What works to prevent youth violence: evidence summary

Introduction

Background

This report summarises available international evidence of what works to prevent youth violence. The way in which youth violence is conceptualised is contested as there is no universally agreed international definition of youth, and violence is defined variably across different contexts and ideological interests (Batchelor, Armstrong, & MacLellan, 2019).

In line with the World Health Organisation (WHO) we have taken the decision to adopt a broad definition of youth violence, which encompasses “violence that occurs among individuals aged 10–29 years who are unrelated and who may or may not know each other, and generally takes place outside of the home” (2015: 5). Youth Violence occurs most often in community settings, between acquaintances and strangers, and can take many forms: from threats (with or without weapons), bullying and physical fighting to more severe sexual and physical assault, and homicide (WHO, 2020).^[6]  Youth violence can also take the form of domestic abuse, which involves any form of physical, verbal, sexual, psychological or financial abuse perpetrated by a partner or ex-partner^[7]. Among romantically involved but unmarried adolescents it is often referred to as dating violence or intimate partner violence (WHO, 2016). As well as having physical and psychological consequences for young people, youth violence can have a negative impact on families and the wider community (Bellis, 2017).

Youth violence within a Scottish context

Scottish Government’s Justice Analytical Services (JAS) is currently undertaking a programme of analytical work around violence in Scotland. A range of statistical sources are utilised to provide an account of the magnitude, scope and characteristics of violence within this context. These measure different types of violence and include (i) Scottish Crime and Justice Survey (SCJS), (ii) Police Recorded Crime and (iii) Criminal Proceedings data. Using these sources, bespoke analyses^[8] of data pertaining to non-sexual violence in young people aged 10 to 29 was conducted to provide insights into youth violence within Scotland.

The SCJS is a face-to face victimisation survey, where randomly selected individuals aged 16 and over living in private residential households in Scotland are asked about their experiences and perceptions of crime over the last 12 months. The survey captures a range of offences and provides some details of the crimes experienced by individuals, which may not have been reported to the police. Despite a fall in violent victimisation rates for 16 to 24^[9] year olds over the past decade, this age group has re-emerged in the 2018/19 Scottish Crime and Justice Survey as the cohort most likely to report being the victim of violence. Looking at those aged 16 to 29, in line with the definition of youth violence in this report, almost 1 in 20 young people (4.6%) reported experiencing violence in 2018/19.

Police Recorded Crime data captures a broad range of non-sexual violent crime. This statistical source is particularly useful when examining patterns of low-volume crimes that are challenging to access through victimisation surveys. Analysis of a deep dive of this data demonstrates that between 2008/09 and 2017/18 there was a decrease of 10 percentage points in the proportion of victims of serious assault and attempted murder who were aged between 10 and 29 years old. This is mainly driven by a decrease in the 16 to 29 age group. That being said, of the crimes sampled, 45% of victims in 2017/18 were young people aged 10 to 29^[1]. In this ten year period, there has also been a reduction of 10 percentage points in the proportion of perpetrators  of serious assault and attempted murder who were aged between 10 and 29 years old. Similarly, this was due to a reduction in the 16 to 29 age group. However, nearly half (47%) of the perpetrators in 2017/18 were young people aged 10 to 29^[2].

Scottish Government Criminal Proceedings data provides details of offences dealt with by courts in Scotland, sentencing outcomes and characteristics of convicted offenders^[10]. This data shows that, within the 10-29 age group, there has been a substantial reduction in court proceedings and convictions relating to Group 1^[11] Non-sexual crimes of violence over the past ten years. This was also found to be the case for cases involving common assault. Whilst encouraging, over 6,000 main charges of violent crimes and common assault dealt with by the court in 2018/19 involved young people aged 10-29 years old. Within this age group, these proceedings resulted in 4,762 convictions^[12].

Although data from established sources suggests substantial progress has been made in reducing violent crime involving young people in Scotland during the past decade, youth violence remains a key public health priority. Moreover, when considering these figures from Scotland alongside concerns that the indirect social and economic consequences of the COVID-19 pandemic may lead to an increase in youth violence (Irwin-Rogers, Muthoo, & Billingham, 2020), there’s a pressing need to better understand what works to prevent violence between young people in order that those who are at risk of becoming involved can be best supported.

Aim of this report

This report is intended to be a useful resource for policy and practitioners, drawing together evidence of what is known about what works in preventing youth violence.

