ViolenceICC-T_PakNCT06001554
Preventing Physical and Emotional Violence by Teachers in Public Schools in Pakistan
A study testing Interaction Competencies with Children - for Teachers (ICC-T) in people with Violence, run by Bielefeld University at 1 site in Pakistan.
Trial 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. Read more about this study
- Who is it for?
- Ages 11 to 62 years
- Conditions the study is for
- Violence
- What is being tested?
- Interaction Competencies with Children - for Teachers (ICC-T)
- Type of treatment
- Lifestyle or therapy programme
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 2,100 participants
- Where
- 1 sitePakistan
- Study dates
- 15 Sep 2023to Dec 2026
- Phase
- Interventional
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 11 to 62 years
- All sexes
- No healthy volunteers
- Child, Adult
Who may be able to join
- All: Written informed consent (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
Who cannot join
- Students and teachers:
- Acute drug or alcohol intoxication Acute psychotic disorder
Trial locations and contacts
1 site in 1 country. Contact the study team or a site near you to ask about taking part.
Pakistan1 site, 1 recruiting
- Recruiting
Shifa International Hospitals
Islamabad
Abdul Wahab Yousafzai, MBBS, wahab.yousafzai@gmail.com
About this study
Official title: Improving Adolescent Student Mental Health and Quality of Life Through a Reduction in Physical and Emotional Violence by Teachers in Pakistan: A Cluster Randomized Controlled Trial
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.
- Conditions
- Violence
- Being tested
- Interaction Competencies with Children - for Teachers (ICC-T)
- Keywords
- school violence, teacher violence, teachers, intervention, students, public schools, secondary schools
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Interaction Competencies with Children - for Teachers (ICC-T)Behavioural
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
| Study group | Role | What they receive |
|---|---|---|
| ICC-T | Experimental | 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 Receives: Behavioral: Interaction Competencies with Children - for Teachers (ICC-T) |
| monitoring condition | No intervention | No intervention |
What is being measured
The primary outcome is the main question the study is designed to answer.
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.
Measured: 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)
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.
Measured: 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 (4)
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.
Measured: 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)
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.
Measured: 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)
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.
Measured: 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)
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.
Measured: 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)
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted21 Aug 2023
- Study start15 Sep 2023
- Primary completionJul 2026 (estimated)
- Study completionDec 2026 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (1)Papers the sponsor has linked to this study.
- Other trials for ViolenceStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Prevention
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind
- Who is masked
- Participant, Outcomes assessor
- Enrolment
- 2,100 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Bielefeld University
- Sponsor type
- University, hospital or other
- Collaborators
- Shifa Foundation, Shifa International Hospital, Mclean Hospital, University of Konstanz
- Responsible party
- Sponsor
- Investigators
- Alaptagin Khan, MBBS, Principal investigator, McLean Hopstial
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT06001554
- Sponsor's protocol ID
- ICC-T CRCT Pakistan
- Acronym
- ICC-T_Pak
- Status last verified
- Jul 2023
- First submitted
- 14 Aug 2023
- Last updated
- 9 Apr 2024
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- 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.
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
Study at a glance
From the registry record, last updated by the sponsor on 9 Apr 2024. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Improving Adolescent Student Mental Health and Quality of Life Through a Reduction in Physical and Emotional Violence by Teachers in Pakistan: A Cluster Randomized Controlled Trial
- ClinicalTrials.gov ID
- NCT06001554
- Acronym / sponsor ID
- ICC-T_Pak / ICC-T CRCT Pakistan
- Conditions
- Violence
- Keywords
- school violence, teacher violence, teachers, intervention, students, public schools, secondary schools
- Study type
- Interventional
- Recruitment status
- Recruiting
- Enrolment
- 2,100 participants (estimated)
- Lead sponsor
- Bielefeld UniversityUniversity, hospital or other
- Collaborators
- Shifa Foundation, Shifa International Hospital, Mclean Hospital, University of Konstanz
- Study start
- 15 Sep 2023 (actual)
- Primary completion
- Jul 2026 (estimated)
- Study completion
- Dec 2026 (estimated)
- First posted
- 21 Aug 2023 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
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.
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.
Study design
- Primary purpose
- Prevention
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind (participant, outcomes assessor)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| ICC-T | Experimental | Behavioral: Interaction Competencies with Children - for Teachers (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 |
| monitoring condition | No intervention | –No intervention |
Who may qualify
- Ages
- 11 to 62 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Child, Adult
Key inclusion criteria (3 listed)
- All: Written informed consent (if underaged by parents (written) \& minors themselves (written) Students: Enrollment in selected secondary school Teachers: All teachers employed at the selected schools
- Public secondary schools Day schools At least 30 students in selected class/stream
Key exclusion criteria (2 listed)
- Acute drug or alcohol intoxication Acute psychotic disorder
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Interaction 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 | Behavioural | ICC-T |
Primary outcome
Change of students' exposure to emotional and physical violence by teachers
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)
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.
Change of teachers' use of emotional and physical violence
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)
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.
4 secondary outcomes
Change of teachers' positive attitudes towards emotional and physical violence
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)
Change of student's mental health
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)
Change of students' quality of life
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)
Change of students' cognitive functioning
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)
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 9 Apr 2024.
- Derived from this study: PubMed 40413430Khan 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.
- Individual participant dataSharing planned: 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.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
Alaptagin Khan, MBBS principal investigator
McLean Hopstial
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Interaction Competencies with Children - for Teachers (ICC-T) in people with Violence, run by Bielefeld University at 1 site in Pakistan.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 3 inclusion and 2 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: looking for participants now, as of the sponsor's last update on 9 Apr 2024. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Pakistan. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Contact Tobias Hecker, PhD (+49 521 106 3105, tobias.hecker@uni-bielefeld.de), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Change of students' exposure to emotional and physical violence by teachers (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)). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT06001554, which also lists 1 linked publication.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 9 Apr 2024.