant ( Q B  = 0.595; df  = 1; p  = .441).

For bullying victimization outcomes, similar results were obtained. Under the MVA model, non‐peer‐reviewed evaluations gave statistically significant larger mean effect sizes (OR = 1.403; 95% CI, 1.262 1.560; p  < .001) than peer‐reviewed evaluations (see Table  11 ; Q B  = 27.197; df  = 1; p  < .001). Yet, there was a marginal difference under the random effects model between peer‐reviewed (see Table  11 ) and non‐peer‐reviewed (OR = 1.231; 95% CI, 1.059–1.431; p  = .007) and the difference was not statistically significant ( Q B  = 0.048; df  = 1; p  = .827).

The mean summary effect size for “2009” studies on the year of publication moderator was OR = 1.487 (95% CI, 1.430–1.546; p  < .001) under the MVA model and OR = 1.411 (95% CI, 1.315–1.513; p  < .001) under the random effects model for bullying perpetration outcomes. Across both computational models these summary effects were larger than those for studies labeled “2016” on bullying perpetration for the MVA model (OR = 1.243; 95% CI, 1.667–1.324; p  < .001) and the RE model (OR = 1.184; 95% CI, 1.087–1.289; p  < .001). Moderator analysis analogous to the ANOVA showed that this difference was statistically significant ( Q B  = 76.412; df  = 1; p  < .001) under fixed effects and mixed effects analysis ( Q B  = 9.676; df  = 1; p  = .002).

In relation to bullying victimization, the mean summary effect size for studies labeled “2009” was larger (OR = 1.322; 95% CI, 1.220–1.432; p  < .001) under the MVA model than the mean summary effect size for studies labeled “2016” (OR = 1.229; 95% CI, 1.175–1.285; p  < .001). Moderator analysis analogous to the ANOVA found that this difference was statistically significant ( Q B  = 10.115; df  = 1; p  = .001) but the difference between odds ratios was marginal. However, under the random effects model the minimal difference between the “2009” studies (OR = 1.215; 95% CI, 1.094–1.350; p  < .001) was not statistically different to the mean summary effect size for “2019” studies (OR = 1.223; 95% CI, 1.139–1.313; p  < .001; Q B  = 0.010; df  = 1; p  = .920).

9.5.4. Intervention program

The mean summary effect sizes for 10 different intervention programs in relation to reducing bullying perpetration behaviors and 9 different intervention programs in relation to reducing bullying victimization behaviors. Table  13 outlines the effectiveness of specific antibullying programs in reducing both school‐bullying perpetration and victimization. The effectiveness of these programs varied greatly.

Moderator analyses results: Intervention program

In relation to school‐bullying perpetration outcomes, the OBPP was associated with the largest mean effect sizes. In addition, evaluations of the OBPP in Norway were associated with larger summary effect sizes than evaluations of OBPP conducted in the United States. However, the difference was not statistically significant for school‐bullying perpetration outcomes when moderator analysis analogous to the ANOVA was conducted ( Q b  = 3.65; df  = 1; p  = 0.06).

Other programs were significantly effective in reducing school‐bullying perpetration behaviors, for example KiVa, Second Step, and Steps to Respect. Positive effect sizes (i.e., OR > 1) were also observed for the BPYS and NoTrap! programs but these effects were not statistically significant in relation to reduction in bullying perpetration outcomes. Negative effects were found for two antibullying programs, the fairplayer manual and ViSC, although these effects were not statistically significant.

In relation to school‐bullying victimization outcomes, NoTrap! was associated with the largest mean effect size, followed by the BPYS Program, and then the OBPP. Our analysis identified that other antibullying programs were also significantly effective in reducing school‐bullying victimization, for example, Steps to Respect and KiVa.

Again, effect sizes for the OBPP varied between evaluations conducted in Norway and evaluations conducted in the United States for bullying victimization outcomes. Moreover, our analysis found that the difference in the magnitude of these effect sizes was statistically significant ( Q b   =  74.95; df  = 1; p  < 0.001). Our analysis also identified negative effects of the Second Step program in relation to bullying victimization outcomes. Evaluations of the ViSC program also had a negative effect on bullying victimization, although this effect was not statistically significant.

9.5.5. Unit of allocation/randomization

Table  14 outlines the mean effects for subgroups of studies according to how participants were allocated to experimental or control groups. Results are presented for bullying perpetration and victimization outcomes for all studies that allocated studies in classes, schools, or individual students. The mean effects for RCT and BAEC for each allocation unit are also presented separately.

Moderator analyses results: Unit of allocation/randomization

In relation to bullying perpetration outcomes, under the MVA model, studies that assigned participants in classes were associated with the largest effect sizes. However, the difference between the mean effect for all evaluations that used classes or schools as the unit of allocation were verging on statistically significance ( Q b   =  3.705, df  = 1, p  = .054). Under the random effects model, evaluations that assigned students to experimental conditions were associated with the largest effect size for bullying perpetration outcomes when all designs were included, and for RCT evaluations and BA/EC evaluations individually. However, the mean effect size for many of the subgroups were not collectively statistically significant overall under the random effects model.

Similarly, under the MVA model, evaluations conducted using a RCT design, and assigned classes to conditions, were associated with the largest effect size for bullying perpetration, although the mean group for this subgroup was not statistically significant. Moreover, moderator analysis analogous to the ANOVA found that the difference in the mean effect size for RCT designs that assigned classes to experimental and control conditions were not statistically different to RCT designs that assigned schools to experimental and control conditions ( Q b   =  1.140, df  = 1, p  = .286 ) .

In relation to BAEC designs, evaluations that assigned students to experimental conditions were associated with the largest mean effect size, although the effect was not statistically significant. However, the difference between the mean effect for BAEC evaluations that assigned classes and those that assigned schools to conditions was statistically significant under the MVA model ( Q b   =  4.551, df  = 1, p  = .033).

For bullying victimization outcomes, studies where the unit of allocation was classes of participants were associated with the largest effect sizes, followed by schools and individual students under the MVA model. The difference between studies that allocated classes and studies that allocated schools was statistically significant ( Q b   =  12.450, df  = 1, p  < .001). This pattern was observed when all designs were included, and for the subgroup of RCT evaluations and the subgroup of BA/EC evaluations. Thus, when participants were assigned in classes the mean effect size for these RCT evaluations were significantly associated with larger effect sizes ( Q b   =  13.590, df  = 1, p  < .001) for reductions in bullying victimization than RCT evaluations that assigned schools. Yet the difference between the mean effect sizes for BA/EC evaluations that assigned classes were not statistically significant ( Q b   =  3.359, df  = 1, p  = .067) than BA/EC evaluations that assigned schools to experimental conditions.

9.5.6. Conflict of interest

COI was a categorical moderator variable with three levels: high‐risk (H), low‐risk (L), and possible‐risk (P). Moderator analysis analogous to the ANOVA was conducted so as to assess the differences between evaluations on each level. Studies categorized as possible‐risk on COI variable were excluded from subgroup comparisons to establish the differences between evaluations that were clearly high‐risk and evaluations that were clearly low‐risk. Table  15 outlines the mean summary effects for each group for both bullying perpetration and bullying victimization outcomes.

Moderator analyses results: Conflict of interest

Note : Four studies and six studies were excluded from the present moderator analysis for perpetration and victimization outcome respectively as not enough information was available.

Moderator analyses found that the difference between high‐risk and low‐risk studies on COI variable was statistically significant for bullying perpetration outcomes under both the MVA model ( Q B  = 50.129; df  = 1; p  < .001) and the random effects model ( Q B  = 4.900; df  = 1; p  = .027). This suggests that evaluations considered to have high COI were associated with larger overall effect sizes for bullying perpetration. Similarly, high‐risk COI studies were significantly associated with slightly larger effect sizes for bullying victimization in comparison to low‐risk COI studies when compared under both the MVA model ( Q B  = 16.127; df  = 1; p  < .001) and the random effects model ( Q B  = 4.449; df  = 1; p  = .035).

9.5.7. Program specificity

The majority of evaluations included in our meta‐analysis were of highly specific intervention programs, that is, those that targeted bullying behaviors and no other outcomes. Consistently across computational model and both perpetration and victimization outcomes these subgroups were associated with the largest mean effect sizes. These results are presented in Table  16 . Additionally, highly specific programs were the only subgroup of evaluations that gave a statistically significant mean summary effect under both the MVA model and the random effects model for bullying victimization outcomes. In relation to bullying perpetration outcomes, the subgroup of evaluations that were coded as “medium” on the program specificity moderator were associated with a statistically significant mean effect size under the MVA model ( p  < .001) and the random effects model ( p  = .036).

Moderator analyses results: Program specificity

10. DISCUSSION

10.1. summary of main findings.

