Prevalence, risk indicators and outcomes of bullying among on-reserve First Nations youth.
Lemstra, Mark ; Rogers, Marla ; Redgate, Lauren 等
Bullying is defined as "an interaction in which a dominant
individual (the bully) repeatedly exhibits aggressive behaviour intended
to cause distress to a less dominant individual (the victim)." (1)
This definition encompasses physical, verbal, social and electronic
types of bullying. (2) The World Health Organization (WHO) Health
Behaviour in School-aged Children (HBSC) study conducted in 2006
revealed that 36% of Canadian children in grades 6-10 were victims of
bullying. (3)
Studies have shown that victims of bullying have higher levels of
physical and mental health problems, including somatic complaints,
anxiety, depression and suicide ideation. (4-7) As well, the long-term
effects of bullying include: difficulty with interpersonal
relationships, higher rates of unemployment, higher rates of criminality
and higher school dropout rates. (1)
There are no data on the prevalence, risk indicators and impact of
bullying on First Nations youth on-reserve in Canada. (8) Even the First
Nations Regional Longitudinal Health Survey, a survey specifically
designed for First Nations living on-reserve, does not address bullying
in the youth questionnaire. (9)
Given the lack of data, the purpose of this paper is to examine the
prevalence, risk indicators and impact of bullying within a First
Nations youth population currently living on-reserve.
METHODS
The Saskatoon Tribal Council (STC) consists of seven on-reserve
First Nations communities within a 250-kilometre radius of the city of
Saskatoon, Canada. Based on the 2006 census, the median income per
household is $8,572, the percentage of adults who receive all of their
income from government transfers is 37.1%, lone-parent families
represent 26.3%, the high school graduation rate among adults is 50.7%,
and the male adult unemployment rate is 27.5% while the female adult
unemployment rate is 20.7%.10
In comparison, the Canadian Aboriginal population has a median
income of $16,752, with 18.1% of income received from government
transfers. The high school graduation rate among Aboriginal adults in
Canada is 56.3% with an unemployment rate of 16.1% for males and 13.5%
for females. Lone-parent families account for 8.2% of Aboriginal
families across Canada.10
In May 2010, students in grades 5 through 8 within the STC were
asked to complete a youth health survey. Of the seven schools, only four
schools had grade 8 students. Among the seven schools, 271 students were
eligible to participate.
Prior to conducting the study, the Chief, Band Councillors and
Health Directors from each of the seven First Nation communities, as
well as the Education Director, gave written consent to proceed. The
principal of each school and the teacher of each classroom gave verbal
consent. Additionally, each parent and each youth participant gave
written, informed consent prior to the youth's participation in the
survey. Ethics approval was obtained from the University of Saskatchewan
Behavioural Research Ethics Board (BEH#10-14).
The measure used to assess bullying was the Safe School Study
developed by the Canadian Public Health Association, which was based on
a survey used by the World Health Organization. (2,11) This
questionnaire measures the prevalence of bullying by asking "In the
past four weeks, how often have you been bullied by other students ...
[physically, verbally, socially or electronically]?" There are four
potential responses: never, once or twice a month, every week, or many
times a week. The survey also queries causes of bullying, where bullying
occurs, responses to bullying and what should be done to prevent or
reduce bullying. Despite widespread usage of the survey, its validity
and reliability were never formally tested.
Questions on demographics, socio-economic status and body mass
index were taken from Statistics Canada's National Longitudinal
Survey of Children and Youth (NLSCY). This comprehensive health survey
was designed to collect information about factors that influence a
youth's social, emotional and behavioural development. The NLSCY
has been validated for youth aged 10 to 13 years old. (12)
The instrument used to measure depressed mood among youth was the
Center for Epidemiologic Studies Depression scale (CES-D 12). (13) This
scale was used in the NLSCY, which has been validated for youth, and has
been shown to have good internal consistency and content validity with a
Cronbach's alpha of .85. (14) A cut-off score of 16 or higher is
used to determine depressed mood.
Parenting questions came from the Parenting Relationship Scale that
was used in the HBSC study. Although validity and reliability have never
been published, the scale has been used in an international project
facilitated by the World Health Organization. (15)
Cross tabulations were performed between ever being physically
bullied and demographics, socio-economic status, living arrangements,
relationship with parents and depressed mood. The frequency of verbal,
social and electronic bullying was also cross tabulated with depressed
mood. After these initial cross tabulations, binary logistic regression
was used to determine the independent association between the outcome
variable of being physically bullied within the previous four weeks (in
comparison to not) and the potential explanatory variables. Due to the
smaller sample size of the study, the unadjusted effect of each
covariate was determined and then entered one step at a time based on
changes in the -2 log likelihood and the Wald test. (16) The final
results are presented as adjusted odds ratios with 95% confidence
intervals.
