Whole-school approach to addressing Gender-Based violence in secondary school (Equally Safe at School): A type I hybrid effectiveness-implementation trial

BACKGROUND: Gender-Based Violence (GBV), including sexual harassment, is common in secondary schools and has significant detrimental impact on physical and mental health in adolescence and later life. Schools are key sites to address GBV because norms are established and experience of GBV often begins in adolescence. Intervening to improve gender equal attitudes and prevent GBV at school can interrupt pathways to adult male aggression towards women in later life. Whole-school approaches to addressing GBV have political support but the evidence base is sparse. Equally Safe at School (ESAS) is a whole-school approach designed by Rape Crisis Scotland/University of Glasgow, co-produced and piloted in 8 schools, and recently launched in Scotland. Schools access resources via a web-based Hub and undertake self-assessment, establish an action group, and complete staff training, curriculum enhancement, and policy review. Theorised mechanisms of sustainable change include perceived coherence of the approach; active and collective staff/student involvement in efforts to change school culture; development of skills to recognise and address GBV; and social reward for positive attitudes and behaviour. AIM: To evaluate the effectiveness and cost-effectiveness of ESAS. OBJECTIVES: (1) Establish the effect of ESAS on student experiences of sexual harassment and a priori secondary outcomes regarding school prevention of, and response to, GBV. (2) Assess implementation processes and intervention mechanisms, how these vary within and between schools, and if/how ESAS embeds in school systems over time; (3) Establish what ESAS costs (and what activities it displaces) compared with the outcomes, and the long-term societal cost effectiveness. METHODS: Cluster randomised trial with repeated cross sections in 36 schools in Scotland, randomised (1:1) to immediate start or 12-month delayed start. Primary outcome (student experience of sexual harassment) and secondary outcome measures collected at baseline, 12 and 24 months. Process evaluation involving in-depth data collection in 6 case-study schools and monitoring/key staff surveys in all schools, to assess: fidelity, reach and acceptability; mechanisms of action; if/how ESAS embeds over time. Economic evaluation to compare the intervention outcomes (consequences) with costs of implementation and evaluate the likely long-term societal cost effectiveness. TIMELINE: Year1: Schools recruited and randomised after baseline survey; immediate start schools begin ESAS; process evaluation measures collected in all schools and in-depth in case study schools. Year2: Follow up survey at 12 months (primary outcome); delayed start schools begin ESAS activities; immediate start schools continue to embed ESAS; process evaluation activities in both arms. Year3: 24-month follow-up in all schools; analysis; dissemination to participants, stakeholders & scientific community. IMPACT: Potential impacts on: students - less exposed to sexual harassment; more confident to intervene and report incidents of GBV. School staff - acquire advanced skills to prevent and intervene to address GBV. Wider society – reduced GBV-related harms (and associated burdens on healthcare, policing, education sector, and wider economy).