Bystander Action Research Articles

Teaching bystander action: forming identities that promote opposition to prejudice towards Muslim people

Prejudice towards Muslim people in Western countries is common and increasing. This paper describes an educational intervention aimed at increasing positive attitudes and actions to support Muslim Australians. University students participated in a 12-week educational programme that drew on prejudice reduction principles and a pedagogical approach that emphasised active discussion. Results (N = 94) showed an increase in positivity towards Muslim people, increased intention to take bystander action to confront prejudice, and social identification (as a supporter of positive relations between Muslim and non-Muslim Australians). Boosts in positivity towards Muslim people and intention to confront prejudice were mediated by increases in social identity, although changes in social identification only explained increased commitment to confront prejudice in a low risk scenario. Results suggest that educational interventions such as these can foster new, inclusive identities that provide a basis for action to support Muslim people.

Adequacy of bystander actions in unconscious patients: an audit study in the Ghent region (Belgium).

Early recognition and appropriate bystander response has proven effect on the outcome of many critically ill patients, including those in cardiac arrest. We wanted to audit prehospital bystander response in our region and identify areas for improvement. We prospectively collected data, including Emergency Medical Services dispatch center audio files, on all patients with a decreased level of consciousness presenting to the Ghent University Hospital prehospital emergency care unit (n = 151). Three trained emergency physicians reviewed the bystander responses, both before and after dispatcher advice was given. Suboptimal actions (SAs) were only withheld if there was 100% consensus. SAs were recognized in 54 (38%) of the 142 cases, and most often related to delayed (n = 35) or inaccurate (n = 12) alerting of the dispatch center. In seven cases, the aid given was considered suboptimal in itself. Importantly, in 21 (25.9%) of the 81 cases where a clear advice was given by the dispatcher, this advice was ignored. In 12 cases, a general practitioner was present at scene. We recognized SAs in 80% of these cases (8/10; insufficient information, n = 2). Cardiopulmonary resuscitation was started in only 29 (43.3%) of the 67 cases of cardiac arrest where dispatcher-assisted cardiopulmonary resuscitation was indicated at the moment of first Emergency Medical Services call. We audited bystander response for unconscious patients in our region and found a high degree of suboptimal actions. These results should inform policy makers and healthcare professionals and force them to urgently reflect on how to improve the first parts of the chain of survival.

Perceptions of campus authorities: Institutional responses, fairness, and bystander action

Objective: This study is an examination of college students’ bystander behaviors in relation to several exosystem factors related to their institution, including trust in their college’s support systems, perceived procedural justice by campus police, and perceived procedural justice by campus administrators. Participants: Online surveys were completed by 223 students at a mid-sized public institution in the Northeastern U.S. Methods: Responses were analyzed using an OLS multiple regression to examine bystander behaviors in relation to their perceptions of institutional exosystem factors. Results: Students who felt more favorably about both campus police and campus admin were more likely to have intervened in the past as a bystander; trust in school had no effect. Conclusions: Perceptions of institutional leaders and representatives are important to consider as influential motivators for bystander behavior. School personnel trainings and policies which increase visibility of staff as trustworthy and fair should be part of comprehensive campus antiviolence efforts.

You're It-You've Got to Save Someone: Immediate Responders, Not Bystanders.

Recurring disasters and life-threatening emergencies mandate that communities across the world be adequately prepared to prevent, respond, and recover from these events. Experiences throughout the world with mass casualty incidents and other disasters have increasingly highlighted the vital role that “active bystanders”—persons at the scene of an event who step forward to help—can play in preventing, containing, reporting, saving lives, decreasing morbidity, and increasing resilience. This paper seeks to emphasize the importance of the public in response to emergencies. No longer should we use the passive word “bystanders.” Rather immediate responders fill a critical silent gap before trained professionals arrive. In support of immediate responders this paper will identify the barriers to bystander action, and provide next steps to increase the number of individuals who take action at times of emergency. Immediate responders can and do play a valuable and unique role in reducing mortality, morbidity, and suffering from emergency events. While some cultures and countries have a long history of engaging the public as critical in an emergency response, others do not. The challenge is how best to increase the number of individuals who are motivated, prepared and ready to respond appropriately when they find themselves at the scene of an active shooter, bombing, hurricane, earthquake, tornado, fire, vehicle crash, or other life-threatening emergency.

