Abstract
Background
Despite the implementation of antibullying policies, schools in the United Arab Emirates (UAE) witnessed an increase in bullying prevalence. The aim of our study was to assess bullying victimization in schools in the UAE, types of bullying, and factors and outcomes related to bullying behavior.
Methods
A cross-sectional survey was conducted in randomly selected private and public schools in Al Ain City. A structured, self-administered questionnaire was used to collect data from students in grades 6–8 (Ages 10–15). We adapted the US CDC ‘Bully Survey’ for cultural relevance in the UAE through feedback from focus group meetings with teachers. Data analysis, conducted using R software, involved stratified analysis by school type and utilized Chi-Squared and Fisher’s exact tests to identify factors associated with school bullying.
Results
The study sample consisted of 723 students of whom 68% were males, and 58% were Emirati nationals. The overall prevalence of bullying victimization in schools was 37%, with 40% in private schools and 35% in public schools. Cyberbullying was more prevalent in private schools (37%). Physical bullying was reported by 20% and verbal bullying by 12%, with a higher prevalence of physical bullying in private schools (24%) and among males (23%). The study’s findings showed significant emotional and academic impacts of bullying, including feelings of sadness and learning difficulties, contributing to a rise in school absenteeism.
Conclusions
The study reveals widespread bullying victimization in UAE schools, mainly in classrooms, with group exclusion and verbal abuse as key forms. It underscores bullying’s psychological impact and the greater awareness of parents compared to teachers. The effective intervention strategies should not only involve students, teachers, and school staff, but also actively engage parents by fostering stronger communication channels between schools and families, and providing parents with resources and training to recognize and address bullying. These strategies should aim to create a cohesive network involving the entire school community, thus fostering a safer and more inclusive environment for students. The findings stress the need for inclusive antibullying programs involving the entire school community to foster a safer environment.
Keywords: Bullying, Victimization, Violence, Children, Adolescent, United Arab Emirates, School health, School, Mental health
Background
School bullying is a serious public health problem affecting children, families, schools, and communities. According to the United Nations Educational, Scientific and Cultural Organization (UNESCO), “Bullying is characterized by aggressive behaviour that involves unwanted, negative actions, is repeated over time, and an imbalance of power or strength between the perpetrator or perpetrators and the victim.” [1]. There are different types of bullying, including physical, psychological, sexual, and cyberbullying [2]. Physical bullying involves harming a person’s body or possessions. It includes actions such as hitting, kicking, pushing, or damaging someone’s belongings [3]. Psychological bullying, also known as emotional bullying, includes actions that harm someone’s emotional well-being and self-esteem. This can involve spreading rumors, excluding someone socially, or verbal abuse such as name-calling and insults [4]. Sexual bullying encompasses behaviors with a sexual element, such as making inappropriate sexual comments, unwanted touching, or sharing explicit content without consent [5]. Cyberbullying refers to bullying that occurs through digital means like social media, text messages, or emails. It involves sending or sharing harmful, false, or mean content about someone else [6].
The consequences of bullying can be devastating for victims, perpetrators, and bystanders, affecting their mental health, quality of life, and academic performance [1, 7]. Unsafe learning environments can raise anxiety, fear, and insecurity [1]. Bullied children are twice as likely compared to those who were not bullied to feel lonely, are unable to sleep at night, and to have contemplated suicide [1, 8]. Children experience a decrease in self-confidence, escalated anxiety levels, depressive symptoms, and instances of self-harm [9]. Students without proper social support can have more adverse impacts [10]. Bullying is also associated with smoking and drug and alcohol use [1].
The catalysts for bullying encompass a range of factors, including the physical attributes of children (such as weight or body size), social skill deficits, nationality, religion, disability, socio-economic status, and the absence of contemporary technological devices [1, 9]. The behavior of bullies is often attributed to underlying causes such as jealousy, lack of supervision in internet usage, and the imitation of behaviors observed in media, including television and video games [9]. Early socialization significantly influences the likelihood of a child becoming either a bully or a victim [11]. Alomosh’s (2008) study from the UAE revealed a tenuous connection between schools and students’ homes, attributed to families’ minimal engagement in their children’s education. This disinterest and the schools’ low educational standards have been linked to a significant increase in student dropout rates [12].
Global School-based Health Survey (GSHS) based on data from 96 countries, reported that 19.4% of children had been bullied at school in one or two days [1]. The prevalence ranged from 7.1 to 74%. With growing age, the proportion of children who report bullying is decreasing [1]. In the United Arab Emirates (UAE), the prevalence of bullying among children, particularly within educational settings, emerges as a critical issue warranting attention. GSHS reported an increasing trend in school bullying in the UAE from 21% in 2005 to 27% in 2016 [13, 14]. A survey executed by Cartoon Network in collaboration with YouGov reveals that over 50% of parents in the UAE report incidents of bullying affecting their young children, predominantly in school environments [9]. This incidence rate surpasses the global average, which estimates that approximately one in three adolescents experiences bullying at some stage. Alomosh et al. (2019) found that 19.1% of pupils in the sample of schools in Sharjah were bullied [15]. A newer study by Al-Darmaki et al. (2022) described that 8.7% of college students at one of the national universities reported being bullied and 3.6% bullying others [16]. Notably, there is an ascending trend in cyberbullying, with about 62% of UAE parents noting a surge in such episodes [1, 9].
UAE is a fast-developing country with a federal structure consisting of seven Emirates – Abu Dhabi, Dubai, Sharjah, Ras Al Khaimah, Fujairah, Ajman, and Umm Al Quwain. The demographic composition of the UAE is predominantly characterized by a substantial expatriate majority compared to the native population. As per the statistical data of 2021, the UAE’s total populace stood at approximately 10 million, with Emirati nationals accounting for merely 10%, approximately 1 million [17]. This demographic distribution indicates a significant preponderance of expatriates over Emirati nationals. The UAE hosts a diverse array of over 200 nationalities, primarily concentrated in its major urban centers such as Abu Dhabi and Dubai. This heterogeneous demographic configuration exerts considerable influence on the educational domain, particularly within school environments. The substantial expatriate presence creates a multicultural and international ambiance within many educational institutions. Such diversity potentially enhances the educational environment, affording students the opportunity to engage with a variety of cultural perspectives and worldviews. This diversity also introduces certain challenges. These include potential language barriers, the complexity of cultural integration, and the imperative of ensuring that the educational content is not only relevant but also respectful and inclusive of the diverse backgrounds represented in the student body. The balancing act between enriching educational experiences through exposure to multiculturalism and addressing the inherent challenges therein forms a pivotal aspect of the current educational dynamics within the UAE [17].