RESULTS
Out of 271 students in grades 5 through 8 who were eligible to
participate, 204 youth completed the eight-stage consent protocol and
the school survey for a response rate of 75.3%.
Of the 204 youth participants, 10.3% were 10 years old, 48% were 11
to 12 years old, and 40.2% were 13 to 16 years old; 44.1% were male
(55.9% female). With regard to socio-economic status, 36.3% had an
unemployed father, with 92.6% of the employed fathers working in a
non-professional occupation (non-management or occupation not requiring
a degree); 44.6% had an unemployed mother, with 73.6% of the employed
mothers working in a non-professional occupation. Overall, 43.6% lived
with both their mother and father, while 21.6% were living with a
guardian.
Of all STC youth in grades 5 through 8, 44.1% were male, compared
to 50.7% reported in the Canadian Census. (17)
In our study, 36% of youth reported being physically bullied; 59%,
verbally bullied; 47%, socially bullied; and 30%, electronically bullied
at least once or twice in the previous four weeks (Table 1). The
prevalence of being physically bullied within the previous four weeks
ranged from 20% to 61% by community.
Table 2 displays self-reported causes, locations and potential
anti-bullying interventions listed by students themselves. Two of the
three leading self-reported causes for being bullied were the way a
youth looks or their body shape (38.8%) and body weight (28.7%).
Additionally, 31.7% of youth self reported that they were bullied
because they did well in school. The area where bullying occurred most
frequently was the classroom (45.6%). When asked what can be done to
prevent or reduce bullying in their school, 29.7% of students reported
that they wanted more discipline for bullies whereas only 12.5% wanted
more anti-bullying programs and 10.9% wanted more supervision at school.
After cross tabulation, there were no significant associations
found between physical bullying in the previous four weeks and age,
gender, parental employment status, mother's occupation and body
mass index. However, youth who had a father with a professional
occupation were more likely to be the victim of physical bullying (Table
3).
After cross tabulation, youth who felt that their parents expected
too much of them or felt that their parents did not trust them were more
likely to be physically bullied within the previous four weeks (Table
4).
Table 5 shows the cross tabulation performed between physical,
verbal, social and electronic bullying and depressed mood. There was a
statistically significant association between depressed mood and
frequency of being physically, socially or electronically bullied, but
no statistically significant association between depressed mood and
being verbally bullied. This information also appears in Figure 1.
Binary logistic regression analysis was used to determine the
independent risk factors for ever being physically bullied. There were
three covariates, including 1) having a father who works in a
professional occupation, 2) doing well in school, and 3) having the
perception that parents expect too much from them. The results are
presented in Table 6.
DISCUSSION
The CPHA Safe School Study quantified bullying in Canadian children
in grades 4 to 12 and found that 21% of children reported being
physically bullied; 48%, verbally bullied; 30%, socially bullied; and
8%, electronically bullied. (3) In contrast, our First Nations youth
population had a prevalence of being physically (35.8%), verbally
(59.3%), socially (47.5%) and electronically (30.3%) bullied at least
once or twice in the previous four weeks. These rates are all higher
than the national average.
This discrepancy in results might be partially explained by
differing questionnaires, methodologies and age group. However, the same
survey and methodology used in our study was also used in a study of
children from the city of Saskatoon (n=4,197) within the same age group
in February of 2008. (18) From the Saskatoon survey, 23% reported being
physically bullied; 42%, verbally bullied; 31%, socially bullied; and
10%, electronically bullied at least once or twice in the previous four
weeks. (18)
In an American study of over 78,000 youth, it was found that
American Indian youth were at an increased risk of being bullied (27.5%
in comparison to 20.1% youth overall). (19)
Our study found three independent risk indicators for being bullied
in STC youth. Having a father in a professional occupation increased a
student's risk for being physically bullied. This finding is
contradictory to literature which has found that low SES students are
often bullied more than higher SES students. (20) STC youth who perform
better in school are also at increased risk for being physically
bullied. This, again, opposes previous findings. A study of 11, 13 and
15 year olds
from 26 European countries, Canada, the United States and Israel
found that those who have higher academic achievement, attendance, and
overall connection to the school were significantly less likely to be
bullied than other students. (21) The third risk indicator for being
bullied was believing that a parent expects too much from the student.
