Effectiveness of Digital Health Tools to Prevent Bullying among Middle School Students
1.1. Negative Behavioral and Mental Health Consequences of Bullying and Cyberbullying
1.2. Primary Prevention of Bullying and Cyberbullying
1.3. The Promise of Educational Video Games
1.4. Life Skills Training
1.5. Goal of Present Study
2. Materials and Methods
2.2. Research Design
2.5. Program Sequence
2.6. Online Provider Training Workshop
2.7.1. Demographic Information
2.7.3. Skills Knowledge
2.8. Data Analysis
4.1. Implications for School-Based Bullying Prevention
4.2. Strengths and Limitations
4.3. Future Directions
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
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|Lesson||Goals and Objectives||Key Skills||Sessions|
|Self-Image and Self-Improvement||Teach what self-image and self-improvement are |
and how they impact one’s behavior.
|Self-analysis, self-improvement, goal-setting, reframing |
|Making Decisions||Teach to use effective decision-making skills and |
solve problems independently.
|3 Cs of effective decision-making (clarify, consider, choose); |
resisting group pressure.
|Smoking: Myths and Realities||Debunk common myths and misconceptions about |
cigarettes and other forms of tobacco use.
|Analyzing data; checking assumptions; considering pros/ |
|Smoking and Biofeedback||Teach immediate physiological effects of smoking.||Measuring heart rate; understanding scientific method.||1|
|Alcohol: Myths and Realities||Debunk common myths and misconceptions |
about alcohol use.
|Analyzing data; checking assumptions; considering pros/ |
cons; separating fact and fiction.
|Marijuana: Myths and Realities||Debunk common myths and misconceptions |
about marijuana use.
|Analyzing data; checking assumptions; considering pros/ |
cons; separating fact from fiction.
|Advertising||Increase awareness of and teach resistance to |
techniques used by advertisers to manipulate
|Analyzing ads; recognizing persuasive techniques; |
separating fact from fiction and want from needs.
|Violence and the Media||Increase awareness of media influences on |
violence and how to check media presentations
|Analyzing perceptions about violence; comparing images in |
media and reality; resistance to media distortions.
|Coping with Anxiety||Define anxiety and common situations which |
|Recognizing anxiety and its physical effects; healthy |
techniques to manage anxiety; progressive relaxation skills,
mental rehearsal/ visualization, and deep breathing.
|Coping with Anger||Teach common situations that trigger anger and |
how to cope with them.
|Recognizing anger, its physical effects, and how to control |
|Communication Skills||Teach how to communicate effectively.||Using verbal and non-verbal communication; techniques for |
avoiding misunderstandings; clarifying; asking questions;
being specific; and paraphrasing.
|Social Skills||Teach basic social skills to develop successful |
|Making social contacts; giving and receiving compliments; |
effective listening; being persistent; having self-awareness;
considerate of others
|Assertiveness||Teach assertiveness and resist peer resistance |
skills for drug use.
|Reflecting on types of responses, consequences; awareness |
of persuasive tactics; repertoire of refusal responses; verbal
and non-verbal assertiveness.
|Resolving Conflicts||Teach life skills for resolving conflicts.||Analyzing conflict resolution choices; controlling anger; |
building consensus; problem solving; negotiation and
|Bullying and Cyberbullying||Identify types of bullying, roles in bullying |
situations, bystander intervention skills, and
techniques for coping.
|3 Rs of Bullying (Recognize, Respond, Report), 3 Ds |
Technique for Active Bystander Intervention (Direct,
Distract, Delegate), RISE-UP Against Bullying, techniques
for reporting bullying.
|Total Class Periods||20|
|Scenario||Objective||Trigger||Correct Avatar Response||Points Earned|
|A character is verbally |
aggressive toward other
characters and player
(through avatar) after
receiving failing grade
|Managing Anger||Teacher did not allow students to use most modern |
|Reframe Situation to Stay Calm|
and Control Anger
|Stop Bullying||Character is verbally aggressive||Be Direct as an Active Bystander||150|
|Managing Anger||Character is verbally aggressive||Remind Yourself to Stay Calm||225|
|Stop Bullying||A character insults everyone because they are leaving |
school for Winter break, but she has nowhere to go.
|Express Yourself Using ‘I’ |
|A character has received |
a number of negative
|Stop Bullying||Anonymous person threatens to send to the entire school |
unflattering pictures of a main character
|Consider Consequences before |
|Accusations and gossip about |
who is sending threatening
|Stop Bullying||One character is verbally abusive||Be Direct as an Active Bystander||450|
Without adult supervision, characters plan to
investigate who’s sending anonymous texts
Tell a Trusted Adult or Ally
|Role playing with |
counselor on how to
|Stop Cyberbullying||Teacher offers to Help||Make a Specific Request||600|
|Stop Cyberbullying||Bully ridicules other for asking for help from an |
|Tell a Trusted Adult or Ally||675|
|Stop Bullying||Threat of physical aggression||Leave the Situation||750|
|One character breaks |
controller on a game
|Managing Anger||Character broke game controller and demands that |
the owner hands over spare controller
|Take a Deep Breath and Silently Count to 10||825|
|Character receives |
another bad grade
|Character realizes she neglected to study which |
caused her poor academic performance
|Don’t Focus on Negative |
|Character considers not |
going home for Winter
break to avoid criticism
|Make a Decision||Character faces the prospect of not going home |
for Winter break
|Consider Alternatives and |
|Character thinks she knows |
the identity of the cyberbully
|Managing Anger||Characters considering retaliating against person |
believed to be sending anonymous text messages
|Stop and Calmly Count to 10||1050|
|Module||Training Activities for Providers|
|Module 1: Introductions |
|● Get acquainted through trainer-moderated discussion board to promote a cohesive and supportive learning community.|
● Share workshop expectations and identify potential barriers to implementation for immediate feedback from the lead
|Module 2: Orientation||● View archived presentation that describes study’s purpose.|
● Ask lead trainer questions and concerns about provider roles and responsibilities.