While some global studies indicate that bullying is more prevalent in homogenous societies due to less exposure to diversity [18], others suggest that multicultural environments, like those in the UAE, might experience bullying driven by cultural misunderstandings and socio-economic disparities [19]. In the UAE, the dynamic interplay of local customs, expatriate cultures, and varying socio-economic statuses creates a unique backdrop for bullying incidents. These dynamics influence not only the prevalence and forms of bullying but also the effectiveness of intervention strategies.
Since its inception, the UAE has seen substantial development in its education sector. Initially concentrated in urban areas, the system expanded significantly by the mid-1970s, leading to a notable increase in literacy rates. Presently, the UAE boasts nearly equal literacy rates among men and women and operates thousands of schools catering to its diverse population [20].
The UAE’s education system encompasses public schools, private schools, and higher education institutions, each varying significantly in quality and pedagogical methods. It reflects a blend of traditional and modern teaching methodologies, catering to a multicultural student population [21]. Public schools are free, mandatory, and gender-segregated for Emirati children, with Arabic as the primary medium of instruction. In contrast, expatriate children frequently enroll in private or international schools, which provide diverse international curricula, including British, American, and International Baccalaureate (IB) programs [20].
In the UAE, educational regulation is decentralized. The Ministry of Education (MOE) establishes federal guidelines for admissions, graduation criteria, and curricula. However, each emirate maintains its regulatory authority, such as Abu Dhabi Department of Education and Knowledge (ADEK) and Dubai’s Knowledge and Human Development Authority (KHDA), which supervise private schools. This leads to regional variations in education within the UAE [20]. These structural and regulatory differences can influence bullying rates and dynamics between public and private schools. Diverse student bodies in private schools might experience higher instances of bullying due to cultural misunderstandings and socio-economic disparities. Conversely, public schools, with a more homogenous student population, may have different bullying patterns, potentially influenced by local cultural norms and stricter regulatory oversight [18].
The UAE has implemented notable measures for bullying prevention. The Ministry of Education conducts National Bullying Prevention Week, where specialized educators and consultants engage with both public and private schools to raise awareness about the impact of bullying on children’s mental health and lives [22]. This initiative also encompasses training for teachers, counselors, and principals in effective bullying prevention techniques. While the UAE is developing bullying prevention measures, there is a lack of coordination and scientific research evaluating the effectiveness of antibullying interventions in its schools despite the recognition of school bullying as a growing public health concern [23].
The role of teachers in preventing and addressing bullying in schools has been highlighted worldwide [24]. Abbas et al. reported that in many cases, teachers did not notice the bullying due to some misconceptions and not being fully aware of the issue [25]. Teachers’ preparedness to manage bullying and their experiences vary depending on their teaching experience. The nature and quality of the teacher-student relationship, proper classroom management, and proper learning environment in the classroom may prevent bullying [25]. Some negative stereotypes abound and might make bullying behavior worse. For instance, teachers may not believe that teasing or verbal aggression are legitimate forms of bullying [25].
Addressing school bullying is crucial for attaining the Sustainable Development Goals (SDGs), especially SDG-4, which focuses on providing inclusive and equitable quality education, and promoting peaceful and inclusive societies, aligning with the broader objectives of the SDGs [1]. The countries should address issues like bullying and demonstrate a proactive approach to ensuring a safe and inclusive learning environment.
The aim of our study was to assess bullying prevalence in schools in the UAE, assess types of bullying, and factors and outcomes related to bullying behavior.
Methods
A cross-sectional study was conducted in a sample of private and public schools in Al Ain City between October and December 2022.
Sample size calculations
The required sample size for our study was determined using a specific formula, where N represents the required sample size, Z represents the critical value at 95% confidence, p estimates the bullying prevalence, q is (1 - p), and σ is the allowable error. Based on the Global School-based Student Health Survey in 2010 report on bullying prevalence for male students in the UAE, given a 26% bullying prevalence [26], the calculated sample size was 296 boys. For female students, with a 21% prevalence in the UAE [26], the sample size was determined to be 255 girls. To account for potential non-participation or refusals by either students or parents, an adjustment was made by increasing the sample size by 20%. This adjustment led to a total required sample size of 661 students. This approach aimed to mitigate the potential effects of non-participation, ensuring that our study maintained its statistical power and reliability by having a sufficiently large sample size for meaningful analysis and robust conclusions.
Sampling procedures
Initially, we obtained a list of public and private schools in the Al Ain region, with 97 government schools and 60 private schools [27]. Two private and three public (governmental) schools were randomly selected using a random number generator with unique identification numbers to obtain a representative sample. The principals of schools were contacted. All classes in cycle 2 (middle cycle, grades 6–8) from the chosen schools were included. Focusing predominantly on the sixth to eighth grades (middle cycle) is supported by research indicating that these are critical years for social and emotional development, as well as for the emergence of bullying behaviors. This age group is often experiencing significant transitions, such as moving from childhood to adolescence, which can exacerbate social hierarchies and peer victimization [28]. Studies have shown that bullying peaks during middle school years due to these developmental changes and increased social interactions among students [29]. Additionally, early adolescence is a crucial period for interventions aimed at preventing bullying and promoting healthy peer relationships, making it a strategic focus for research and intervention efforts [19, 30].
The questionnaire
Data were collected using a structured self-administered questionnaire. Information on demographics, school bullying, types/forms of school bullying, location of bullying, school settings, bullying prevalence, forms of bullying, and bullying effects were obtained from these students.
The quantitative instrument was developed by adapting and adjusting a comprehensive bullying survey initially crafted by the US Centers for Disease Control and Prevention [31]. The ‘Bully Survey’ is a comprehensive instrument designed to assess various experiences related to bullying, including victimization, perpetration, witnessing, and attitudes towards such behaviors. Targeted at youths aged 10 to 18, the survey boasts strong reliability with Cronbach’s alpha values of 0.79 for physical bullying and 0.85 for verbal bullying. This instrument was developed by Swearer and Carey in 2003, with further contributions by Swearer, Turner, Givens, and Pollack in 2008 [32]. The questionnaire was piloted on a sample of 20 children. Following the translation, focus group discussions were conducted with school teachers in Al Ain to review the adapted questionnaire. Their feedback was invaluable in highlighting certain terms, scenarios, or behaviors that might not be as prevalent or perceived in the same manner as they would be in the US. For instance, particular forms of cyberbullying or slang might differ between the two cultures, and these differences were captured and adjusted in the final survey. Furthermore, two pilot studies were conducted to validate the questionnaire and ensure its alignment with the cultural context of the UAE, incorporating students from both private and public schools in Al Ain city. This adaptation process ensured consideration of cultural appropriateness and relevance within the UAE context.
