Matt Masiello, M.D., MPH

Category: Bullying Prevention

  • Press Release: Highmark Foundation reaches more than 210,000 school children with bullying reduction measures

    20120517-164639.jpgPITTSBURGH (Dec. 7, 2011) – According to Bullying Prevention: The Impact on Pennsylvania School Children, a report released by the Highmark Foundation today, 13 percent of Pennsylvania school children have experienced reductions in bullying behavior through exposure to the Olweus Bullying Prevention Program (OBPP), funded by the Foundation for the region’s schools. The wide-scale implementation represents the largest in the nation and has led to Pennsylvania’s rise as a national leader in bullying prevention.

    By 2012, OBPP will reach 210,000 students, 13 percent of all public schools, more than 17,000 teachers and approximately 345,000 parents. It has been classified as a model program by the Blueprints for Violence Prevention, a project of the Center for the Study and Prevention of Violence at the University of Colorado.

    “A safe school climate is so important to the overall health and well-being of children, and this report showcases the impact of evidence-based OBPP in schools and the positive effect they have on decreasing bullying incidents,” said Yvonne Cook, Highmark Foundation President. “It is the Highmark Foundation’s goal to continue to collaborate between public and private entities and offer this model program to others in an effort to affect more positive change across the system.”

    The 2011 report brings to light a two year analysis of bullying prevention program outcomes from more than 400 Pennsylvania schools. The Highmark Foundation supported the report’s development by renowned bullying prevention experts at Windber Research Institute, the Center for Safe Schools and Clemson University, which reflects the significance of the scope of bullying prevention efforts made in Pennsylvania schools through Highmark Healthy High 5, a five-year initiative of the Highmark Foundation.

    Highmark Foundation reaches more than 210,000 school children with bullying reduction measures

    The 2011 data, compiled through student self-reports, indicates that the percentage of students being bullied two to three times per month or more (between 2008 and 2010) decreased by 10 percent among elementary students, 15 percent among middle school students and 13 percent for high school students. Students’ incidents of bullying others 2-3 times per month or more also decreased.

    “Bullying prevention has certainly become a higher priority on the national agenda through anti-bullying legislation and federal lawmakers,” said Dr. Matt Masiello, Director of the Center for Health Promotion and Disease Prevention at Windber Research Institute. “The positive results found within Pennsylvania schools can serve as an even greater example for other states to follow. Students themselves are emerging as leaders and ongoing data collection and analysis predicts even more positive change for the future.”

    The report findings also demonstrate that Pennsylvania school students are beginning to reach out to their peers in a more positive way. Findings show that the percentage of students who said they would “try to help the bullied student in some way or other” increased by 7 percent among elementary students, 10 percent among middle school students and 13 percent among high school students.

    The Highmark Foundation has led this coalition of OBPP experts, educators and public health professionals to implement OBPP to the largest population of students to date. With an evidence-based program in place and motivating outcomes on the rise in Pennsylvania, the positive impact of bullying prevention programming in schools is the driving force to fostering healthier, happier children.

    About the Highmark Foundation

    Created in 2000, the Highmark Foundation is a charitable organization, a private foundation and an affiliate of Highmark Inc. Its mission is to improve the health, well-being and quality of life for individuals who live in the communities served by Highmark Inc., its affiliates and subsidiaries. In 2006, the Foundation launched Highmark Healthy High 5, a children’s health promotion initiative designed to improve the health of children and adolescents, ages 6-18. Through a $100 million commitment, Highmark Healthy High 5 addresses five critical issues – nutrition, physical activity, grieving, self-esteem, and bullying prevention.

    The Highmark Foundation awards high-impact grants to charitable organizations and hospitals to launch programs aimed at improving community health and addresses four key areas of health care concern: chronic disease, communicable disease, family health, and service delivery systems. Find more information about the Highmark Foundation at www.highmarkfoundation.org

  • After the Volcano

    Another year and we find ourselves not only going back to Europe but being asked to go back. Having a World Health Organization Collaborative Center doing the asking is not a bad deal. Next week Mr Tom Kurtz, our CEO at the Windber Research Institute (WRI) will be leading a five person entourage from Pennsylvania to the World Health Organization Health Promoting Hospital Conference in Turku, Finland. This team will consist of Mr Kurtz, Dr. Carla Zema from St Vincent University, Barbara Adons, RN from St Mary Medical Center, Ms Charvonne Holliday and myself from WRI. Spending an extra week in the UK last year due to mother nature was certainly an event, especially for my 17 year old son who most definitely benefited from that academic and environmental experience. Some ground shaking work will be in the offering this year but hopefully, and only, from our own doing.

