Efficacy of Bystander Intervention Program in Nursing Students

The Effect of Bystander Intervention Program on Bystander Efficacy, Behavior and Intent to Help for Dating Violence in Nursing Students

This randomized controlled trial evaluated the effectiveness of a bystander intervention program for dating violence among nursing students. The study was conducted with second-year nursing students at Istanbul University-Cerrahpaşa Florence Nightingale Faculty of Nursing. A total of 84 students were randomized to the intervention and control groups. Due to missing data from one participant in the control group, 83 students were included in the final analysis (intervention group, n=42; control group, n=41). Participants were allocated to the groups using computer-generated randomization. The intervention group received the Bystander Intervention Program, which was developed based on the Bystander Behavior Model and the Theory of Planned Behavior and adapted to the cultural and institutional context. The control group received a single 90-minute educational session on dating violence during the study period. After completion of all outcome assessments, participants in the control group were also offered the Bystander Intervention Program for Dating Violence. Data were collected face-to-face using an Individual Information Form, the Bystander Efficacy Scale, the Intention to Help Scale-Short Version, the Bystander Behavior Scale, and a Program Evaluation Form. Bystander efficacy and intention to help were assessed at baseline, immediately after the intervention, and at two-month follow-up. Bystander behavior was assessed at baseline and at two-month follow-up.

Dating violence is an important public health concern among young adults and may have adverse physical, psychological, and social consequences. Young people exposed to dating violence may experience difficulties in seeking help or disclosing violence, highlighting the importance of prevention approaches that extend beyond individuals directly involved in violent relationships (Choi et al., 2017; Park & Kim, 2021).

Bystander intervention is a prevention approach that focuses on individuals who witness or become aware of situations involving violence and who may have opportunities to intervene safely. Bystanders may intervene directly or indirectly, and previous studies have reported that bystander-focused programs can influence outcomes including knowledge, attitudes, confidence to intervene, intentions to help, and bystander behaviors (Amar et al., 2015; Jouriles et al., 2018; Peterson et al., 2018).

The intervention evaluated in this study was developed specifically for nursing students and was informed by the Bystander Behavior Model and the Theory of Planned Behavior. The program was adapted to the cultural and institutional context and aimed to strengthen students' ability to recognize dating violence, assume responsibility when intervention is appropriate, identify safe intervention strategies, and provide appropriate support and referral.

Nursing students constitute a relevant population for bystander intervention because they may encounter dating violence both within their peer environments and, as future health professionals, in the care of individuals exposed to violence. Developing their knowledge, confidence, intentions, and behaviors related to safe bystander intervention may therefore be relevant to both violence prevention and future nursing practice.

The study evaluated the Bystander Intervention Program for Dating Violence in a randomized controlled trial among nursing students. The primary outcomes were bystander efficacy, intention to help, and bystander behavior. Bystander efficacy and intention to help were assessed at baseline, immediately after the intervention, and at two-month follow-up; bystander behavior was assessed at baseline and at two-month follow-up.

Inclusion Criteria:

-Being actively enrolled as a student at the nursing faculty of a public university in Istanbul during the 2024-2025 academic year.

Exclusion Criteria:

• Not being actively enrolled at the nursing faculty during the 2024-2025 academic year due to reasons such as suspension or termination of enrollment, transfer to another institution, or transfer to another academic program.
• Having a diagnosed mental disorder (e.g., major depression or post-traumatic stress disorder) and/or receiving regular psychiatric treatment.
• Having previously participated in a seminar, workshop, group activity, conference, congress, training program, or similar educational activity related to dating violence prevention and/or bystander intervention.