This standardized framework measures various dimensions of bullying experiences, including bystanders, victims, and bullies. The self-administered questionnaire comprised five parts, with a total of 66 questions, each focusing on different aspects of bullying. The sections are as follows:
Demographic Information: This section collected details about the students’ demographics, including height, weight, GPA, and number of siblings.
Bullying Victims: Questions in this section focused on students’ experiences as victims of bullying.
Bystanders: This part addressed students’ observations of bullying incidents.
Perpetrators: Questions here explored instances where students may have been involved in bullying others.
Awareness of Antibullying Interventions: This section gauged students’ awareness of and experiences with antibullying programs and policies at their schools.
For the purposes of this study, the focus was primarily on demographic information and students’ experiences as victims of bullying. This questionnaire was prepared initially in English and then translated into Arabic to cater to both data collectors and participants. The survey definition used for bullying was, “bullying is anything from teasing, saying mean things, or leaving someone out of a group, to physical attacks where one person or a group of people picks on another person over a prolonged period. Bullying refers to bullying incidents in school, on school grounds, or while traveling to and from school.”
Data collection
All students who were present on the day of data collection and who agreed to participate were included in the study. The data collection was executed by trained research assistants and the principal investigator, involving three data collectors in the survey process. Before distributing the self-administered questionnaire, the research team explained to students the purpose of the survey and the definition of bullying. The team was ready to answer any clarifications the students raised.
Data management and statistical analysis
Questionnaires were pre-coded for entry. Data were verified and entered using a template into the Excel Sheet with a quality check to eliminate keystroke, range, and consistency errors. Stratified analysis based on school type was performed with private and public schools as the strata, and findings were reported separately for each school. Categorical variables were summarized and presented as frequencies and percentages, while age and body mass index as quantitative variables with skewed distributions were summarized using median and interquartile range. Factors associated with school bullying were examined using the Chi-Squared and Fisher’s exact tests as appropriate. These factors were further modeled, using multivariable binary logistic regression, to investigate those independently associated with school bullying adjusting for potential confounders. The outcome variable was school bullying (whether a pupil was bullied in school or not), while the explored factors include age category, gender, nationality, grade, academic performance, body mass index, and cyberbullying status. The rationale behind using binary logistic regression is that it is appropriate for identifying factors associated with a binary outcome. A school-type stratified analysis was used reporting all results separately for private and public schools. All statistical tests were performed at a 5% level of significance. R software version 4.1.2 was used for data analysis.
The ethical considerations
The ethical approval for the study was obtained from the UAE University Human Medical Research Ethics Committee (ERS_2021_7250). We adhered to ethical standards, ensuring participant confidentiality, informed consent, and voluntary participation. We used passive parental content when parents were informed about the study prior to the data collection and could express that their children should not participate. All children were given verbal consent on the day of data collection, and they could withdraw from the study at any time. School principals were informed about the study’s aim and design and gave permission to conduct the study. The anonymity was maintained in analysis and reporting.
Results
Characteristics of study participants
The study encompassed 723 pupils, with a distribution of 33.6% (n = 243) from private schools and 66.4% (n = 480) from public schools. The median age among participants was 12 years, with an interquartile range of 12–13 years. A notable proportion of the sample, 68%, were male (Table 1). The educational level of the participants primarily included those in the seventh (35%) and eighth grades (40%). The majority (58%) of the participants were of Emirati nationality. Regarding academic performance, 36% of the pupils reported typically achieving A-grades. The median body mass index (BMI) was recorded at 19.3 Kg/m2, with an interquartile range of 16.8–22.5 Kg/m2. Analysis of BMI categories revealed that less than half of the participants (43%) fell within the normal BMI range (18.5–24.9 Kg/m2), while the remaining participants were categorized as underweight (42%) or overweight/obese (15%).
Table 1.
Participants’ characteristics and prevalence of school bullying by type of school
| Characteristic | Demographic characteristics | Prevalence of school bullying | |||||
|---|---|---|---|---|---|---|---|
| All | Private | Public | Private | Public | |||
| Prevalence | p-value | Prevalence | p-value | ||||
| Total/Overall | 723 | 243 | 480 | 39.5 | - | 35.2% | - |
| Age (median, IQR) | 12 (12, 13) | 12 (12, 13) | 12 (12, 13) | - | - | - | - |
| Gender | 0.599 | < 0.001 | |||||
| Female | 230 (32%) | 123 (51%) | 107 (22%) | 38% | 13% | ||
| Male | 491 (68%) | 118 (49%) | 373 (78%) | 42% | 42% | ||
| Grade | 0.077 | 0.136 | |||||
| Six | 181 (25%) | 62 (26%) | 119 (25%) | 27% | 34% | ||
| Seven | 253 (35%) | 81 (33%) | 172 (36%) | 44% | 41% | ||
| Eight | 289 (40%) | 100 (41%) | 189 (39%) | 43% | 31% | ||
| Nationality | 0.085 | 0.906 | |||||
| UAE | 408 (58%) | 95 (40%) | 313 (68%) | 33% | 35% | ||
| Others | 293 (42%) | 144 (60%) | 149 (32%) | 44% | 35% | ||
| Birth order | 0.225 | 0.918 | |||||
| Only | 10 (1.4%) | 4 (1.7%) | 6 (1.3%) | 75% | 33% | ||
| Youngest | 151 (22%) | 40 (17%) | 111 (24%) | 33% | 35% | ||
| Middle | 328 (47%) | 101 (43%) | 227 (49%) | 38% | 33% | ||
| Oldest | 209 (30%) | 90 (38%) | 119 (26%) | 46% | 37% | ||
| Academic performance | 0.379 | 0.331 | |||||
| Mostly As | 221 (36%) | 96 (42%) | 125 (32%) | 43% | 32% | ||
| Mostly As & Bs | 253 (41%) | 97 (43%) | 156 (39%) | 41% | 36% | ||
| Mostly Bs & lower | 148 (24%) | 34 (15%) | 114 (29%) | 29% | 41% | ||
| BMI category | 0.386 | 0.771 | |||||
| Underweight | 189 (42%) | 62 (37%) | 127 (44%) | 48% | 39% | ||
| Normal | 194 (43%) | 80 (48%) | 114 (40%) | 40% | 34% | ||
| Overweight/obese | 69 (15%) | 24 (14%) | 45 (16%) | 33% | 38% | ||
IQR = Interquartile range
Prevalence of bullying
The study found that the overall prevalence of bullying in schools to be 36.7% (95% confidence interval = 33.2–40.3%). This prevalence was observed to be marginally higher among students attending private schools, at 39.5%, compared to their counterparts in public schools, who had a prevalence of 35.2% (Table 2). However, this difference was not statistically significant (p = 0.257). More specifically, 20% and 12% of the pupils reported physical and verbal bullying respectively, with physical bullying more prevalent in private schools (24% versus 18% in public schools, p = 0.051). Physical bullying was significantly more prevalent among males (23% versus 13%, p = 0.002). Cyberbullying was also significantly more common among private school pupils (37% versus 27% in public schools, p = 0.037).