    20120517-163251.jpgAs these large international conferences go the plenary session is a key event where all of the participants, 500 in this WHO event, are expected to attend. Charvonne Holliday and I are preparing a presentation that will allow this esteemed audience to hear about the work our WRI team has done in the area of violence prevention. Over the years we have been successful in identifying funding for our community based projects due to our compulsive nature to evaluate and monitor what we do. The alternative to that at times and unfortunately is to fund a program, offer the program to the community but never fully or appropriately evaluate all the steps in that process. For the first time in the 19 years of this conference there will be a 2 hour workshop on just how to do that. The scientific committee of the organization has asked the Pennsylvania based group to be that scientific team doing the honors for this international group of hospital and health service administrators, public health professionals and health care workers.

    I have once again been asked to present our work at one of the break out sessions. Here we will talk about our collaborative project with one of the largest health care systems in Europe, Ospidal Civili. Per the invitation of this hospital I will have the opportunity to spend a week in Brescia, Italy prior to the WHO conference preparing this presentation and advancing this pediatric asthma clinical and health promotion project. While in Italy I will also be traveling to Padova where I will have the opportunity to present our bullying prevention work to the Psychology Dept at the University of Padova. This Center and the Windber Research Institute have been collaborating in determining the health effects of bullying and the cost benefit to prevention programs.

    And as I did last year, I will be moderating a session where several hospital and health system leaders will present their programs to that interested group of colleagues. In a similar session The Italian University and WRI will be presenting our collabotrative work on developing a pediatric clinical/health promotion data base.

    As we did at the Windber Research Institute and the Windber Medical Center several years ago, Tuku will be holding a event similar to our WHO Winter School, but this time in sunny Finland. Here, I will have the opportunity to teach new members of this 700 hospital organization about the Health Promoting Hospital Network and our many other projects, including the Windber and Copenhagan health promotion project which is about to be published. Lastly, I have the privilege to represent the United States and Pennsylvania at the Governance Board meeting of the organization.

    All of this is funded though our Pfizer grant as well as stipends we will receive from the World Health Organization Health Promoting Hospital organization and our Italian colleagues. Wish us well. We will do Pennsylvania proud. Baring any volcanoes we will be back June 5th to report on a successful journey.

  • JAMA Commentary Promotes Investment in Disease Prevention

    http://www.rwjf.org/publichealth/product.jsp?id=38452

  • Bullying Prevention Takes Time to Implement, But Worth The Effort

    As with any public health issue, it takes time for effective change to take hold. Just think about how many years it took to educate Americans on the dangers of tobacco, childhood obesity, the importance of car passenger seat belts and bike helmets. Think about the time and resources that continue to be invested to convince millions that these issues negatively effect ones health. However, despite these challenges, we are seeing a shift towards greater awareness.

    However, when you discuss bullying in the context of other public health issues it is only recently that we feel the same urgency associated with these other examples. The effects of bullying are now considered as tangible as lung cancer or Type II Diabetes. We now know that bullying can lead to long-term negative physical and mental health problems.

    20120518-175238.jpgWe see too often on the news the very worst of bullying; stories only told when a violent act or a suicide takes place. And, these violent acts may be just that, examples of violence which may or may not be consistent with the accepted definition of bullying. There are countless untold stories of bullying that happen every single day to thousands of children.

    The twenty years of study directed towards bullying prevention requires an approach equal to other pressing public health concerns. It requires a strategic allocation of resources along with expertise and eventually the right legislation to effect change and eliminate this harmful behavior.

    Five years ago, when the Highmark Foundation decided to make bullying prevention one of the five key focus areas in its Healthy High Five Initiative, educators and public health professionals knew at that point we were about to make great strides to help prevent bullying in Pennsylvania. In 2007 the Highmark Foundation embarked on developing a public health strategy to appropriately and effectively implement programs at the school level to positively effect change.

    The first step was to identify that well studied and highly respected Olweus Bullying Prevention Program (OBPP) as the foundation to our effort. Founded by Swedish professor Dan Olweus, who is acknowledged as the founding father of bullying prevention, the OBPP has been successfully implemented in schools worldwide, and has become the basis for the Foundation’s efforts to deal with bullying in local schools.

    To follow this public health approach in addressing the epidemic of bullying, the Highmark Foundation also built a strong coalition of professionals to successfully implement the OBPP. By working with Clemson University’s Institute on Family and Neighborhood Life, Dr. Olweus, the Center for Health Promotion and Disease Prevention, Windber Research Institute and the Pennsylvania Center for Safe Schools, the Foundation was able to develop a strategy to reach thousands of school children as well as monitor and evaluate the process.

    Research consistently reveals that school-based prevention programs—including those that target bullying—are more likely to produce desired changes in behavior if they are implemented with fidelity, monitored and evaluated. Knowing this, the coalition of experts used the existing evaluation strategies imbedded in the Olweus Bullying Prevention Program as well as developed a range of additional evaluation strategies to determine a school’s readiness to participate in anti-bullying efforts, to monitor the school’s implementation of the OBPP and to assess outcomes from the program.

    Our constant evaluation allowed us to make sure that we adapted, modified and enhanced the Highmark Foundation bullying prevention initiative for schools in our region. To do this, the Highmark Foundation also created the Bullying Prevention Institute (BPI). Among the BPI’s responsibilities was to develop enhancements that could be implemented in the existing OBPP. For example, since the OBPP was developed in Europe, modifications needed to be made for implementation in Pennsylvania schools. Another major enhancement to the OBPP was implementation at the high school level. This had never been done on such a wide scale before.