Overall, our updated meta‐analysis found that school‐based antibullying programs are effective in reducing both school‐bullying perpetration and victimization. For school‐bullying perpetration the weighted mean OR = 1.324 under the MVA model, or OR = 1.309 under a random‐effects model (RE) were associated with reductions of approximately 19–20%. 9 In comparison, the weighted mean ORs for bullying victimization outcomes were 1.248 and 1.242 under the MVA model and the random effects model respectively. These mean effect sizes correspond to an approximate reduction in bullying victimization of 15–16%. These results suggest that the included interventions were slightly more effective at reducing school‐bullying perpetration than school‐bullying victimization.

The results of this meta‐analysis are consistent with findings from most of previous reviews that indicate that antibullying programs have a small but significant effect, with some variations in overall results being attributable to methodological differences in inclusion and exclusion criteria (Ttofi et al.,  2014 ). Our mean effect sizes are also consistent with the earlier review (Farrington & Ttofi, 2009 ; Ttofi & Farrington,  2011 ), although the differences further outline that moderator variables such as methodological design may be responsible for variability. For example, the weighted mean effect sizes for both bullying perpetration and bullying victimization outcomes estimated in the earlier Campbell report were larger than those estimated in the present report.

Yet, we included publication year as a categorical moderator variable in the present analysis. We found that more recent studies (i.e., those that were not included by Farrington & Ttofi,  2009 ) were significantly different to studies that were included in the earlier review. Namely, recent studies were actually associated with significantly larger effect sizes for both bullying perpetration and victimization outcomes (see Section 8.5.3).

Therefore, as we excluded studies considered to have utilized less scientifically rigorous methodological designs this may explain the differences in the weighted mean effect sizes. Specifically, we excluded evaluations conducted using “other experimental‐control designs,” described in the earlier review as evaluations in which participants were assigned to experimental and control conditions but bullying outcomes were only measured after implementation of the intervention. Thus, attributing any change in behaviors to the intervention is potentially risky because there may be other reasons why a positive effect of the intervention was observed. For example, the experimental and control groups were not comparable at baseline, but this remains unknown as no measure of bullying was obtained.

Thus, the inclusion of these less methodologically rigorous evaluations may explain why the weighted mean effects sizes reported in the earlier review were larger than those reported in the current report, but our moderator analysis found a contradictory pattern. The following sections of this report will aim to discuss the findings obtained by our moderator analyses and also the strengths and limitations of the current analysis and potential avenues for future research. The heterogeneity in this meta‐analysis was very large for both bullying perpetration and victimization outcomes. This may suggest that there was a wide range of effects across programs and we may not be able to explain differences using moderator analysis.

10.2. Moderator analyses

10.2.1. evaluation method.

Under both the MVA and random effects models, evaluations conducted using age cohort designs were identified to be, collectively, the most effective, or at least associated with the largest mean effect sizes. This is consistent with Farrington and Ttofi's ( 2009 ) review. This methodological design was first introduced as an evaluation design for the OBPP (Olweus,  1991 ). This approach has been criticized for the potential threats to internal validity, history and testing effects (Farrington & Ttofi,  2009 , p. 15). It has been suggested that this design avoids the threats of aging and maturation effects, as individuals within the same school act as a control group for same‐aged experimental participants (Olweus,  2005a ). However, this design is vulnerable to cross‐contamination between experimental and control participants which would impact the overall effectiveness. Notably, intervention researchers have tested the OBPP with other methodological designs (e.g., Bauer et al.,  2007 ) which resulted in smaller effects.

Interestingly, the pattern between RCTs and BA/EC designs was less clear. In relation to bullying victimization outcomes, evaluations using BA/EC designs appear to be more effective than evaluations using RCT designs. However, for bullying perpetration outcomes, evaluations using RCT designs appear to be more effective than evaluations that utilized BA/EC designs. Further research is needed to understand these effects. However, the nature of these analyses is correlational and the differences between effect sizes are marginal. Thus, no concrete conclusion can be drawn in relation to the association between randomized and nonrandomized quasi experimental designs and effect size in the present context.

10.2.2. Unit of allocation/randomization

In theory, RCTs are the best method of evaluation of interventions because random allocation ensures that any observed differences between experimental and control groups occurs as a result of experimental manipulation, thus giving the best possible internal validity (Farrington,  1983 ,  2003 ). However, the unit of random allocation can have an impact on internal validity. For example, we assume that individuals are randomly assigned to experimental and control conditions, so that RCT designs adequately account for the random variation that occurs in real‐world research (Weisburd,  2003 ).

However, in practice, evaluations of antibullying programs may be more likely to assign groups of individuals, for example in terms of classrooms or schools, to experimental conditions rather than individual students. This is true for both randomized (e.g., classrooms, Chaux et al.,  2016 ; or schools, Espelage et al.,  2015 ) and nonrandomized (e.g., classrooms, Ortega‐Ruiz et al.,  2012 ; or schools, Rawana et al.,  2011 ) methodologies. When this is the case, we need larger numbers to ensure adequate statistical conclusion validity and avoid issues of selection effects and differential attrition (Farrington & Ttofi,  2009 ; Ttofi & Farrington,  2011 ). There was a lot of variation in the unit of allocation in our primary studies, which may explain why we did not find that one methodological design was more effective than another.

Moreover, the majority of included evaluations did not use the same unit for allocation and analysis, thus, posing a threat to our results. We approach the results therefore with caution, favouring more conservative estimates. Furthermore, the relationship between the unit of randomization/allocation moderator variable and the effect sizes for bullying perpetration and victimization outcomes was unclear. Whether or not the differences between subgroups of evaluations that assigned classes or schools to experimental conditions were statistically significant or not depended on the computational model used and the bullying outcome in question. For bullying perpetration, the differences between studies based on unit of allocation were not statistically significant for randomized and nonrandomized studies. For bullying victimization outcomes, studies where classes were the unit of allocation were associated with the largest effect sizes when all designs where included and for randomized evaluations, but not for nonrandomized evaluations, separately.

Risk of bias analysis also found that a large number of RCT studies were categorized as being high risk for allocation‐related items on the EPOC tool. Therefore, the differences observed between primary evaluations in our meta‐analysis may be due to the observation that largely the unit of allocation and the unit of analysis were not the same in primary studies. However, further analysis and investigation is needed to better understand these results.

10.2.3. Location of intervention

Overall, the results of our meta‐analysis are consistent with previous findings and show that school‐based antibullying programs have a modest but significant effect in reducing bullying behaviors. However, our meta‐analysis included evaluations of antibullying programs from a wide range of countries and specific intervention programs, far more than previous meta‐analyses (e.g., Cantone et al.,  2015 ; Chalamandaris & Piette,  2015 ; Evans et al.,  2014 ; Jiménez‐Barbero et al.,  2012 ,  2016 ). As a result, the results of this meta‐analysis are robust and have implications for bullying research globally.

Our analysis identifies that antibullying programs worldwide are effective in reducing school‐bullying perpetration and victimization by significant amounts. Moreover, evaluations in different countries appear to vary in effectiveness. In Greece, where evaluations included in our meta‐analysis were associated with the largest effect sizes, school‐bullying perpetration behaviors were reduced by approximately 40%. Evaluations conducted in the Norway, Italy and the United States were also effective in reducing bullying perpetration by approximately 21–25%.

Antibullying programs implemented and evaluated in Italy were associated with the largest reduction in school‐bullying victimization in our meta‐analysis, with the odds ratio effect size corresponding to an approximate reduction of 31%. Moreover, evaluations conducted in Spain and Norway reduced school‐bullying victimization by approximately 28% and 23%, respectively. Evaluations conducted in Finland, Germany and the UK were also significantly effective, although less so, reducing school‐bullying victimization by approximately 8–12%.

There are many potential explanations for the differences in effectiveness observed between countries. For example, definitions of school‐bullying, and behaviors that constitute bullying, differ between countries. Previous research conducted by Smith et al. (2000) showed that school‐bullying is perceived differently across different countries and cultures and this may explain variability in bullying reporting. Definitions of school bullying, and behaviors that constitute bullying, differ between countries. For example, Smith et al. ( 2016 ) showed that school bullying in Eastern cultures manifests more often as exclusion or isolation of an individual victim. In comparison, school bullying in Western cultures comprises a wider range of physical, verbal and relational forms of aggression.

Our meta‐analysis included several examples of cases where the same intervention program was evaluated in different countries (e.g., KiVa program in Finland (Kärnä et al.,  2013 ) and in Italy (Nocentini & Menesini, 2016)). While societal practices, educational systems, and individual lifestyles may differ greatly, some argue that there may be some support for the cross‐national applicability of specific intervention programs. However, there is a current lack of existing research comparing the effectiveness of specific interventions in specific countries.

