Bullying is defined as a direct and indirect behavioral act where the perpetrator abuses the victim physically, verbally, and emotionally. Mental health issues as a result of bullying are at an all-time high. Bullying victimization is a public health issue that many countries are currently facing around the world. Prevalence around the world is estimated to be around 15-35% among North American and European countries; 22-56% among sub-Saharan African countries; and 9-28% among Asian countries (Kim et al., 2022; Aboagye et al., 2021). With a higher prevalence being reported in sub-Saharan African countries, arguably due to urbanization that can contribute to higher rates of marginalization, this is a public health equity concern (Tutu, 2021).

In Ghana, adolescents between the ages of 10 and 24 are experiencing bullying in school-based settings at 41.3% (Aboagye et al., 2021). Of the 41.3% of Ghanaian adolescents that face bullying victimization, 60.8% have engaged in fighting, 51.6% felt anxious, 55% felt lonely, and 61.7% had attempted suicide (Aboagye et al., 2021).

To address this ongoing crisis, a team of global health enthusiasts organized under the auspices of the Washington DC-based Global Health and Education Projects, Inc.’s (GHEP) Public Health 360 fellowship were charged to design a shovel-ready program to address bullying among school-aged students in Ghana. Design and development of a community outreach program and a shovel-ready capstone program addressing an emerging global issue are core components of the Public Health 360 fellowship.

An interdisciplinary team of 7 public health professionals worked together over three months during summer 2024 on an intervention aimed to reduce the negative outcomes associated with bullying (perpetrator and victim). We met two-three times per week for a minimum of 2 hours to consolidate research findings and create an outreach program. One subject of contention was our name. We all loved our former name, The Braves, but we found a similar program that provided mental health support so we came up with STEP or Standing Together for Equity and Peace. Although initially reluctant about the name change, we designed a program around the step phrase to empower people to step into action against bullying.

Rising to the challenge, our PH 360 group designed the Standing Together for Equity and Peace (STEP) program to reduce the negative impacts of bullying among youth aged 10-24 in Ghana. We developed a school-based program supported by local citizens as group leads who facilitate peer-based support groups. Students enrolled in the program learn about bullying and receive social and emotional skill training, and receive counseling referral services aimed at preventing and reporting bullying perpetration. The STEP program targeted three cities in Ghana in different phases of urbanization including the capital city Accra, the port city of Tema, and the peri-urban, 2nd largest city in Ghana, Kumasi.

As an international, interdisciplinary team, STEP team made sure to create systems around collaborations with local, national, and international stakeholders to support longevity in the program. STEP will achieve the overall objective of its program of increasing Ghanaian students’ awareness of the effects of bullying. It will also improve students’ comfortability in reporting bullying, and increase support, access, and use of anti-bullying resources.

From our experience, we would assert that program development is an iterative process and despite all your planning, there can still be unintended changes. As a team, we learned to be adaptable and made sure to craft a program that is just as adaptable. It can be tailored to any region, city, or locale as long as the community stakeholders and community social determinants of health are uniquely considered. We look forward to the opportunity to identify potential partners and funders so we can implement this robust and shovel-ready project in Ghana. If you are interested in learning more or partnering, reach out to the GHEP program office.

Project Team: Kendra Hester, MA, USA; Cha’Coya Williams, MA, USA; Noon Ibrahim, BPharm Sudan/Egypt; Megan Baker, BSPH, USA
Project Mentors: Romuladus Azuine, DrPH, MPH; Brownmagnus Olivers, BS; Sussan Ekejiuba, DVM, PhD; Chidubem Egboluche, DVM, MPH; Nzube Egboluche, MS, PhD
Further Information: Brownmagnus Olivers, outreach at globalhealthprojects.org

Sources
Aboagye, R. G., Seidu, A. A., Hagan, J. E., Jr, Frimpong, J. B., Okyere, J., Cadri, A., & Ahinkorah, B. O. (2021). Bullying Victimization among In-School Adolescents in Ghana: Analysis of Prevalence and Correlates from the Global School-Based Health Survey. Healthcare (Basel, Switzerland), 9(3), 292. https://doi.org/10.3390/healthcare9030292

Kim SS, Craig WM, King N, Bilz L,Cosma A, Molcho M, Qirjako G,Gaspar De Matos M, Augustine L,Šmigelskas K and Pickett W (2022). Bullying, Mental Health, and the Moderating Role of Supportive Adults: A Cross-National Analysis of Adolescents in 45 Countries. Int J Public Health 67:1604264. doi: 10.3389/ijph.2022.1604264

Tutu, Raymond Asare. (2011). Internal migration, risks and social resilience in Ghana
The Pennsylvania State University ProQuest Dissertations & Theses: 3576118.