Abstract 472: Organizations Unite in “Call-Push-Shock” Movement to Impact Public Understanding That Drives Action

Introduction: The incidence of OHCA in the U.S. is high (>350,000); the survival rate is low, about 1 in 10. Less than half of victims receive bystander CPR (39%) or treatment with an AED (6%) before EMS arrival. Consumer research indicates the public’s motivation to learn CPR/AED skills and help in emergencies increases with understanding of CA and the impact of bystander action. Two tested messages resonate most with the public: CPR/AED use can double or triple the chance of survival, and CA can happen to a loved one. Hypothesis: An inclusive national movement of organizations using unified, co-branded and tested messaging in a coordinated, multi-channel social media campaign could improve targeted reach and, over time, public understanding of CA and the importance of bystander action. Creating a gold standard for educational content on CA could improve message retention and motivation to act over time. Methods: We created a movement through consistent messaging in a user-friendly toolkit. We built a landing page (CallPushShock.org) and co-sponsored a social media campaign on CA and the importance of bystander action. We launched the campaign during CPR-AED Awareness Week (June 2018). We invited other organizations to join for SCA Awareness Month (Oct 2018), providing co-branded social media assets (Facebook/Twitter posts, videos, infographic) and posting schedules to all partners. Social media analytics were used to measure the reach of the campaign. Results: The campaign launched in June, attracting 20 partners by October. Combined co-sponsor results for June were: News release: 548,464 headline impressions (PR Web); hashtag (#callpushshock) impressions: 243,345 (Keyhole); FB reach: 86,134; Twitter impressions: 25,107; YouTube views: 351; e-news opens: 4,226 (MailChimp, Constant Contact); landing page: 1,291 users (Google). [ Oct 2018 and June 2019 results in development, reflecting extended partner reach.] Conclusion: A social media campaign, leveraging consumer-tested messaging used by multiple organizations in a unified, consistent movement can be effective in improving targeted reach and educational outcomes. A sustained effort is needed to determine campaign impact in improving public understanding of CA and bystander action over time.

Do Violence Acceptance and Bystander Actions Explain the Effects of Green Dot on Reducing Violence Perpetration in High Schools?

This study extends prior analyses from a 5-year multisite cluster-randomized controlled trial to examine how the previously reported effects of the Green Dot bystander-based prevention program worked to reduce violence perpetration. Bystander-based interventions are hypothesized to prevent violence by reducing violence acceptance and increasing trained participants' willingness and ability to actively engage others in violence prevention using safe and effective bystander actions to diffuse or avoid potentially violent situations. We tested this hypothesis by examining whether Green Dot worked to reduce violence through two mediators measured over time: reducing violence acceptance and increasing bystander actions. When accounting for changes in these mediators over time, the effect of this intervention on violence perpetration was hypothesized to be attenuated or explained. At baseline (spring 2010) and annually (2011-2014), all students in recruited high schools (13 intervention, 13 control) completed an anonymous survey (response rate = 83.9%). Student responses were aggregated as school-level counts for the analysis. Path analyses estimated direct and indirect effects at specific points in the implementation of the intervention. Longitudinal models were used to determine if changes in violence acceptance and bystander actions could explain or attenuate the effect of the intervention. Time-framed path model analyses indicated that the intervention worked as expected to increase bystander behaviors and reduce violence acceptance; both potential mediators were significantly associated with sexual violence perpetration. In addition, after adjusting intent-to-treat models for the hypothesized mediators, the intervention was no longer associated with violence perpetration. In conclusion, these findings indicate that this bystander intervention worked as hypothesized to reduce sexual violence perpetration by creating theory-based changes in students' violence acceptance and bystander actions.

Accountability and Empathy by Design

Bystander intervention can reduce the amount of cyberbullying victimization on social media, but bystanders often fail to act. Limited accountability for their behavior and a lack of empathy for the victim are frequently cited as reasons for why bystanders do not act against cyberbullying. We developed design interventions that aimed to increase accountability and empathy among bystanders. In Study 1, participants were experimentally exposed to three social media posts with different types of empathy nudges. Empathy nudges embedded into social media posts displayed the potential to motivate empathy. In Study 2, participants took part in a 3-day experiment that simulated a social media experience. Results suggested that increased social transparency on social media promoted accountability through heightened self-presentation concerns, but empathy nudges did not encourage greater bystander empathy. Both accountability and empathy predicted bystander intervention, but the types of bystander actions promoted by each mechanism differed. We consider how these results contribute to theories of bystander behavior and designing social media to promote prosocial behaviors.

What happened next? New measures of consequences of bystander actions to prevent interpersonal violence.

What happened next? New measures of consequences of bystander actions to prevent interpersonal violence.

