Evaluation of the Effect of a PRECEDE-PROCEED Model-Based "Laughter Yoga-Supported Education Program" on Peer Bullying
Evaluation of the Effect of a PRECEDE-PROCEED Model-Based "Laughter Yoga-Supported Education Program" on Peer Bullying
Adolescence is a critical developmental period marked by rapid cognitive, emotional, and social changes that shape personality and psychosocial functioning. During this stage, peer relationships play a central role in adolescents' mental well-being, academic performance, and social adjustment. However, unhealthy peer interactions and exposure to peer bullying significantly increase the risk of adverse physical, psychological, and social outcomes, including anxiety, depression, low self-esteem, academic difficulties, and risky health behaviors, making bullying a major public health concern.
Recent evidence indicates a rising prevalence of peer bullying, particularly among middle school students, highlighting the need for effective school-based interventions. Previous programs have demonstrated reductions in bullying behaviors and improvements in school adjustment and self-confidence, yet meta-analytic findings suggest that existing educational interventions have limited effectiveness, underscoring the need for innovative and theory-driven approaches.
The PRECEDE-PROCEED Model offers a comprehensive framework for designing sustainable health promotion interventions by addressing predisposing, enabling, and reinforcing factors influencing behavior. In this context, a laughter yoga-supported education program grounded in this model aims to increase adolescents' awareness of peer bullying, enhance physiological, psychological, and social well-being, strengthen social interaction, and improve quality of life. To date, no studies have examined the effects of a PRECEDE-PROCEED Model-based laughter yoga intervention on peer bullying. The aim of this study is to examine the effect of the "Laughter Yoga-Supported Education Program," developed based on the PRECEDE-PROCEED Model, on peer bullying among adolescents.
Objectives:
To improve adolescents' levels of awareness regarding peer bullying through the PRECEDE-PROCEED Model-based "Laughter Yoga-Supported Education Program," To enhance adolescents' awareness of health behaviors related to peer bullying through the PRECEDE-PROCEED Model-based "Laughter Yoga-Supported Education Program," To develop adolescents' social skills through PRECEDE-PROCEED Model-based laughter yoga educational practices, To significantly reduce the post-test mean peer bullying scores of adolescents in the intervention group compared with their pre-test mean scores, To ensure that the findings of the study contribute to the literature and guide future research on PRECEDE-PROCEED Model-based interventions.
Hypotheses:
H0-1: There is no significant difference in Peer Bullying Identification Scale scores between adolescents who receive the PRECEDE-PROCEED Model-based Laughter Yoga-Supported Education Program and those who do not.
H1-1: There is a significant difference in Peer Bullying Identification Scale scores between adolescents who receive the PRECEDE-PROCEED Model-based Laughter Yoga-Supported Education Program and those who do not.
This study is a randomized controlled trial designed to evaluate the effects of a PRECEDE-PROCEED Model-based laughter yoga-supported education program on peer bullying, empathy, and related knowledge among 8th-grade students in a middle school located in the Altındağ district of Ankara, Türkiye.
The study population consists of 8th-grade students enrolled in a randomly selected middle school in a socioeconomically disadvantaged district. Participants who meet the inclusion criteria and provide parental consent will be randomly assigned to intervention and control groups using a simple random allocation method to ensure equal probability of group assignment and minimize selection bias.
The intervention group will receive a 6-week structured program based on the PRECEDE-PROCEED Model, consisting of weekly theoretical education sessions (30-40 minutes) on peer bullying and health-related outcomes, and laughter yoga sessions (40-45 minutes) conducted twice per week by a certified instructor. Educational materials will also be shared with families to reinforce learning. The control group will receive no intervention during the study period.
Data will be collected at three time points: baseline (pre-test), immediately after the 6-week intervention (post-test), and 3-month follow-up. Outcome measures include peer bullying behaviors, peer bullying knowledge, and empathy and sympathy levels, assessed using validated measurement tools.
After completion of the study, a single-session educational intervention will be provided to the control group for ethical considerations.
Data will be analyzed using SPSS software. Descriptive statistics will be calculated, and group comparisons will be performed using independent samples t-test, ANOVA, and non-parametric equivalents where appropriate. Statistical significance will be set at p < 0.05.
Inclusion Criteria:
Exclusion Criteria: