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. Author manuscript; available in PMC: 2021 Jun 1.
Published in final edited form as: J Sch Nurs. 2018 Oct 24;36(3):222–232. doi: 10.1177/1059840518808013

Parent Communication and Bullying Among Hispanic Adolescent Girls

Ariel Uniqua Smith 1, Anne E Norris 2
PMCID: PMC8152480  NIHMSID: NIHMS1699369  PMID: 30354928

Abstract

In this paper, we report findings regarding parent communication and daughter’s experiences of bullying and victimization in a sample of Hispanic families with seventh-grade daughters. About 57% of daughters reported experiencing any form of victimization and 37% reported engaging in some type of bullying behavior. Overall, the most common type of victimization reported was verbal/emotional bullying (36%). Nearly all parents agreed they had spoken with their daughters about the dangers of bullying perpetration (95%) and how to handle being victimized (96%), but there was no association between the frequency with which parents spoke with their daughters about bullying perpetration and their child’s victimization experiences. Additionally, the gap between parent and child acculturation did not appear to moderate this association. The high incidence of self-reported bullying perpetration and victimization experiences underscores the need for school nurses, parents, and school personnel to address bullying behavior.

Keywords: Parent Communication, Bullying, Hispanic, Early Adolescents, Acculturation Gap

Bullying prevalence peaks in middle school (Wang, Iannotti, & Luk, 2012; Wang, Iannotti, Luk, & Nansel, 2010) and has been shown to significantly affect female Hispanic adolescents (Romero, Wiggs, Valencia, & Bauman, 2013). Female Hispanic adolescents are at risk for various negative mental health outcomes including depression, substance use, and suicide, all of which have been associated with bullying experiences within this population (Steele & Doey, 2007; Romero et. al., 2013).

Increased family support has been shown to decrease levels of both bullying perpetration and victimization (Matsunaga, 2009) suggesting parents can fulfil a key role in addressing bullying among Hispanic youth. Hispanic parents’ involvement with their children is also highly congruent with familisma. Familisma is an important Hispanic cultural value that highlights the importance of maintaining strong family support and fulfilling family obligations (Sabogal, Marin, Otero-Sabogal, Marin, & Perez-Stable, 1987; Niemeyer et. al., 2009). Unfortunately, little is known about parent communication regarding bullying in Hispanic families and its relationship to/association with child reports of bullying perpetration and victimization experiences. Hence, we address this gap by examining Hispanic, parent-child communication regarding both of these experiences. We use the results of this study to provide implications for school nurses who can serve an important role in preventing bullying in academic settings (Pigozi & Jones Bartoli, 2016).

Background

Bullying

Bullying is defined as chronic aggressive behavior intentionally directed toward an individual to perpetuate a power disturbance (Olweus & Limber, 2010; Corvo & Delara, E., 2010). This aggressive behavior can present in different forms including physical bullying (i.e. hitting, pushing, or beatings that inflict pain), verbal/emotional bullying (i.e. name calling, threats, insults, spreading rumors), and relational bullying (i.e. social isolation, manipulation of peer relationships; Chester et. al., 2017, Duy, 2013, Wolf et. al., 2001). Bullying perpetration and victimization experiences have been linked to a variety of negative mental health and developmental consequences including depression, anxiety, negative self-esteem, social isolation, poor school performance, and decreased health-related quality of life (Peskin et. al., 2007, Esbensen & Carson, 2009; Chester et. al., 2017). Without intervention, these consequences can persist and influence youth’s long-term physical, psychological, and social well-being (Brimblecombe et. al., 2018; Greener, 2016; Wolke & Lereya, 2015).

Parent Communication and Bullying

Parents have the strongest influence and supportive effect against bullying perpetration and victimization experiences. For example, Offrey and Rinaldi (2017) conducted a study examining the type and effectiveness of problem solving strategies parents presented to children. The results of the study revealed an association between parent communication and the effectiveness of problem-solving strategies generated to address physical and cyber bullying situations (Offrey & Rinaldi, 2017). Moreover, Ledwell & King (2015) found that parent communication moderated the relationship between bullying and internalizing problems in a sample of young adolescents. Increased levels of parent communication buffered adolescents from experiencing the internalizing problems that resulted from bully experiences. Unfortunately, literature about Hispanic parents’ awareness of their child’s experiences with bullying is very limited.

