ClinicalTrials.gg
RecruitingNCT06001554ICC-T_PakUpdated Apr 9, 2024

Preventing Physical and Emotional Violence by Teachers in Public Schools in Pakistan

An interventional study of Interaction Competencies with Children - for Teachers (ICC-T) in Violence, sponsored by Bielefeld University. Recruiting at 1 site in Pakistan. Open to participants aged 11 Years to 62 Years. Per ClinicalTrials.gov, last updated 2024-04-09.

Sponsored by Bielefeld University · Not applicable, Interventional, and Prevention

From the registry’s dates

  • Primary completion was expected by Jul 2026, 4 months ago, but the record still lists the study as recruiting.
  • Started Sep 2023; still recruiting 3 years 1 month later.
Phase
Not applicable
Study type
Interventional
Enrollment
2,100
Allocation
Randomized
Ages
11 Years to 62 Years
Sex
All
01

Study summary

Violence has severe and long-lasting negative consequences for children and adolescents' well-being and psychosocial functioning, thereby also hampering communities and societies' economic growth. Studies show high prevalence rates of violence by teachers against children in Pakistan. In addition to legal and structural factors (e. g. stressful working conditions for teachers), attitudes favoring violence against children as an effective and acceptable discipline method and the lack of access to alternative non-violent strategies are likely to contribute to teachers' ongoing use of violence against children.

Notwithstanding, there are currently very few school-level interventions to reduce violence by teachers that a) have been scientifically evaluated and b) that focus both on changing attitudes towards violence and on equipping teachers with non-violent discipline strategies.

Thus, the present study tests the effectiveness of the preventative intervention Interaction Competencies with Children - for Teachers (ICC-T) in secondary schools in Pakistan. Previous studies have provided initial evidence on the feasibility to implement teacher violence interventions in secondary schools in Pakistan. This study aims to provide first evidence for the effectiveness of ICC-T to reduce violence and to improve children's functioning (i.e. mental health, well-being, academic performance) in Pakistan.

Read the detailed description

The study is a multi-site cluster randomized controlled trial with schools (clusters) as level of randomization. Three districts in each site of the four sites (Khyber Pakhtunkhwa province, Sindh province, the State of Azad Jammu \& Kashmir, and the federal capital Islamabad+Punjab province) will be purposely selected to ensure diversity of schools in terms of geographical, economical, social, and politically background. In each site, 12 public schools will be randomly selected, resulting in a total number of 48 schools (12 per sites). Schools will be stratified based on school type (girls or boys school). In each site, 6 schools (3 girls and 3 boys schools) will be randomly allocated to the intervention group (that will receive the ICC-T intervention) and the control group (that will receive no intervention).

At each school, 30 students in the first year of secondary and all teachers (expected average number: 15) will be recruited. Thus the final sample will comprise 1440 students and at least 720 teachers at baseline.

The study will have three data assessment points: baseline assessment prior to the intervention, the first follow-up assessment six months after the intervention and the second follow-up assessment 18 months after the intervention. In addition, feasibility data will be assessed in the intervention group at the beginning and the end of the intervention.

Primary outcome measures are student- and teacher-reported physical and emotional violence by teachers in the past week. Secondary outcome measures include children's emotional and behavioral problems, quality of life, cognitive functioning, academic performance, and school attendance.

02

Conditions studied

  • Violence

Keywords

  • school violence
  • teacher violence
  • teachers
  • intervention
  • students
  • public schools
  • secondary schools
03

In context

Lead sponsor

Bielefeld University is the lead sponsor of 9 studies on the registry; 4 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
11 Years to 62 Years
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

General:

Inclusion criteria

Inclusion Criteria:

All: Written (if underaged by parents (written) \& minors themselves (written) Students: Enrollment in selected secondary school Teachers: All teachers employed at the selected schools

Schools:

Public secondary schools Day schools At least 30 students in selected class/stream

Exclusion criteria

Exclusion criteria:

Students and teachers:

Acute drug or alcohol intoxication Acute psychotic disorder

Terms in these criteria, in plain language(1)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

05

Study design

Phase
Not applicable
Primary purpose
Prevention
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Double (Participant, Outcomes assessor)
Enrollment
2,100 participants (estimated)

Study arms

  • Experimental
    ICC-T

    5 days with 8 hours of training for teachers. Core training components include teacher-student interaction, maltreatment prevention, effective discipline strategies, identifying and supporting burdened students and implementation of the training materials into the school setting

    Behavioral: Interaction Competencies with Children - for Teachers (ICC-T)

  • No intervention
    monitoring condition

    No intervention

Interventions

  • BehavioralInteraction Competencies with Children - for Teachers (ICC-T)

    Core training components include teacher-student interaction, maltreatment prevention, effective discipline strategies, identifying and supporting burdened students and implementation of the training materials into the school setting

06

What researchers measure

Primary outcomes

  1. Change of students' exposure to emotional and physical violence by teachers

    The Conflict Tactics Scale (CTS) will be used to assess students' self-reported experiences of emotional and physical violence by teachers at school in the past week. Higher scores indicate higher levels of violence that is used by teachers. We hypothesize a stronger reduction of exposure to violence in the intervention group compared to the control group.

    Time frame: The CTS will be used at T0 (baseline, prior to intervention), T1 (first follow-up, 6 months after intervention) and T2 (second follow-up, 18 months after intervention)

  2. Change of teachers' use of emotional and physical violence

    The Conflict Tactics Scale (CTS) will be used to assess teachers' use of emotional and physical violent discipline measures against students in the past week. Higher scores indicate higher levels of violence that is used by teachers. We hypothesize a stronger reduction of the use of violence in the intervention group compared to the control group.

