2014 Emerging Knowledge Podium Presentation Abstract| Volume 28, ISSUE 6, e51-e52, November 2014

An Intervention to Address Bullying in 5th Grade Students


      The purpose of this study was to measure the effectiveness of a comprehensive anti-bullying training program on child health outcomes, bullying behaviors, and educational outcomes among 5th graders in an urban public school setting.

      Background and Significance

      Bullying has received increasing attention among pediatric nurse practitioners (PNP’s), pediatric nurses, public health nurses and educators. It is relevant to the health of children and adolescents and includes physical, psychological and/or verbal behaviors that are repeated and involve an intention to harm. Children who bully others and those who are victimized are at higher risk of many biopsychosocial problems including depression and low self-esteem, sleep problems, low moods, abdominal pain, headaches, and nocturnal enuresis. Bullying has been in the national spotlight recently with media reports of severe injuries, deaths, and suicides. Equally worrisome is the pervasiveness of among youth in general and its impact on the health of children. PNP’s can join other professionals in identifying bullying behaviors and developing and evaluating interventions to combat this issue and improve children’s lives.

      Research Questions

      What is the prevalence of bullying among fifth graders in an urban school? What self-reported health issues are associated with being bullied?


      Johns Hopkins University School of Nursing, in partnership with Elev 8, (a school-based initiative of East Baltimore Development Inc [EBDI], that collaborates with schools, families and community) and two elementary public schools conducted an anti-bullying program focused on 5th graders. The study is a quasi-experimental pretest, posttest control group design with one middle school receiving the anti-bullying program intervention and the comparison school receiving the same anti-bullying program in a delayed intervention. The intervention involved six weekly classroom sessions and the sample included students from two 5th grade classrooms, one classroom in the intervention school and the other in the delayed intervention school. The study is approved by the Johns Hopkins Medicine Office of Human Subjects Research - Institutional Review Boards. All students who had a signed parental consent completed two instruments (approximately 35-40 minutes to complete) to provide baseline health data and bullying prevalence data. Descriptive statistics and Chi Square analyses provided information about the extent of bullying behavior among the 5th graders pre and post intervention, their health related behaviors, and the relationship of being bullied and health of the children.


      The prevalence of bullying behaviors among fifth graders in one school (N=23) was approximately 30% for those reporting being bullied once to several times per week. Seventeen percent reported bullying others 2-3 times per month to several times per week. There was a significant relationship between bullying behaviors and children’s feelings of sadness and being afraid.

      Clinical Implications

      Pediatric nurse practitioners in primary care must be proactive in identifying bullying behaviors and victims of bullying in their pediatric patients and work with parents and educators to protect children. Further research must be done to determine the best ways for PNP’s to identify and educate children with respect to bullying to diminish the deleterious effects of bullying and promote child health.