) 1. 福州大学人文社会科学学院, 福州 350108
2. 青少年网络心理与行为教育部重点实验室,华中师范大学心理学院, 湖北省人的发展与心理健康重点实验室, 武汉 430079
收稿日期:2018-04-13出版日期:2018-12-15发布日期:2018-10-30通讯作者:任志洪E-mail:ren@mail.ccnu.edu.cn基金资助:*福建省社科基金资助(FJ2017B028)The effect and moderators of school-based anti-bullying programs: Meta-analysis and GRADE evidence
ZHAO Lingbo1, LAI Lizu2, LIN Yuzhong1, ZHAO Chunxiao2, REN Zhihong2() 1. School of Humanities and Social Sciences, Fuzhou University, Fuzhou 350108, China
2. Key Laboratory of Adolescent Cyberpsychology and Behavior (CCNU), Ministry of Education; School of Psychology, Central China Normal University; Key Laboratory of Human Development and Mental Health of Hubei Province, Wuhan 430079, China
Received:2018-04-13Online:2018-12-15Published:2018-10-30Contact:REN Zhihong E-mail:ren@mail.ccnu.edu.cn摘要/Abstract
摘要： 通过文献检索和筛选, 选取了43个校园欺凌的干预研究, 使用CMA 3.0分析干预效果及影响因素, 并使用GRADE系统对所有结局指标的证据质量进行评估。结果显示, 针对欺凌者的干预项目具有中等效果量(g = 0.57, p < 0.05); 针对欺凌受害者的干预项目使得受害者的受欺凌行为减少(g = 0.42, p < 0.05), 心理健康得到改善(g = 0.40, p < 0.01); 针对所有学生的欺凌干预项目对其欺凌行为的效果g =0.17 (p < 0.001), 对其受欺凌行为效果g = 0.19 (p < 0.001), 可能存在出版偏差; 学生态度改变的效果g = 0.40 (p < 0.01)。除了态度改变的证据质量为中等, 其他结局指标的证据都为低或者极低质量。对于所有学生干预项目, 干预周期小于1学期的效果量大于干预周期大于1学期的效果量, 教育干预项目效果量小于系统干预效果量, 非随机研究效果量大于随机对照研究。直接针对欺凌者或者欺凌受害者的干预效果量中等, 但是样本量少, 需要进一步的研究证据支持。针对所有学生的欺凌干预项目虽然效果量低, 但是仍具有实践意义, 其效果量受到干预周期和干预特征的影响。
图/表 9
图1文献纳入排除流程图
图1文献纳入排除流程图表2针对欺凌者或欺凌受害者的干预效果
| 干预对象 | 结果 | N | G | 95%CI | Z | Q | I2 |
|---|---|---|---|---|---|---|---|
| 欺凌者 | 欺凌行为 | 4 | 0.57 | 0.08, 1.05 | 2.30* | 48.23*** | 93.79 |
| 欺凌受害者 | 受欺凌行为 | 6 | 0.42 | 0.10, 0.74 | 2.60** | 18.55** | 73.04 |
| 心理健康 | 5 | 0.40 | 0.14, 0.65 | 3.04** | 7.95 | 49.66 |
表2针对欺凌者或欺凌受害者的干预效果
| 干预对象 | 结果 | N | G | 95%CI | Z | Q | I2 |
|---|---|---|---|---|---|---|---|
| 欺凌者 | 欺凌行为 | 4 | 0.57 | 0.08, 1.05 | 2.30* | 48.23*** | 93.79 |
| 欺凌受害者 | 受欺凌行为 | 6 | 0.42 | 0.10, 0.74 | 2.60** | 18.55** | 73.04 |
| 心理健康 | 5 | 0.40 | 0.14, 0.65 | 3.04** | 7.95 | 49.66 |
表3针对所有学生的反欺凌项目预防干预效果