Previous research has indicated that are also cultural differences in bullying behaviors among adolescents (e.g., Smith et al.,  2016 ). As such, an antibullying program to reduce these behaviors may be impacted by these differences. This is particularly evident when we observe the variations in effect sizes for the OBPP (Olweus,  1993 ) and the KiVa antibullying program. These programs may be the most well‐known antibullying programs that are commercially available, and as such as the only examples in our review of interventions evaluated in completely different locations.

The OBPP program was originally designed and implemented in Norway, and it is therefore not surprising that the OBPP program appears to be effective in reducing both school‐bullying perpetration and victimization when evaluated in Norway, compared to evaluations in the United States (see Table  13 ). While the program was still significantly effective in the United States, the percentage decrease in school‐bullying perpetration was roughly 25% and in school‐bullying victimization was roughly 11%. These figures are lesser in comparison to the decreases in bullying behaviors seen in Norwegian evaluations (35% perpetration; 29% victimization). These differences could be attributed to different evaluation methodologies (see Gaffney et al., 2019), however, they most likely reflect cultural and societal differences between youth in Norway and youth in the United States.

Interestingly, the opposite is observed with the KiVa program. When KiVa was evaluated in Finnish samples, the program was effective in reducing school‐bullying perpetration by approximately 4–5% and school‐bullying victimization by approximately 6% (Kärnä et al.,  2011a ,  2011b ,  2013 ). However, when evaluated in Italian primary and secondary schools, the effect sizes were much larger. Nocentini and Mensini (2016) found that KiVa was effective in reducing school‐bullying perpetration by approximately 15–20% and school‐bullying victimization by approximately 25%.

In the case of KiVa, each of the evaluations used the same methodology (i.e., RCT), but varied greatly in the sample size. Thus, further research is needed to explain why some interventions (e.g., OBPP or KiVa) appear to be more effective in some samples compared to others. The programs are still effective, but the variation in effect size could be attributable to a number of different methodological and implementation factors that warrant further exploration.

10.2.4. Intervention program

Following this logic, we also explored the effectiveness of the specific antibullying programs. Out of the four most widely disseminated antibullying programs included in our review (i.e., KiVA, NoTrap!, OBPP, ViSC), the OBPP was collectively the most effective in reducing school bullying perpetration of these. Across 11 evaluations, the OBPP reduced bullying perpetration by approximately 26%, which was larger than any other widely disseminated program.

In relation to school‐bullying victimization outcomes, the NoTrap! program was the most effective, reducing victimization by around 37%. NoTrap! also reduced bullying perpetration by a considerable amount, approximately 22%, but this effect was not statistically significant. The KiVA program, significantly reduced school bullying perpetration by approximately 9% and school bullying victimization by approximately 11%. The ViSC program was the only program to increase bullying perpetration (by roughly 4%) and bullying victimization (by roughly 4%) although these effects were not statistically significant.

Another moderator we used to code differences between included evaluations was the specificity of the intervention program. In other words, we evaluated each intervention program on how specific it related to bullying behaviors. Unsurprisingly, our findings suggest that antibullying programs gave the largest overall effect sizes. While the significance of the differences between subgroups was not computed due to the large discrepancies between the numbers of evaluations included in each subgroup.

However, our inclusion criteria for the current report was strictly concerned with school‐bullying intervention programs and behavioral outcomes of bullying. As such, we may have overlooked effective programs that only included nonbehavioral outcomes of bullying (e.g., attitudes toward bullying, awareness of bullying) or other problem behaviors (e.g., peer aggression or victimization, mental health issues, juvenile delinquency, etc.) that occur among young people in schools. Changes in these behaviors may also impact bullying, either directly or indirectly, yet, more research is needed to understand this potential effect. Most obvious in the present report is how programs that target specifically school‐bullying may impact cyber‐bullying, and vice versa, given the significant overlap in the prevalence of these behaviors (Baldry et al.,  2017 ).

Further research is also needed to better understand specifically “what works” in these “specific interventions.” In the previous review, (Farrington and Ttofi  2009 ; Ttofi & Farrington,  2011 ) conducted detailed coding of interventions and evaluations and analyzed how effect sizes varied between components and features of primary studies. For example, parent training, playground supervision, and more intense and longer programs were significantly correlated with larger reductions in bullying perpetration (Ttofi & Farrington,  2011 ). Moreover, several intervention components were associated with larger reductions in bullying victimization (e.g., videos, disciplinary methods, co‐operative group work and more intense and longer programs). Therefore, an important avenue for future research is to assess the differences in effectiveness of antibullying programs according to specific intervention components across the 100 evaluations included in our meta‐analysis. Such research would have important implications for policy and the development of future antibullying programs.

Additionally, it appears that since 2009 several large‐scale antibullying programs have been implemented and evaluated (e.g., KiVa; Kärnä et al.,  2013 ; NoTrap!; Menesini et al.,  2012 ; Palladino et al.,  2016 ). Because there is typically more information available on the specific components of these programs, we may be able to code more specific details in future analyses. For example, many studies may fit the criteria for “parent training,” but there is a significant difference between the intensity of parental involvement. For example, some studies may include parents merely by sending letters home with participant children (e.g., Brown et al.,  2011 ), while others include parents more actively by holding information evenings or requiring children to complete take‐home tasks with parental involvement (e.g., Berry & Hunt,  2009 ; Domino,  2013 ).

Earlier research highlighted how varying levels of implementation of each intervention component may explain variability in intervention outcomes (Bloom et al.,  2003 ). Interestingly, a narrative review by Smith et al. ( 2003 ) reported that although 14 whole‐school antibullying programs obtained modest effects overall, those that monitored implementation obtained twice the mean effects on self‐reported rates of bullying and victimization than those that did not monitor implementation. Thus, additional analyses are required to better understand specifically what works in existing antibullying programs and the underlying mechanisms of behavioral change

10.2.5. COI and publication type

Possibly the most conclusive results from our moderator analyses were observed in relation to COI and publication type. First, across both computational models and outcomes, studies that were categorized as being high‐risk for COI were associated with significantly larger reductions in bullying perpetration and victimization. Second, under the MVA model of meta‐analysis, non‐peer‐reviewed evaluations were associated with significantly larger reductions in both bullying perpetration and victimization outcomes. However, the same results were not observed under the random effects.

We examined COI in terms of the involvement of the program developer in the evaluation. Our results may indicate possible sources of biases. For example, it may be that when the individual, or team, that are credited with developing an antibullying program are also involved in the evaluation of said intervention, biases such as confirmation bias may impact the results. However, it may not be a perceivably “negative” source of bias. Perhaps, when the program developer is involved in the implementation of the program, the intervention is simply delivered better and more effectively. There are a number of other factors that could also be affected and in turn impact the effect size, such as teacher and staff efficacy and motivation to participate the in the program.

There are more sophisticated measures of COI (e.g., Eisner et al.,  2012 ) that include elements such as whether or not the evaluator could potentially benefit financially from the intervention program. Further indicators of COI are thus needed to better understand the impact on evaluation results. For example, our findings in relation to COI and larger effect sizes may be explained as: evaluations in which the program developer was included appear to be more effective because of the expertise and intricate knowledge of the developer. Therefore, the results may reflect differences in the quality of program implementation rather than troublesome biases. Additional research is needed.

10.3. Limitations and avenues for future research

Like most meta‐analyses, the current report is largely limited by the lack of understanding as to what is the “true effect.” When comparing mean effect sizes between moderators for example, it is difficult to determine the validity of the result. Throughout our discussion of result we discuss that one subgroup of studies was associated with larger or smaller effect sizes than another, and the statistical significance of these differences. Thus, we avoid saying studies in subgroup A (e.g., evaluations conducted in Greece) are more effective than studies in subgroup B (e.g., evaluations conducted in Italy). Due to the correlational nature of our moderator analyses we cannot make causal inferences. In addition to this limitation, and those previously discussed (Section  9.2 ), the following section of this report discusses some further limitations.

10.3.1. Measurement of bullying

Experts in the area of school‐bullying research have outlined how there still remain issues of comparability in the assessment of school‐bullying perpetration and victimization (Volk et al.,  2017 ). Studies included in the present meta‐analysis used a wide variety of quantitative measures of school‐bullying behaviors, including self‐report measures (e.g., the Revised Olweus Bully/Victim Questionnaire—Olweus,  1986 ,  1996 ), or peer‐report measures (e.g., the Participant Role Questionnaire—Salmivalli et al.,  1996 ). One issue that arises is that the timeframe within which participants are required to indicate the frequency of bullying can vary greatly. One scale may ask about bullying experiences within the last 3 months, while another may ask about ever having experienced, or participated in, school‐bullying. Moreover, included studies utilized a mixture of continuous or dichotomous measures of school‐bullying, and the cut‐off points used to categorize someone as either a bully, victim, or not‐involved also varied.