This report aims to:

• Synthesise existing evidence about the effectiveness about youth violence prevention interventions and signpost to further evidence to help inform decision making.
• Provide a clear indication of the effectiveness of an intervention based on a critical assessment of the available evidence base.
• Provide information around barriers and facilitators to the successful implementation of interventions.

Determining prevention levels

Within this report, we examine interventions that seek specifically to prevent youth violence. The following WHO (2002) definition^[13] of prevention levels have been adopted:

• Primary prevention – approaches that aim to prevent violence before it occurs
• Secondary prevention – approaches that focus on the more immediate responses to violence, such as pre-hospital care or emergency services
• Tertiary prevention – approaches that focus on long-term care in the wake of violence, such as rehabilitation and reintegration, and attempts to lessen trauma or reduce the long-term disability associated with violence

This review focuses on primary prevention approaches to youth violence. In focusing on prevention and early intervention, this report reflects the Scottish Government’s public health approach to violence prevention. Within the ScotPHN Violence Prevention Framework (2019:9), it has been noted that:

While all forms of prevention are important, if we actively want to reduce new cases of violence in Scotland, significant weight must be placed on a shared understanding of the public health approach with the effective pursuit of primary prevention as a key constituent of this.

For successful primary prevention, early intervention is required that focuses on young people (WHO, 2010:2).

The public health approach acknowledges that the pathway to violence is complex and multifaceted, with causes at the individual, relationship, community, and societal levels. As such, to prevent youth violence it is necessary to reduce risk and promote protective factors (Figure 1) at each of these levels. The evidence reviewed within this report reflects that the majority of available evaluation research concerns strategies that address risk factors at the individual and relationship levels. There are fewer outcome evaluations which focus on the impact of community- and society- level strategies.

Graphic text

Societal

Rapid social change Gender, social and economic inequalities Poverty Weak economic safety nets Poor rule of law Cultural norms that support violence/aggression towards others

Community

Poverty High crime levels/community violence Poor neighbourhood support High residential mobility High unemployment/diminished economic opportunity Local illicit drug trade Situational factors

Relationship

Poor parenting/parent-child relationships Marital discord/ family conflict Low socioeconomic household status Friends that engage in violence Isolation/lack of social support

Individual

Experience of ACEs Poor mental health Alcohol/substance abuse History of violent behaviour History of violent victimisation Low educational attainment

Report Approach

This report identified relevant existing evidence reviews and reports, such as those produced by the World Health Organisation (WHO) and used these as a starting point from which to explore evidence on what works to prevent youth violence. Consultation has taken place with academics and key experts in the field and they have been involved in quality assuring drafts of the report.

It is important to note that this report is not an exhaustive and definitive account of the evidence in this area. Rather, it constitutes a collation of evidence that was identified and accessed during the time available. It focuses on the most common interventions, assessing their effectiveness and signposting to relevant evidence. This work aims to be a foundation upon which new and existing research can be added as it becomes available or is identified in the future^[14].

To acknowledge the overlaps between different forms of violence within certain interventions, this report has been structured by intervention-type, rather than violence-type. However, where an intervention related explicitly to one form of youth violence, this has been highlighted.

Out of scope interventions

Within this report, certain interventions were classed as beyond the current scope. Two possible reasons for being out of scope were identified:

i) Topic out of scope – areas which are wider than preventing violence^[15] and where the policies relating to this would sit outwith the remit of Justice Analytical Services, and/or where interventions focus exclusively on reducing violence perpetration in young people (rather than preventing it from happening).

Analysts within Justice Analytical Services at The Scottish Government are working to update the 2015 publication What Works to Reduce Reoffending: A Summary of the Evidence and such interventions (e.g. therapeutic interventions) sit better within the context of that report than this one.

ii) Evidence base out of scope: i.e. we have looked at the evidence base, but it does not directly address violence related outcomes, therefore we cannot draw trustworthy conclusions regarding the impact of such interventions on violence prevention or reduction.

Due to limited available evidence, cost, and cost effectiveness have also not been covered within this report.