| 结果 | N | G | 95%CI | Z | Q | I2 |
|---|---|---|---|---|---|---|
| 态度 | 11 | 0.40 | 0.19, 0.61 | 3.79*** | 131.79*** | 94.41 |
| 行为 | 42 | 0.21 | 0.15, 0.26 | 7.09*** | 330.23*** | 87.58 |
| 欺凌 | 38 | 0.17 | 0.12, 0.22 | 6.91*** | 123.96*** | 70.15 |
| 受欺凌 | 38 | 0.19 | 0.12, 0.26 | 5.27*** | 354.73*** | 89.57 |
表3针对所有学生的反欺凌项目预防干预效果
| 结果 | N | G | 95%CI | Z | Q | I2 |
|---|---|---|---|---|---|---|
| 态度 | 11 | 0.40 | 0.19, 0.61 | 3.79*** | 131.79*** | 94.41 |
| 行为 | 42 | 0.21 | 0.15, 0.26 | 7.09*** | 330.23*** | 87.58 |
| 欺凌 | 38 | 0.17 | 0.12, 0.22 | 6.91*** | 123.96*** | 70.15 |
| 受欺凌 | 38 | 0.19 | 0.12, 0.26 | 5.27*** | 354.73*** | 89.57 |
表4欺凌干预对欺凌行为改变效果量的亚组分析
| 亚组变量 | N | G | 95%CI | Z | Q | I2 | p |
|---|---|---|---|---|---|---|---|
| 年级 | 0.228 | ||||||
| 小学 | 17 | 0.14 | 0.09, 0.18 | 6.18*** | 21.37 | 25.14 | |
| 初高中 | 21 | 0.20 | 0.11, 0.29 | 4.27*** | 100.77*** | 80.15 | |
| 干预周期 | 0.004 | ||||||
| <=1学期 | 20 | 0.26 | 0.18, 0.35 | 5.96*** | 64.08*** | 70.35 | |
| >1学期 | 18 | 0.11 | 0.05, 0.17 | 3.69*** | 45.60*** | 62.72 | |
| 干预特征 | 0.001 | ||||||
| 多水平 | 22 | 0.30 | 0.20, 0.40 | 5.97*** | 26.89* | 44.22 | |
| 个体水平 | 16 | 0.10 | 0.07, 0.17 | 4.73*** | 62.90*** | 66.61 | |
| 实验设计 | 0.016 | ||||||
| 随机 | 19 | 0.12 | 0.08, 0.17 | 5.08*** | 47.99*** | 62.49 | |
| 非随机 | 19 | 0.28 | 0.16, 0.39 | 4.67** | 60.86** | 70.43 |
表4欺凌干预对欺凌行为改变效果量的亚组分析
| 亚组变量 | N | G | 95%CI | Z | Q | I2 | p |
|---|---|---|---|---|---|---|---|
| 年级 | 0.228 | ||||||
| 小学 | 17 | 0.14 | 0.09, 0.18 | 6.18*** | 21.37 | 25.14 | |
| 初高中 | 21 | 0.20 | 0.11, 0.29 | 4.27*** | 100.77*** | 80.15 | |
| 干预周期 | 0.004 | ||||||
| <=1学期 | 20 | 0.26 | 0.18, 0.35 | 5.96*** | 64.08*** | 70.35 | |
| >1学期 | 18 | 0.11 | 0.05, 0.17 | 3.69*** | 45.60*** | 62.72 | |
| 干预特征 | 0.001 | ||||||
| 多水平 | 22 | 0.30 | 0.20, 0.40 | 5.97*** | 26.89* | 44.22 | |
| 个体水平 | 16 | 0.10 | 0.07, 0.17 | 4.73*** | 62.90*** | 66.61 | |
| 实验设计 | 0.016 | ||||||