Furthermore, the majority of evaluations included in our analysis reported bullying outcomes at different time points, largely, before implementation, after implementation, with a possible additional follow‐up time point. However, we computed effect sizes using measures of bullying taken before implementation and immediately post implementation of the intervention. Therefore, we cannot generalize results to the long‐term effectiveness of antibullying programs, or any potential influence of dose‐response effect. Future research should aim to examine the longitudinal effectiveness of interventions to reduce bullying perpetration and victimization in the long‐term.

When conducting our systematic searches for the present review, we did not set restrictions based on measurement issues, other than including quantitative measures of school‐bullying behaviors. However, types of reports, for example, could influence the overall effectiveness effect size. This may possibly explain why our meta‐analysis found that programs are more effective in reducing bullying perpetration outcomes. For example, if programs are concerned with raising awareness about bullying and the associated negative impact on victims, participants who reported bullying perpetration before the intervention may be less likely to self‐report bullying behaviors after completing the program. As a result, the intervention may be perceived as being effective, but the change in reports of bullying may have been a result of social desirability responding (He et al.,  2015 ; Rigby & Johnson,  2006 ). Conversely, raising awareness on the negative impact of school bullying may lead to increased reporting of victimization due to sensitization effects (Stevens et al.,  2000 ). Notably, sensitization effects due to raised awareness may affect not only self‐report data but also peer nomination data and teacher reports (Smith et al.,  2003 , p. 597). Therefore, future research could aim to examine whether the style of report used, differing cut‐off points and varying timeframes affect estimations of intervention effectiveness.

10.3.2. Cyberbullying behaviors

Another key limitation of the present review is the omission of cyberbullying behaviors. Prominent researchers in the area have argued that cyberbullying behaviors do not warrant a completely separate line of study, because of the significant overlap between offline and online bullying (Olweus & Limber,  2017 ). A recent meta‐analysis of cyberbullying intervention and prevention programs found that, out of studies assessing various facets of cyberbullying, a large number were concerned with this overlap (Gaffney et al., 2019). The Gaffney et al. (2019) meta‐analysis concluded that anticyberbullying programs were effective in reducing cyberbullying perpetration by roughly 9–15% and cyberbullying victimization by roughly 14–15%. As illustrated in that other review, there is a need for future research to assess the effectiveness of intervention programs that target both online and offline bullying concurrently. As a result of the significant overlap (e.g., Waasdorp & Bradshaw, 2015), it is important for policy makers, researchers, and program developers to know whether or not these forms of aggressive behaviors should be targeted together or individually. Future research should aim to examine the effectiveness of programs designed to reduce school‐bullying on cyberbullying outcomes, and vice versa. Additional analysis to examine the differences between programs that target offline and online behaviors concurrently in terms of effectiveness to reduce both school‐ and cyber‐bullying is also needed.

10.3.3. Models of meta‐analyses

The current report presents findings using two computational models of meta‐analyses: the random effects model and the multiplicative variance adjustment model. While, the random effects model is often suggested as the preferred model for meta‐analyses in social sciences, for reasons already discussed (Section  7.3 ), this approach is also limited. However, even though many meta‐analyses in medical sciences (e.g., Ayieko et al.,  2014 ; Dorjee et al.,  2018 ; Woolf‐King et al.,  2013 ) have used the MVA model as an alternative method of accounting for between‐study heterogeneity in weighted mean effect sizes, this model is yet to be widely accepted in behavioral sciences. A number of recent publications (e.g., Portnoy & Farrington,  2015 ; Zych et al.,  2019 ) have begun to use the MVA model.

It is evident in the current report that the results are influenced by the computational model used. The overall mean effect sizes for bullying perpetration and victimization were not that different under both models but the results of moderator analyses were greatly influenced by how we accounted for the between‐study heterogeneity. Further research is needed in order to examine the reasons for this and also evaluate how best to choose an appropriate computational model when conducting a meta‐analysis.

10.4. Concluding remarks

This report presents an updated systematic and meta‐analytical review of the effectiveness of school‐bullying intervention and prevention programs. Overall, our review found that school‐based antibullying programs are effective in reducing both bullying perpetration and bullying victimization, and that effect sizes can vary according to several moderator variables. However, further research is needed to better understand the reasons for variation in observed effect sizes. Research is needed to investigate the specific components of antibullying programs that work best to reduce bullying behaviors. The results of our meta‐analysis have important implications for policy and the development of future antibullying programs, but future research should aim to better understand the effective mechanisms in bullying intervention and prevention.

11. TECHNICAL APPENDICES

11.1. calculating the before‐after intervention effect.

Williams et al. ( 2015 ) evaluated the effectiveness of the Start Strong program based on students' self‐reported experiences of bullying victimization. The primary study found that, at baseline, 23% of participants in the experimental group ( N  = 717) reported bullying victimization, while 23% of participants in the control group ( N  = 800) also reported bullying victimization at baseline. Hence, the baseline OR was calculated as follows (Table  17 ):

Data used to estimate baseline odds ratio

Thus, the OR before  = 0.999, Ln OR before  = −0.002, and var Ln OR before  = 0.015. Williams et al. ( 2015 ) report that after implementation of the Start Strong program, bullying victimization was reported by 28% of experimental participants and 34% of control participants. Accordingly, the posttest OR was calculated as follows (Table  18 ):

Data used to estimate postintervention odds ratio

Thus, the OR after  = 1.323; Ln OR after  = 0.28; and var Ln OR after  = 0.013. Employing these figures, the ln OR for the intervention effect of the Start Strong program was calculated as:

The ln OR change is computed as the difference between the before and after effect size and the variance of this new estimate is adjusted by multiplying the sum of the variances of before and after variances by 0.75. This is an approximation of the assumed correlation between before and after effect sizes. The ln OR change and the SE of ln OR change were then entered into CMA as an estimation of the intervention effect.

11.2. Multiplicative variance adjustment

In the present meta‐analysis, the summary effect size estimated for bullying perpetration was OR = 1.324 with 95% confidence intervals of 1.298–1.351 under a fixed effects model. The effect size in the MVA model is the same as the effect size in the fixed effects model. The variance of the effect size in the MVA model is calculated as follows:

Therefore, in the above example of the summary effect size for bullying perpetration outcomes, the FE var is 0.000104. Therefore, with Q  = 458.555 and df  = 109, the MVA adjustment for fixed effects is 0.02098, calculated as:

Therefore, the adjusted standard error is 0.0209. In this example thus, the MVA fixed effect is OR = 1.324, and the 95% confidence intervals are 1.271–1.380.

11.3. Odds ratio to percentage conversion

The conversion from weighted mean odds ratio to percentage value is also described in the previous Campbell report (see Farrington & Ttofi, 2009 ). The formula involves assuming equal allocation of participants to experimental and control conditions and that the % of bullies and/or victims was lesser in the experimental condition than in the control condition (as supported by our overall positive mean effect size).

For example, if there are 200 participants in each experimental condition and approximately 30% of participants report bullying victimization in the control condition and 25% victims in the experimental condition, the numbers of victims and nonvictims would be as follows: (Table  19 ).

Data used to convert odds ratio to percentage

Therefore using the previously described formula for estimating an odds ratio, the following data would correspond to an odds ratio of 1.286 (i.e., [150 × 60]/[140 × 50]). Moreover, the percentage decrease would be approximately 16.67% (i.e., (10/60) × 100).

Using this basic formula, we can manipulate the % and number of victims in each experimental condition in order to achieve a odds ratio that corresponds to our weighted mean effect size (i.e., MVA: OR = 1.324 and RE: OR = 1.309 for bullying perpetration; MVA: OR = 1.248 and RE: OR = 1.242 for bullying victimization). Using the n values that give the closest possible mean effect size we can thus estimate the corresponding percentage reduction in either bullying perpetration or victimization outcomes.

APPENDIX A. 

Appendix: full search syntax, database: web of science.

Bully* AND Intervention AND Evaluation

Anti‐Bullying AND School AND Program* AND Evaluation

Anti‐Bully* AND Program* AND Outcome

Bully‐victim AND Prevention AND Evaluation

Bully* AND School AND Intervention

Bully* AND School AND Prevention

Database: Scopus

Bully* AND School AND Program*

Bully* AND School AND Evaluation

Bully* AND School AND Intervention AND Evaluation

Bully* AND School AND Prevention AND Evaluation

Anti‐bullying AND Program* AND Evaluation

Database: National Criminal Justice Reference Service

Bully* AND Prevention AND Evaluation

Anti‐bullying AND Program* AND Effect*

Database: PsycINFO

Bully* AND Intervention AND Program* AND Evaluation

Bully* AND Prevention AND Program* AND Effect*

Database: Cochrane Controlled Trials Register

Bully* AND Intervention AND Program*

Bully* AND Prevention AND Program AND Evaluation

Database: British Education Index

Bully* AND Prevention AND Program* AND Evaluation

Bully* AND Intervention AND Program* AND Effect*

Database: Embase

Database: medline, database: eric & criminal justice abstracts.

www.scholar.google.co.uk

APPENDIX B. 