Assessment of effectiveness of interventions

Decision-making tools (effectiveness classification criteria and decision tree) were developed to inform the process undertaken in synthesising the available evidence (see Annex B, C and D). These tools were developed for, and initially implemented within, the Scottish Government report What Works to Prevent Violence Against Women and Girls: A Summary of the Evidence. They have been adopted within this report to ensure a consistent and transparent approach to classifying the effectiveness of interventions to prevent violence. In particular, the following aspects are considered in classifying the available evidence:

• The relevance of the evidence: must include outcomes related to violence prevention/reduction or risk factors or intermediate outcomes for violence
• What the evidence says about the effectiveness of the intervention
• The strength of the available evidence (see Annex B on methodology)

The following six colour-coded categories of effectiveness^[16] are used throughout:

Effective (Green)

Promising (Amber)

Mixed (Amber)

No effect (Red)

Negative effect/potentially harmful (Red)

Inconclusive (Grey)

It should be noted that the inconclusive category is:

• distinct from the no effect^[17] category
• is based on insufficient evidence to make a judgement on impact of an intervention (e.g. only pilot evaluations available)
• indicates the need for further research and evidence before conclusions can be drawn on the effectiveness of an intervention

School and education-based programmes

Classification: Effective

Background

School and education-based programmes can be Universal (i.e., delivered to all pupils in a year group or school) or can be Targeted at those who are considered to be at increased risk of engaging in youth violence. They typically aim to “build their skills, knowledge, and motivation to choose nonviolent behaviours and conflict resolution approaches” (David-Ferdon & Simon, 2014). Programmes that take this approach include bullying prevention programmes, social and emotional development programmes, and dating violence prevention programmes.

The WHO Practical Handbook on School-Based Violence Prevention highlights that:

Schools can be ideal places for activities aimed at preventing violence. They can involve many young people at one time, influencing them early in life. Skilled teachers can deliver violence prevention programmes and act as significant role models outside of family or community life.

Available Evidence

Bullying prevention programmes

Bullying (including cyberbullying) refers to “unwanted aggressive behaviour by another child or group of children who are neither siblings nor in a romantic relationship with the victim. It involves repeated physical, psychological or social harm, and often takes place in schools and other settings where children gather, and online” (WHO, 2019)

Bullying prevention or anti-bullying programmes have been consistently shown to reduce bullying perpetration and victimisation, as well as improving bystander responses or attitudes and beliefs about bullying (Bellis et al., 2017; Zych et al., 2015). An international systematic review conducted by Gaffney et al (2019a) estimated that on average, anti-bullying programmes were able to reduce bullying behaviours by about 19-20%, and rates of being bullied by 15-16%.

Whilst a growing body of evidence provides support for the potential role of bullying prevention programmes in reducing involvement in cyberbullying (Gaffney et al., 2019b) further research in this area is necessary. Going forward, this work will be important given that cyberbullying and cyber victimisation are predicted to become an increasing challenge within modern society. Moreover, there are concerns that cyberbullying has the potential to cause as much (or more) harm than traditional bullying due to the relative anonymity of perpetrators in many cases, larger audiences, the potential of 24/7 access to technology, and the permanence of posted messages (Campbell, 2019). As there is often an overlap between offline and online bullying, there is a need for more research examining whether these type of behaviour should be targeted simultaneously and if it is possible to do so effectively (Gaffney et al., 2019b)

One of the most widely researched and best-known bullying prevention programme is the Olweus Bullying Prevention Programme. This programme aims to reduce existing bullying problems amongst school pupils, prevent the development of new bullying problems, and improve peer relations at school (Olweus & Limber, 2010). It uses a whole-school approach^[18] which includes: implementation of clear school rules and management structures for bullying; training for staff; a classroom curriculum for students; awareness raising for parents; improvements to the physical school environment; and the use of evaluation tools. As such it has been noted that the Olweus Bullying Prevention Programme should be regarded as a coordinated collection of research based components^[19] that form a unified, multi-level, whole school approach to bullying (Olweus & Limber, 2019).

The programme has shown to reduce child reports of both perpetrating and being a victim of bullying behaviour (Gaffney, Farrington & Ttofi, 2019a); Limber et al., 2018; Olweus et al., 2019). Overall, effects were stronger the longer the programme had been in place. The Olweus Bullying Prevention Programme was initially developed and tested in Norway and has since been evaluated with young people in the United States. It has also been implemented within the UK, but further evaluation is required within the context.

Another example of an effective bullying prevention programme is KiVa, which according to the WHO “takes a whole school approach, incorporating curricula, online games, work with bullies and victims, materials for teachers, and a guide for parents. It aims to improve social and emotional skills, influence group norms and bystander behaviour, and create a climate of non-bullying in classrooms and the rest of the school” (WHO, 2019: 29). It does so through discussions, short videos, and learning-by-doing exercises and the lessons are accompanied by online games tailored to each age group.

