A Call to Action – The Pediatricians of Pennsylvania – Support for the large population based public health approach to bullying prevention – the Pennsylvania Model

In 2006, the Highmark Foundation of western Pennsylvania launched the Healthy High 5™ initiative, and partnered with the Center for Health Promotion and Disease Prevention, at the Windber Research Institute; Pennsylvania Deptartment of Education, and Clemson University to address school-based bullying on a large scale, utilizing the Olweus Bullying Prevention Program (OBPP). By 2012, this project will reach approximately 230,000 out of 1,775,029 school children in Pennsylvania (13% of the total student population), 442 out of 3,280 school buildings (14% of all schools), more than 17,000 teachers, and over 340,000 parents. This is the largest implementation and evaluation of the OBPP in the U.S. In fact, approximately one third of all U.S. students who have taken the Olweus Bullying Questionnaire reside in Pennsylvania. Based on the work at the Windber Research Institute our state wide data now allows us to offer preliminary comment on the cost effect of a large population bullying prevention initiative. The Pennsylvania implementation of OBPP reduces mental health costs in children and adolescents by $9 million. Other health consequences that will be included in the cost effect analysis are alcohol and substance abuse, abdominal pain, headache, and psychosomatic symptoms (i.e. vomiting, bedwetting, sleep disturbance, poor appetite). And this is only with three years of implementation.

In January 2011, Dr. Susan Limber, of Clemson University’s Institute on Family & Neighborhood Life analyzed nearly 113,000 Olweus Bullying Questionnaire (OBQ) responses, the standard measurement tool of the OBPP. These students, from grades 3-12, represent 225 Pennsylvania schools. Positive changes were seen across almost every OBQ category, including bullying prevalence, types of bullying, duration of bullying, students’ feelings and attitudes about bullying, and students’ reactions to bullying. Specifically, after two years of OBPP impmentation, our data analyis has shown that there are fewer student reporting that they are being bullied ( a relative reduction of 10%-13%) and fewer students reporting they had bullied others (a relative reduction of 27%-41%).  Out of the 230,000 Pennsylvania students our initative will reach, as a result of our efforts conservatively 23,000 fewer students will be bullied, and 62,100 fewer students will bully others.

The Highmark funding has allowed for both large population implementation as well as a strategic continuing education process inclusive of local and regional onsite educational events, training and professional web educational opportunities. I have taken excerpts from the formal observations made by Susan Limber, PhD Clemson University on the national Impact of Highmark Funding for the Olweus Bullying Prevention Program

• ‘Highmark funding provided the resources needed to develop the trainer recertification process (which includes a 2-day face-to-face training and on-line learning modules) and pilot the process in Pennsylvania.  The recertification process began in 2009 in Pennsylvania and has been free to all PA trainers.  The process was opened nationally to all eligible OBPP trainers in 2010.”

• “We have been able to adapt Olweus International’s Quality Assurance System (which was developed for use in Norwegian schools) for use in the American school context.  This process, which is currently being piloted in Pennsylvania schools, involves the establishment of clear quality assurance standards, the coaching of trainers to aid schools in meeting these standards, documentation and site visits to monitor fidelity and progress, and an opportunity to correct any deviations from fidelity.  Schools that successfully complete this process may proudly declare themselves “Olweus Schools”.  The pilot process in Pennsylvania will be invaluable in helping us fine-tune this procedure, which we anticipate will significantly increase the motivation and abilities of school personnel to implement the OBPP with fidelity across the US.”

• “We were able to convene a national working group consisting of trainers who have experience in implementing the OBPP in high schools.  This group examined the extent to which elements of the OBPP had been modified for use in high schools and collected ideas and resources to assist schools in implementing the OBPP effectively.  The culmination of this group’s work has yielded:  (a) revised training materials (PPT slides and agendas) for use in training high school Bullying Prevention Coordinating Committees, (b) an annotated list of suggested supplemental resources and curricular support materials for high school personnel implementing the OBPP, and (c) a tip sheet for educators and family members to assist them in discussing bullying with teens.  These resources will be invaluable tools for trainers in Pennsylvania and across the US who are interested in implementing the OBPP in high schools but currently lack the program supports to do so.”

• “Schools have dramatically different levels of success in meaningfully involving parents in OBPP planning and activities.   We have made needed revisions to the OBPP Workbook, the key planning tool for implementation of the OBPP.  These revisions include a much heightened focus on engaging parents in various levels of the OBPP.  These training materials will be available to trainers within Pennsylvania and across the US.”

• (The Pennsylvania initiative allowed ) “us to analyze the data in the OBQ database, we would have been much delayed in producing and releasing these important (national) findings.”

In addition, and in collaboration with Professors Olweus and Limber, the PA Coalition has implemented multiple layers of Evaluation, The Olweus Bullying Questionnaire, Online Surveys for HALT!-Teacher, Parent and School Support Staff,  Integrated Teacher Survey, School Level Fidelity Report, Integrated BPCC Coordinator Evaluation Survey, and the Readiness Series for Prevention of School Violence

We feel that this PA initiative can serve as model program for other states that want to deliver an internationally recognized bullying prevention initiative at low cost to a large population of students and with the highest level of programmatic fidelity, monitoring and evaluation. We need to approach these public health/social epidemics from a public health perspective rather then from only a school or district setting so as to gain maximum behavior and health impact; with the appropriate monitoring and evaluation; and in a cost effective manner where it can later be stated that the initiative has been identified as a legitimate cost benefit to society, especially now during these difficult economic times. Many thanks.