Appendix: risk of bias results for included studies.

Note : H, hig risk, score 3; L, low risk, score 0; U, unclear risk, score 2. Risk of bias score is estimated as sum of scores on individual risk of bias items.

Abbreviations: AC, Allocation concealment; AS, Allocation sequence; BC, Baseline Equivalence on Characteristics; BE, Baseline Equivalence of Outcome; BOA, Blind Outcome Assessment; CP, Contamination Protection; ID, Incomplete Data; SOR, Selected Outcome Reporting.

Gaffney, H., Ttofi, M. M., & Farrington, D. P. (2021). Effectiveness of school‐based programs to reduce bullying perpetration and victimization: An updated systematic review and meta‐analysis . Campbell Systematic Reviews , 17 , e1143. 10.1002/cl2.1143 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]

Systematic review

Plain language summary on the Campbell website

1 The authors regret that more detailed information concerning specific combinations of keywords and databases searched as per the Campbell MECCIR reporting standards. This information is held on restricted access computers and due to COVID‐19 pandemic, the closure of University buildings, this data could not be retrieved.

2 Web of Science Core Collection database.

3 Unfortunately detailed information about the datas of searches cannot be provided for this review, contrary to MECCIR R35.

4 We were unable to double code in this review. However, as some studies were included in the present review and an earlier review (Farrington & Ttofi,  2009 ), a proportion of the studies were double‐coded.

5 A worked example is provided in Technical Appendix 10.1.

6 Calculated as: total number of students/number of classrooms.

7 A worked example of this adjustment is provided in Technical Appendix 10.2.

8 Moderator analyses under the MVA model will be greatly affected by the presence of very large studies in the meta‐analysis. Unfortunately, we were not able to follow recommendations made by the methods editor to windsorize weights or conduct sensitivity analyses by removing these large studies. Due to the COVID‐19 pandemic the software to carry out these tests was not available to us. Thus, the reader should consider the impact of large studies when interepting the results of moderator analyses under the MVA model.

9 The procedure used to estimate approximate percentage values for weighted mean odds ratios is provided in Technical Appendix 10.3.

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REFERENCES TO EXCLUDED STUDIES

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• Open access
• Published: 16 May 2024

Perceived school bullying and psychotic-like experiences in sexual minority adolescents: the mediating and moderating roles of resilience

• Dongfang Wang 1   na1 ,
• Xiao-Yan Chen 2   na1 ,
• Andrew Scherffius 3 ,
• Zhijun Yu 1 ,
• Xuan Wang 1 ,
• Meng Sun 4 &
• Fang Fan 1 , 5  

Child and Adolescent Psychiatry and Mental Health volume  18 , Article number:  55 ( 2024 ) Cite this article

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Metrics details

This two-wave, longitudinal study aimed to examine the potential moderating and mediating effects of resilience on the association between perceived school bullying and psychotic-like experiences among Chinese sexual minority adolescents.

A total of 4192 senior high students were included and 984 (23.5%) of them were identified as a sexual minority (mean age = 16.68 years, SD = 0.71). Participants completed two online surveys during April 21 to May 12, 2021 and December 17 to 26, 2021, respectively, as well as completed self-report measures of sample characteristics, perceived school bullying, resilience, and psychotic-like experiences (including two dimensions: delusional experiences and hallucinatory experiences).

Perceived school bullying and resilience were associated with psychotic-like experiences in sexual minority adolescents. Resilience mediated the relationship between perceived school bullying and subsequent psychotic-like experiences (b = 0.03, 95% CI = 0.01 ~ 0.04)/ delusional experiences (b = 0.03, 95% CI = 0.01 ~ 0.04)/ hallucinatory experiences (b = 0.02, 95% CI = 0.01 ~ 0.03). Additionally, resilience only moderated the associations of perceived school bullying with hallucinatory experiences (b = −0.06, 95% CI = −0.12 ~ −0.01).

Conclusions

These findings indicated that resilience plays a crucial role in mediating or moderating the relationship between perceived school bullying and psychotic-like experiences. Assessing and reducing school bullying, as well as promoting resilience, may have important clinical implications for reducing the risk of psychotic-like experiences in sexual minority adolescents.

Introduction

Psychotic-like experiences (PLEs) are defined as experiences that resemble the positive symptoms of psychosis in the absence of a full-blown psychotic disorder [ 1 ]. A growing body of research has focused on PLEs in children and adolescents, because PLEs at an early age often predict the later onset of serious psychopathology [ 2 , 3 , 4 ]. Indeed, PLEs are common in youth and adolescent samples, with 17% of children 9 ~ 12 and 7.5% of adolescents aged 13 ~ 18 years having PLEs [ 5 ], which was significantly higher than in the adult population (~ 5%) [ 6 , 7 ]. In China, one survey of 5427 adolescents showed that 95.7% of adolescents had had at least one PLE during their lifetime, while 17.2% continued to experience frequent PLEs [ 8 ]. More recently, a large sample study showed that the prevalence of monthly PLEs was 15.4% among adolescents in urban China [ 9 ]. Given the relatively high prevalence of PLEs among adolescents and the strong predictability of psychological symptoms, it is necessary to explore their influencing factors in order to reduce their rates.

A recent meta-analysis of 23 studies from 8 countries suggests that the proportion of sexual minority adolescents in the studies ranged from 2.3 to 12% [ 10 ]. One recent study showed that 4.1% of Chinese adolescents self-reported as sexual minorities and 17.3% were unsure [ 11 ]. Compared to other demographic groups, sexual minorities may experience a greater frequency of PLEs. Based on the minority stress model [ 12 ], sexual minorities tend to suffer from excess stress (e.g., stigmatized social status, discrimination, and violence), which may lead to mental health issues, such as depression [ 13 ], anxiety [ 14 ], suicidality [ 15 ], and psychotic symptoms [ 16 ]. The association between sexual minority status and PLEs appears inconclusive. For instance, one study among the general population in England showed that non-heterosexual orientation was associated with greater risk of PLEs [ 17 ]. Oh (2021) reported that non-heterosexuality was positively associated with PLEs among Latin Americans in the general population, though the association was not significant among Asian American [ 18 ]. To date, however, this link has not yet been reported in adolescents, a group with a high incidence of PLEs.

Sexual minority adolescents are more likely to feel unwelcome or unsafe in school due to unsupportive policies and stigma [ 19 ]. Bullying is a subset of aggressive behavior, which is generally defined as behavior intended to inflict injury or discomfort upon another individual [ 20 ]. Socially, sexual minority status is a risk factor for bullying on school property [ 21 , 22 ]. In particular, Chinese sexual minority adolescents may perceive high levels of prejudice and rejection by their peers related to traditional Chinese social and cultural norms. A survey of Chinese high school students showed that the prevalence of school bullying experienced by gay and bisexual adolescents was as high as 25.9% and 16.2%, respectively, which was significantly higher than that of their heterosexual peers (12.1%) [ 23 ]. School bullying is a traumatic event that has been linked to increased adversity and mental health conditions [ 24 ]. For instance, a cross-sectional study of 623 high school students found that bullying in school led to the occurrence of PLEs [ 25 ]. Karcher and colleagues have found that children who endured a greater number of adverse childhood experiences, such as school bullying, experienced more PLEs [ 26 ]. While not all students experience bullying at school, the presence of bullying can make students feel threatened and powerless. Perceived school bullying can be understood as a subjective perception of bullying in schools, which directly reflects the safety of the school. One study has found that a strong association between perceived school safety and mental health problems in adolescents [ 27 ]. However, empirical data on the correlation between perceived school bullying and PLEs is lack.

Resilience generally refers to the adaptive ability to maintain an active life despite adversity and stressful event. In a compensatory model of resilience, it is acknowledged that there can be a direct positive effect of promotive factors on mental health outcomes, independent of the presence of risk factors [ 28 ]. The negative relationship between resilience and adolescent PLEs has been well elucidated [ 29 , 30 ]. Meanwhile, previous work on bullying and mental health problems also has raised a host of modalities (i.e., mediating or moderating) through which resilience is related to mental health problems. The mediating and moderating role of resilience has been evidence in previous work with different hypotheses and analytical methods [ 31 ]. Specifically, resilience is a process of dynamic change whereby external protective factors from family, school, and peer groups can enhance individual resilience, while exposure to risky environments can diminish it [ 32 ]. Thus, resilience mediates the relationship between school bullying and poor mental health [ 33 , 34 ]. On the other hand, resilience as an inherent personal attribute, it empowers individuals to thrive in the face of adversity [ 35 ]. The protective model of resilience supported that assets or resources moderate or reduce the effects of risks on a negative outcome [ 28 ]. In line with this model, some studies have showed that resilience can function as a moderator to buffer the negative effects of school bullying on mental health problems [ 36 , 37 ].