We could identify no studies specific to Hispanic families or early adolescents examining the relationship or association between parent communication with their child regarding bullying and the child’s reported experiences. Four studies involving other groups of youth have been conducted. These include: Dutch elementary school children (Fekkes et. al., 2005), undergraduate students in the northeastern United States (Matasunaga, 2009), fifth grade students from an ethnically diverse school in the northeastern United States (Holt, Kantor, & Finkelhor, 2008), and a nationally representative sample of 6-10th grade adolescents (Spriggs, Iannotti, Nanselt & Haynie, 2007). Fekkes and colleagues (2008) found that almost half of bullied Dutch elementary school children did not tell their teacher about their experiences. Furthermore, 35% of teachers and 39% of parents reportedly were unaware that the child was being bullied. Holt and colleagues (2008) found that the rates of bullying perpetration and victimization were higher when reported by the students compared to parents, and parents were often unaware of their child’s experiences with bullying. Lastly, Spriggs and colleagues (2007) examined the association between bullying in reference to family, school, and peer relations for White, Black, and Hispanic adolescents in grades 6-10. Multivariate analysis revealed that parent communication, social isolation, and classmate relationships were associated with bullying for all racial ethnic groups (Spriggs, Iannotti, Nanselt & Haynie, 2007). Results specific to Hispanic adolescents were not reported. More research is needed regarding the relationship between parent communication and child experiences among Hispanic populations.

Acculturation Gap and Parent Communication

Parent- child acculturation gaps emerge when Hispanic youth are more acclimated to American culture while their parents remain accustomed to their native practices (Telzer, 2010). Hispanic youth attending American schools tend to gravitate toward American culture while their parents typically may continue functioning well using their native languages and customs, especially in environments where their native culture is dominant (i.e. Miami; Padilla, 2006; Schwartz et. al., 2012). Parent- child acculturation gaps have been associated with decreased family functioning, compromised parent-child communication, and negative behavioral outcomes (Schwartz et. al., 2012; Smokiwski, Rose, & Bacallao, 2008). Additionally, Schwartz and colleagues (2012) found that parent-child acculturation gaps predicted compromised parent-child communication.

Theoretical Framework

The theoretical framework guiding this study comes from early work by Cohen and Willis (1985) regarding the importance of social support for promoting individual well-being directly as well as indirectly, by buffering the impact of stressors. According to this framework, parent-child communication regarding bullying provides an important, informational form of social support (Nakonezny, Rodgers, & Nussbaum, 2003). In this study, we investigate whether parent-child communication about bullying is occurring in Hispanic families, and if so, whether this communication is related to daughters’ reported experiences of bullying perpetration and victimization experiences. Of interest is whether a parent-child acculturation gap moderates associations between the frequency of parent communication about these topics and daughters reports of bullying perpetration and victimization experiences.

Method

We employed a cross sectional survey research design that integrates data from two separate studies to determine whether parent reports of talking with their daughters about bullying would be related to the child’s reported bullying experiences. Each of these studies were approved by the University of Miami Institution Review Board. The parents study data are from a survey of parents of girls enrolled in an efficacy trial of an early pregnancy prevention intervention (“JUEGA”). The daughter data are from this efficacy trial which is a clinical trial involving early adolescent Hispanic/Latinas. This trial is registered, under the name “JUEGA: A fun study for Hispanic/Latino adolescent girls” (#NCT02578147), and hereafter will be referred to as “JUEGA.”

Each study uses different sampling methods, procedures, and measures. For example, the survey in the parents’ study asks parents to report on their communication with their child about bullying. Whereas, the survey in JUEGA asks girls about bullying perpetration and victimization experiences. Given the methodological differences between these two studies, we will discuss the sample, survey, and procedures for each study separately, beginning with the parents study. We will conclude the methods section with a single data analysis subsection in which we describe the analyses conducted after linking the data from these two separate studies together.

Parents Study

Sample.

A random sample of parents of participants in JUEGA was drawn to create a representative sample of parents meeting the following eligibility criteria: (1) daughter currently actively participating in JUEGA; (2) parent signed a written agreement of willingness to be contacted for future research studies involving parents during the JUEGA consent process (or was the spouse of this parent whom this parent had asked if the spouse could participate in his/her place, and this spouse expressed interest in participating); and (3) willing to provide informed consent to participate in the parents study. The sample was stratified to so that the proportion of parents of girls attending each of the 22 schools that participated in JUEGA mirrored the proportions in the JUEGA sample.

