Bullying and the Effectiveness of a Health Education Program Among Female Middle School Students in Riyadh, Saudi Arabia: An Application of Social Cognitive Theory

Bullying is a significant issue that poses various health concerns, particularly in school environments. The study aimed to determine bullying practices and assess the health education program's effectiveness in changing bullying attitudes among female middle school students using the social cognitive theory (SCT). An interventional one-group pretest/post-test design study was conducted among 304 female middle school students in Riyadh. The primary outcome was the change in students' attitudes toward bullying after the intervention. This study revealed that 97.7% (n=297) of the students did not consider themselves bullies, and 70.7% (n=215) had a neutral attitude toward bullying. Regarding the SCT conceptual elements, a relationship was found between bullying and bullying's attitude (p = 0.000); there was also a significant association between bullying and the social environment (p = 0.025). The effectiveness of the health education program was highly significant (p=0.000, Z=-4.725). Based on the current study findings, the majority of the participants reported themselves as not bullies, and their attitude toward bullying was neutral. Conversely, there was no significant relationship between attitude toward bullying and the social environment. Lastly, the health education program was very successful. Thus, building a curriculum is necessary to promote anti-bullying attitudes in schools, besides carrying out further qualitative theory-based studies to explore the factors behind the pro-bullying attitude in Saudi Arabia.