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NCT Number: NCT06001554

Preventing Physical and Emotional Violence by Teachers in Public Schools in Pakistan

Violence has severe and long-lasting negative consequences for children and adolescents' well-being and psychosocial functioning, thereby also hampering communities and societies' economic growth. Studies show high prevalence rates of violence by teachers against children in Pakistan. In addition to legal and structural factors (e. g. stressful working conditions for teachers), attitudes favoring violence against children as an effective and acceptable discipline method and the lack of access to alternative non-violent strategies are likely to contribute to teachers' ongoing use of violence against children.

Notwithstanding, there are currently very few school-level interventions to reduce violence by teachers that a) have been scientifically evaluated and b) that focus both on changing attitudes towards violence and on equipping teachers with non-violent discipline strategies.

Thus, the present study tests the effectiveness of the preventative intervention Interaction Competencies with Children - for Teachers (ICC-T) in secondary schools in Pakistan. Previous studies have provided initial evidence on the feasibility to implement teacher violence interventions in secondary schools in Pakistan. This study aims to provide first evidence for the effectiveness of ICC-T to reduce violence and to improve children's functioning (i.e. mental health, well-being, academic performance) in Pakistan.

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Key information

Conditions

Violence

Age range

11 year–62 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Shifa International Hospitals

Islamabad, Pakistan

Location status: Recruiting

Location contact

Abdul Wahab Yousafzai, MBBS

CONTACT

[email protected]

About this study

The study is a multi-site cluster randomized controlled trial with schools (clusters) as level of randomization. Three districts in each site of the four sites (Khyber Pakhtunkhwa province, Sindh province, the State of Azad Jammu & Kashmir, and the federal capital Islamabad+Punjab province) will be purposely selected to ensure diversity of schools in terms of geographical, economical, social, and politically background. In each site, 12 public schools will be randomly selected, resulting in a total number of 48 schools (12 per sites). Schools will be stratified based on school type (girls or boys school). In each site, 6 schools (3 girls and 3 boys schools) will be randomly allocated to the intervention group (that will receive the ICC-T intervention) and the control group (that will receive no intervention).

At each school, 30 students in the first year of secondary and all teachers (expected average number: 15) will be recruited. Thus the final sample will comprise 1440 students and at least 720 teachers at baseline.

The study will have three data assessment points: baseline assessment prior to the intervention, the first follow-up assessment six months after the intervention and the second follow-up assessment 18 months after the intervention. In addition, feasibility data will be assessed in the intervention group at the beginning and the end of the intervention.

Primary outcome measures are student- and teacher-reported physical and emotional violence by teachers in the past week. Secondary outcome measures include children's emotional and behavioral problems, quality of life, cognitive functioning, academic performance, and school attendance.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

General:

Inclusion criteria

All: Written informed consent (if underaged by parents (written) & minors themselves (written) Students: Enrollment in selected secondary school Teachers: All teachers employed at the selected schools

Schools:

Public secondary schools Day schools At least 30 students in selected class/stream

Exclusion criteria

Students and teachers:

Acute drug or alcohol intoxication Acute psychotic disorder

Treatment and study plan

Interaction Competencies with Children - for Teachers (ICC-T)

Behavioral

Core training components include teacher-student interaction, maltreatment prevention, effective discipline strategies, identifying and supporting burdened students and implementation of the training materials into the school setting

Primary outcomes

  1. Change of students' exposure to emotional and physical violence by teachers

    Time frame: The CTS will be used at T0 (baseline, prior to intervention), T1 (first follow-up, 6 months after intervention) and T2 (second follow-up, 18 months after intervention)

    The Conflict Tactics Scale (CTS) will be used to assess students' self-reported experiences of emotional and physical violence by teachers at school in the past week. Higher scores indicate higher levels of violence that is used by teachers. We hypothesize a stronger reduction of exposure to violence in the intervention group compared to the control group.