Table 2.
Prevalence of different bullying types by school type, gender, and nationality
| Bullying type | Overall n (%) |
School type | Gender | Nationality | ||||||
|---|---|---|---|---|---|---|---|---|---|---|
| Private n (%) |
Public n (%) |
p-value | Females n (%) |
Males n (%) |
p-value | Emiratis n (%) |
Others n (%) |
p-value | ||
| School bullying | 265 (37%) | 96 (40%) | 169 (35%) | 0.257 | 61 (27%) | 204 (42%) | < 0.001 | 142 (35%) | 115 (39%) | 0.228 |
| Physical | 146 (20%) | 59 (24%) | 87 (18%) | 0.051 | 31 (13%) | 115 (23%) | 0.002 | 77 (19%) | 65 (22%) | 0.282 |
| Verbal | 85 (12%) | 31 (13%) | 54 (11%) | 0.552 | 27 (12%) | 58 (12%) | 0.977 | 46 (11%) | 37 (13%) | 0.584 |
| Cyber | 135 (31%) | 59 (37%) | 76 (27%) | 0.037 | 37 (25%) | 98 (33%) | 0.083 | 75 (30%) | 56 (32%) | 0.558 |
In terms of location, a significant proportion of bullying incidents occurred in classrooms, with 80% in private schools and 65% in public schools (Fig. 1). The second most frequent location for bullying differed between school types: in private schools, 31% of bullying occurred in gym/sports playgrounds, while in public schools, 36% took place inside buses. Additionally, corridors or hallways were noted as common bullying spots in both types of schools, with 28% in private and 23% in public schools.
Fig. 1.
Places where students were bullied at school
Regarding the nature of bullying, the predominant form of physical bullying reported was pushing or shoving, experienced by 62% of bullied students in private schools and 50% in public schools. The most prevalent forms of verbal/emotional bullying included being called bad names, as indicated by 84% of bullied students in private schools and 78% in public schools, and being made fun of, reported by 78% in private and 79% in public schools (Fig. 2).
Fig. 2.
Forms of school bullying in private and public schools
Concerning awareness and reporting of bullying incidents, 23% of the bullied students stated that their teachers were aware of the bullying. Meanwhile, a higher percentage, 44%, reported the incidents to their parents. When considering school type, 26% of bullied students in private schools and 21% in public schools reported teacher awareness. In contrast, a higher percentage of students from both private (46%) and public (42%) schools informed their parents about the bullying incidents.
Reasons for being bullied
The pupils were mostly bullied due to their academic performance and looks (Table 3). Most (39%) of the bullied pupils said they were bullied because “they get good grades,” which is true for both private (44%) and public (37%) schools. A quarter (25%) said they were bullied because “they think my face looks funny.” A further 18% said they were bullied because they were fat. “They think I am a wimp/nerd” was another popular reason for being bullied as reported by 19% of the bullied pupils. Being unable to “get along with other people” was significantly a more common reason to be bullied in private schools (13% versus 4% for public schools, p = 0.008), and among females (14% versus 5% for males, p = 0.014), and non-Emirati (10% versus 6% for Emiratis, p = 0.111) pupils. Females were more likely to be bullied because they were fat (24% versus 15% for males, p = 0.102). Non-Emiratis were more likely to be bullied due to their skin color (10% versus 4% for Emiratis, p = 0.039). Other reasons more common in private schools were “they think my friends are weird” and “because I cry a lot.” The reason “because I cry a lot” was also more common among females.
Table 3.
Reasons for being bullied by school type, gender, and nationality
| Reason | All (N = 325) |
School type | Gender | Nationality | ||||||
|---|---|---|---|---|---|---|---|---|---|---|
| Private (N = 111) |
Public N = 186) |
p-value | Female (N = 71) |
Male N = 226 |
p-value | Emirati (N = 165) |
Others (N = 124) |
p-value | ||
| They think my face looks funny | 75 (25%) | 27 (24%) | 48 (26%) | 0.776 | 15 (21%) | 60 (27%) | 0.359 | 38 (23%) | 34 (27%) | 0.393 |
| They think I’m fat | 52 (18%) | 17 (15%) | 35 (19%) | 0.442 | 17 (24%) | 35 (15%) | 0.102 | 29 (18%) | 22 (18%) | 0.971 |
