Anti-bullying interventions at school: aspects of programme adaptation and critical issues for further programme development.

Recently, a growing interest in problems at school of peer aggression and victimization was observed. As a result, intervention strategies appropriate for this kind of problem were required. The Norwegian anti-bullying intervention that was developed and evaluated by Olweus (1992) in the region of Bergen was considered to be a good model for other countries to implement interventions against peer aggression within the school environment. It was therefore adapted to the educational settings of other countries. This paper aims to discuss the adaptation processes of the Bergen anti-bullying programme and to give guidelines to advance further programme development. For this, the DFE Sheffield Bullying Project (Smith and Sharp, 1994), the Anti-bullying Intervention in Toronto schools (Pepler et al., 1994) and the Flemish anti-bullying project (Stevens and Van Oost, 1994) were considered in the analyses. Discussion of the adaptation processes of the Bergen model programme revealed that the adapted interventions largely succeeded in incorporating the core components of the Bergen model programme, taking into account the characteristics of the implementation environment. This suggests that for bully/victim interventions, the dilemma of programme fidelity and programme adaptation could be solved adequately. However, from a health promotion perspective, some critical issues for programme improvement were observed. Three suggestions for change were made, indicating that anti-bullying actions at schools may benefit from: (i) a clear overview of the learning objectives, specified per target population; (ii) more attention to parental involvement and family interventions; and (iii) additional information about the adoption processes of the anti-bullying interventions within schools.

Bullying in Flemish schools: an evaluation of anti-bullying intervention in primary and secondary schools.

BACKGROUND: The positive of the Norwegian anti-bullying programme (Olweus, 1992) stimulated other countries to tackle bully/victim problems. However, outcome studies found rather low levels of effect or even inconsistent results. AIMS: The purpose of the present study was to evaluate behavioural effectiveness of a school-based anti-bullying approach within Flemish schools. In addition, specific attention was given to the relationship between outcome findings and external support. SAMPLE: A total of 18 schools, comprising 1104 primary and secondary school children were recruited for this study. Students ranged in age from 10 to 16 years. METHOD: For this study, an experimental pre-test/post-test design was used which included a control group. Three groups were established. The first group, Treatment with Support, involved students from schools that implemented a school-based anti-bullying intervention with additional support from the research group. The second group, Treatment without Support, also involved students from schools that implemented a school-based anti-bullying programme. However, in contrast with those falling under the first condition, this group of schools could not appeal to the research group for additional help. The last group involved students from schools that did not implement the anti-bullying programme and served as a Control condition. Repeated measures analyses of variance were carried out. RESULTS: The findings regarding the effects of the school-based anti-bullying intervention programme on the extent of bullying and victimisation showed a mixed pattern of positive changes in primary schools and zero outcomes in secondary schools. The findings regarding the effects of external support revealed limited outcomes. CONCLUSIONS: The outcomes of the evaluation study confirm that a school-based anti-bullying intervention strategy can be effective in reducing problems with bullying, especially within primary schools. It was argued that the developmental characteristics of secondary school students interfered with the programme outcomes. In addition, the findings revealed no extra effects of specific training sessions.

Stimulation seeking and hyperactivity in children with ADHD. Attention Deficit Hyperactivity Disorder.

Thirty hyperactive and 30 non-hyperactive children were confronted with a delay, consisting of a waiting situation of 15 minutes, either with or without extra stimulation provided by the presentation of a videotape. The behaviour of the child during the waiting period was videotaped and later coded by two naive observers. In line with theories that emphasise the stimulation-seeking function of hyperactive behaviours, such as the optimal stimulation account and the delay aversion theory, a group by stimulation effect was hypothesised. For two categories of activity this was found, with ADHD children displaying more activity than non-ADHD children in the no-stimulation but not in the stimulation condition. These data provide support for the stimulation-seeking function of certain features of ADHD hyperactivity.

The effects of an anti-bullying intervention programme on peers' attitudes and behaviour.

This study aimed to evaluate the effect of an anti-bullying intervention programme on peers' attitudes towards bullying and their attempts to solve bully/victim conflicts. An experimental pre-test/post-test design with a control group was used. For secondary school students, positive outcomes were observed at post-test 1 on attitudes and on actual rates of intervention. However, the effects had disappeared at post-test 2. For primary school students, significant differences were found at post-test 2, showing a smaller decline in seeking teacher's help and in heightening students' support for victims. Students' competence to solve bully/victim problems in relation to their general pro-social development is discussed.

A cluster-analytical approach toward physical activity and other health related behaviors.

PURPOSE: The purpose of our study was to investigate, on the basis of cluster analysis, whether healthy behavior clusters in a healthy or unhealthy way, whether physical activity can discriminate among those clusters, and whether the groups identified could be characterized by demographic variables. METHODS: The relationships between physical activity and other health related behaviors were studied in three age groups, ages 16-25, 35-45, and 50-65. Almost 2400 subjects from a medium-sized Belgian town were interviewed at home to assess their level of physical activity in the past year and to obtain information on other healthy behaviors. RESULTS: The two-cluster solution was found to be most reliable in all three age groups. Smoking discriminated most among the clusters. Cluster analysis divided each age group into a healthy and a more unhealthy subgroup, in which the healthy subgroup is larger than the unhealthy one. Sex differences were found in all three age groups, with more men in the unhealthy cluster. Socio-economic differences are especially strong in the two youngest samples. CONCLUSIONS: The hypothesis that leisure time physical activity had discriminating power between healthy and unhealthy subgroups was not confirmed. Physical activity seems to be a unique factor in contrast to other health related behaviors. In the future, specific intervention directed at the promotion of physical activity in the population is necessary.

