Effects of an intervention to prevent the bullying in first-grade secondary schools of Palermo, Italy: the BIAS study

Bullying affects the entire educational environment and has an impact on one’s right to a proper education. It represents the most common expression of violence in the peer context during school years [1]. Considering the strong amount of evidence of the negative health consequences for bullies, their victims, and observers as documented by studies from different countries, bullying in schools has become an important and complex global public health issue [1, 2].

According to a widely used research definition of bullying, a student is bullied or victimized when he or she is exposed repeatedly and over time to negative actions by one or more students [3]. Negative actions are further defined as when an individual (the perpetrator) intentionally inflicts or attempts to inflict injury or discomfort to another (the victim) [3]. Three criteria define aggressive behaviour as bullying: 1) repetition, 2) intentionality, and 3) an imbalance of power. Given these characteristics, bullying is often defined as the systematic abuse of power by peers [4]. Negative actions can be verbal (e.g. threats, taunts, teasing, name calling), physical (e.g. hitting, kicking, pushing, shoving, or pinching), and relational/social (e.g. social exclusion, rumour spreading), and can include the most recent forms of attacks on the Internet and using new technologies (also referred to as cyberbullying) [3, 5‐8].

The effects of bullying and victimization have been widely studied during the past decades. Researchers have documented how bullying affects both the victims and the bullies, being associated with negative outcomes from all points of view, including poor academic performance and more school days missed for the victims and poor health outcomes, psychological maladjustment (e.g. in terms of well-being, self-esteem, and self-confidence), and psychosomatic health problems [2, 9‐11]. This is why much effort has been exerted to contrast this phenomenon and, over the past 40 years, a large amount of research on anti-bullying has been produced [12‐17].

Most of the research has examined school-based programmes, using a whole-school approach involving the individual students, parents, classrooms, and the entire school in one complex structure. Even if proven to been scientifically valid, the feasibility and capacity of the results of this research to fit within different contexts must be tested in different fields.

Both the selection and implementation of evidence-based school violence and bullying prevention and intervention programmes in schools have sometimes been problematic, perhaps because programmes are often chosen without consideration of the unique experiences and needs of each specific school or of the context in which the programme has proven to be successful [18, 19].

In Italy, bullying involves a significant percentage of school-age children: two in 10 children between the ages of 11 and 17 years report having been bullied two or more times in a month [20]. However, very little evidence on anti-bullying interventions implemented in Italy is available and none in Sicily, the first Italian region by territorial extension and the fourth by resident population [21, 22].

The Bullying in Sicilian Schools (BIAS) study was therefore designed to estimate the prevalence of the different forms of bullying observed or perceived by teachers and students in a representative sample of first-grade secondary schools in Palermo before and after the implementation of a bullying prevention intervention [23, 24].

A pre-post intervention study involving nine school institutions in the city of Palermo (Sicily) was conducted during the 2017/2018 and 2018/2019 school years. Approval of the Palermo Ethical Committee 1 (session of 12 July 2017, protocol no. 07/2017) was obtained.

Overall, 553 students enrolled in the 30 selected classes were invited to participate in the study. Of these, 151 (27.3%) were absent on one of the two days of the questionnaires’ administration. The pre- and post-intervention questionnaires were administered to the following groups: SEI school group A comprised three schools, for a total of 11 classes and 171 students (93 girls, or 54%; mean age 11.6); SEI school group B comprised four schools, for 13 classes and 180 students (97 girls, or 54%; mean age 12.0); and SEI school group C comprised two school institutions, accounting for six classes and 51 students (26 girls, or 51%; mean age 12.1). A total of 402 students thus participated in the study (response rate 72.7%), 210 (52.2%) of whom were female, with a mean age of 12.3 years, or 12 years and four months (standard deviation 1.3 years; median 12.5 years; range 11–16 years), by the end of the study, and seven (1.9%) were foreign. All teachers who carried out all or part of their teaching activities in the sampled classes were invited to participate in the project. With the aim of including all the teachers’ opinions and for them to determine together the answers to be provided, the questionnaire was completed collegially by the entire class council. All teachers chose to participate in the project. There were a total of 45 class councils. The mean age of the teaching staff was 57.2 years. 83% of the teachers were female.

The results of the survey in the six bullying areas were analysed using the three methods, that is, sentinel questions, the five-question method, and the score of seven method. The prevalence of different types of bullying (physical, verbal, indirect) decreased after the intervention, with the percentage changes varying according to the estimation method used (Table 2).

Specifically, the prevalence of physical bullying decreased when estimated with the sentinel question method (− 1.7% change), the five-question method (− 4.2% change), and the score of seven method (− 2.1% change). The prevalence of verbal bullying decreased between the pre- and the post-intervention questionnaires with all three methods (− 2.8, − 5.5%, and − 6.0% changes respectively).

The prevalence of indirect bullying was slightly reduced as measured by both the sentinel question method (− 1.2%) and the five-question method (− 1.3%) and decreased from 43.3 to 38.8%, for a change of − 4.5%, using the score of seven method between the pre- and post-intervention questionnaires.