| They think I’m skinny | 32 (11%) | 8 (7.2%) | 24 (13%) | 0.126 | 5 (7.0%) | 27 (12%) | 0.245 | 21 (13%) | 11 (8.9%) | 0.301 |
| They think I look too old | 4 (1.3%) | 0 (0%) | 4 (2.2%) | 0.301 | 0 (0%) | 4 (1.8%) | 0.576 | 3 (1.8%) | 1 (0.8%) | 0.638 |
| They think I look too young | 39 (13%) | 9 (8.1%) | 30 (16%) | 0.048 | 3 (4.2%) | 36 (16%) | 0.011 | 22 (13%) | 16 (13%) | 0.915 |
| The color of my skin | 20 (6.7%) | 7 (6.3%) | 13 (7.0%) | 0.82 | 5 (7.0%) | 15 (6.6%) | > 0.999 | 7 (4.2%) | 13 (10%) | 0.039 |
| The clothes I wear | 19 (6.4%) | 10 (9.0%) | 9 (4.8%) | 0.155 | 6 (8.5%) | 13 (5.8%) | 0.412 | 10 (6.1%) | 9 (7.3%) | 0.684 |
| I am too tall | 29 (9.8%) | 8 (7.2%) | 21 (11%) | 0.251 | 8 (11%) | 21 (9.3%) | 0.625 | 17 (10%) | 12 (9.7%) | 0.861 |
| I am too short | 46 (15%) | 15 (14%) | 31 (17%) | 0.467 | 7 (9.9%) | 39 (17%) | 0.133 | 30 (18%) | 15 (12%) | 0.158 |
| I’m disable | 11 (3.7%) | 4 (3.6%) | 7 (3.8%) | > 0.999 | 4 (5.6%) | 7 (3.1%) | 0.301 | 9 (5.5%) | 2 (1.6%) | 0.123 |
| My brother | 15 (5.1%) | 8 (7.2%) | 7 (3.8%) | 0.19 | 5 (7.0%) | 10 (4.4%) | 0.363 | 7 (4.2%) | 8 (6.5%) | 0.402 |
| My sister | 11 (3.7%) | 4 (3.6%) | 7 (3.8%) | > 0.999 | 1 (1.4%) | 10 (4.4%) | 0.47 | 8 (4.8%) | 3 (2.4%) | 0.362 |
| My parents | 11 (3.7%) | 4 (3.6%) | 7 (3.8%) | > 0.999 | 2 (2.8%) | 9 (4.0%) | > 0.999 | 7 (4.2%) | 4 (3.2%) | 0.763 |
| My family is poor | 9 (3.0%) | 2 (1.8%) | 7 (3.8%) | 0.492 | 2 (2.8%) | 7 (3.1%) | > 0.999 | 6 (3.6%) | 3 (2.4%) | 0.737 |
| My family has a lot of money | 5 (1.7%) | 3 (2.7%) | 2 (1.1%) | 0.366 | 1 (1.4%) | 4 (1.8%) | > 0.999 | 4 (2.4%) | 1 (0.8%) | 0.396 |
| Someone in my family has a disability | 12 (4.0%) | 2 (1.8%) | 10 (5.4%) | 0.222 | 3 (4.2%) | 9 (4.0%) | > 0.999 | 9 (5.5%) | 3 (2.4%) | 0.2 |
| I get bad grades | 28 (9.4%) | 7 (6.3%) | 21 (11%) | 0.155 | 4 (5.6%) | 24 (11%) | 0.21 | 16 (9.7%) | 11 (8.9%) | 0.811 |
| I get good grades | 117 (39%) | 49 (44%) | 68 (37%) | 0.196 | 22 (31%) | 95 (42%) | 0.096 | 62 (38%) | 52 (42%) | 0.453 |
| My religious background | 5 (1.7%) | 1 (0.9%) | 4 (2.2%) | 0.654 | 0 (0%) | 5 (2.2%) | 0.343 | 3 (1.8%) | 2 (1.6%) | > 0.999 |
| They think I am a wimp/nerd | 55 (19%) | 23 (21%) | 32 (17%) | 0.45 | 10 (14%) | 45 (20%) | 0.27 | 29 (18%) | 26 (21%) | 0.467 |
| They think my friends are weird | 22 (7.4%) | 13 (12%) | 9 (4.8%) | 0.029 | 5 (7.0%) | 17 (7.5%) | 0.893 | 11 (6.7%) | 11 (8.9%) | 0.484 |
| I am in special education | 8 (2.7%) | 1 (0.9%) | 7 (3.8%) | 0.266 | 1 (1.4%) | 7 (3.1%) | 0.685 | 7 (4.2%) | 1 (0.8%) | 0.144 |
| I cry a lot | 21 (7.1%) | 11 (9.9%) | 10 (5.4%) | 0.14 | 10 (14%) | 11 (4.9%) | 0.008 | 9 (5.5%) | 12 (9.7%) | 0.171 |
| I can’t get along with other people | 22 (7.4%) | 14 (13%) | 8 (4.3%) | 0.008 | 10 (14%) | 12 (5.3%) | 0.014 | 9 (5.5%) | 13 (10%) | 0.111 |
| The area where I live | 7 (2.4%) | 1 (0.9%) | 6 (3.2%) | 0.263 | 0 (0%) | 7 (3.1%) | 0.203 | 3 (1.8%) | 4 (3.2%) | 0.467 |
| I’m sick a lot | 10 (3.4%) | 5 (4.5%) | 5 (2.7%) | 0.509 | 3 (4.2%) | 7 (3.1%) | 0.707 | 5 (3.0%) | 4 (3.2%) | > 0.999 |
| I get angry a lot | 30 (10%) | 12 (11%) | 18 (9.7%) | 0.754 | 5 (7.0%) | 25 (11%) | 0.327 | 20 (12%) | 9 (7.3%) | 0.173 |
| The way I talk | 35 (12%) | 19 (17%) | 16 (8.6%) | 0.028 | 10 (14%) | 25 (11%) | 0.491 | 18 (11%) | 16 (13%) | 0.603 |
| I am different | 29 (9.8%) | 18 (16%) | 11 (5.9%) | 0.004 | 5 (7.0%) | 24 (11%) | 0.376 | 13 (7.9%) | 16 (13%) | 0.159 |
| Others | 18 (6.1%) | 9 (8.1%) | 9 (4.8%) | 0.253 | 9 (13%) | 9 (4.0%) | 0.018 | 10 (6.1%) | 7 (5.6%) | 0.882 |
Factors associated with school bullying
In the adjusted multivariable model (Table 4), school bullying and gender, grade and academic performance were observed to be associated with school bullying in private schools. Male students were more than four times more likely to be victims of bullying than females (aOR = 4.57, 95% CI = 1.39–17.7). Those in eighth grade had 7.7 times the odds of being bullied at school compared to students in sixth grade (aOR = 7.72, 95% CI = 1.16–63.7). Students predominantly achieving B grades and lower exhibited a significantly reduced likelihood of being bullied compared to students who generally received A grades (aOR = 0.09, 95% CI = 0.01–0.46).
Table 4.