In randomised controlled trials in Finland and Italy, KiVa was found to significantly reduce rates of being bullied and bullying behaviour in children aged 10-12 years old (Karna et al., 2011; Nocentini et al, 2017; White, 2019). The effects of the programme were apparent across various forms of bullying, including cyber bullying and victimization (Salmivalli, Kärnä, & Poskiparta, 2011; Williford et al., 2013). Moreover, the programme influenced bystanders’ behaviours, students’ anti-bullying attitudes, and their empathy towards victimized peers (Kärnä, Voeten, Little, Poskiparta, Kaljonen, et al., 2011; Saarento, Boulton, & Salmivalli. Impacts on bullying perpetration and victimisation were also reported following a trial of the programme in Wales (Clarkson, Charles & Saville, 2019).

Moderating factors

Potential facilitators

A recent systematic review of reviews relating to youth violence prevention from Kovalenko et al (2020:7) provided recommendations on how to improve the effectiveness of programmes that aim to prevent bullying. The authors suggest that “anti-bullying programs should be well planned (Vreeman & Carroll, 2007), intensive, and of longer duration (Ttofi & Farrington, 2011).

Curricula should be based on theories of bullying perpetration and victimization (Baldry & Farrington, 2007) and include training in:

• Empathy (Polanin et al., 2012; Ttofi & Farrington, 2011)
• Social perspective-taking (Ttofi & Farrington, 2011; Vreeman & Carroll, 2007)
• Emotional control
• Problem-solving
• Peer counselling

Whole-school approaches involving school rules and sanctions should be used to prompt student and teacher training.

Howard et al. (1999) argued that programs should use multiple delivery modes, including media (e.g., video), face-to-face interaction, and physical-environment redesign and ensure consistency and complementarity across modes.

Ttofi and Farrington (2011) suggested that families should be involved in planning and implementation. Student needs, school climate (Polanin et al., 2012), and playground supervision (e.g., identification of “hot spots,” Ttofi & Farrington, 2011) should be considered. Bullying behaviors should be regarded as group processes where each participant has their role and social status and treated accordingly (Polanin et al., 2012). Ttofi and Farrington (2011) suggested that secondary school programs could be more effective because of decreasing impulsiveness and increasing rational decision making. Thus, age-tailored programs are needed”.

Potential barriers

Olweus and Limber (2019) note that educators who seek to implement the programme in their school can face some challenges. These include:

• Resistance and scepticism on the part of administrator and staff around the problem of bullying (i.e. underestimating the frequency and consequences of bullying, as well as the ability of youth to effectively address it without adult support)
• Lack of readiness of school staff to implement and sustain a comprehensive effort^[20]
• Implementation the components of the programme with fidelity. In light of the competing demands placed on teachers’ time and resources, those responsible for implementing the programme may be more inclined to adopt programme elements that appear less demanding relative to those that require more time, attention, and training (Olweus & Limber, 2010a)
• Unexpected changes that burden the school staff (e.g. staff turnover, change of the head teacher, problems with the school building, challenging classrooms, changes to/demanding curriculum)

Social, emotional, and life skills development programmes

There is international evidence that programmes that seek to develop young people’s social, emotional, and life skills can have a positive impact on a range of violence related outcomes (i.e., perpetration and victimisation (Bellis et al., 2012; Bellis et al., 2017; David-Ferdon, 2016)). Moreover, the WHO INSPIRE package highlights increasing access to social-emotional learning and life-skills training as one of seven key strategies to have shown success in ending violence against children (including youth violence) (WHO, 2016).

Wilson and Lipsey (2017) synthesised the results of 249 studies that examined the impact of social, emotional, and life skills development programmes on aggressive and disruptive behaviours. These programmes reduced violent outcomes in young people (such as fighting, hitting, and bullying) by 25%.

According to WHO (2015) these skills include:

• problem-solving
• critical thinking
• communication
• decision-making
• creative thinking
• relationship skills
• self-awareness building
• empathy
• coping with stress and emotions

An example of an intervention that takes this socio-emotional learning and skills-building approach is Promoting Alternative Thinking Strategies (PATHS). This Universal intervention is a social and emotional development programme that is designed to be delivered by teachers and targets young people between the ages of 3 and 12 years of age. The curriculum focuses on increasing self-control, feelings and relationships, and interpersonal and cognitive problem solving. The PATHS program concepts should be used by all staff in the school including the senior management team, guidance teachers, and support staff.  This provides a school-wide common language for emotional awareness, self-control, and problem solving.

