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

BackgroundSchools 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 widespr...

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Main Authors: Agley, Jon, Jun, Mikyoung, Eldridge, Lori, Agley, Daniel L, Xiao, Yunyu, Sussman, Steve, Golzarri-Arroyo, Lilian, Dickinson, Stephanie L, Jayawardene, Wasantha, Gassman, Ruth
Format: Article
Language:English
Published: JMIR Publications 2021-01-01
Series:JMIR Mental Health
Online Access:http://mental.jmir.org/2021/1/e25860/
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spelling doaj-05f7b20ba82c4b6d9f395b00c08d3c572021-05-02T19:41:21ZengJMIR PublicationsJMIR Mental Health2368-79592021-01-0181e2586010.2196/25860Effects of ACT Out! Social Issue Theater on Social-Emotional Competence and Bullying in Youth and Adolescents: Cluster Randomized Controlled TrialAgley, JonJun, MikyoungEldridge, LoriAgley, Daniel LXiao, YunyuSussman, SteveGolzarri-Arroyo, LilianDickinson, Stephanie LJayawardene, WasanthaGassman, Ruth BackgroundSchools 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. ObjectiveThis 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. MethodsThis 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. ResultsIntervention 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. ConclusionsThis 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 RegistrationClinicaltrials.gov NCT04097496; https://clinicaltrials.gov/ct2/show/NCT04097496 International Registered Report Identifier (IRRID)RR2-10.2196/17900http://mental.jmir.org/2021/1/e25860/
collection DOAJ
language English
format Article
sources DOAJ
author Agley, Jon
Jun, Mikyoung
Eldridge, Lori
Agley, Daniel L
Xiao, Yunyu
Sussman, Steve
Golzarri-Arroyo, Lilian
Dickinson, Stephanie L
Jayawardene, Wasantha
Gassman, Ruth
spellingShingle Agley, Jon
Jun, Mikyoung
Eldridge, Lori
Agley, Daniel L
Xiao, Yunyu
Sussman, Steve
Golzarri-Arroyo, Lilian
Dickinson, Stephanie L
Jayawardene, Wasantha
Gassman, Ruth
Effects of ACT Out! Social Issue Theater on Social-Emotional Competence and Bullying in Youth and Adolescents: Cluster Randomized Controlled Trial
JMIR Mental Health
author_facet Agley, Jon
Jun, Mikyoung
Eldridge, Lori
Agley, Daniel L
Xiao, Yunyu
Sussman, Steve
Golzarri-Arroyo, Lilian
Dickinson, Stephanie L
Jayawardene, Wasantha
Gassman, Ruth
author_sort Agley, Jon
title Effects of ACT Out! Social Issue Theater on Social-Emotional Competence and Bullying in Youth and Adolescents: Cluster Randomized Controlled Trial
title_short Effects of ACT Out! Social Issue Theater on Social-Emotional Competence and Bullying in Youth and Adolescents: Cluster Randomized Controlled Trial
title_full Effects of ACT Out! Social Issue Theater on Social-Emotional Competence and Bullying in Youth and Adolescents: Cluster Randomized Controlled Trial
title_fullStr Effects of ACT Out! Social Issue Theater on Social-Emotional Competence and Bullying in Youth and Adolescents: Cluster Randomized Controlled Trial
title_full_unstemmed Effects of ACT Out! Social Issue Theater on Social-Emotional Competence and Bullying in Youth and Adolescents: Cluster Randomized Controlled Trial
title_sort effects of act out! social issue theater on social-emotional competence and bullying in youth and adolescents: cluster randomized controlled trial
publisher JMIR Publications
series JMIR Mental Health
issn 2368-7959
publishDate 2021-01-01
description BackgroundSchools 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. ObjectiveThis 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. MethodsThis 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. ResultsIntervention 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. ConclusionsThis 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 RegistrationClinicaltrials.gov NCT04097496; https://clinicaltrials.gov/ct2/show/NCT04097496 International Registered Report Identifier (IRRID)RR2-10.2196/17900
url http://mental.jmir.org/2021/1/e25860/
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