| 随机 | 19 | 0.12 | 0.08, 0.17 | 5.08*** | 47.99*** | 62.49 | |
| 非随机 | 19 | 0.28 | 0.16, 0.39 | 4.67** | 60.86** | 70.43 |
图2针对所有学生的态度干预效果漏斗图; 剪补研究 = 0
图2针对所有学生的态度干预效果漏斗图; 剪补研究 = 0
图3针对所有学生的欺凌行为干预效果漏斗图; 剪补研究 = 14, 随机效应g = 0.08, 95%CI: 0.03, 0.14
图3针对所有学生的欺凌行为干预效果漏斗图; 剪补研究 = 14, 随机效应g = 0.08, 95%CI: 0.03, 0.14
图4针对所有学生的受欺凌行为干预效果漏斗图; 剪补研究 = 13, 随机效应g = 0.05, 95%CI: -0.02, 0.12
图4针对所有学生的受欺凌行为干预效果漏斗图; 剪补研究 = 13, 随机效应g = 0.05, 95%CI: -0.02, 0.12表5欺凌干预对受欺凌行为改变效果量的亚组分析
| 亚组变量 | N | G | 95%CI | Z | Q | I2 | p |
|---|---|---|---|---|---|---|---|
| 年级 | 0.457 | ||||||
| 小学 | 18 | 0.21 | 0.14, 0.28 | 5.93*** | 63.73*** | 73.33 | |
| 初高中 | 20 | 0.16 | 0.04, 0.28 | 2.72* | 234.53*** | 91.90 | |
| 干预周期 | 0.003 | ||||||
| <=1学期 | 17 | 0.31 | 0.20, 0.42 | 5.59*** | 98.35*** | 83.73 | |
| >1学期 | 21 | 0.10 | 0.02, 0.18 | 2.38* | 170.90*** | 88.30 | |
| 干预特征 | 0.001 | ||||||
| 多水平 | 24 | 0.39 | 0.24, 0.55 | 4.88*** | 52.19*** | 77.09 | |
| 个体水平 | 14 | 0.10 | 0.03, 0.18 | 2.78* | 232.15*** | 90.12 | |
| 实验设计 | 0.042 | ||||||
| 非随机 | 20 | 0.28 | 0.15, 0.41 | 4.29*** | 130.97*** | 85.49 | |
| 随机 | 18 | 0.12 | 0.04, 0.21 | 2.77** | 198.72** | 91.45 |
表5欺凌干预对受欺凌行为改变效果量的亚组分析
| 亚组变量 | N | G | 95%CI | Z | Q | I2 | p |
|---|---|---|---|---|---|---|---|
| 年级 | 0.457 | ||||||
| 小学 | 18 | 0.21 | 0.14, 0.28 | 5.93*** | 63.73*** | 73.33 | |
| 初高中 | 20 | 0.16 | 0.04, 0.28 | 2.72* | 234.53*** | 91.90 | |
| 干预周期 | 0.003 | ||||||
| <=1学期 | 17 | 0.31 | 0.20, 0.42 | 5.59*** | 98.35*** | 83.73 | |
| >1学期 | 21 | 0.10 | 0.02, 0.18 | 2.38* | 170.90*** | 88.30 | |
| 干预特征 | 0.001 | ||||||
| 多水平 | 24 | 0.39 | 0.24, 0.55 | 4.88*** | 52.19*** | 77.09 | |
| 个体水平 | 14 | 0.10 | 0.03, 0.18 | 2.78* | 232.15*** | 90.12 | |
| 实验设计 | 0.042 | ||||||
| 非随机 | 20 | 0.28 | 0.15, 0.41 | 4.29*** | 130.97*** | 85.49 | |
| 随机 | 18 | 0.12 | 0.04, 0.21 | 2.77** | 198.72** | 91.45 |
表6结果变量证据GRADE总结表
