School Violence, Mental Health, and Educational Performance in Uganda

Devries, Karen; Child, Jennifer; Allen, Elizabeth; Walakira, Eddy; Parkes, Colin Murray; Naker, Dipak

doi:10.1542/peds.2013-2007

Cited by 106 publications

(137 citation statements)

References 14 publications

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“…Teachers reported the most challenges in “ignoring mild misbehavior” (with below mean level of confidence in applying such strategy: M(SD) = 1.78). Although reliance on the commonly used cane or stick for discipline was reduced (used by more than 90% of Ugandan teachers from the Kampala region (Devries et al, 2014)), 59% of teacher still relied on this strategy on occasion.…”

Section: Resultsmentioning

confidence: 99%

Transportability of an Evidence-Based Early Childhood Intervention in a Low-Income African Country: Results of a Cluster Randomized Controlled Study

et al. 2017

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Children in Sub-Saharan Africa (SSA) are burdened by significant unmet mental health needs. Despite the successes of numerous school-based interventions for promoting child mental health, most evidence-based interventions (EBIs) are not available in SSA. This study investigated the implementation quality and effectiveness of one component of an EBI from a developed country (United States) to a SSA country (Uganda). The EBI component, Professional Development, was provided by trained Ugandan mental health workers to Ugandan primary school teachers. It included large group experiential training and small group coaching to introduce and support a range of evidence-based practices (EBPs) to create nurturing and predictable classroom experiences. The study was guided by the Consolidated Framework for Implementation Research, the Teacher Training Implementation Model and the RE-AIM evaluation framework. Effectiveness outcomes were studied using a cluster randomized design, in which 10 schools were randomized to intervention and wait-list control conditions. A total of 79 early childhood teachers participated. Teacher knowledge and use of evidence-based practices (EBPs) were assessed at baseline and immediately post-intervention (4–5 months later). A sample of 154 parents was randomly selected to report on child behavior at baseline and post-intervention. Linear mixed effect modeling was applied to examine effectiveness outcomes. Findings support the feasibility of training Ugandan mental health professionals to provide Professional Development for Ugandan teachers. Professional Development was delivered with high levels of fidelity and resulted in improved teacher EBP knowledge and use of EBPs in the classroom, and child social competence.

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Section: Resultsmentioning

confidence: 99%

Transportability of an Evidence-Based Early Childhood Intervention in a Low-Income African Country: Results of a Cluster Randomized Controlled Study

et al. 2017

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“…9 In Uganda, similar to other countries in the region, exposure to violence from various perpetrators including parents, peers and school staff may be more normative and more chronic versus some high-income settings. [21][22][23] Further research is needed to fully understand the implications of this, both in terms of the health effects of exposure, and designing appropriate intervention strategies for children in Uganda and similar settings.…”

Section: Discussionmentioning

confidence: 99%

Witnessing intimate partner violence and child maltreatment in Ugandan children: a cross-sectional survey

et al. 2017

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ObjectivesExisting evidence, mainly from high-income countries, shows children who witness intimate partner violence (IPV) at home are more likely to experience other forms of violence, but very little evidence is available from lower income countries. In this paper we aim to explore whether Ugandan children who witness IPV at home are also more likely to experience other forms of maltreatment, factors associated with witnessing and experiencing violence, and whether any increased risk comes from parents, or others outside the home.DesignA representative cross-sectional survey of primary schools.Participants3427 non-boarding primary school students, aged about 11–14 years.SettingLuwero District, Uganda, 2012.MeasuresExposure to child maltreatment was measured using the International Society for the Prevention of Child Abuse and Neglect Child Abuse Screening Tool-Child Institutional, and 2 questions measured witnessing IPV.Results26% of children reported witnessing IPV, but nearly all of these children had also experienced violence themselves. Only 0.6% of boys and 1.6% of girls had witnessed partner violence and not experienced violence. Increased risk of violence was from parents and also from other perpetrators besides parents. Both girls and boys who witnessed and experienced violence had between 1.66 (95% CI 0.96 to 2.87) and 4.50 (95% CI 1.78 to 11.33) times the odds of reporting mental health difficulties, and 3.23 (95% CI 1.99 to 5.24) and 8.12 (95% CI 5.15 to 12.80) times the odds of using physical or sexual violence themselves.ConclusionsIn this sample, witnessing IPV almost never occurred in isolation—almost all children who witnessed partner violence also experienced violence themselves. Our results imply that children in Uganda who are exposed to multiple forms of violence may benefit from intervention to mitigate mental health consequences and reduce use of violence. IPV prevention interventions should be considered to reduce child maltreatment. Large numbers of children also experience maltreatment in homes with no partner violence, highlighting the need for interventions to prevent child maltreatment more broadly.Trial registration numberNCT01678846, results.