This finding is consistent with the literature. (22)
The location where bullying occurs most often was also
contradictory to previous findings, (23) as the classroom was the most
commonly reported location. Generally, children report most bullying in
areas of low supervision, such as playgrounds, hallways, bathrooms and
school buses. (24) Since the classroom is generally a well supervised
area, this finding is surprising. It suggests that it is important to
recognize more covert forms of bullying, especially since indirect
bullying has been found to be associated with higher rates of depression
and suicide than direct bullying. (25)
Our study showed that irrespective of the type of bullying, youth
who were bullied were at least twice as likely to suffer from depressed
mood. This finding is also consistent with the litera ture. (3,4)
The high prevalence of all types of bullying has had a significant
impact on the mental health of this First Nations youth population.
Previous studies have found that being a victim of bullying has a
negative effect on mental health, including depressive symptoms, low
self-esteem and suicide ideation. (3,4) The Cochrane Collaboration found
that secondary prevention programs implemented through schools led to a
statistically significant decrease in aggressive behaviour.
Multidisciplinary school-based intervention programs are effective in
reducing bullying behaviours, as evidenced by a systematic review in
2007. (26) Given the high prevalence of bullying victimization in First
Nations youth on-reserve, and the effectiveness of such programs on
bullying prevention, initiation of these strategies should be a
priority.
In summary, we found that bullying is more common for First Nations
youth living on-reserve compared to other Canadian youth. Given that the
independent risk indicators also appear to be different, we hope this
new information can aid in the design of effective bullying strategies.
Acknowledgement: The authors thank the Saskatoon Tribal Council for
their support.
Conflict of Interest: None to declare.
Received: October 6, 2010
Accepted: May 23, 2011
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Correspondence: Dr. Mark Lemstra, Department of Pediatrics,
University of Saskatchewan, Health Sciences Building, 107 Wiggins Road,
Saskatoon, SK S7N 5E5, Tel: 306-230-3911, E-mail: mark.lemstra@usask.ca
Mark Lemstra, PhD, [1] Marla Rogers, BA, MPA, [2] Lauren Redgate,
MD, [3] Meghan Garner, MD, [3] John Moraros, MD, PhD [4]
Author Affiliations
[1.] Adjunct Professor, Department of Psychiatry and Adjunct
Professor, Department of Pediatrics, University of Saskatchewan,
Saskatoon, SK
[2.] Researcher, School of Public Health, University of
Saskatchewan, Saskatoon, SK
[3.] Pediatric Resident, Department of Pediatrics, University of
Saskatchewan, Saskatoon, SK
[4.] Assistant Professor, School of Public Health, University of
Saskatchewan, Saskatoon, SK
Table 1. Prevalence of Different Types of Bullying Among
STC First Nations Youth (N=204)
Bullying Question Prevalence
N (%)
In the past 4 weeks, how often have you been bullied
by other students... physically?
Never 120 (58.8)
Once or twice a month 54 (26.5)
Every week 8 (3.9)
Many times a week 11 (5.4)
Missing 11 (5.4)
In the past 4 weeks, how often have you been bullied
by other students. verbally?
Never 71 (34.8)
Once or twice a month 80 (39.2)
Every week 19 (9.3)
Many times a week 22 (10.8)
Missing 12 (5.9)
In the past 4 weeks, how often have you been bullied
by other students. socially?
Never 95 (47.0)
Once or twice a month 61 (29.9)
Every week 19 (9.3)
Many times a week 17 (8.3)
Missing 12 (5.9)
In the past 4 weeks, how often have you been bullied
by other students. electronically?
Never 129 (63.2)
Once or twice a month 37 (18.1)
Every week 9 (4.4)
Many times a week 16 (7.8)
Missing 13 (6.4)
Table 2. Self-report Causes, Locations and Interventions to
Reduce Bullying Among STC First Nations Youth
Causes of bullying in past month * Percentage
The way you look or body shape 38.8%
You do well in school 31.7%
Your weight 28.7%
Your gender 28.2%
The way you dress 25.3%
Physical disability 24.5%
School is hard for you 22.3%
Because of how little money you have 21.2%
Learning disability 21.6%
Mental disability 17.2%
Locations where bullying happens most *
Classroom 45.6%
Malls or stores 45.6%
Lunchroom or eating area 43.6%
Hallways 43.1%
Gymnasium 40.2%
Washrooms 31.4%
On the computer or cell phone 23.0%
On the way to and from school 21.6%
Coatroom 20.6%
On the school bus 18.1%
Change rooms 15.7%
Computer room 15.7%
Library 10.8%
Outdoor area around school 10.8%
What can your school do to prevent or
reduce bullying? *
More discipline for bullies 29.7%
More anti-bully programs or education 12.5%
Increase supervision at school 10.9%
Nothing can be done 9.4%
Other 37.5%
* Students were instructed to check all that apply; as such, totals
exceed 100%.