Accordingly, resilience can play a mediating role by being negatively affected by adverse life events, such as perceived school bullying, which in turn can influence the development of mental disorders. On the other hand, resilience can also act as a moderate factor, providing protection against mental health issues. While some studies have shown that resilience can both mediate and moderate the relationship between childhood adversity and poor mental health [ 38 , 39 ], these studies are limited by their cross-sectional designs, which make it difficult to establish causal inferences between variables. In this longitudinal study, sexual minority adolescents were surveyed in order to unpack the relationship linking perceived school bullying, resilience, and PLEs. Our major hypotheses are: (1) Perceived school bullying is positively significantly associated with PLEs in sexual minority adolescents; (2) Based on the dynamic process theory of resilience [ 32 ], resilience mediates the perceived school bullying-PLEs link; (3) According to the protective model of resilience [ 28 ], resilience moderates the perceived school bullying-PLEs link.

Participants and procedures

Data was extracted from the Mental Health Screening Program for Students in Bao’an district, Shenzhen (Guangdong province), China. This program aims to understand the mental health issues of primary and secondary school students in Bao’an district, Shenzhen in each semester through a convenience sample. Details of procedure can be found elsewhere [ 40 ]. In this study, only high school students were considered, so a total of 46 schools were included in the study. The data collection was conducted using the “Survey Star” system, which is a customized online platform developed specifically for this project by our team. Before each investigation, the local education bureau and target schools send the survey invitation letter to each participant and their guardians. Students and their guardians were required to agree and sign the informed consent form before participating in this study. Participants scanned the Quick Response (QR) code on their mobile phones to obtain an electronic version of the questionnaire to complete the survey. Student identities were anonymous across both surveys, and participants were permitted to interrupt or withdraw from the survey at any time. We also opened a psychological hotline (‘Xinqing’ hotline) to provide free help to students should they experience any psychological distress. After each survey, we provided training for all teachers to professionally respond to their students’ psychological needs. The investigation was carried out in accordance with the Helsinki Declaration as revised 1989 and approved by the Ethics Committees of South China Normal University (SCNU-PSY-2021-094).

Two surveys were included in this study. As shown in Fig.  1 , a total of 17,068 senior high school students (grades 10–12) were recruited in the first timepoint (Time1, T1: April 21 to May 12, 2021), and 21,841 students were recruited in the second timepoint (Time2, T2: December 17 to 26, 2021). To improve data quality, the exclusion criteria were as follows: (1) incorrect identity information, (2) short response time, (3) inconsistent survey contents, and/or (4) current mental health diagnoses that were either self-reported or reported by a teacher or guardian. A small number of participants met these exclusion criteria, leaving 16,907 and 21,716 students in the T1 and T2 sample, respectively. This study was a two-timepoint repeated cross-sectional survey with a nested longitudinal subsample. In T1 survey, students in the third year of senior high school (Grade 12) did not participate in T2 survey because they took the Chinese College Entrance Exam (i.e., Gaokao) in June 2021 and entered colleges/ universities. In T2 survey, the students of 10th graders did not participate in T1 survey, because they were still in junior high school when T1 survey started. Through data integration, a total of 4192 senior high students participated in all two web-based surveys and provided complete data on all measures. We used the χ 2 test to compare the prevalence of T1 PLEs between participants who provided complete data across two waves and those who did not participate in the second survey (T2). There was no difference between these two groups (13.9% vs. 14.7%, χ 2  = 1.35, p  < 0.254). Among the respondents, a total of 984 students were sexual minorities (23.5%), including 19 gay men, 204 bisexual men, 22 lesbian women, and 739 bisexual women.

Participation flow chart

Gender and sexual orientation

At T1, we obtained birth sex (male/female) of students from the local education bureau’s student status database. We reconfirmed participants’ gender orientation with one item (i.e., “What do you perceive your gender to be”) at T2. In this study, all participants fully identify with their biological sex (i.e., cisgender). Meanwhile, sexual orientation was used to evaluate by the single item Kinsey’s scale [ 41 ], which was back-translated into Chinese and has been validated in samples of Chinese adolescents [ 23 ]. Responses included 7 options: K0 = Exclusively heterosexual with no homosexual orientation; K1 = Predominantly heterosexual, only incidentally homosexual; K2 = Predominantly heterosexual, but more than incidentally homosexual; K3 = Equally heterosexual and homosexual; K4 = Predominantly homosexual, but more than incidentally heterosexual; K5 = Predominantly homosexual, only incidentally heterosexual; K6 = Exclusively homosexual. Respondents who chose mostly other sexual attraction (K1 and K2) and mostly same sexual attraction (K4 and K5) were categorized as having equally other and same sexual attraction (K3) [ 42 ]. To facilitate interpretation, we grouped the responses on the 7-point scale into three categories of sexual orientation: heterosexual (K0), homosexual (K6), and bisexual (from K1 to K5). Respondents with K1 to K6 scores were categorized as sexual minorities in this study.

• Perceived school bullying

Participants’ perceived school bullying at T1 was assessed through the school bullying subscale, which derived from the 2016 Version of Delaware School Climate Scale-Student (DSCS-S) [ 43 ]. This subscale had four items, as follows: Item 9: Students threaten and bully others; Item 14: Students worry about others bullying them; Item 24: Bulling is a problem; and Item 27: Students bully one another. Responses were made on a four-point scale, ranging from 1 = strongly disagree to 4 = strongly agree. A higher total score reflected more perceived school bullying. The Chinese version of DSCS-S has demonstrated satisfactory psychometric properties [ 44 ]. In our study, the Cronbach’s α of the school bullying subscale was 0.72.

Resilience was measured by the 10-item Connor-Davidson Resilience Scale (CD-RISC-10) [ 45 ] at T2. The item of CD-RISC-10 ranged from 0 = not true at all to 4 = true nearly all the time. A higher total score indicated greater resilience. The Chinese version of CD-RISC-10 has good reliability and validity [ 46 , 47 ]. The CD-RISC-10 has been widely used in studies exploring the moderating [ 48 , 49 ] or mediating role [ 50 , 51 ] of resilience. The Cronbach’s α was 0.97 in this study.

This study utilized the 8-item Positive Subscale of the Community Assessment of Psychic experiences (CAPE-P8) to measure current PLEs in both surveys. The CAPE-P8 originated in the Community Assessment of Psychic Experiences (CAPE) [ 52 , 53 ]. There are 8 items in CAPE-P8, six of which assess delusional experiences (DEs), with the remaining items measuring hallucinatory experiences (HEs). Each item was rated within a time-frame of the last one month on a four-point Likert scale, from 1 = never to 4 = nearly always. Higher scores represent higher levels of PLEs. The CAPE-P8 has described acceptable psychometric properties in the Chinese adolescent sample [ 54 , 55 ]. In the current study, Cronbach’s α scores were 0.89 and 0.91 at T1 and T2, respectively. Participants were categorized as having high frequent PLEs in the present study if they selected either “3-often” or “4-nearly always” or both items [ 9 ].

The controlled sample characteristics include age, school type, ethnicity, parental marital status, family income, single child status, parental education, chronic physical illness status, and family history of psychiatric illness.

Negative life events experienced over the past six months was assessed at T2 by the Adolescent Self-Rating Life Events Check List (ASLEC) [ 56 ], which was consisted of 27 items, and clustered into six dimensions: interpersonal conflicts, academic pressure, being punished, personal loss, physical health problems, and others. Each was rated on a five-point Likert scale from 1 (not at all) to 5 (extremely severe), with higher total scores reflecting a higher level of stress. The Cronbach’s α of the ASLEC was 0.96 in this sample.

Data analysis

We used SPSS 24.0 for all analyses. Descriptive statistics (Mann-Whitney U test and Chi-square test) were used to compare the sample characteristics and research variables between sexual minorities and heterosexual subjects. The Pearson correlation analysis was applied to examine the bivariate correlations between research variables. We tested for potential multicollinearity among all variables by variance inflation factor (VIF) [ 57 ]. We also conducted an exploratory factor analysis (EFA) to assess common method bias (CMB) [ 58 ]. The single factor explained by EFA did not explain more than 40% of the variance, indicating no significant CMB [ 59 ]. Furthermore, we tested the hypothetical mediation model using the PROCESS macro. We employed Model 4 to investigate the mediating role of resilience based on Hayes’ suggestions [ 60 ]. All continuous variables were standardized (converted to Z scores), which allows each variable to have the same range and variance. Such standardization procedures facilitate the comparison of results among different results. We entered T1 perceived school bullying as an independent variable, T2 resilience as the mediator, and T2 PLEs as the dependent variable. All demographic characteristics, baseline PLEs (T1), and negative life events (T2) were included as covariates in the analysis. In model analysis, the 5000 bootstrapping resamples method could provide 95% confidence intervals (95% CI) to estimate both direct and indirect effects simultaneously. Similarly, we explored the moderating effect of resilience using Model 1 [ 60 ]. We entered T1 perceived school bullying as an independent variable, T2 resilience as the moderator, T2 PLEs as the dependent variable, and all sample characteristics, baseline PLEs (T1), and negative life events (T2) as covariates. In addition, we have conducted separate analysis on the two dimensions (i.e., DEs and HEs) of PLEs as dependent variables to further examine if the results remain consistent across both dimensions.