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“…Levels of emotional and sexual violence are yet to be published for the end-line Good School Study. Previously, more than 48.6% of students reported lifetime emotional violence while 11.8% of girls and 2.5% of boys reported life time sexual violence during the baseline Good Schools Study [40]. …”

Section: Introductionmentioning

confidence: 99%

Secondary distress in violence researchers: a randomised trial of the effectiveness of group debriefings

Grundlingh

Knight

Naker³

et al. 2017

BMC Psychiatry

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BackgroundSecondary distress including emotional distress, vicarious trauma (VT) and secondary traumatic stress (STS) due to exposure to primary trauma victims have been described in helping professionals and in violence researchers. To our knowledge, there are few prevalence studies, and no tailored interventions have been tested to reduce secondary distress in violence researchers. The study aims to (1) describe the epidemiology of secondary distress experienced by violence researchers; to (2) assess the effectiveness of group debriefings in mitigating secondary distress; to (3) assess risk and protective factors.MethodsWe conducted an un-blinded, individually randomised trial with parallel assignment. Eligible participants were 59 Ugandan researchers employed by the Good Schools Study to interview children who experienced violence in a district of Uganda. Fifty-three researchers agreed to participate and were randomly allocated. The intervention group (n = 26) participated in three group debriefings and the control group (n = 27) in three leisure sessions (film viewings). The primary outcome was change in levels of emotional distress (SRQ-20); secondary outcomes were levels of VT and STS at end-line. A paired t-test assessed the difference in mean baseline and end-line emotional distress. Un-paired t-tests compared the change in mean emotional distress (baseline vs. end-line), and compared levels of VT and STS at end-line. Separate logistic regression models tested the association between end-line emotional distress and a-priori risk or protective factors.ResultsBaseline and end-line levels of emotional distress were similar in control (p = 0.47) and intervention (p = 0.59) groups. The superiority of group debriefing over leisure activities in lowering levels of emotional distress in the intervention group (n = 26; difference in SRQ-20 = 0.23 [SD = 2.18]) compared to the control group (n = 26; difference in SRQ-20 = 0.23 [SD = 1.63]) could not be detected (p = 1). In regression analysis (n = 48), baseline distress increased the odds of end-line distress (OR = 16.1, 95%CI 2.82 to 92.7, p = 0.002). Perceived organisational support (OR = 0.09, 95%CI 0.01 to 0.69, p = 0.02) and belief in God (OR = 0.21, 95%CI 0.03 to 1.26, p = 09) was protective against end-line distress.ConclusionWe found no evidence that violence researchers experienced elevated emotional distress after doing violence research. There was no difference between group debriefings and leisure activities in reducing distress in our sample. However, the hypotheses presented should not be ruled out in other violence research settings. Our findings suggest that organisational support is a significant protective factor and belief in God may be an important coping mechanism.Trial registrationClinical Trials NCT02390778. Retrospectively registered 19 March 2015. The Good Schools Trial was registered at (NCT01678846), on August 24, 2012.Electronic supplementary materialThe online version of this article (doi:10.1186/s12888-017-1327-x) contains supplementary...

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School Violence, Mental Health, and Educational Performance in Uganda

Cited by 106 publications

References 14 publications

Transportability of an Evidence-Based Early Childhood Intervention in a Low-Income African Country: Results of a Cluster Randomized Controlled Study

Transportability of an Evidence-Based Early Childhood Intervention in a Low-Income African Country: Results of a Cluster Randomized Controlled Study

Witnessing intimate partner violence and child maltreatment in Ugandan children: a cross-sectional survey

Secondary distress in violence researchers: a randomised trial of the effectiveness of group debriefings

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