The CDC Technical Package for the Prevention of Youth Violence reports that “Multiple evaluations of PATHS show significant programme impacts on aggression, violent behaviours, and a number of developmental risk factors for violent behaviour among participants” (David-Ferdon, 2016: 22). PATHS has been identified as a Model Program by Blueprints for Violence Prevention, which indicates that it is supported by a strong evidence base (Mihalic, 2001). This programme has been implemented within Scotland, and the UK more broadly but evaluation is required to better understand the effectiveness of this intervention in preventing youth violence outcomes within this context.

Another effective programme which sets out prevent youth violence by improving young people’s personal and social competence is Life Skills Training (WHO, 2009). This is a substance prevention programme that targets psychological and social factors known to promote the initiation of substance use and other risk behaviours (including violence). It comprises three major components: drug resistance skills, self-management skills, and general social skills. Stronger prevention benefits have been found for youth who participated in at least half of the program. These included less physical and verbal aggression, fighting, and delinquency (Botvin et al., 2006).

Moderating factors

Potential facilitators

When looking at facilitators to the effectiveness of social and emotional learning (SEL) in general, Bowles et al (2017:6) note that “program selection should be based on a needs assessment of the different factors that will affect program implementation at the school (e.g., administrative support and feasibility; acceptance by teachers and administrators; cultural considerations). SEL programs should be intensive, proactive, sustainable, embedded in broader efforts to create positive school climate, and address multiple levels of the school context (Jimerson et al., 2012; Jimerson et al., 2010). Best practice suggests implementing SEL within a multi-tiered system of supports framework (Jimerson, Burns, & VanDerHeyden, 2016). SEL programs need to be culturally sensitive and implemented in a culturally competent fashion. In addition, careful and continued monitoring of the programs is necessary to ensure it is being implemented with fidelity”. (p. 7)

Further, Clarke et al (2015:7) notes that the effective programmes identified in their review of school-based and out-of-school programmes in the UK shared a number of common characteristics. These include:

• Focus on teaching of skills, in particular the cognitive, affective and behavioural skills and competencies as outlined by The Collaborative for Academic, Social, and Emotional Learning (CASEL).
• Use of competence enhancement and empowering approaches
• Use of interactive teaching methods including role play, games and group work to teach skills (practice skills they were taught)
• Well-defined goals and use of a coordinated set of activities to achieve objectives
• Provision of explicit teacher guidelines through teacher training and programme manuals (e.g. it is important to have capable and motivated educators and provide them with good-quality training on the content of messages and how to deliver them)

When combined with teacher training and parental education, social development programmes may also provide longer term benefits (WHO, 2009). However, further research is required here as a limited body of research focuses on the longer term effects of these programmes.

Dating violence prevention programmes

Classification: Promising

Within the context of youth, dating violence can be defined as “physical, sexual, or psychological/emotional violence, including stalking, occurring within a teen dating relationship” (Niolon et al., 2019:2). Given that young people typically begin dating for the first time during adolescence, programmes that seek to prevent dating violence tend to target secondary school pupils. Overall, these programmes are based on the “assumption that these healthy attitudes and skills will carry through as they transition into later adolescent years and form long-term intimate relationships” (Lundgren and Amin, 2015: 546).

According to the WHO School-Based Violence Prevention Handbook (2019:32), “these approaches aim to prevent and reduce violence in dating and intimate partner relationships through developing life skills, adding to children’s knowledge of abuse, and challenging social norms and gender stereotypes that increase the risk of violence”. There is promising evidence that these interventions are effective in improving violence-related attitudes and knowledge. However, the evidence on behavioural outcomes is less clear (White 2019). Whilst research suggests that dating violence prevention programmes may reduce the number of young people who are exposed to or perpetrate violence against women and girls (physical, emotional, or sexual) within the context of an intimate partner relationship, findings are not consistent (Kovalenko et al., 2020). Evaluations have largely focused on short-term outcomes and so the long term impact of these interventions on behavioural violence outcomes is not clear. Consequently, Ludgren and Amin (2015) noted that more research on school based interventions measuring violence as an outcome is needed.

