Effects of ACT Out! Social Issue Theater on Social-Emotional Competence and Bullying in Youth and Adolescents: Cluster Randomized Controlled Trial

Abstract

Background Schools increasingly prioritize social-emotional competence and bullying and cyberbullying prevention, so the development of novel, low-cost, and high-yield programs addressing these topics is important. Further, rigorous assessment of interventions prior to widespread dissemination is crucial. Objective This study assesses the effectiveness and implementation fidelity of the ACT Out! Social Issue Theater program, a 1-hour psychodramatic intervention by professional actors; it also measures students’ receptiveness to the intervention. Methods This study is a 2-arm cluster randomized control trial with 1:1 allocation that randomized either to the ACT Out! intervention or control (treatment as usual) at the classroom level (n=76 classrooms in 12 schools across 5 counties in Indiana, comprised of 1571 students at pretest in fourth, seventh, and tenth grades). The primary outcomes were self-reported social-emotional competence, bullying perpetration, and bullying victimization; the secondary outcomes were receptiveness to the intervention, implementation fidelity (independent observer observation), and prespecified subanalyses of social-emotional competence for seventh- and tenth-grade students. All outcomes were collected at baseline and 2-week posttest, with planned 3-months posttest data collection prevented due to the COVID-19 pandemic. Results Intervention fidelity was uniformly excellent (>96% adherence), and students were highly receptive to the program. However, trial results did not support the hypothesis that the intervention would increase participants’ social-emotional competence. The intervention’s impact on bullying was complicated to interpret and included some evidence of small interaction effects (reduced cyberbullying victimization and increased physical bullying perpetration). Additionally, pooled within-group reductions were also observed and discussed but were not appropriate for causal attribution. Conclusions This study found no superiority for a 1-hour ACT Out! intervention compared to treatment as usual for social-emotional competence or offline bullying, but some evidence of a small effect for cyberbullying. On the basis of these results and the within-group effects, as a next step, we encourage research into whether the ACT Out! intervention may engender a bystander effect not amenable to randomization by classroom. Therefore, we recommend a larger trial of the ACT Out! intervention that focuses specifically on cyberbullying, measures bystander behavior, is randomized by school, and is controlled for extant bullying prevention efforts at each school. Trial Registration Clinicaltrials.gov NCT04097496; https://clinicaltrials.gov/ct2/show/NCT04097496 International Registered Report Identifier (IRRID) RR2-10.2196/17900

Perpetration of and Victimization in Cyberbullying and Traditional Bullying in Adolescents with Attention-Deficit/Hyperactivity Disorder: Roles of Impulsivity, Frustration Intolerance, and Hostility

“…SED is central to navigating challenges in social interactions in everyday life and to adapting flexibly to situational demands [ 11 ]. Research has supported the role of deficits in SED for bullying involvement in adolescents [ 12 , 13 , 14 , 15 ]. The present study examined the roles of three social-emotional difficulties, including impulsivity, frustration discomfort, and hostility for victimization in and perpetration of both cyberbullying and traditional bullying in adolescents with ADHD.…”

School-Based Nursing Interventions for Preventing Bullying and Reducing Its Incidence on Students: A Scoping Review

“…ACT OUT! Social Issue Theater Program is an education that is packaged through drama [ 29 ]. Participants perform an interactive, semi-improvised psychodrama performance for one hour.…”

Family and Educational Strategies for Cyberbullying Prevention: A Systematic Review

“…In 2021, Agley et al [ 27 ] explored the effectiveness of ACT Out!, a social issue theatre tested in Indiana, whose scenarios are specifically designed to meet the audience’s needs, although its performances, which were attended during school hours, are improvisational and interactive. The principle upon which this intervention is founded is catharsis, through which a dramatic performance can convey new ways of perception about a situation, in this case, new ways of feeling and thinking about behaviours and attitudes.…”

“…With the same objectives in mind, other interventions point to stimulating youngsters’ emotional education in a less conventional way by interacting in a theatre performance on the theme (as in ACT Out! [ 27 ]) or by developing apps, videogames, or automated SMS text-messaging to deliver the intervention remotely (as in IMPACT [ 39 ], in Cooperative Cybereduca 2.0 [ 43 ], and in the study by Ranney [ 41 ], respectively).…”