Background School-based violence prevention interventions offer enormous potential to reduce children’s experience of violence perpetrated by teachers, but few have been rigorously evaluated globally and, to the best of our knowledge, none in humanitarian settings. We tested whether the EmpaTeach intervention could reduce physical violence from teachers to students in Nyarugusu Refugee Camp, Tanzania. Methods and findings We conducted a 2-arm cluster-randomised controlled trial with parallel assignment. A complete sample of all 27 primary and secondary schools in Nyarugusu Refugee Camp were approached and agreed to participate in the study. Eligible students and teachers participated in cross-sectional baseline, midline, and endline surveys in November/December 2018, May/June 2019, and January/February 2020, respectively. Fourteen schools were randomly assigned to receive a violence prevention intervention targeted at teachers implemented in January–March 2019; 13 formed a wait-list control group. The EmpaTeach intervention used empathy-building exercises and group work to equip teachers with self-regulation, alternative discipline techniques, and classroom management strategies. Allocation was not concealed due to the nature of the intervention. The primary outcome was students’ self-reported experience of physical violence from teachers, assessed at midline using a modified version of the ISPCAN Child Abuse Screening Tool–Child Institutional. Secondary outcomes included student reports of emotional violence, depressive symptoms, and school attendance. Analyses were by intention to treat, using generalised estimating equations adjusted for stratification factors. No schools left the study. In total, 1,493 of the 1,866 (80%) randomly sampled students approached for participation took part in the baseline survey; at baseline 54.1% of students reported past-week physical violence from school staff. In total, 1,619 of 1,978 students (81.9%) took part in the midline survey, and 1,617 of 2,032 students (79.6%) participated at endline. Prevalence of past-week violence at midline was not statistically different in intervention (408 of 839 students, 48.6%) and control schools (412 of 777 students, 53.0%; risk ratio = 0.91, 95% CI 0.80 to 1.02, p = 0.106). No effect was detected on secondary outcomes. A camp-wide educational policy change during intervention implementation resulted in 14.7% of teachers in the intervention arm receiving a compressed version of the intervention, but exploratory analyses showed no difference in our primary outcome by school-level adherence to the intervention. Main study limitations included the small number of schools in the camp, which limited statistical power to detect small differences between intervention and control groups. We also did not assess the test–retest reliability of our outcome measures, and interviewers were unmasked to intervention allocation. Conclusions There was no evidence that the EmpaTeach intervention effectively reduced physical violence from teachers towards primary or secondary school students in Nyarugusu Refugee Camp. Further research is needed to develop and test interventions to prevent teacher violence in humanitarian settings. Trial registration clinicaltrials.gov (NCT03745573)

Background: South Africa has among the highest rates of intimate partner violence (IPV) globally, with young women at heightened risk due to inequitable gender roles, limited relationship skills, and inadequate social support. Despite an urgent need for low-cost, scaleable IPV solutions, most efficacious approaches are time-intensive and costly to deliver. Digital, interactive chatbots could deliver behaviourally-informed strategies to help young women navigate their relationships in the context of high IPV prevalence. Methods: Young women (18-24 years old) across South Africa were recruited via Facebook for participation in an individually randomised controlled trial (n=19,643). Users were randomly allocated, using a pipeline algorithm, to one of four trial arms: Pure Control (PC) had no user engagement outside of study measures; Attention Treatment (T0) provided didactic information about sexual health through a text-based chatbot; Gamified Treatment (T1) was a behaviourally-informed gamified text-based chatbot; Narrative Treatment (T2) was a behaviourally-informed drama delivered through pre-recorded voice notes. All chatbots were delivered in WhatsApp, through which users were invited to complete brief “quizzes” comprising adapted versions of validated scales. A direct chat link to a trained counsellor was a safety measure (and was accessed by 4·5% of the sample). Primary outcomes were adapted validated scales of gender beliefs and past-month IPV. Secondary outcomes were identification of unhealthy relationship behaviours and depressive symptoms. We estimated treatment effects using ordinary least squares and heteroskedasticity robust standard errors.Findings: Compared to control, all treatments were effective in improving gender beliefs (Cohen’s D=0·10, 0·29, 0·20 for T0, T1, and T2, respectively). The gamified chatbot (T1) had small but significant effects on IPV: 56% of young women reported past-month IPV, compared to 62% among those without treatment (marginal effects=-0·07, 95%CI=-0·09to-0·05). The narrative treatment (T2) had no effect on IPV exposure. T1 significantly increased identification of unhealthy relationship behaviours (Cohen’s D=0·25). Neither T1 nor T2 had a measurable effect on mental health, nor did either treatment arm cause mental distress.Interpretation: A behaviourally-informed, gamified chatbot increased gender equitable beliefs and skills and was protective for IPV exposure among young women in South Africa. These effects, while modest in magnitude, could represent a meaningful impact were the gamified chatbot to be scaled.

Las mujeres empresarias de pequeñas y medianas empresas (pymes) enfrentan muchos retos en todo el mundo. En particular, en Honduras, son vulnerables a varios tipos de violencia que atentan contra su bienestar y el desarrollo de sus empresas. Este documento presenta los resultados de una investigación cualitativa realizada en 2020 y propone siete estrategias de solución basadas en las ciencias del comportamiento, las cuales se enfocan en prevenir la violencia basada en género y reducir la discriminación contra las empresarias, así como en fomentar el crecimiento de sus empresas.

EmpaTeach was the first intervention to address teacher violence to be tested in a humanitarian setting and the first to focus on reducing impulsive use of violence, but a cluster randomised trial found no evidence that the intervention was effective in reducing physical and emotional violence from teachers. We aimed to understand why. We conducted a quantitative process evaluation to describe the intervention implementation process (what was implemented and how); examine teachers’ adoption of positive teaching practices (was the content of the intervention taken up by participants), and test mechanisms of impact underlying the program theory (how the intervention was supposed to produce change). Despite participation in the intervention activities and adoption of intervention-recommended strategies (classroom management and positive disciplinary methods), we show that teachers who used more positive discipline did not appear to use less violence; and teachers in intervention schools did not experience gains in intermediate outcomes such as empathy, growth mindset, self-efficacy or social support. Our findings suggest that the intervention did not work due to the failure of some key hypothesised mechanisms, rather than because of implementation challenges.