Although evidence is promising for this approach overall, there is strong evidence that Safe Dates is one of the most effective school-based programmes for preventing different types of dating violence (i.e. physical, psychological, and sexual) (Lester et al., 2017).This intervention targets 12-18 year olds and promotes equal relationships. It “includes a number of different school-based activities: a 10-week curriculum looking at behaviour and attitudes associated with dating abuse (50 minutes a week), a play about dating abuse and violence, a poster contest, and materials for parents such as newsletters. Alongside this, community activities such as support services and training for service providers are provided. In the USA, the curriculum has been successful in reducing sexual, physical and emotional abuse due to changes in dating-violence norms, gender role norms and knowledge of support services” (WHO, 2019:33).

Safe Dates was recently adopted within Dating Matters: Strategies to Promote Health Teen Relationships^[21].

Bystander interventions have also been implemented with the aim of preventing violence within the context of young people’s intimate partner relationships.

As highlighted in What Works to Prevent Violence Against Women and Girls: A Summary of the Evidence, bystander^[22] approaches aim to modify: "gender inequitable attitudes, beliefs and cultural norms which support abuse, and ultimately increasing pro-social bystander behaviour^[23] to prevent it" (Gainsbury et al. 2020:2). Adopting a bystander approach involves understanding individuals as potentially empowered and active bystanders with the ability to support and challenge their peers in a safe way, rather than being understood as potential victims/survivors or perpetrators.

An example of bystander intervention designed to be implemented with youth is the Mentors in Violence Prevention (MVP) programme. Within the context of MVP, males and females are not looked at as potential victims/survivors or perpetrators but as empowered bystanders with the ability to support and challenge peers^[24].

It is important to note that existing evaluations of bystander interventions with young people predominantly focus on attitudinal change, rather than the reduction of violence as an explicit outcome. This focus is, in part, due to the difficult nature of measuring Gender Based Violence.

Evaluations of MVP programmes in secondary schools in the United States have found positive results in changing pupils’ attitudes and behaviours both in the shorter and longer-term (see Powell, 2011; and multi-year MVP evaluations here). MVP has been evaluated within three secondary schools in Scotland. However, further research is needed within this context.

Further detail on MVP, and its effectiveness in preventing gender based violence in youth, is presented within the report What Works to Prevent Violence Against Women and Girls: A Summary of the Evidence (2020). As can other examples of interventions that apply a bystander approach (e.g. Coaching Boys into Men, Green Dot programme).

Moderating factors

Potential facilitators

Kovalenko et al ‘s (2020:7) systematic review on effective interventions to prevent youth violence  notes that programme content should be “underpinned by evidence-based theories and appropriately tailored to the culture and needs of target audiences”. Effective dating and relationship violence programs involved:

• peer education
• use of drama and poster activities
• education on legislation, personal safety, consequences, health and sexuality, gender roles, healthy relationships, and the role of bystanders
• focus on conflict resolution, problem-solving, sexual decision making, and dealing with pressure
• be incorporated into school policies
• these programmes should clearly define terms such as aggression, rape, and dating violence and be gender-specific or gender-neutral (De Koker et al., 2014)”

Moreover, according to WHO (2010:83): “Dating programmes are more effective if they are delivered in multiple sessions over time (rather than in a single session) and if they aim to change attitudes and norms rather than simply provide information”. Where programmes set out to change norms, there is the potential for violence also to be reduced among those who haven’t received the programme through those who have via changes in norms within social networks and modelled bystander behaviours (Coker et al., 2016).

The WHO (2009:5) report on Violence Prevention: the Evidence suggest that there is evidence that “for men, programmes presented to mixed male and female groups are less effective in changing attitudes than those presented to all-male group”.

Barriers

Fox et al. (2014) note that UK evaluations of safe dating programmes have “highlighted some of the challenges in terms of service delivery and suggestions for good practice, such as what should be taught (i.e. programme content), how it should be taught (e.g. teaching methods) and who should deliver it (e.g. teachers or external organisations)” (Fox et al., 2014:29).

With regards to bystander interventions, Williams and Neville’s (2017) identified staff and mentor workload and a strain on time as potential barriers to the implementation of sustainable MVP programmes.

A WHO (2010:45) evidence review on preventing forms of VAWG^[25] also identifies that additional research is required to:

Evaluate the effectiveness of dating violence prevention programmes in the longer term, when integrated with programmes for the prevention of other forms of violence, and when delivered outside North America and in resource-poor settings.