‘That's not funny!’ Standing up against disparaging humor

The current article addresses bystander action to confront disparaging humor as a form of moral courage. We ask: When is disparaging humor seen as harmless fun or as a pernicious form of prejudice? What are the social and psychological processes through which bystanders confront, evade, or collaborate in disparaging humor? Three experiments (Ns = 95, 213, 220), involving a novel paradigm (‘the shared media paradigm’) test the role of bystander emotional responses (anger/amusement) in shaping action to confront disparagement humor, through emotion-based social influence. Study 1 demonstrates that bystander action to confront disparagement humor as prejudice is shaped by the angry (but not amused) responses of co-present others. Study 2 considers a moderator of the influence process: the role of one's own emotional reaction to disparagement humor (angry/amused). Bystander confrontation was more intense when one's own angry reaction was validated by that of other bystanders but there was otherwise mixed evidence that the two interacted to promote collaboration/confrontation. Study 3 tests the claim that disparagement humor is especially challenging to confront because humor disarms opposition. Intergroup commentary was seen as more amusing and confrontation was more strongly resisted when humor was used (vs. a non-humorous control remark). Overall, the results show that the reactions of bystanders play an important role in shaping what is (or is not) perceived to be prejudice. Courageous action to confront the disparagement of members of minority groups is enabled by the emotional signals of others who are co-present.

P4169The crucial role of the bystander in out-of-hospital cardiac arrest resuscitation

Abstract Background Out-of-hospital cardiac arrest (OHCA) is a major public health concern in France, given that there are 61.5 cases per 100,000 inhabitants a year. The impact of bystander action, performed before the arrival of emergency medical services (EMS), on survival has never been studied in France. Purpose Determine whether bystander cardiopulmonary resuscitation (CPR), performed before the arrival of EMS, was correlated with an increased 30-day survival rate after an OHCA. Methods 24,885 out-of-hospital cardiac arrests witnessed in France from 1 January 2012 to 1 May 2018 were analysed to determine whether CPR, performed before the arrival of EMS, was correlated with survival. Data from the Electronic Registry of Cardiac Arrests was used. The association between the effect of CPR performed before the arrival of EMS and 30-day survival rate was studied, using propensity analysis (which included variables such as age and sex of the patient, location, cause, and year of cardiac arrest, initial cardiac rhythm, EMS response time and no-flow time). Results CPR was performed before the arrival of EMS in 14,904 cases (59.9%) and was not performed in 9,981 cases (40.1%). The 30-day survival rate was 10.2% when CRP was performed by bystanders versus 3.9% when CRP was not performed before the EMS arrival (p<0.001). CPR performed by bystanders was associated with an increased 30-day survival rate (odds ratio 1.269; 1.207 to 1.334). The effect of bystander CPR on survival Conclusion Bystander CPR performed before the arrival of EMS was associated with an increased 30-day survival rate after an out-of-hospital cardiac arrest in France.

Preventing Teen Relationship Abuse and Sexual Assault through Bystander Training: Intervention Outcomes for School Personnel.

The purpose of the current study was to examine the impact of exposure to Bringing in the Bystander-High School Curriculum (BITB-HSC) on school personnel, which included a seven session classroom curriculum for ninth through twelfth graders (student curriculum), a bystander training workshop for school personnel (school personnel workshop), and reading materials (handout). We examined how exposure to these various BITB-HSC intervention components was associated with school personnel's knowledge and bystander efficacy, intentions, and barriers specific to student relationship abuse (RA) and sexual assault (SA). Participants were 488 school personnel from 12 high schools in upper New England who completed the 4-month follow-up survey that assessed for intervention exposure (284 participants completed both the baseline and follow-up survey). Whereas 53% of participants were exposed to no intervention components, the other half of the sample were exposed to a combination of intervention components. Higher baseline knowledge and reactive bystander intentions were associated with subsequent exposure to both the student curriculum and the handout, and fewer barriers to bystander action predicted exposure to the school personnel workshop. Exposure to the school personnel workshop, student curriculum, and handout was associated with subsequent greater knowledge, exposure to the student curriculum predicted reactive bystander intentions, and exposure to the handout predicted higher reactive bystander intentions and bystander efficacy. Findings suggest that despite challenges with engagement, exposure to the BITB-HSC components may be a useful tool in improving school personnel's responses to RA and SA among high school students.