Descriptive statistics

The current study included 4192 senior high students, 984 of whom were sexual minorities (23.5%). Within the sexual minority sample, only 4.2% students ( N  = 41) reported they were homosexual, whereas 95.8% reported being bisexual ( N  = 943). The proportion of girls (22 lesbian women; 739 bisexual women) was much higher than boys (19 gay men; 204 bisexual men) (77.3% vs. 22.7%). The age of sexual minorities ranged from 14 to 19 years; the mean (SD) age was 16.68 (0.71) years. The vast majority of participants are of Han ethnicity and 22.3% were from single-child families. Other sample characteristics of sexual minorities are reported in Table  1 .

The sample characteristics of the sexual minority group and of other adolescents are also shown in Table  1 . The two groups were significantly different in terms of sex, parental marital status, father’s educations, mother’s educations, chronic physical illness, and family history of psychiatric illness. Details can be found in Table  1 .

Table  1 also outlined that compared to their heterosexual peers, sexual minority students scored much higher on T1 perceived school bullying, T1 PLEs, and T2 PLEs, whereas they scored lower on T2 resilience. In addition, Sexual minority adolescents report more frequent PLEs at T1 and T2 than heterosexuality adolescents.

The VIF of T1 perceived school bullying, T2 resilience, and T2 PLEs were 1.09, 1.08, and 1.11, respectively, suggesting a low possibility of multicollinearity.

Correlation analysis

T2 PLEs were positively associated with T1 perceived school bullying ( r  = 0.17, p  < 0.001) while negatively associated with T2 resilience ( r = −0.40, p  < 0.001). T2 resilience had a negative relationship with T1 perceived school bullying ( r = −0.19, p  < 0.001).

Mediation of resilience

An EFA found 12 factors with eigenvalues > 1 and the first factor accounted for 22.14% of the total variance, indicating that this sample is less affected by CMB. Table  2 depicts the standardized regression results of mediation to test the significance of the effects of T1 perceived school bullying on T2 PLEs through T2 resilience in sexual minority adolescents, after controlling for sample characteristics, baseline PLEs, and negative life events. T1 Perceived school bullying had a significant negative effect on T2 resilience (b = −0.12, p  < 0.001). While T2 resilience negatively predicted T2 PLEs (b =−0.21, p  < 0.001), the predictive effect of T1 perceived school bullying on T2 PLEs was not significant (b = −0.02, p  = 0.434). Therefore, T2 resilience significantly and fully mediated the relation between T1 perceived school bullying and T2 PLEs in sexual minority adolescents (Model 1: b = 0.03, 95% CI = 0.01 ~ 0.04). The model explained 13.5% variances in T2 resilience and 37.7% variances in T2 PLEs. When separating different dimensions of PLEs, we found similar mediating roles of resilience in the relationship between perceived school bullying and DEs (Model 2: b = 0.03, 95% CI = 0.01 ~ 0.04) and HEs (Model 3: b = 0.02, 95% CI = 0.01 ~ 0.03).

Moderation of resilience

The moderating effect was also tested, with T1 perceived school bullying entered as the predictor, T2 resilience as the moderator, and T2 PLEs as the outcome. Sample characteristics, baseline PLEs, and negative life events were included in the analyses as covariates. As shown in Table  3 , T2 resilience had a main effect on T2 PLEs (b = −0.21, 95% CI = −0.26 ~ −0.16), while no significant effect of T1 perceived school bullying (b = −0.01, 95% CI = −0.07 ~ 0.04) and its interaction with T2 resilience (b = −0.04, 95% CI = -0.09 ~ 0.01) was found (Model 4). Thus, there was no identified moderation by resilience in the perceived school bullying-PLEs association in sexual minority adolescents. We further explored the moderating role of resilience between perceived school bullying and DEs (Model 5)/HEs (Model 6). Our data showed that the interaction between perceived school bullying and resilience did not significantly predict DEs (b = −0.04, 95% CI = −0.09 ~ 0.01), but significantly predicted HEs (b = −0.06, 95% CI = −0.12 ~ −0.01). Further, simple slope analyses found a significant positive relationship between perceived school bullying and HEs at low (b = 0.09, 95% CI = 0.01 ~ 0.17). However, when resilience reached a medium (b = 0.05, 95% CI = −0.02 ~ 0.11) or high level (b = −0.01, 95% CI = −0.08 ~ 0.05), there was no significant relationship between perceived school bullying and HEs. These findings indicated that a higher level of resilience may buffers the association between perceived school bullying and HEs (see Fig.  2 ).

Interaction effect between perceived school bullying and resilience on hallucinatory experiences

This longitudinal study aimed to advance our understanding of how perceived school bullying may be linked to PLEs by testing the mediating and moderating roles of resilience in a sample of sexual minority adolescents. Our findings showed that sexual minority adolescents perceived higher school bullying, reported lower resilience, and experienced more frequent PLEs than their heterosexual peers. Among sexual minority adolescents, resilience played a salient role in mediating this link, while the hypothesized moderation of resilience is not supported.

The current data showed that the prevalence of frequent PLEs was 24.3% at T1 and 20.9% at T2 for sexual minority adolescents, which is not only significantly higher their heterosexual peers (10.8% and 9.3%) in the current sample, but is also higher than one previous survey in Chinese junior and senior high school students using the consistent standard (15.4%) [ 9 ]. The Minority Stress Model [ 12 ] might explain this higher prevalence of PLEs among sexual minorities. The theory assumes that minorities experience consistently high levels of stress due to prejudice, discrimination, and/or stigma, which can lead to negative mental health outcome, such as PLEs. In addition, sexual minorities perceived higher bullying in school and reported lower resilience level than their heterosexual peers, an observation line with the existing literature [ 19 , 61 ].

The cross-sectional association between school bullying and poor mental health has been firmly established in previous studies [ 24 , 62 ]. As hypothesized, correlation analysis observed that perceived school bullying was positively associated with subsequent PLEs among sexual minority adolescents. However, the longitudinal significance did not remain after controlling for other variables in the regression model. This suggests that the longitudinal relationship between perceived school bullying and PLEs may be influenced by other additional variables. Among these potential variables, resilience is one of the most extensively studied factors [ 36 , 37 ]. Adolescents with higher levels of resilience are less likely to experience PLEs [ 29 , 30 ]. In the present study, the longitudinal association between perceived school bullying and PLEs was fully mediated by resilience. In other words, sexual minority adolescents with perceived school bullying might develop lower levels of resilience, rendering them more susceptible to stress, and thereby increasing the likelihood of experiencing PLEs in the future. The dynamic developmental view of resilience [ 32 ] supported that adolescents’ resilience is likely to be influenced by situational factors. We surmised that school bullying makes sexual minority adolescents aware of the potential risks posed by the school environment, thereby adversely affecting their resilience development and increasing their risk of PLEs. In light of these theories, we continued to test the mediating role of resilience when considering different types of PLEs in sexual minorities, and we found no significant differences. Specifically, we found that resilience fully mediates the relationship between school bullying and delusional experiences, as well as between school bullying and hallucinatory experiences.

Although some previous work observed the significant mediating but not moderating roles of resilience on other mental health problems, such as victimization-associated anxiety [ 34 ] and self-harm [ 33 ], fact that resilience is a buffer against negative stressful events is undeniable. The protection model also assumed that higher levels of resilience could moderate or decrease the adverse mental health effects via counter-acts and the acquisition of resources [ 28 ]. For instance, Schnarrs et al. proposed that resilience moderates the relationship between adverse childhood experiences and quality of physical and mental health in sexual minority adults [ 63 ], with a higher level of resilience, the negative effect of adverse childhood experiences on quality of physical and mental health would be diminished to a greater extent. However, we found only a moderating effect of resilience on the association between perceived school bullying and HEs, but limited moderating effect on the relationship between perceived school bullying and overall PLEs and DEs. This may reflect the different functions of DEs and HEs in adolescents and warrants further exploration in the future. In addition, sexual minority adolescents in the present study had impaired resilience compared to their heterosexual peers, which may partially explain the results of resilience fails to mitigate the impact of perceived school bullying on overall PLEs. Previous research has also pointed to the barriers sexual minorities face in accessing resources that can help increase resilience [ 61 ]. Impaired resilience among sexual minorities may hinder their ability to mobilize the resources (e.g., self-efficacy, family support) to buffer the impact of school bullying.