| 干预 对象 | 结局 指标 | 实验 设计 | 纳入 研究 | 结果的 不一致 | 间接 证据 | 结果 不精确 | 发表 偏倚 | 实验组 | 对照组 | 相对效应 | 证据 质量 | 结果 变量 重要性 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 欺凌者 | 欺凌行为 | RCT1 | 2 | 严重2 | 无 | 严重3-4 | 无 | 24 | 24 | 0.96(-1.04, 2.95) | ?OOO | 关键 |
| 受凌者 | 受欺凌行为 | RCT1 | 2 | 严重2 | 无 | 无 | 无 | 209 | 216 | 0.79(-0.56, 2.14) | ??OO | 关键 |
| 非RCT | 3 | 无 | 无 | 无 | 无 | 104 | 63 | 0.33(0.07, 0.59) | ??OO | 关键 | ||
| 心理健康 | RCT1 | 2 | 严重2 | 无 | 无 | 无 | 209 | 216 | 0.57(-0.13, 1.27) | ??OO | 关键 | |
| 非RCT | 2 | 无 | 无 | 无 | 无 | 93 | 49 | 0.49(0.15, 0.84) | ??OO | 关键 | ||
| 所有 学生 | 欺凌行为 | RCT1 | 14 | 严重2 | 无 | 严重3 | 无 | 1110 | 1101 | 0.12(0.08, 0.17) | ??OO | 关键 |
| 非RCT | 10 | 严重2 | 无 | 严重3 | 严重 | 1505 | 1776 | 0.28(0.20, 0.40) | ?OOO | 关键 | ||
| 受欺凌行为 | RCT1 | 13 | 严重2 | 无 | 严重3 | 无 | 12630 | 10731 | 0.12(0.04, 0.21) | ??OO | 关键 | |
| 非RCT | 12 | 严重2 | 无 | 严重3 | 严重 | 7697 | 3791 | 0.28(0.15, 0.41) | ?OOO | 关键 | ||
| 态度 | RCT1 | 6 | 无 | 无 | 无 | 无 | 1479 | 1589 | 0.34(0.06, 0.61) | ???O | 重要 |
表6结果变量证据GRADE总结表
| 干预 对象 | 结局 指标 | 实验 设计 | 纳入 研究 | 结果的 不一致 | 间接 证据 | 结果 不精确 | 发表 偏倚 | 实验组 | 对照组 | 相对效应 | 证据 质量 | 结果 变量 重要性 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 欺凌者 | 欺凌行为 | RCT1 | 2 | 严重2 | 无 | 严重3-4 | 无 | 24 | 24 | 0.96(-1.04, 2.95) | ?OOO | 关键 |
| 受凌者 | 受欺凌行为 | RCT1 | 2 | 严重2 | 无 | 无 | 无 | 209 | 216 | 0.79(-0.56, 2.14) | ??OO | 关键 |
| 非RCT | 3 | 无 | 无 | 无 | 无 | 104 | 63 | 0.33(0.07, 0.59) | ??OO | 关键 | ||
| 心理健康 | RCT1 | 2 | 严重2 | 无 | 无 | 无 | 209 | 216 | 0.57(-0.13, 1.27) | ??OO | 关键 | |
| 非RCT | 2 | 无 | 无 | 无 | 无 | 93 | 49 | 0.49(0.15, 0.84) | ??OO | 关键 | ||
| 所有 学生 | 欺凌行为 | RCT1 | 14 | 严重2 | 无 | 严重3 | 无 | 1110 | 1101 | 0.12(0.08, 0.17) | ??OO | 关键 |
| 非RCT | 10 | 严重2 | 无 | 严重3 | 严重 | 1505 | 1776 | 0.28(0.20, 0.40) | ?OOO | 关键 | ||
| 受欺凌行为 | RCT1 | 13 | 严重2 | 无 | 严重3 | 无 | 12630 | 10731 | 0.12(0.04, 0.21) | ??OO | 关键 | |
| 非RCT | 12 | 严重2 | 无 | 严重3 | 严重 | 7697 | 3791 | 0.28(0.15, 0.41) | ?OOO | 关键 | ||
| 态度 | RCT1 | 6 | 无 | 无 | 无 | 无 | 1479 | 1589 | 0.34(0.06, 0.61) | ???O | 重要 |
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