The Effects of Group Membership on College Students’ Social Exclusion of Peers and Bystander Behavior

Bystanders represent one major avenue for reducing the incidence and severity of social exclusion, yet little research has examined behavioral measurement of bystander intervention. Utilizing the most common low risk form of exclusion, this study examined how group membership impacts college students’ behavioral response to a peer’s social exclusion through an Internet-based ball tossing game (N = 121). Participants played the game with three other virtual players, in which two of these players excluded the third player. Results demonstrated increased inclusive behavior towards the excluded peer across study conditions. This inclusion was strengthened when the excluded player was in the participant’s in-group. Participants displayed an initial preference for in-group members, although attitudes towards all peers improved after the shared activity. Findings point to the interaction of social norms of inclusion, group membership, and changes in familiarity in determining bystander responses to social exclusion. In low-risk exclusion, group membership maintains an impact but does not provide sufficient motivation to counteract the social norm of inclusivity. The implication of bystander actions for promotion of community and future research are discussed.

Measurement of bystander actions in violence intervention evaluation: Opportunities and Challenges.

This review discusses design and methodological challenges specific to measuring bystander actions in the evaluation of bystander-based violence prevention programming. "Bystanders" are defined as people who are present immediately before, during and/or after a violent event, but are not a perpetrator nor the intended victim. Bystander-based violence prevention programs seek to prevent or mitigate violent events by empowering bystanders to intervene on acts of violence and social norms that promulgate violence. Effective bystander-based violence prevention programs demonstrate increased bystander intentions, actions, and attitudes [Bringing in the Bystander;12 iSCREAM;33; The Men's Project;20 and Green Dot,3] lowered violence acceptance scores19,21,22,23,36 and reduced sexual violence perpetration and victimization.3••,6,20 However, bystander-based violence prevention programs are methodologically challenging to evaluate, due to the wide diversity of programs being implemented and the multifactorial and contextual nature of acts of violence. Measures of bystander actions temporally-connected to specific, high-risk opportunities are recommended approaches to capture bystander experiences and address the methodological challenges in measuring bystander actions and evaluating violence prevention programming.

School Personnel's Bystander Action in Situations of Teen Relationship Abuse and Sexual Assault: Prevalence and Correlates.

Relationship abuse (RA) and sexual assault (SA) are major problems among high school students, and school personnel are an important part of preventing RA and SA among youth. Therefore, we examined the rates and correlates of bystander intentions among school personnel in situations of RA and SA. School personnel (N = 1150) from 25 high schools in New England completed surveys that assessed their RA and SA knowledge, perceptions of school climate specific to RA and SA, and RA and SA bystander efficacy and bystander intentions. Across each type of bystander behavior measured, the vast majority of school personnel reported intentions to intervene. In the multilevel regression analyses, both proactive and reactive bystander intentions were related to higher levels of RA and SA bystander efficacy and perceptions of a more positive school climate and lower levels of RA and SA barriers to intervene. These data support the utility of school-based interventions that seek to improve school climate and teach school personnel skills that enhance bystander efficacy and reduce bystander barriers in student situations of RA and SA. Although they would need to be evaluated, such interventions could promote positive bystander action among school personnel and untimely contribute to reductions in RA and SA among high school youth.

Youth Strategies for Positive Bystander Action in Situations of Dating and Sexual Violence: Implications for Measurement and Programming.

Research on bystander behavior in situations of dating violence (DV) and sexual violence (SV) in youth populations is growing; yet, there is a distinct lack of qualitative studies to identify nuances in specifically how and when youth are taking action to help to inform theory, measurement, and programming. The current study examined bystander action plans of high school youth after their participation in a classroom-based, bystander-focused prevention program, to inform bystander behavior measurement and programming within the context of DV and SV research and practice. High school youth (N = 889) from schools across New England completed a bystander-focused violence prevention curriculum and subsequently wrote a bystander plan of action addressing a situation of DV or SV that they had seen before or were likely to see again in the future. The responses were qualitatively coded for type of situation and bystander action, while noting situational aspects (e.g., location, relationship to those involved, engagement of others). Students reported a variety of strategies (ranging from directly telling the perpetrator to stop to creating a distraction) and ways of thinking about situations of DV and SV, and related behaviors (e.g., bullying). Many students listed unique situations and bystander behaviors that were not addressed as part of the curriculum. Bystander action plans also varied as a function of situational variables (e.g., relationship to those involved). These results indicate that measures of bystander behavior for high school students need to look different from established measures for older age groups. Furthermore, bystander programming may be more effective if more thoughtful attention is given to how youth see helping in situations of DV and SV as connected to other problematic behaviors.