According to current findings, several implications were highlighted for sexual minority adolescents from an intervention and health-enhancement perspective. On the one hand, anti-school bullying interventions, such as civic education, cultural practices [ 64 ] and socio-environmental anti-bullying campaigns [ 65 ] may reduce bullying in schools. Also important are efforts to address those dysfunctions associated with poor resilience that can transform students’ mental wellbeing [ 66 ]. Finally, psychological therapies, such as cognitive-behavioral strategies, mentoring [ 67 ], mindfulness training, and psycho-social skills training [ 68 ] have all shown significant effectiveness in fostering resilience and promoting the development of mental health.

Finally, several limitations of this study should be noted. First, we used a self-reported scale to measure participants’ PLEs, which may have resulted in recall bias. In consideration of this possibility, it is worth noting that the false-positive rate of self-reports in the CAPE-P8, the measure for PLEs in the current study, has been shown to have acceptable self-evaluation-interview consistency (α = 0.78) in the Chinese population [ 55 ]. Second, we used only 4 items from the DSCS-S to examine school bullying. These items can only reflect the perceived bullying in the overall school climate, but cannot determine whether the participants suffered or participated in bullying. Thus, we could not tease out different types of bullying because of unavailable data. Meanwhile, we did not measure resilience at T1, so we are unable to account for its baseline level. Therefore, caution should be exercised when interpreting the current findings. Resilience can be regarded as either a trait or a state condition. Therefore, further research employing specific measurements for trait and state resilience is necessary to validate and corroborate our existing findings. Moreover, this exploratory study explored the relationship between perceived school bullying, resilience, and different PLE dimensions (i.e., DEs, HEs), but overlooked the potential influence of two components of PLEs on one another. In addition, there is a significant sex imbalance in sexual minorities (boys vs. girls: 22.7% vs. 77.3%), which may bias the current results. Consistent with previous studies showing the relevant preponderance of bisexual women compared to men [ 69 ], the number of bisexual women ( N  = 739) exceeded other sexual minority groups in our study. Lastly, sexual minorities in this study were screened from the total sample based on the Kinsey’s scale, a relatively old instrument that appears to screen a higher proportion of sexual minorities than in previous studies [ 10 ]. This high rate may be attributed to the inclusion of all adolescents who do not identify as heterosexual within the sexual minority group [ 42 ]. Senior high school students are still not fully mature in terms of sexual physiology and psychology, and thus may not yet be fully certain about their sexual orientation. In addition, differences in measures and sociocultural environments may also impact the detection of sexual minorities. Thus, the results need to be interpreted with caution.

Our longitudinal study among Chinese sexual minority adolescents demonstrated that resilience mediates the association between perceived school bullying and PLEs, as well as moderates the association of perceived school bullying with HEs. These findings draw attention to the potential roles of educators and clinicians in considering and adopting measures to reduce school bullying and promote adolescents’ resilience. In light of our findings, further research will be needed to better understand the psychological mechanisms underpinning and linking school bullying, resilience, and PLEs in sexual minority adolescents.

Data availability

The dataset used and/or analyzed during the current study are available from the corresponding author (F.F) on reasonable request.

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Acknowledgements

The authors want to express their sincere gratitude to all participants for participating in the study.

The present study was funded by the National Natural Science Foundation of China (32271135; 82101575), Key Research Base of Humanities and Social Sciences of the Ministry of Education - Centre for Studies of Psychological Applications of South China Normal University Project (22JJD190008), Science and Technology Program of Guangzhou (2024A04J10000, 2024A03J0223), and Research Incubation Fund for Young Teachers of South China Normal University (23KJ06).

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Dongfang Wang and Xiao-Yan Chen contributed equally to this work.

Authors and Affiliations

School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, Guangdong Emergency Response Technology Research Center for Psychological Assistance in Emergencies, South China Normal University, Guangzhou, China

Dongfang Wang, Zhijun Yu, Xuan Wang & Fang Fan

School of Psychology, Fujian Normal University, Fuzhou, China

Xiao-Yan Chen

Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA

Andrew Scherffius

Department of Social Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China

School of Psychology, South China Normal University, Shipai Road, Guangzhou, China

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Conceptualization, D.W., X.C., and F.F.; Data curation, D.W., Z.Y., X.W and F.F.; Formal analysis, D.W., and X.C.; Writing-original draft, D.W., and X.C.; Preparing all the figures and tables, D.W.; Writing-review and editing, A.S., M.S., and F.F.; Funding acquisition, F.F.; Project administration, F.F. All authors reviewed and approved the final manuscript.

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Correspondence to Fang Fan .

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This study was approved by the Human Research Ethics Committee of South China Normal University (SCNU-PSY-2021-094). The survey was under the principle of voluntary participation. The participants and their guardians carefully read, signed and returned the informed consent form to the researcher.

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Wang, D., Chen, XY., Scherffius, A. et al. Perceived school bullying and psychotic-like experiences in sexual minority adolescents: the mediating and moderating roles of resilience. Child Adolesc Psychiatry Ment Health 18 , 55 (2024). https://doi.org/10.1186/s13034-024-00747-7

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Received : 13 December 2023

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Published : 16 May 2024

DOI : https://doi.org/10.1186/s13034-024-00747-7

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First case of influenza A (H5) detected in Michigan resident

May 22, 2024

The Michigan Department of Health and Human Services (MDHHS) is announcing the first case of influenza A (H5) virus identified in a Michigan farmworker who had regular exposure to livestock infected with influenza A (H5). This follows extensive public heath actions over the course of the last few months by the state of Michigan to allow farmworkers to monitor and notify local public health officials should they have symptoms. According to the Centers for Disease Control (CDC), the risk to the public remains low; the Michigan farmworker diagnosed with influenza A (H5) had mild symptoms and has recovered. To protect farm and farmworker privacy, additional details are not being provided.

The virus has been circulating in dairy and poultry farms across the U.S. this spring, and state and local public health officials have been closely monitoring for human cases, which can occur sporadically in individuals with close contact to ill animals. This virus has been associated with the ongoing multistate outbreak of influenza A (H5N1). As such, it is not unexpected that comprehensive testing identified a human infection. Information to date suggests this is a sporadic infection, with no associated ongoing spread person-to-person.

“Michigan has led a swift public health response, and we have been tracking this situation closely since influenza A (H5N1) was detected in poultry and dairy herds in Michigan. Farmworkers who have been exposed to impacted animals have been asked to report even mild symptoms, and testing for the virus has been made available,” said Dr. Natasha Bagdasarian, chief medical executive. “The current health risk to the general public remains low. This virus is being closely monitored, and we have not seen signs of sustained human-to-human transmission at this point. This is exactly how public health is meant to work, in early detection and monitoring of new and emerging illnesses.”

MDHHS and local health departments continue to work closely with the Michigan Department of Agriculture and Rural Development (MDARD), farms and workers to conduct monitoring of the health of people exposed to ill animals.

“ Since the first detection of influenza A (H5N1) in dairy cattle on March 29, Michigan has prioritized both the animal and human health aspects of this disease outbreak. Today’s news underscores the continued importance of limiting nonessential farm visits, including farm tours and field trips, as well as the use of personal protective equipment when working with livestock,” said MDARD Director Tim Boring.

MDARD continues to implement a proactive, science-based approach to mitigating the spread of influenza A (H5N1). Michigan's response to influenza A (H5N1) has been a one-health approach, working with federal, state and local partners to address animal and public health concerns rapidly. Three U.S. Department of Agriculture (USDA) emergency management teams have been on the ground assisting MDARD in day-to-day responses at all impacted poultry facilities statewide. An epidemiological team from USDA is also deployed to further assist in tracing and testing within dairy herds to be able to provide real-time information. 

Director Boring has taken proactive actions by signing an  "Determination of Extraordinary Emergency"  order Wednesday, May 1, which further protects Michigan's poultry and livestock industries from the ongoing threat of influenza A (H5N1). Michigan's order enhances USDA's federal order, which was issued Wednesday, April 24. 

MDARD has identified both dairy and poultry farms that have tested positive for influenza A (H5N1) in several Michigan counties. Risk is not limited to those geographies as additional detections may be possible.

MDHHS recommends seasonal flu vaccination for people working on poultry or dairy farms. It will not prevent infection with avian influenza viruses, but it can reduce the risk of coinfection with avian and flu viruses.

Since 2022, there have been two previous human cases related to bird and dairy exposure in the U.S. -- one in Colorado in 2022 and one in Texas in 2024.

For more information, visit Michigan.gov/InfluenzaA.

En Español

First case of influenza A (H5) detected in Michigan resident - 5/22/2024 Press Release - ASL Version

Chelsea Wuth

517-241-2112

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