Immediate imitation and joint attention in young children with autism.

There is growing scientific interest in the precursors to the ability of conceiving other people's minds. The present study investigates two candidate precursors, imitation and joint attention, in young children with autism and a control group of nonautistic children with a developmental delay. Children with autism were found to be impaired or delayed in both abilities. Gestural and procedural imitation were significantly related to mental age and chronological age in subjects with autism. Although the evidence for an autism-specific deficit appears to be stronger in the domain of joint-attention behaviors than it is in the domain of imitation, it seems premature to reject imitation as a possible precursor to the development of mindreading skills. Systematic investigations of the imitation deficit in autism are urgently needed.

Family members' influence on decision making about food: differences in perception and relationship with healthy eating.

PURPOSE: This study provides insight into decision making about food choices in the family and its relationship with (un)healthy eating, by including the responses of four members of the family as a sampling unit. SETTING: The study was conducted through four medical centers, visited by 69 classes from 19 different schools in Belgium. SUBJECTS: Ninety-two family quartets, including both parents and two adolescents between 12 and 18 years old, completed questionnaires independently. MEASURES: Four previously investigated measures of decision-making power (30 items on a seven-point scale) were administered, along with a short food choice questionnaire and demographic variables. RESULTS: Results indicate that the influence of fathers but more especially that of children is important in food decisions. Moreover, the relative influence of each family member is dependent on the kind of product or product group considered. Differences in perceptions between the four family members show the importance of considering the responses of all the people involved in family decision making. Finally, it is clear that in families where adolescents have more power, food choices are less healthy. CONCLUSIONS: Our main conclusion is the rejection of the "gatekeeper hypothesis" as an artifact of biased measurement. A multidimensional approach to the issue of influence in food decision making in the family is potentially richer and leads to different conclusions. The necessity of the involvement of the entire family for the introduction and adoption of healthy eating is emphasized.

'Appropriate' male and female safer sexual behaviour in heterosexual relationships.

This paper is an attempt to explore how traditional gender role socialization runs counter to safer sexual practices. Structured interviews (N = 448 sexual encounters) were conducted with heterosexual young adults in 'natural settings' such as summer music festivals and youth houses/youth clubs. Congruent with a perspective of gender role theory, females were found to care more about safer sex. The data do not suggest that females are forced to rely on less efficient ways of practising safer sex, but they have to try harder to be successful. Males may implement safer sex in an encounter without negotiation, because it is obvious, or they just have to mention it at the moment of sexual intercourse. Females have to start negotiating safer sex long before the actual encounter in order to be as successful as males. There is one important critical situation for females, notably the encounter in which they perceive the male to be dominant.

Impact of a school-based prevention programme on traditional and egalitarian adolescents' safer sex intentions.

The study assessed the impact of a school-based sexual risk reduction program on adolescent's knowledge, need for information, problem-solving and communications skills, intention to talk about and to practise safer sex. The primary goal of working with adolescents in schools was successful, in that significant treatment effects occurred on knowledge, perception of skills and frequency of communication. The program was not effective in improving intentions to use condoms. Evidence for the importance of social context aspects for safer sexual decision-making was found, since the impact of the programme differed for subjects differing in gender role attitudes.

Nasal carriage and peritonitis by Staphylococcus aureus in patients on continuous ambulatory peritoneal dialysis: a prospective study.

OBJECTIVE: To establish whether or not patients on continuous ambulatory peritoneal dialysis (CAPD) using current infection control measures who are nasal carriers of Staphylococcus aureus are at risk for the development of S. aureus peritonitis. DESIGN: A prospective 22-month study analyzing nasal and skin/nasal (i.e., nasal and/or exit-site) carrier status for S. aureus and peritonitis episodes. Nasal swab cultures for S. aureus were taken with 1- to 3-month intervals; swab cultures from the catheter exit site were taken only when infection was suspected. SETTING: Renal unit, tertiary-care center. PATIENTS: All patients on CAPD at our center that could be observed during at least 2 months. INTERVENTIONS: None. MAIN OUTCOME MEASURES: Nasal and skin/nasal carrier status, occurrence of peritonitis. RESULTS: Of 54 enrolled patients, 31 (57%) were nasal carriers for S. aureus: 6 of these 31 developed S. aureus peritonitis as opposed to none of 23 non-carriers (p = 0.03). The S. aureus peritonitis rate in 28 skin/nasal carriers was increased when compared to non-carriers (p = 0.02), but there was no difference between chronic and intermittent skin/nasal carriers (p = 0.63). CONCLUSIONS: In our population, nasal carriers are at increased risk for the development of S. aureusperitonitis. Further studies should evaluate the effect of eradication of nasal carriage of S. aureus and the effect of additional preventive hygienic measures on the occurrence of peritonitis by S. aureus.

Principals' and teachers' views of sexuality education in Flanders.

This survey was part of the first systematic large-scale assessment on the practice of sexuality education in Flanders. A representative sample of 400 secondary schools was drawn from a total of 1,050 schools. A positive view toward school-based sexuality education was found for both school principals and teachers. However, time devoted to sexuality education is too restricted, and teaching strategies are too verbal to expect changes in attitude and behavior with regard to contraception and AIDS prevention. Next to the low popularity of active teaching methods, ignorance of the discrepancy between goals set and methods used, and the low value attached to improving the skills of students in using contraceptives, were critical findings. Rather than increasing instruction time, discussion of the relationship among goals, methods, and training in the use of active methods would be more beneficial to improving sexuality education in Flanders.