|Module 3: Principles and |
Practices of the LifeSkills
|● View narrated video presentation about the theoretical framework and research supporting the LST program. |
● Demonstrate understanding of how research principles and practices are incorporated into the LST instructional materials
and are reflected in key teaching strategies.
|Module 4: Teaching Skills |
for Facilitating Discussion
|● Practice teaching skills, including facilitation, coaching, and behavioral rehearsal, to promote social emotional, cognitive |
behavioral learning, and advance the acquisition of pro-health ideas, skills, and attitudes.
● View video presentations of the teaching skills demonstrated by a master trainer.
|Module 5: Becoming |
Familiar with LST
|● Complete a virtual walk-through of a sample lesson noting key design elements to support fidelity delivery of the LST |
lessons and facilitate preparation to implement the program.
● Take a virtual tour of the teaching resources on the LST website.
|Module 6: Exploring the |
LST Middle School
|● Providers view video presentations of each unit in the LST Middle School curriculum.|
● Providers analyze two units of their choice and identify key objectives, skill sets, points to make and summaries by
completing and uploading a unit review worksheet for review and feedback by lead trainer.
● Discuss with other providers knowledge gained from each unit.
● Address specific challenges they foresee in delivering the lessons.
|Module 7: Teaching |
|● Providers review key learning objectives and activities in bullying and cyberbullying units by completing check points and |
engaging in peer-to-peer discussion posts.
● Reviewed video game dashboard to monitor student progress.
|Module 8: Prevention |
|● Providers reviewed a virtual resource center with links to research articles and websites to enhance educator understanding |
of evidence-based practices that address risk and protective factors impacting adolescent health and wellness.
● Reviewed resources and how they could be used to support high-quality program implementation.
|Module 9: Bullying and |
|● Providers reviewed tools and resources essential for delivering live sessions and documenting their activities in the research |
● Examine fidelity, community events reports, and attendance forms to be submitted over the course of the program
|Module 10: Course |
|● Providers gave feedback on the quality of the teacher training using an online survey instrument. |
● Provider feedback used for continuous improvement of the online training.
|Age in Years: M (SD)||11.74 (0.61)||11.44 (0.61)||11.64 (0.66)|
|Racial Minority (Non-White)||18.2%||26.4% *||20.9%|
|Mean (SE)||Mean (SE)||Mean (SE)||Mean (SE)|
|Physical||1.20 (0.04)||1.32 (0.08)||1.29 (0.10)||1.41 (0.11)|
|Verbal||1.73 (0.06)||1.69 (0.10)||1.74 (0.18)||1.71 (0.20)|
|Social||1.43 (0.05)||1.64 (0.10) *||1.43 (0.14)||1.73 (0.16)|
|Cyber||1.17 (0.04)||1.41 (0.11) *||1.17 (0.12)||1.50 (0.14) *|
|Mean (SE)||Mean (SE)||Mean (SE)||Mean (SE)|
|Bullying Prevention||4.38 (0.05)||4.04 (0.08) ***||4.27 (0.17)||4.16 (0.19)|
|Self-Image||2.22 (0.04)||2.07 (0.06) *||2.15 (0.08)||2.13 (0.09)|
|Decision Making||1.75 (0.03)||1.64 (0.04) *||1.72 (0.06)||1.68 (0.07)|
|Advertising/Media||2.34 (0.14)||2.26 (0.14)||1.75 (0.03)||1.85 (0.06)|
|Violence & the Media||1.75 (0.03)||1.84 (0.06)||1.67 (0.08)||1.84 (0.09)|
|Coping with Anxiety||2.40 (0.04)||2.22 (0.06) *||2.39 (0.12)||2.24 (0.14)|
|Coping with Anger||2.18 (0.04)||2.05 (0.05) *||2.15 (0.10)||2.13 (0.11)|
|Communication Skills||2.35 (0.04)||2.32 (0.05)||2.33 (0.11)||2.21 (0.12)|
|Social Skills||2.39 (0.04)||2.35 (0.06)||2.37 (0.07)||2.34 (0.08)|
|Assertiveness||2.56 (0.04)||2.40 (0.06) **||2.53 (0.11)||2.38 (0.13)|
|Conflict Resolution||2.36 (0.04)||2.28 (0.05)||2.32 (0.11)||2.29 (0.13)|
|Overall Skills Knowledge||25.94 (0.22)||24.48 (0.36) ***||25.51 (1.00)||24.95 (1.15)|
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Williams, C.; Griffin, K.W.; Botvin, C.M.; Sousa, S.; Botvin, G.J. Effectiveness of Digital Health Tools to Prevent Bullying among Middle School Students. Adolescents 2023, 3, 110-130. https://doi.org/10.3390/adolescents3010009
Williams C, Griffin KW, Botvin CM, Sousa S, Botvin GJ. Effectiveness of Digital Health Tools to Prevent Bullying among Middle School Students. Adolescents. 2023; 3(1):110-130. https://doi.org/10.3390/adolescents3010009Chicago/Turabian Style
Williams, Christopher, Kenneth W. Griffin, Caroline M. Botvin, Sandra Sousa, and Gilbert J. Botvin. 2023. "Effectiveness of Digital Health Tools to Prevent Bullying among Middle School Students" Adolescents 3, no. 1: 110-130. https://doi.org/10.3390/adolescents3010009