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Original research
Broader impacts of an intervention to transform school environments on student behaviour and school functioning: post hoc analyses from the INCLUSIVE cluster randomised controlled trial
  1. Christopher Bonell1,
  2. Matthew Dodd1,
  3. Elizabeth Allen2,
  4. Leonardo Bevilacqua3,
  5. Jennifer McGowan3,
  6. Charles Opondo2,4,
  7. Joanna Sturgess2,5,
  8. Diana Elbourne2,6,
  9. Emily Warren2,7,
  10. Russell M Viner8,9
  1. 1Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
  2. 2Department of Medical Statistics, London School of Hygiene & Tropical Medicine, London, UK
  3. 3University College London, London, UK
  4. 4London School of Hygiene and Tropical Medicine, London, UK
  5. 5Department of Population Health, London School of Hygiene and Tropical Medicine, London, UK
  6. 6EPH, LSHTM, London, UK
  7. 7Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
  8. 8Population, Policy and Practice Research Programme, UCL Institute of Child Health, London, UK
  9. 9Institute of Child Health, University College London, Londn, UK
  1. Correspondence to Dr Christopher Bonell; chris.bonell{at}


Background We have previously reported benefits for reduced bullying, smoking, alcohol and other drug use and mental health from a trial of ‘Learning Together’, an intervention that aimed to modify school environments and implement restorative practice and a social and emotional skill curriculum.

Objectives To conduct post hoc theory-driven analyses of broader impacts.

Design Cluster randomised trial.

Settings 40 state secondary schools in southern England.

Participants Students aged 11/12 years at baseline.

Outcomes Student self-reported measures at 24 and 36 months of: cyberbullying victimisation and perpetration; observations of other students perpetrating aggressive behaviours at school; own perpetration of aggressive behaviours in and outside school; perceived lack of safety at school; participation in school disciplinary procedures; truancy and e-cigarette use.

Results We found evidence of multiple impacts on other health (reduced e-cigarette use, cyberbullying perpetration, perpetration of aggressive behaviours) and educational (reduced participation in school disciplinary procedures and truancy) outcomes.

Conclusion These analyses suggested that the intervention was effective in bringing about a broader range of beneficial outcomes, adding to the evidence that the intervention is a promising approach to promote adolescent health via an intervention that is attractive to schools.

Trial registration number ISRCTN10751359.

  • public health
  • epidemiology
  • statistics & research methods

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  • Contributors All those who contributed significantly to this work are listed as authors. CB and RMV directed the trial from which the data are drawn. CB, MD, EA and CO designed the analysis for this paper. MD implemented this design and undertook the analysis. DE provided additional statistical expertise. CB wrote the first draft of the paper which was then edited and commented on by MD, EA, LB, JM, CO, JS, DE, EW and RMV.

  • Funding This work was supported by the National Institute for Health Research (NIHR) in England under its Public Health Research Board (12/153/60) and the Education Endowment Foundation (no grant number). The views expressed in this publication are those of the authors and do not necessarily reflect those of the National Health Service, the NIHR or the Department of Health for England. The study funders (NIHR and Education Endowment Foundation) played no role in the study; collection, analysis and interpretation of data; the writing of the report or the decision to submit the manuscript for publication.

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were involved in the design, or conduct, or reporting, or dissemination plans of this research. Refer to the Methods section for further details.

  • Patient consent for publication Not required.

  • Ethics approval The trial was prospectively registered as ISRCTN10751359 with the ISRCTN Registry on 30 January 2014 and approved by the UCL Ethics Committee (ref 5248/001).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available upon reasonable request. Data are available upon reasonable request.