Table 3. Cross Tabulations of Being Physically Bullied Ever in
Past Four Weeks by Demographics, Socio-economic
Status and Body Mass Index
Physically Bullied
in Past Month
Prevalence p-value
Within Each
Variable
Age (Years) 0.771
10 38.1%
11-12 39.1%
13-16 34.6%
Gender 0.280
Male 42.5%
Female 34.8%
Father is employed 0.908
Yes 38.9%
No 38.0%
If employed, father's occupation 0.038
Professional 71.4%
Non-professional 35.3%
Mother is employed 0.134
Yes 43.5%
No 32.6%
If employed, mother's occupation 0.981
Professional 40.9%
Non-professional 40.7%
Body Mass Index 0.479
Underweight 36.7%
Normal 41.1%
Overweight or Obese 51.7%
Table 4. Cross Tabulations of Being Physically Bullied Ever in
Past Four Weeks by Family Unit and Parental
Relationship
Physically Bullied
in Past Month
Prevalence p-value
Within Each
Variable
Who do you live with? 0.966
Both my mother and father 37.9%
Other than both mother and father 38.2%
Parenting Relationship Scale
My parents understand me 0.983
Strongly agree or agree 35.8%
Neither agree nor disagree 37.1%
Strongly disagree or disagree 37.5%
I have a happy home life 0.748
Strongly agree or agree 34.8%
Neither agree nor disagree 38.5%
Strongly disagree or disagree 42.9%
My parents expect too much from me 0.018
Strongly agree or agree 47.4%
Neither agree nor disagree 28.3%
Strongly disagree or disagree 25.9%
My parents trust me 0.002
Strongly agree or agree 30.8%
Neither agree nor disagree 29.2%
Strongly disagree or disagree 65.2%
I have a lot of arguments 0.177
with my parents
Strongly agree or agree 42.1%
Neither agree nor disagree 43.6%
Strongly disagree or disagree 29.5%
There are times when I would 0.083
like to leave home
Strongly agree or agree 42.9%
Neither agree nor disagree 21.7%
Strongly disagree or disagree 30.2%
What my parents think of me 0.092
is important
Strongly agree or agree 40.4%
Neither agree nor disagree 28.0%
Strongly disagree or disagree 16.7%
My parents expect too much from 0.690
me at school
Strongly agree or agree 37.9%
Neither agree nor disagree 38.3%
Strongly disagree or disagree 29.0%
Table 5. Cross Tabulations of Frequency of Different Types of Bullying
and Depressed Mood
Physical Bullying Frequency in Past Four Weeks
Never Once or Every Week or Rate p-value
Bullied Twice a Many Times Ratio *
Month a Week
Prevalence of 21.1% 31.4% 57.9% 2.74 0.003
depressed mood
Verbal Bullying Frequency in Past Four Weeks
Never Once or Every Week or Rate p-value
Bullied Twice a Many Times Ratio *
Month a Week
Prevalence of 18.2% 29.5% 38.5% 2.12 0.067
depressed mood
Social Bullying Frequency in Past Four Weeks
Never Once or Every Week or Rate p-value
Bullied Twice a Many Times Ratio *
Month a Week
Prevalence of 18.9% 31.7% 42.4% 2.24 0.023
depressed mood
Electronic Bullying Frequency in Past Four Weeks
Never Once or Every Week or Rate p-value
Bullied Twice a Many Times Ratio *
Month a Week
Prevalence of 22.0% 33.3% 47.8% 2.17 0.026
depressed mood
* Rate ratio is bullied every week or many times a week in comparison
to never bullied
Table 6. Logistic Regression Model--Independent Risk
Indicators of Being Physically Bullied Within the
Previous Four Weeks Among STC First Nations
Youth (n=172)
Independent Variables Odds Ratio 95%
Confidence
Interval
Father has a professional occupation 17.99 1.71-89.13
Youth is doing well in school 1.51 1.15-1.72
Parents expect too much from youth 4.23 1.50-11.90
Figure 1. Frequency of different types of bullying and
depressed mood among STC First Nations youth
Once or twice Every week or
Never a month many times a week
Physical Bullying 21.1 31.4 57.9
Verbal Bullying 18.2 29.5 38.5
Social Bullying 18.9 31.7 42.4
Electronic Bullying 22 33.3 47.8
Note: Table made from bar graph.