Univariate and multivariable logistic regression for factors associated with school bullying
| Factor | Private schools | Public schools | ||||||
|---|---|---|---|---|---|---|---|---|
| cOR | 95% CI | aOR | 95% CI | cOR | 95% CI | aOR | 95% CI | |
| Age | ||||||||
| <= 12 | 1 | — | 1 | — | 1 | — | 1 | — |
| > 12 | 1.34 | 0.76, 2.38 | 1.35 | 0.30, 6.36 | 0.90 | 0.59, 1.36 | 1.77 | 0.51, 6.43 |
| Gender | ||||||||
| Female | 1 | — | 1 | — | 1 | — | 1 | — |
| Male | 1.15 | 0.69, 1.93 | 4.57 | 1.39, 17.7 | 4.72 | 2.68, 8.93 | 16.30 | 3.88, 91.2 |
| Nationality | ||||||||
| Non-Emirati | 1 | — | 1 | — | 1 | — | 1 | — |
| Emirati | 0.62 | 0.36, 1.06 | 0.52 | 0.15, 1.72 | 1.03 | 0.68, 1.55 | 0.95 | 0.36, 2.45 |
| Grade | ||||||||
| Six | 1 | — | 1 | — | 1 | — | 1 | — |
| Seven | 2.12 | 1.05, 4.38 | 2.99 | 0.64, 15.5 | 1.31 | 0.81, 2.13 | 0.32 | 0.07, 1.19 |
| Eight | 2.00 | 1.02, 4.03 | 7.72 | 1.16, 63.7 | 0.84 | 0.52, 1.38 | 0.09 | 0.01, 0.49 |
| Academic performance | ||||||||
| Mostly As | 1 | — | 1 | — | 1 | — | 1 | — |
| Mostly As & Bs | 0.94 | 0.53, 1.67 | 0.40 | 0.10, 1.43 | 1.19 | 0.72, 1.97 | 1.07 | 0.36, 3.18 |
| Mostly Bs & lower | 0.56 | 0.23, 1.27 | 0.09 | 0.01, 0.46 | 1.49 | 0.88, 2.54 | 0.8 | 0.24, 2.73 |
| BMI category | ||||||||
| Normal weight | 1 | — | 1 | — | 1 | — | 1 | — |
| Underweight | 1.41 | 0.72, 2.76 | 2.94 | 0.81, 12.0 | 1.21 | 0.71, 2.05 | 1.98 | 0.76, 5.34 |
| Overweight/obese | 0.75 | 0.28, 1.92 | 0.69 | 0.13, 3.57 | 1.17 | 0.56, 2.38 | 1.67 | 0.49, 5.89 |
| Cyberbullied | ||||||||
| No | 1 | — | 1 | — | 1 | — | 1 | — |
| Yes | 3.05 | 1.54, 6.31 | 5.31 | 1.58, 21.5 | 4.31 | 2.40, 8.10 | 7.08 | 2.40, 25.1 |
In public schools, bullying was found to be associated with male gender (aOR = 16.30, 95% CI = 3.88–91.2). Conversely, being in the eighth grade, as opposed to the sixth grade, was negatively associated with bullying (aOR = 0.09, 95% CI = 0.01–0.49).
Experiencing cyberbullying had a significant association with being bullied in physical settings in both private (aOR = 5.31, 95% CI = 1.58, 21.5) and public (aOR = 7.08, 95% CI = 2.40–25.1) schools.
Effects of school bullying and the problems experienced by bullied students
The predominant issue reported by students subjected to bullying in both private and public schools was a negative impact on their emotional well-being. Specifically, 81% of bullied students in private schools and 59% in public schools indicated that bullying led to feelings of sadness or general distress. Furthermore, a significant portion of these students also reported academic difficulties as a result of the bullying. In private schools, 54% of bullied students expressed that bullying hindered their ability to learn, while in public schools, this was reported by 51% of the bullied students.
The study also highlighted the effect of bullying on school attendance. A notable proportion of bullied students, 24% in private schools and 29% in public schools, disclosed that bullying incidents contributed to their absenteeism from school. This finding underscores the substantial impact of bullying on both the emotional and academic aspects of students’ lives, as well as its potential to disrupt regular school attendance.
Discussion
This study has estimated the prevalence of bullying in public and private schools in Al Ain, assessed related factors, and the impact of bullying on children’s emotional and psychological well-being. The current prevalence of bullying victimization is higher than reported by Alomosh et al. (19%) [15] and Al-Darmaki et al. (9%) in 2022 [16]. Compared to other countries in the region, the prevalence of bullying victimization was similar, e.g., in Qatar, 41% of children reported to be victims of bullying [33].
Bullying in the UAE is a continuous problem and occurs slightly more often in public (39%) than in private (31%) schools. Elsewhere, there were differences between public and private schools reported on aggression [34] and cyberbullying being worse in public schools [35]. Private schools may vary greatly in their policies and resources dedicated to bullying prevention and intervention. Public schools, often regulated by government policies, might have more standardized antibullying programs in place [36, 37]. Private schools in the UAE often have a higher proportion of expatriate students. These students might stand out more due to differences in language, culture, or appearance, making them more susceptible to bullying. In public schools, the student body might be more homogenous, with a higher proportion of local students [38].
The perception and reporting of bullying can also vary. In private schools, there might be a higher awareness and reporting of bullying incidents, especially among expatriate communities. This could be due to expatriates being more vocal about their concerns and seeking support from school administrations. A study conducted by the University of York found that private school students are more likely to experience and report bullying, partly due to proactive reporting by parents who have high expectations from the school’s administration [39]. Additionally, a report from Lough indicated that private school students, including those from expatriate families, are more likely to report bullying due to the schools’ proactive policies and greater resource availability [40]. This aligns with findings from Boulton et al., which highlight that proactive parental involvement and higher expectations from private school administrations contribute to greater awareness and reporting of bullying incidents [41]. In public schools, bullying might be underreported or perceived differently [42]. In the UAE, low reporting of bullying to teachers and parents can be attributed to a combination of cultural norms, shame, and perceptions about bullying. Cultural norms may discourage open discussion of personal issues, including bullying. There’s also a sense of shame or dishonor in admitting to being bullied, further inhibiting reporting. Additionally, bullying is often perceived as a normal part of childhood development, leading to its acceptance and underreporting. These factors are compounded by fears of repercussions from bullies, creating a challenging environment for addressing bullying effectively in schools [18].
Economic factors can play a role as well. In some cases, expatriate students in private schools might come from families with different economic backgrounds compared to local students, which can create social tensions and contribute to bullying. As reported elsewhere, students from lower socio-economic backgrounds may be targeted due to perceived differences in lifestyle, access to resources, and material possessions [43]. This can lead to social exclusion and ridicule, exacerbating feelings of inferiority and vulnerability among these students [44]. Conversely, students from wealthier families might be bullied out of jealousy or resentment, further illustrating how socio-economic status can influence bullying dynamics [45]. These disparities are particularly evident in private schools in the UAE, where the student body is often a mix of various socio-economic backgrounds. In public schools, the economic homogeneity might reduce such tensions but does not eliminate bullying entirely, as other factors like academic performance and social skills come into play [38]. Addressing these economic disparities through inclusive policies and support systems can help mitigate bullying incidents related to socio-economic status.
A study from Farina suggested that private schools have a more positive climate, leading to lower bullying levels [46]. While this might be a natural assumption to make, Law suggests that it is natural for private schools to underreport bullying [30]. These schools are mostly concerned about sustaining damage to their reputation. A study by Harris et al. showed that retained students (i.e., those who have been set back a grade due to poor marks) subjectively report experiencing more relational, social, and verbal bullying within the private school system, likely because there is more social stigma surrounding performance [47].
Underweight students are more frequently bullied in private schools, where cultural values and socio-economic backgrounds emphasize physical appearance, including weight [48]. This trend is less evident in public schools. In private schools, pressure from parents and the community, along with intense peer dynamics in smaller, more homogenous groups, exacerbates bullying toward those who differ from the ‘norm’ [49]. Academic stress, especially notable during the COVID-19 pandemic can also impact students’ weight and mental health, making underweight students targets for bullying [50]. Studies, including Lin et al., show that perceived weight, particularly among girls, is more closely linked to bullying than actual weight [51]. This perception leads to lower self-esteem and increased vulnerability to bullying, suggesting that antibullying strategies should focus not just on weight management but also on fostering self-esteem and positive body image [52].