    Finally, we had to develop a bullying prevention effort that was sustainable. Support from the Highmark Foundation would have all been for naught had we not increased capacity within schools and school districts to implement the OBPP. By developing long-term resources for administrators and teachers, we ensured that schools will continue to create a culture that deters bullying behaviors.

    We have made a tremendous impact in five years. Since the program began, we have been able to reach:

    • 210,000 students, 13 percent of Pennsylvania’s student population
    • 427 out of 3,280 school buildings
    • More than 17,000 teachers
    • Approximately 345,000 parents

    Most importantly, our bullying prevention efforts are the largest implementation of the Olweus Bullying Prevention Program in the United States. This effort serves as a national model for others to study and replicate. Our work is not done yet, but we are proud of our accomplishments. We are also proud of the thousands of teachers, parents and students that have embraced an anti-bullying culture.

    We’re not free of bullying behavior, just as we are not free of tobacco use or the obesity epidemic, but because of the efforts of many, we are certainly heading in the right direction.

  • Bullying Prevention – A Window of Opportunity

    With the beginning of each school year our office begins to receive the sincere, heartfelt calls from parents regarding their concerns about school or sports based bullying. Theses parents are most disturbed over the manner in which schools are utilizing, or not, available bullying prevention programs. We educators, public health officials and pediatric health care specialists should listen and react appropriately to these legitimate concerns. Bullying, also referred to as peer harassment or peer abuse, is a significant problem. Upwards of 30% of our children are bullied every day; every day 160,000 children miss school; and every seven minutes a child is bullied at school. Additionally, middle school bullies are 3 times more likely to have at least one criminal conviction by the age of 24. Bullying is a factor in school absenteeism, higher drop-out rates, low academic achievement, diminished learning capacity, childhood depression, teen drug & alcohol use, and teen suicide.

    The challenges we face in addressing this distressing situation include the lack of evidence-based practice prevention programs and the schools’ ability to implement these prevention programs with fidelity. This is an issue with all programs – obesity, injury prevention, suicide prevention, etc. Another issue that must be addressed is how long the school- based program should be continued in order to obtain optimal results. Buy-in by the leadership is essential to a successful program. Some schools experience a fairly frequent turnover of superintendents, principals, school counselors, and other staff which requires a renewed, timely commitment to the bullying prevention program.

    Based on all the above, we are learning that schools cannot possibly manage these programs alone. As with any public health epidemic, bullying prevention takes a diverse group of professionals, parents, coaches, bus drivers, lunch room monitors, etc. to achieve maximum results and ensure that it succeeds. With the support and commitment of the Highmark Foundation and Dr. Zahorchak, Pennsylvania Secretary of Education, Pennsylvania has taken the lead in the U.S. in addressing this most prevalent form of school violence in our society today. The results are significant and can be reviewed in a future commentary or editorial piece.

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    So the advice we offer to schools, parents and other leaders in our community:

    • Effective bullying prevention programs are available to schools. Every school in western PA should have one in place.
    • Use these evidence-based programs to the fullest and make every effort to comply with the evaluation process of that program.
    • Physicians should refer to the American Academy of Pediatrics’ policy statement of recommendations to pediatricians on how best to respond to questions or observations when they arise in an office visit.
    • Remember, that when we are dealing with actual violent acts or significant behavioral issues requiring medical advice or counseling, we have often gone beyond what any school-based bullying prevention program can provide.
    • Schools must develop a formal line of communication with parents when a bullying complaint is filed since the state now mandates, through recent legislation, that schools officially respond to such complaints.
    • Peer harassment that we observe in school-based sports has to end. Sideline taunting by parents and coaches at youth sports must end.

    Lastly, to move to a point where bullying behaviors decrease in school will require a change in the culture and climate of our schools as well as our homes. The student and teacher bystander observing peer abuse in a school must learn to react immediately and report such events immediately. Parent-teacher organizations and school boards must become much better informed on the issue and take the lead to insure that an evidence-based bullying prevention program is firmly embedded in their schools; are done correctly with the highest degree of fidelity; and stay beyond any changes made in staff.

    As it has taken years to address teen smoking, teen pregnancy, and seat belt use, it will take a generation of commitment to address this issue of school-based violence. Most importantly, we need to listen, observe, and be empathetic to the concerns and pleas of our parents, students and teachers who are trying to make a difference.

  • 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.”

    And from one of our PA school district superintendents: “We are proud of the positive impact the HALT! (Olweus) program has had on our district and community. In 2008-09, there were over 60 teacher assaults in a particular high school with two teachers seriously injured, in addition to 333 expulsions. In 2010, there were zero expulsions.” And in Cambria County 30% of participating elementary and middle school students now report that they have a friend, when they previously did not.

    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.