A total of 164 parents completed the parents study survey. A majority of the parents were of Cuban origin (51%) and had completed education beyond high school (62%). A majority (67%) completed the survey in Spanish. Less than a third (30%) were highly acculturated, and only 13% were born in the U.S (see also Table 1).

Table 1.

Demographic and Information Regarding Bullying

Subsample Full Sample Parent Sample
Age in years (N = 164) (N = 542) (N = 164)
   Median (Range) 12 years (11-14) 12 years (11-15) 43 years (29-66)
Highly Acculturated 81% (n = 121) 83% (n = 369) 30% (n = 48)
Reduced/Free Lunch 85% (n = 119) 85 % (n = 382) -
Country of Origin
 Cuba 41% (n = 67) 41% (n = 222) 44% (n = 72)
 Nicaragua 6% (n = 9) 6% (n = 32) 7% (n = 12)
 Honduras 5% (n = 8) 5% (n = 25) 6% (n = 10)
 Mexico 4% (n = 6) 4% (n = 19) 4% (n = 7)
 Colombia 3% (n = 5) 3% (n = 18) 6% (n = 9)
 Dominican Republic 4% (n = 6) 3% (n = 15) 4% (n = 7)
 Venezuela 2%( n = 3) 2% (n = 12) 4% (n = 7)
 Puerto Rico 2% (n = 3) 2% (n = 11) 2% (n = 3)
 Peru 2% (n = 3) 2% (n = 10) 2% (n = 3)
 Multiple countries 29% (n = 48) 28% (n = 152) 15% (n = 24)
 Other 4% (n = 6) 5% (n = 27) 6% (n = 10)
U.S. born 70% (n = 114) 72% (n = 389) 13% (n = 12)
Age at Immigration 6 years (n = 41; 1-13 years) 7 years (n = 131; 1-13 years) 24 years (n = 35; 1-51 years)
Education
 8 years or less - - 7.3% (n = 12)
 Some high school - - 7.9% (n = 13)
 Graduated high school/GED - - 22.5% (n = 37)
 Some college/trade school 33.6% (n = 55)
 Graduated from college - - 20.7% (n = 34)
 Master’s degree, professional - - 7.3% (n = 12)
Bullying 37% (n = 53) 41% (n = 183) -
Victimization 57% (n = 85) 64% (n = 270) -
Handling bullying - - 96% (n = 157)
Dangers of bullying - - 95% (n = 156)
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Note. The percentage values of bullying and victimization in the table represent participants who reported any form (physical, relational, and verbal/emotional) of bullying or victimization, regardless of type. Handling bullying = parent report of speaking with daughter about how to handle bullying; dangers of bullying = parent report of speaking with their daughter about the dangers of bullying. GED = general education diploma.

Survey.

The parents study survey assessed demographic information along with the frequency and content of parent-child conversations regarding various health related topics (diet, exercise, reproduction, pregnancy and sexually transmitted infections, alcohol use, and bullying. The 64-item survey was designed in Qualtrics, a cloud based web survey tool. Only the six items related to demographic information and three items related to communication about bullying used in the analyses reported here are described next. Information regarding the full set of items is available upon request from the second author.

Demographic items included: age, race, family country of origin, age at migration, language preference, and level of education. Acculturation was assessed using Norris, Ford, and Bova’s (1996) brief 4-item language based measure that assesses use of English relative to Spanish in the home, with friends, during reading, and during thinking. Response options were: Spanish only, Spanish more than English, Spanish and English equally, English more than Spanish, or English only. The acculturation scale had good reliability (Cronbach ɑ=0.90). Items are summed and divided by 4 to create a score. Individuals who score from 1 to 3 are considered low in acculturation and those who score above 3 are considered high.