The level and quality of health and wellness education in private schools might differ from public schools. If there is less emphasis on teaching acceptance and understanding of different body types, this could contribute to a lack of empathy and an increase in bullying [53].
The level of parental and community involvement in schools can influence bullying. Private schools might have different levels of parental involvement compared to public schools, which can impact the social environment and incidences of bullying [54].
Our study’s findings also illuminate common places where incidents of bullying occur. Bullying occured most often in the classroom, whether the school is private or public. Rapp-Paglicci et al. showed that some of the most notorious hot spots for bullying were in bathrooms, playgrounds, hallways, and classrooms [55], most frequently in the classroom when no teacher was present. The prevalence of bullying in classrooms may be due to the significant amount of time students spend in classrooms, providing more opportunities for bullying incidents [56].
Positive teacher-student relationships are crucial in creating a supportive school environment. When teachers build trust and rapport with their students, it reduces the likelihood of bullying as students feel more secure and respected [57]. Additionally, effective classroom management by teachers can deter bullying by promoting a culture of respect and inclusivity [45]. Peer-peer interactions also play a significant role; a positive peer culture where students support each other can mitigate bullying. On the contrary, a negative peer environment characterized by cliques and social hierarchies can exacerbate bullying behaviors [19].
In the context of UAE schools, where classroom walls are not transparent, the lack of visibility from the outside could contribute to a higher incidence of bullying within the classroom. This is particularly relevant when coupled with inadequate supervision or monitoring by teachers. In such environments, students may feel emboldened to engage in bullying behaviors, knowing that their actions are less likely to be observed by authority figures. Furthermore, the close proximity of students within classroom settings can create conditions where bullying is more likely to occur, especially if the classroom culture does not actively discourage such behavior or promote respect and empathy among students. Therefore, enhancing teacher monitoring and fostering a positive classroom culture are critical steps in addressing and reducing bullying in school settings.
Our results highlighted the bullying occurring on school buses. Bullying is more likely on buses of public schools due to less supervision, whereas private schools, with better resources and fewer students per bus, might have tighter control during commutes. This difference in supervision, coupled with varying social dynamics between public and private schools, can affect the nature and frequency of bullying incidents on buses. Students often perceive bus drivers as having less authority than teachers, given their indirect disciplinary role [58].
In examining gender variations, our study shows minimal gender differences in verbal/emotional and physical bullying, a shift from past research [1, 16, 29]. This change may stem from evolving digital media influence, effective school antibullying programs, and increasing awareness of gender equality. Additionally, variations in peer group dynamics and underreporting due to perception biases could be influencing these new bullying patterns. Nieto-Sobrino et al. showed that over 40% of bullying behavior involves excluding students from a group, while less than 25% involves threats or coercion [59]. For this study, threats and coercion were the least popular form of bullying in public and private schools. Group exclusion seems a common form of bullying, compromising humans’ fundamental need to belong [60]. A study by Gomez-Baya et al. found that 17.6% of students experienced exclusion, while 20.8% experienced harassment as a form of bullying [61]. Furthermore, there could be reasons why group and social exclusion happens more frequently than other forms of bullying. According to Mulvey et al., exclusion can be a self-perpetuating cycle, with adolescents who feel marginalized being less likely to intervene to help peers suffering from exclusion within the school environment [62]. These findings are corroborated by Consiglio, who discusses that exclusion, which is much more popular than physical violence, is classified as “relational aggression” [63].
Cyberbullying was prevalent in our study. The causes of cyberbullying in schools in the UAE can be multifaceted, often intertwined with the unique socio-cultural and technological landscape of the region. It could have also increased due to the COVID-19 pandemic lockdown when students were forced to distance learning and used the internet and social media more often. Bullies who engage in aggressive behavior in person are likely to extend their bullying to the digital realm, as the internet provides an additional, often anonymous, platform to exert control and aggression. This overlap indicates that the underlying causes of bullying behavior, such as a desire for power, personal insecurities, or a lack of empathy, manifest across different environments.
The UAE has high internet penetration and widespread use of smartphones among young people, facilitating cyberbullying. Social hierarchies and peer pressures, which are prevalent in many cultures, can manifest in online environments [64]. Furthermore, cyberbullying can be done anonymously, emboldening individuals who might not engage in traditional bullying [65]. Additionally, there might be a gap in understanding the impact of online behaviors among youth, leading to more cyberbullying incidents. The online activities of young people might not be adequately monitored or regulated by parents or schools, leading to unchecked cyberbullying [66].
In our study, children with excellent grades were bullied more often, highlighting a trend where both low- and high-achieving students face bullying in schools due to peer dynamics and social hierarchies. Lower achievers are targeted for perceived weaknesses, while high achievers face jealousy or resentment, potentially due to their standout success [67]. This bullying is influenced by stereotypes, with high achievers labeled as “nerds” and low achievers as “slow,” leading to isolation and increased vulnerability to bullying [68]. Additionally, teachers’ and schools’ responses to academic achievement can exacerbate this issue.
Parental emphasis on academic success can also contribute to bullying. High-achieving students, under pressure to excel for future career prospects, may become isolated and thus more susceptible to bullying [69, 70]. Low achievers, struggling with self-esteem and societal expectations, face similar risks. This reflects the broader cultural value placed on academic achievement and its significant impact on student behavior and social interactions, where both ends of the academic spectrum are prone to bullying due to societal attitudes towards academic success and failure.
Furthermore, while some students experienced minimal negative consequences of bullying, 25% of students in private schools suggested that being victimized always made them feel bad or sad. In comparison, 15% of students in public schools reported the same. Juvonen and Graham found that some of the adverse effects experienced by bullying victims include problems adjusting to new environments, anxiety, depressed mood, psychosomatic issues, stomachaches, and difficulties learning at school [43]. These findings corroborate the information from the study results, which suggests that students felt they had difficulties learning while being bullied. Furthermore, Vanderbilt notes that damage from bullying may be so extensive that it may require psychological support for victims [71].
School climate plays a definite role in bullying, and the results show that surprisingly, the bullied students in private schools feel sadder and worse than the students in public schools [57].
Finally, the paper brings some interesting information regarding how much teachers and parents are aware of bullying. The study showed that, across genders and public and private schools, parents were more likely to know about their child’s bullying than teachers. Children may feel more comfortable discussing personal issues with their parents, whom they trust deeply, rather than with teachers who might be seen as authority figure . (58). Additionally, parents might spend more time with their children outside of school, giving them more opportunities to notice changes in behavior that could indicate bullying [45].