    Time frame: The CTS will be used at T0 (baseline, prior to intervention), T1 (first follow-up, 6 months after intervention) and T2 (second follow-up, 18 months after intervention)

Secondary outcomes

  1. Change of teachers' positive attitudes towards emotional and physical violence

    Teacher's attitudes towards emotional and physical violence will be assessed with an adapted version of the Conflict Tactic Scale (CTS). Higher scores indicate higher levels of positive attitudes towards violence. We hypothesize a stronger decrease of positive attitudes towards violence in the intervention group compared to the control group.

    Time frame: The adapted version of CTS will be used at T0 (baseline, prior to intervention), T1 (first follow-up, 6 months after intervention) and T2 (second follow-up, 18 months after the intervention)

  2. Change of student's mental health

    The Pediatric Symptom Checklist - Youth Report (PSC-Y) will assess students' emotional and behavioral problems. Higher scores indicate higher levels of students' mental health problems. We hypothesize a stronger reduction of mental health problems in the intervention group compared to the control group.

    Time frame: The PSC-Y will be used at T0 (baseline, prior to intervention), T1 (first follow-up, 6 months after intervention) and T2 (second follow-up, 18 months after intervention)

  3. Change of students' quality of life

    The KIDSCREEN-10 will assess students' quality of life. Higher scores indicate higher levels of students' quality of life. We hypothesize an overall improvement of in the quality of life in the intervention group compared to the control group.

    Time frame: The KIDSCREEN-10 will be used at T0 (baseline, prior to intervention), T1 (first follow-up, 6 months after intervention) and T2 (second follow-up, 18 months after intervention)

  4. Change of students' cognitive functioning

    Five tasks from the tablet application Inquisit will be used to assess children's cognitive abilities including selective attention (Letter Cancellation Task), working memory (Corsi Block Tapping Backwards), response inhibition (Arrow Flanker Task), planning and problem solving (Tower of London) and cognitive flexibility (Wisconsin Card Sorting Test). The test results in each test will be z-standardized and then combined to one compound score. Higher scores indicate higher levels of students' cognitive abilities. We hypothesize higher levels of cognitive functioning in the intervention group compared to the control group.

    Time frame: The app-based tasks will be used at T0 (baseline, prior to intervention), T1 (first follow-up, 6 months after intervention) and T2 (second follow-up, 18 months after intervention)

Other outcomes

  1. Change of students' academic performance

    Students' grades in the previous term's exams will be obtained from the school administration. An improvement in academic performance in the intervention group is hypothesized.

    Time frame: Students' grades will be collected at T0 (baseline, prior to intervention), T1 (first follow-up, 6 months after intervention) and T2 (second follow-up, 18 months after intervention).

  2. Change of peer violence

    The Multidimensional Peer Victimization Scale will be used assess students' experiences of violence by peers. Higher scores indicate higher levels of students' experiences of peer violence. We hypothesize a stronger decrease of peer violence in the intervention group compared to the control group.

    Time frame: he Multidimensional Peer Victimization Scale will be used at T0 (baseline, prior to intervention), T1 (first follow-up, 6 months after intervention) and T2 (second follow-up, 18 months after intervention)

07

Study locations

1 of 1 sites recruiting
08

References and documents

Publications

  • Khan A, Goessmann K, Scharpf F, Shah FKS, Kirika A, Azhar K, Yousafzai AW, Hoeffler A, Hecker T. Preventing physical and emotional violence by teachers in public schools in Pakistan: study protocol for a cluster-randomized controlled trial of the intervention Interaction Competencies with Children - for Teachers (ICC-T). BMC Public Health. 2025 May 24;25(1):1924. doi: 10.1186/s12889-025-23144-x. PubMed 40413430 ↗

Individual participant data

Plan to share: Yes — The ICC-T intervention is being tested in various other countries including Haiti, Ghana, Tanzania and Uganda. We will share anonymized data with project partners from the different countries for combined and/or comparative analyses. In addition, we will share anonymized data with other researchers working on prevention of violence against children in school settings for the purpose of conducting synthesizing analyses such as meta-analyses. Finally, the anonymized data collected in the study will be made publicly available in a data repository.

Supporting information: Study protocol, Statistical analysis plan, Clinical study report, Analytic code

Time frame: The anonymized data will be made publicly available after completion of the project in 2027

Access criteria: During the project, anonymized data will be shared only with partners working in other ICC-T projects and other researchers working in prevention of violence against children upon request. After the completion of the project, the anonymized data will be available to the public.

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Apr 9, 2024, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT06001554
Lead sponsor
Bielefeld University
Collaborators
Shifa Foundation, Shifa International Hospital, Mclean Hospital, University of Konstanz
Responsible party
Sponsor
First posted
Aug 21, 2023
Start date
Sep 15, 2023
Primary completion
Jul 2026 (estimated)
Completion
Dec 2026 (estimated)
Last update
Apr 9, 2024

Study contacts

Tobias Hecker, PhD
Contact
tobias.hecker@uni-bielefeld.de
+49 521 106 3105
Alaptagin Khan, MBBS
Contact
AKHAN@MCLEAN.HARVARD.EDU
+1 617 855 2096
Alaptagin Khan, MBBS
principal investigator · McLean Hopstial

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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