Bystanders in workplace bullying: working university students’ perspectives on action versus inaction

There is increasing interest in bystanders to workplace bullying, including from human resource management (HRM) perspectives. This paper draws on literature from the fields of sexual harassment and helping behaviour to develop understanding of bystander action and inaction. Part of a project on workplace bullying, this study used online story‐based responses from university students in Australia, India and Turkey with workplace experience to elicit bystander and target interpretations of the behaviour. Findings suggest that even when bystanders are aware of bullying, they do not always intervene for reasons ranging from powerlessness and fear to avoidance and ignorance. Helping behaviours, including private support or making a report, were described by some respondents, with contextual factors linked to the perpetrator or the organisation influencing responses. The importance of the HRM role in facilitating bystander action, drawing on the helping behaviour and sexual harassment literature, is a focus of the findings and implications.

Supplemental Material for What Happened Next? New Measures of Consequences of Bystander Actions to Prevent Interpersonal Violence

Supplemental Material for What Happened Next? New Measures of Consequences of Bystander Actions to Prevent Interpersonal Violence

Inhibition of mTOR in head and neck cancer cells alters endothelial cell morphology in a paracrine fashion

Head and neck squamous cell carcinoma (HNSCC) represent aggressive classes of tumors with a high mortality rate. The mammalian target of rapamycin (mTOR) pathway is instrumental in their initiation and expansion. Although results from pre-clinical models promise mTOR targeting as a potent novel therapeutic approach, its impact on the tumor microenvironment, such as endothelial cells is only scarcely investigated. Here, we first confirmed the effects of mTOR pharmacological inhibition on cell viability, clonogenicity, and proliferation in HNSCC human cell lines, HN26, and HN30. While Everolimus and Torin1 potently blunted mTOR-based proliferation of HN26 and HN30 lines, endothelial cells were left intact. To further explore the possibility of a paracrine bystander action of HNSCC-treated cells on endothelial cells, conditioned medium from Everolimus- and Torin1-challenged HN26 and HN30 cells were collected and applied to naive human endothelial cells. Although endothelial cell viability was again not modified, morphology and mobility were changed. Indeed, spreading of endothelial cells was altered upon challenge with mTOR-pretreated tumor conditioned-media, as measured via cell impedance and imagery. Interestingly, this was associated with an augmentation of focal adhesion kinase (FAK) active phosphorylation and enhanced migratory behavior. From a molecular standpoint, the production of vascular endothelial growth factor was elevated in treated HNSCC cells and might contribute to FAK phosphorylation. Although mTOR inhibition in tumor cells did hinder their growth, it also favors the release of factors that subsequently enable endothelial cell migration. Further studies will address how this paracrine action may affect tumor-driven angiogenesis upon pharmacological treatments.

Measurement Tools to Assess Relationship Abuse and Sexual Assault Prevention Program Effectiveness Among Youth.

This article describes the adaptation, development, and psychometric properties of survey instruments to assess outcomes of bystander-focused violence prevention efforts among high school students, including media literacy, rape myths, bystander readiness, bystander barriers and facilitators of bystander action, bystander intentions, perceptions of school personnel helping, perceptions of peer helping, and victim empathy. The study was based on data collected from 3,172 high school students across 25 schools in northern New England. Overall, the measures demonstrated acceptable fit indices in multilevel exploratory and confirmatory factor analyses. Whereas most measures and subscales had adequate reliability, several measures had less than ideal internal consistency, likely because of the limited number of items. Although additional measurement work is needed, these measures provide researchers and practitioners with foundational tools for basic research and program evaluation.

Resisting Unwanted Sexual and Social Advances: Perspectives of College Women and Men.

This study examines college men's (N = 635) and women's (N = 650) reports of women's resistance against unwanted sexual and social advances. Men completed surveys to assess (a) initiation of unwanted sexual contact with a female partner, (b) initiation of unwanted sexual intercourse with a female partner, (c) sexual situations where a female partner decided she did not want to proceed, (d) encouraging a woman to drink when they were aware that the woman did not want to, and (e) attempting to take a woman to an isolated location against her will. Women completed corresponding questionnaires regarding the receipt of such unwanted advances, the outcome of the situation, and the resistance tactics utilized. Many men (5%-46%) and women (15%-38%) initiated or experienced, respectively, at least one of the five unwanted sexual or social advances. Unwanted sexual and social advances most often stopped as a result of women's verbal and physical resistance. Few advances (0%-8%) stopped as a result of bystander intervention. In addition to decreasing men's likelihood of engaging in unwanted sexual and social advances, these data highlight the importance of educating women on the effectiveness of verbal and physical resistance tactics, and increasing the frequency of prosocial bystander action on college campuses.