The data on observers also shows a decrease after the intervention: from 13.4 to 7.5% with the sentinel question method, from 26.4 to 20.4% with the five-question method, and from 40.5 to 30.8% with the score of seven method. A reduction was also reported in the prosociality area with all three methods (− 7.2, − 7%, − 5.5%, respectively). Finally, the prevalence of resiliency increased with the sentinel question method (+ 3.4%) but decreased with both the five- question method (− 3.5%) and the score of seven method (− 5.7%).

Table 3 shows the results for each bullying area before and after the intervention by the neighbourhood SEI of the nine first-grade secondary schools. A statistically significant change between the pre- and post-intervention results was reported for the students attending schools with SEI level B (intermediate level) with regard to physical, verbal, and indirect bullying according to all the three methods. The reduction of indirect bullying in intermediate-SEI schools using the five-question method (from 28.6 to 23.2%; p-value 0.23) was the only result that was nonsignificant.

In the prosociality and observer areas, a statistically significant decrease was demonstrated for the students of schools with an intermediate SEI (level B) with all three methods. Moreover, an increase in all types of bullying among schools with a high SEI (level A) and a decrease among students of low-SEI schools (level C) was observed, neither of them statistically significant. Finally, for the resiliency area, none of the changes observed in any of the schools were significant.

This study aimed to investigate the short-term effects of bullying and bullying-related positive attitudes on students’ perceptions after a prevention intervention on teachers of a sample of nine first-grade secondary schools in Palermo.

Within the theoretical framework of the teacher–student training cascade effect, teachers were identified as the primary target of an anti-bullying intervention, subsequently translating strategies and methodologies for the prevention of bullying in the classroom [25‐27]. To assess the short-term impact of this intervention, a pre-post intervention questionnaire was administered to 428 students and then analysed using three different methods – the sentinel question method, the five-question method, and the score of seven method – for each of the variables in the study [23].

A decrease in the number of bullying episodes between the pre- and post-intervention surveys was reported by the students in all areas of bullying explored (verbal, physical, and indirect) and was confirmed by each of the three estimation methods. In particular, verbal bullying demonstrated the most significant decrease, together with the physical bullying and observer areas, where the decrease documented also appears encouraging. Among the positive attitudes explored, only the effects for resilience increased with the sentinel question method, although the areas of prosociality and resiliency showed a decrease with the five-question and score of seven methods, unlike the other evidence [22]. These results can be partially explained by the fact that the reduction in the number of bullying episodes inevitably leads to a reduction in related positive attitudes (e.g. reporting the case to parents/teachers).

Unlike other studies estimating the prevalence of bullying with a single-item method (sentinel question), the present study provides not only different measures of bullying prevalence but also a more detailed analysis of the different types of bullying (physical, verbal, indirect, observer role) [12, 21, 22]. Given an analysis of the changes between the pre- and post-intervention questionnaire results according to the neighbourhood SEI of the schools enrolled, a statistically significant reduction in the prevalence in all areas of bullying was observed among students attending schools with an intermediate SEI.

This evidence could suggest different degrees of effectiveness of the intervention conducted in each class by the teachers, who were left free to adapt the content acquired during the formative intervention with their students according to the context’s specificities. The use of a non-prestructured intervention for the students but with a focus on the class could also have been important, given specific aspects of Sicilian culture (e.g. violence, especially in the context of neighbourhood disadvantages) within the genesis of bullying in these specific settings.

In line with method suggested by Ttofi MM et al., the WGs of experts and researchers from various disciplines (education, mental health, public health) that conducted the anti-bullying interventions successfully contributed in reducing the prevalence of bullying [12].

Some limitations of the present study should be considered. First, the study only evaluated students’ self-reported perceptions of bullying, which could have biased the results. Even if this aspect could be partly overcome, future official bullying reports should consider integrating these results with the teachers’ perspective, for a wider interpretation of the phenomenon, especially in the future, when laws will require teachers to officially report every episode of bullying within the school context [28]. The students’ results differed from the teachers’ particularly in the areas of physical bullying, where the teachers reported a zero prevalence in the post-intervention period [24]. This discrepancy highlights how teachers might not be aware of episodes of bullying in their absence or that occur in the school context but outside of the classroom (e.g. bathrooms, halls, outside areas).

Moreover, the school sample involved only urban settings, introducing a potential selection bias that could be avoided by extending future research to suburban and rural areas. On the other hand, the schools selected also represent very different socioeconomic backgrounds, an important aspect for the generalizability of the intervention. Finally, only short-term effects were evaluated and the effects will be difficult to follow up in the longer term, since this aspect was not considered in the study structure and no individual contacts for future communications were foreseen.

In conclusion, even if many school-based interventions have been implemented to reduce bullying in school throughout the world, this is one of the first to be conducted in Europe that assesses the effectiveness among students of an anti-bullying intervention tailored for teachers. The encouraging results obtained in reducing the number of bullying episodes, together with the low cost in term of human and economic resources, could suggest extension of the research on a regional basis and to different school grades, to propose a common strategy to address one of the most important public health issues in school today. In particular, it would be interesting to note any differences between schools in more urbanized, metropolitan areas and those in rural contexts in terms of the prevalence of bullying and the effectiveness of the proposed interventions. Lastly, integration of future research in the cyberbullying area could allow for the development of a combined preventive strategy [25, 29]. Additionally, parental involvement, already known to be effective [12], should be considered.