Stavrinides et al. explored the effects of parents’ knowledge sources on children’s bullying and victimization involvement. The results showed a bidirectional parent bonding and bullying, where child disclosure and parental control at time one predicts later bullying. Curiously, only parental solicitation was inversely related to subsequent bullying involvement. Victimization did not moderate parental knowledge sources but mediated child disclosure, indicating that victimized children tend to hide their experiences from their parents [72]. The implication is that bullying could be more harmful if parents are unaware of what is happening, particularly because literature shows repeating instances are common. It also shows that it might be more common than it seems for students to hide their status as victims of bullies from their teachers (since teachers were less aware of bullying than parents).
Parental support in addressing bullying is crucial, but it should be supported by the proper initiatives to promote school climate, including training of school personnel and specific bullying education programs [73–75].
Cultural norms might also play a role; in some cultures, discussing bullying with teachers may be viewed as inappropriate or less effective. To address this discrepancy, schools can enhance teacher awareness and involvement in students’ well-being. Implementing regular training for teachers to recognize signs of bullying and fostering open communication channels between students and teachers is essential [24]. Furthermore, establishing stronger school-family partnerships can ensure that both teachers and parents are equally informed and equipped to handle bullying incidents [57]. This holistic approach can bridge the gap between parental and teacher awareness, creating a more supportive environment for students [45, 72].
In the UAE, strong cultural norms emphasizing family honor, respect for elders, and social conformity can impact how bullying is perceived and addressed [38]. There may be a reluctance to report bullying to teachers due to concerns about bringing shame to the family or fear of retribution [76]. Additionally, the multicultural composition of the UAE, with a significant expatriate population, can lead to cultural clashes and misunderstandings that may manifest as bullying. Expatriate students might be targeted due to their different cultural backgrounds, languages, or religious practices, exacerbating feelings of isolation and vulnerability [16]. Recognizing these cultural dynamics is necessary for developing effective anti-bullying strategies that are culturally sensitive and inclusive. Schools can benefit from incorporating cultural competence training for teachers and promoting a school culture that values diversity and inclusion [19]. Engaging community leaders and parents in anti-bullying initiatives can help bridge cultural gaps and reinforce positive behaviors both at home and in school.
Limitations
This study has some limitations. Foremost, the study largely depends on self-reported data, wherein participants shared their own experiences, attitudes, and perceptions concerning bullying. The way bullying incidents are perceived and reported by students could lead to underreporting of certain types of bullying, affecting the apparent prevalence rates. Using an anonymous questionnaire helps reduce the bias towards socially desirable responses and lowers non-responses to sensitive questions. The study’s focus was narrow, concentrating only on cycle 2 schools in Al Ain and there was a noticeable overrepresentation of specific groups, notably males and Emiratis. The obtained list of schools lacked more detailed demographics, such as nationality or age groups. It might introduce bias and limit generalizability to the whole UAE and the applicability of its findings to other school levels. The study’s design was cross-sectional, suggesting correlations but not necessarily causation. More comprehensive, longitudinal studies would be required to substantiate these relationships further. External factors also played a part. The COVID-19 pandemic, for instance, potentially influenced students’ behaviors and experiences. The restrictions it placed on face-to-face interactions also affected the data collection process, making this a significant consideration when understanding the study’s outcomes. Lastly, the timing of the study might not have been optimal. Conducted in December, just before the midterm exams, students might have been under academic stress, which could have influenced their responses and participation enthusiasm.
Conclusion
Bullying at schools is prevalent in the UAE, occurring across all school types. Classrooms were the main location for bullying, and group exclusion is the most common form of bullying, along with verbal and emotional bullying. The study highlighted the negative psychological consequences of bullying on children. Parents have an important part to play, being often more aware of bullying incidents than teachers. Comprehensive antibullying programs should focus on promoting a safe school environment, involving the whole community, including pupils, teachers, administrators, school nurses, and parents.
Acknowledgements
We are grateful to the principals and teachers at schools, and the students in schools for their excellent and enthusiastic collaboration.
Abbreviations
- ADEK
Abu Dhabi Education and Knowledge Authority
- BMI
Body Mass Index
- CI
Confidence interval
- GPA
Grade Point Average
- GSHS
Global School-based Survey
- KHDA
Dubai’s Knowledge and Human Development Authority
- MOE
Ministry of Education
- OR
Odds ratio
- UAE
United Arab Emirates
- US CDC
Centers for Disease Control and Prevention
- WHO
World Health Organization
Author contributions
A.A.K., I.EL., and M.G. designed the study. I.EL. and B.A.H. collected the data at schools, cleaned and entered the data. A.A. and I.EL. conducted data analysis. A.A.K., I.EL., A.A., I.E., and M.G. were involved in the interpretation of data. I.EL. and A.A.K. wrote the first draft of the paper. All authors participated in critically revising the draft to its current form and approved the final version of the manuscript. A.A.K. and I.EL. shared the first authorship.(A.A.K. - Alfan Al-Ketbi; I.EL. - Ismail Elkonaisi; A.A. - Aminu S. Abdullahi; I.E. - Iffat Elbarazi; B.A.H. - Bayan Abu Hamada; M.G. - Michal Grivna).
Funding
The study was funded by grants from the College of Medicine and Health Sciences, United Arab Emirates University research (Ref No 31M422 and 12M088).
Data availability
The data that support this study’s findings are available from the Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, but restrictions apply to their availability. These data were used under ethical approval for this study. The data are, however, available from the authors upon reasonable request and with the permission of the United Arab Emirates University.
Declarations
Ethics approval and consent to participate
The ethical approval for the study was obtained from the UAE University Human Medical Research Ethics Committee (ERS_2021_7250). We adhered to ethical standards, ensuring participant confidentiality, informed consent, and voluntary participation. We used passive parental content when parents were informed about the study prior to the data collection and could express that their children should not participate. All children were given verbal consent on the day of data collection, and they could withdraw from the study at any time. School principals were informed about the study’s aim and design and gave permission to conduct the study.
Patient consent for publication
Not applicable.
Footnotes
Alfan Al-Ketbi, Ismail Elkonaisi shared first authorship.
Publisher’s note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
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Associated Data
This section collects any data citations, data availability statements, or supplementary materials included in this article.
Data Availability Statement
The data that support this study’s findings are available from the Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, but restrictions apply to their availability. These data were used under ethical approval for this study. The data are, however, available from the authors upon reasonable request and with the permission of the United Arab Emirates University.


