Effect of a PRECEDE–PROCEED model–based laughter yoga–supported education program on adolescent bullying: A randomized controlled trial

Background Peer bullying is a significant public health concern in adolescence. The aim of this study was to examine the effects of a PRECEDE–PROCEED model–based, laughter yoga–supported educational program on peer victimization, bullying perpetration, bullying-related knowledge, and empathy and sympathy among eighth-grade students. Design This randomized controlled trial included 70 eighth-grade students randomized to intervention ( n = 35) or control ( n = 35) groups. Data were collected using the Personal Information Questionnaire, the Peer Victimization Scale, the Peer Bullying Scale, the Peer Bullying Information Form, and the Adolescent Measure of Empathy and Sympathy at baseline and pos t -test. The intervention group received a 6-week health education and laughter yoga program. Data were analyzed using ANCOVA and Quade's ANCOVA. Results At baseline, the groups were comparable on sociodemographic characteristics and on most outcomes. However, the intervention group had significantly lower pre-test scores for PVS total, Terror, Overt Victimization, and Sympathy. These baseline differences were accounted for in the adjusted analyses. At post-test, the intervention group had significantly lower peer victimization and bullying perpetration scores and significantly higher knowledge and empathy–sympathy scores than the control group ( p < 0.05). These differences refer to short-term, immediate post-intervention outcomes. Participant satisfaction with the program was high. Conclusion The PRECEDE–PROCEED model–based Laughter Yoga Supported Education Program was associated with short-term reductions in peer victimization and bullying perpetration and with short-term improvements in bullying-related knowledge and empathy–sympathy skills. School-based, multicomponent programs that combine educational and emotion-focused strategies may contribute to prevention of bullying. Longer follow-up is needed to assess the sustainability of these effects. Clinical trial registration: ClinicalTrials.gov , NCT07534566