title: The Good School Toolkit for reducing physical violence from school staff to primary school students: a cluster-randomised controlled trial in Uganda.
abstract: BACKGROUND
  Violence against children from school staff is widespread in various settings, but few interventions address this. We tested whether the Good School Toolkit-a complex behavioural intervention designed by Ugandan not-for-profit organisation Raising Voices-could reduce physical violence from school staff to Ugandan primary school children.
  
  
  METHODS
  We randomly selected 42 primary schools (clusters) from 151 schools in Luwero District, Uganda, with more than 40 primary 5 students and no existing governance interventions. All schools agreed to be enrolled. All students in primary 5, 6, and 7 (approximate ages 11-14 years) and all staff members who spoke either English or Luganda and could provide informed consent were eligible for participation in cross-sectional baseline and endline surveys in June-July 2012 and 2014, respectively. We randomly assigned 21 schools to receive the Good School Toolkit and 21 to a waitlisted control group in September, 2012. The intervention was implemented from September, 2012, to April, 2014. Owing to the nature of the intervention, it was not possible to mask assignment. The primary outcome, assessed in 2014, was past week physical violence from school staff, measured by students' self-reports using the International Society for the Prevention of Child Abuse and Neglect Child Abuse Screening Tool-Child Institutional. Analyses were by intention to treat, and are adjusted for clustering within schools and for baseline school-level means of continuous outcomes. The trial is registered at clinicaltrials.gov, NCT01678846.
  
  
  RESULTS
  No schools left the study. At 18-month follow-up, 3820 (92·4%) of 4138 randomly sampled students participated in a cross-sectional survey. Prevalence of past week physical violence was lower in the intervention schools (595/1921, 31·0%) than in the control schools (924/1899, 48·7%; odds ratio 0·40, 95% CI 0·26-0·64, p<0·0001). No adverse events related to the intervention were detected, but 434 children were referred to child protective services because of what they disclosed in the follow-up survey.
  
  
  CONCLUSIONS
  The Good School Toolkit is an effective intervention to reduce violence against children from school staff in Ugandan primary schools.
  
  
  BACKGROUND
  MRC, DfID, Wellcome Trust, Hewlett Foundation.
authors.affiliation: London School of Hygiene and Tropical Medicine, London, UK. Electronic address: karen.devries@lshtm.ac.uk.
authors.forename: Karen M
authors.initials: KM
authors.lastname: Devries
authors.affiliation: London School of Hygiene and Tropical Medicine, London, UK.
authors.forename: Louise
authors.initials: L
authors.lastname: Knight
authors.affiliation: London School of Hygiene and Tropical Medicine, London, UK.
authors.forename: Jennifer C
authors.initials: JC
authors.lastname: Child
authors.affiliation: Raising Voices, Kampala, Uganda.
authors.forename: Angel
authors.initials: A
authors.lastname: Mirembe
authors.affiliation: Raising Voices, Kampala, Uganda.
authors.forename: Janet
authors.initials: J
authors.lastname: Nakuti
authors.affiliation: London School of Hygiene and Tropical Medicine, London, UK.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Jones
authors.affiliation: London School of Hygiene and Tropical Medicine, London, UK.
authors.forename: Joanna
authors.initials: J
authors.lastname: Sturgess
authors.affiliation: London School of Hygiene and Tropical Medicine, London, UK.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Allen
authors.affiliation: London School of Hygiene and Tropical Medicine, London, UK.
authors.forename: Nambusi
authors.initials: N
authors.lastname: Kyegombe
authors.affiliation: Institute of Education, University College London, London, UK.
authors.forename: Jenny
authors.initials: J
authors.lastname: Parkes
authors.affiliation: Makerere University, Kampala, Uganda.
authors.forename: Eddy
authors.initials: E
authors.lastname: Walakira
authors.affiliation: London School of Hygiene and Tropical Medicine, London, UK.
authors.forename: Diana
authors.initials: D
authors.lastname: Elbourne
authors.affiliation: London School of Hygiene and Tropical Medicine, London, UK.
authors.forename: Charlotte
authors.initials: C
authors.lastname: Watts
authors.affiliation: Raising Voices, Kampala, Uganda.
authors.forename: Dipak
authors.initials: D
authors.lastname: Naker
mesh_terms: D000293:Adolescent; D000328:Adult; D032763:Behavior Control; D002648:Child; D002649:Child Abuse / Q000517:prevention & control*; D005178:Faculty; D005260:Female; D006801:Humans; D008297:Male; D009939:Organizations, Nonprofit; D000066550:Physical Abuse / Q000517:prevention & control*; D012574:Schools; D013334:Students; D011795:Surveys and Questionnaires; D014454:Uganda