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METHODOLOGY
Open Access

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

Judith McFarlane, Rozina Karmaliani, Hussain Maqbool Ahmed Khuwaja, Saleema Gulzar, Rozina Somani, Tazeen Saeed Ali, Yasmeen H Somani, Shireen Shehzad Bhamani, Ryan D Krone, Rene M Paulson, Atta Muhammad and Rachel Jewkes
Global Health: Science and Practice March 2017, 5(1):115-137; https://doi.org/10.9745/GHSP-D-16-00215
Judith McFarlane
aTexas Woman's University College of Nursing, Houston, Texas, USA.
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  • For correspondence: jmcfarlane@twu.edu
Rozina Karmaliani
bThe Aga Khan University School of Nursing & Midwifery, Karachi, Pakistan.
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Hussain Maqbool Ahmed Khuwaja
bThe Aga Khan University School of Nursing & Midwifery, Karachi, Pakistan.
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Saleema Gulzar
bThe Aga Khan University School of Nursing & Midwifery, Karachi, Pakistan.
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Rozina Somani
bThe Aga Khan University School of Nursing & Midwifery, Karachi, Pakistan.
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Tazeen Saeed Ali
bThe Aga Khan University School of Nursing & Midwifery, Karachi, Pakistan.
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Yasmeen H Somani
bThe Aga Khan University School of Nursing & Midwifery, Karachi, Pakistan.
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Shireen Shehzad Bhamani
bThe Aga Khan University School of Nursing & Midwifery, Karachi, Pakistan.
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Ryan D Krone
cElite Research, LLC, Irving, Texas, USA.
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Rene M Paulson
cElite Research, LLC, Irving, Texas, USA.
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Atta Muhammad
dRight To Play, Hyderabad, Pakistan.
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Rachel Jewkes
eSouth African Medical Research Council, Pretoria, South Africa.
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Peer violence was remarkably high at baseline. Among urban public school students, 94% of 6th-grade boys and 85% of girls reported being victimized by peers in the last 4 weeks. And 85% of boys and 66% of girls reported perpetrating such violence. Boys scored worse on a number of mental health measures. A cluster RCT is underway to evaluate a well-established school-based intervention using sports and games to reduce peer violence.

ABSTRACT

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

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

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

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

  • Received: 2013 Aug 12.
  • Accepted: 2013 Sep 28.
  • Published: 2017 Mar 24.
  • © McFarlane et al.

This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly cited. To view a copy of the license, visit http://creativecommons.org/licenses/by/3.0/. When linking to this article, please use the following permanent link: https://doi.org/10.9745/GHSP-D-16-00215

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Global Health: Science and Practice: 5 (1)
Global Health: Science and Practice
Vol. 5, No. 1
March 24, 2017
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Preventing Peer Violence Against Children: Methods and Baseline Data of a Cluster Randomized Controlled Trial in Pakistan
Judith McFarlane, Rozina Karmaliani, Hussain Maqbool Ahmed Khuwaja, Saleema Gulzar, Rozina Somani, Tazeen Saeed Ali, Yasmeen H Somani, Shireen Shehzad Bhamani, Ryan D Krone, Rene M Paulson, Atta Muhammad, Rachel Jewkes
Global Health: Science and Practice Mar 2017, 5 (1) 115-137; DOI: 10.9745/GHSP-D-16-00215

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Preventing Peer Violence Against Children: Methods and Baseline Data of a Cluster Randomized Controlled Trial in Pakistan
Judith McFarlane, Rozina Karmaliani, Hussain Maqbool Ahmed Khuwaja, Saleema Gulzar, Rozina Somani, Tazeen Saeed Ali, Yasmeen H Somani, Shireen Shehzad Bhamani, Ryan D Krone, Rene M Paulson, Atta Muhammad, Rachel Jewkes
Global Health: Science and Practice Mar 2017, 5 (1) 115-137; DOI: 10.9745/GHSP-D-16-00215
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