The effects and costs of an anti-bullying program (KiVa) in UK primary schools: a multicenter cluster randomized controlled trial

Lucy Bowes; Malavika Babu; Julia R Badger; Matthew R Broome; Rebecca Cannings-John; Suzy Clarkson; Elinor Coulman; Rhiannon Tudor Edwards; Tamsin Ford; Richard P Hastings; Rachel Hayes; Fiona Lugg-Widger; Eleri Owen-Jones; Paul Patterson; Jeremy Segrott; Mia Sydenham; Julia Townson; Richard C Watkins; Holly Whiteley; Margiad E Williams; Stand Together Team; Judy Hutchings

doi:10.1017/S0033291724002666

The effects and costs of an anti-bullying program (KiVa) in UK primary schools: a multicenter cluster randomized controlled trial

Psychol Med. 2024 Nov 12;54(15):1-12. doi: 10.1017/S0033291724002666. Online ahead of print.

Authors

Lucy Bowes^{1

2}, Malavika Babu³, Julia R Badger^{1

2

4}, Matthew R Broome^{2

5

6}, Rebecca Cannings-John³, Suzy Clarkson⁷, Elinor Coulman³, Rhiannon Tudor Edwards⁷, Tamsin Ford⁸, Richard P Hastings⁴, Rachel Hayes⁹, Fiona Lugg-Widger³, Eleri Owen-Jones³, Paul Patterson⁶, Jeremy Segrott³, Mia Sydenham³, Julia Townson³, Richard C Watkins^{7

10}, Holly Whiteley⁷, Margiad E Williams⁷; Stand Together Team; Judy Hutchings⁷

Affiliations

¹ Department of Experimental Psychology, Oxford University, Oxford, UK.
² National Institute for Health and Care Research (NIHR) Oxford Health Biomedical Research Centre, Oxford University, Oxford, UK.
³ Centre for Trials Research, Cardiff University, Cardiff, UK.
⁴ School of Educational Learning and Communication Sciences, University of Warwick, Warwick, UK.
⁵ Institute for Mental Health, University of Birmingham, Birmingham, UK.
⁶ Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK.
⁷ Centre for Evidence-Based Early Intervention, Bangor University, Bangor, UK.
⁸ Department of Psychiatry, University of Cambridge, Cambridge, UK.
⁹ Faculty of Health and Life Sciences, Department for Public Health and Sport Sciences, University of Exeter, Exeter, UK.
¹⁰ GwE (North Wales Regional School Improvement Service), Conwy, UK.

Abstract

Background: Childhood bullying is a public health priority. We evaluated the effectiveness and costs of KiVa, a whole-school anti-bullying program that targets the peer context.

Methods: A two-arm pragmatic multicenter cluster randomized controlled trial with embedded economic evaluation. Schools were randomized to KiVa-intervention or usual practice (UP), stratified on school size and Free School Meals eligibility. KiVa was delivered by trained teachers across one school year. Follow-up was at 12 months post randomization. Primary outcome: student-reported bullying-victimization; secondary outcomes: self-reported bullying-perpetration, participant roles in bullying, empathy and teacher-reported Strengths and Difficulties Questionnaire. Outcomes were analyzed using multilevel linear and logistic regression models.

Findings: Between 8/11/2019-12/02/2021, 118 primary schools were recruited in four trial sites, 11 111 students in primary analysis (KiVa-intervention: n = 5944; 49.6% female; UP: n = 5167, 49.0% female). At baseline, 21.6% of students reported being bullied in the UP group and 20.3% in the KiVa-intervention group, reducing to 20.7% in the UP group and 17.7% in the KiVa-intervention group at follow-up (odds ratio 0.87; 95% confidence interval 0.78 to 0.97, p value = 0.009). Students in the KiVa group had significantly higher empathy and reduced peer problems. We found no differences in bullying perpetration, school wellbeing, emotional or behavioral problems. A priori subgroup analyses revealed no differences in effectiveness by socioeconomic gradient, or by gender. KiVa costs £20.78 more per pupil than usual practice in the first year, and £1.65 more per pupil in subsequent years.

Interpretation: The KiVa anti-bullying program is effective at reducing bullying victimization with small-moderate effects of public health importance.

Funding: The study was funded by the UK National Institute for Health and Care Research (NIHR) Public Health Research program (17-92-11). Intervention costs were funded by the Rayne Foundation, GwE North Wales Regional School Improvement Service, Children's Services, Devon County Council and HSBC Global Services (UK) Ltd.

Keywords: KiVa program; United Kingdom; bullying; costs and cost analysis; intervention studies; primary education; program evaluation; randomized controlled trial; schools; victimization.