  2. Change of teachers' use of emotional and physical violence

    Time frame: The CTS will be used at T0 (baseline, prior to intervention), T1 (first follow-up, 6 months after intervention) and T2 (second follow-up, 18 months after intervention)

    The Conflict Tactics Scale (CTS) will be used to assess teachers' use of emotional and physical violent discipline measures against students in the past week. Higher scores indicate higher levels of violence that is used by teachers. We hypothesize a stronger reduction of the use of violence in the intervention group compared to the control group.

Secondary outcomes

  1. Change of teachers' positive attitudes towards emotional and physical violence

    Time frame: The adapted version of CTS will be used at T0 (baseline, prior to intervention), T1 (first follow-up, 6 months after intervention) and T2 (second follow-up, 18 months after the intervention)

    Teacher's attitudes towards emotional and physical violence will be assessed with an adapted version of the Conflict Tactic Scale (CTS). Higher scores indicate higher levels of positive attitudes towards violence. We hypothesize a stronger decrease of positive attitudes towards violence in the intervention group compared to the control group.

  2. Change of student's mental health

    Time frame: The PSC-Y will be used at T0 (baseline, prior to intervention), T1 (first follow-up, 6 months after intervention) and T2 (second follow-up, 18 months after intervention)

    The Pediatric Symptom Checklist - Youth Report (PSC-Y) will assess students' emotional and behavioral problems.

    Higher scores indicate higher levels of students' mental health problems. We hypothesize a stronger reduction of mental health problems in the intervention group compared to the control group.

  3. Change of students' quality of life

    Time frame: The KIDSCREEN-10 will be used at T0 (baseline, prior to intervention), T1 (first follow-up, 6 months after intervention) and T2 (second follow-up, 18 months after intervention)

    The KIDSCREEN-10 will assess students' quality of life. Higher scores indicate higher levels of students' quality of life.

    We hypothesize an overall improvement of in the quality of life in the intervention group compared to the control group.

  4. Change of students' cognitive functioning

    Time frame: The app-based tasks will be used at T0 (baseline, prior to intervention), T1 (first follow-up, 6 months after intervention) and T2 (second follow-up, 18 months after intervention)

    Five tasks from the tablet application Inquisit will be used to assess children's cognitive abilities including selective attention (Letter Cancellation Task), working memory (Corsi Block Tapping Backwards), response inhibition (Arrow Flanker Task), planning and problem solving (Tower of London) and cognitive flexibility (Wisconsin Card Sorting Test). The test results in each test will be z-standardized and then combined to one compound score. Higher scores indicate higher levels of students' cognitive abilities. We hypothesize higher levels of cognitive functioning in the intervention group compared to the control group.

Other outcomes

  1. Change of students' academic performance

    Time frame: Students' grades will be collected at T0 (baseline, prior to intervention), T1 (first follow-up, 6 months after intervention) and T2 (second follow-up, 18 months after intervention).

    Students' grades in the previous term's exams will be obtained from the school administration. An improvement in academic performance in the intervention group is hypothesized.

  2. Change of peer violence

    Time frame: he Multidimensional Peer Victimization Scale will be used at T0 (baseline, prior to intervention), T1 (first follow-up, 6 months after intervention) and T2 (second follow-up, 18 months after intervention)

    The Multidimensional Peer Victimization Scale will be used assess students' experiences of violence by peers. Higher scores indicate higher levels of students' experiences of peer violence. We hypothesize a stronger decrease of peer violence in the intervention group compared to the control group.

Study contacts

Contact information is provided by the study sponsor or research team.

Alaptagin Khan, MBBS

CONTACT

[email protected]

+1 617 855 2096

Tobias Hecker, PhD

CONTACT

[email protected]

+49 521 106 3105

Sponsors and collaborators

Lead sponsor

Bielefeld University

Other

Collaborators

  • Mclean Hospital
  • Shifa Foundation
  • Shifa International Hospital
  • University of Konstanz

Registry information

Official study title

Improving Adolescent Student Mental Health and Quality of Life Through a Reduction in Physical and Emotional Violence by Teachers in Pakistan: A Cluster Randomized Controlled Trial

Acronym: ICC-T_Pak

Important dates

Study start
2023
Primary completion
2026
Study completion
2026
First posted
Aug 21, 2023
Registry last updated
Apr 9, 2024

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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