Three items were used to assess parent communication regarding physical bullying. One assessed the general frequency of communication regarding bullying without differentiating between perpetration or victimization experiences. This item asked: How often have you spoken with your daughter about pushing, hitting, or shoving? The response options for this item were: 1 (many times), 2 (a few times), 3 (once), 4 (never), or 5 (preferred not to answer). The other two items were more specific about the bullying experience. One asked about discussing the consequences of perpetration (Have you warned your daughter about the dangers of pushing, hitting, and shoving?). The other asked about discussing strategies for responding to victimization (Have you spoken with your daughter about how to handle being hit, pushed, or shoved?). Both of these items used a 5-point Likert scale set of response options ranging from strongly agree (0) to strongly disagree (4). These two items formed a short scale with adequate internal consistency (Cronbach’s ɑ = 0.78).

Procedure.

All parents/guardians were contacted by phone. Study staff provided the elements of informed consent verbally and then asked parents/guardians if they had any questions. Once these questions had been answered, they provided a link via email to access an online consent and survey in the preferred language (e.g. English or Spanish). The first page of the parents study survey was designed as a written consent that parents could click to indicate their agreement to participate. Once parents completed the online consent form, they were provided an ID code that study staff could link to their daughter’s ID code in the JUEGA study. Then, study staff ended the call and allowed the parent/guardian to complete the survey online. The parents study survey took approximately 20-30 minutes to complete. Two $15 Walmart gift card were mailed to parents for completing the survey.

JUEGA

Sample.

The sample used for analysis consists of a subsample of 164 Hispanic girls from the full JUEGA study sample (N = 542) whose parents participated in the parents’ study. The full JUEGA study sample is a convenience sample of girls enrolled in 7th grade at a Miami-Dade County Public School in which 80% or more of the students qualify for a reduced or free lunch, and the percentage of Hispanic enrollment is 60% or higher.

More than half of these participants attended (59%, n = 96 participants) middle schools, with 26% (n = 42 participants) from K-8, and 16% (n = 26 participants) from charter schools. The median age of participants included in the subsample was 12 years (range 11-14), and 85% (n = 119) of this sample had free or reduced lunch. Additionally, 81% (n = 121) of these participants were highly acculturated to US culture. As shown in Table 1, this subsample is similar in demographic characteristics to the full JUEGA sample.

Procedure.

JUEGA study participants were recruited from schools throughout Miami-Dade County in South Florida. Assemblies were held at each school for 7th grade girls who met study criteria. During the assembly, girls were provided details about the study and given a study packet, containing a consent form and information about the study, to take home to their parent/guardian. Girls were instructed to return the completed packet to a school representative with a completed consent if they and their parent/guardian were interested in their being a study participant. All completed consent forms were then verified by calling parents and insuring that they had no questions and were comfortable with their daughter participating.

All study survey data were collected electronically. Prior to instructing participants to enter a unique ID code to access to the study survey, study personnel informed all participants that responses were confidential and only used for research purposes. JUEGA participants took approximately 20- 45 minutes to complete the survey. Completion time varied due to the participants’ reading level and follow-up questions to affirmative responses to sexual or substance use questions.

Survey.

The 83-item JUEGA survey was designed in Lime Survey, a cloud based web survey tool. Only the 8-items related to demographic information and 24-items related to bullying perpetration and victimization experiences used in the analyses reported here are described next. Information regarding the full set of items is available upon request from the second author.

Demographic items included: age, academic grade, birth location, acculturation, puberty, school performance, parent/guardian education, and country of origin. Acculturation was assessed using the same measure employed in the Parent’s Survey described previously: Norris, Ford, and Bova’s (1996) brief 4-item language based measure. Reliability for this measure among the daughter subsample in the present study was .75.

Bullying Perpetration and Victimization Experiences were assessed using items from the Conflict in Adolescent Dating Relationships Inventory (CADRI; Wolf et. al., 2001). The CADRI assesses physical and psychological aggressive behaviors in adolescent peer relationships. Each item is answered twice, once in terms of perpetration and once in terms of victimization. Items from the physical abuse (4 items), relational abuse (3), verbal abuse (10), and threatening behavior (4 items) latent factors were selected for the purposes of this study based on perceived fit for the early adolescent developmental age group. The final scale resulted in a total of 24 items (12 victimization items and 12 perpetration items). Response options for both versions of these items were: 0 (never), 1 (1-2 times), 2 (3-5 times), and 3 (6 or more times). Factor analysis using principal components and a varimax rotation supported separating the CARDI items used in this study into victimization and perpetration subscales, and supported further dividing these subscales into bullying and perpetration specific items falling into physical, verbal/emotional, and relational bullying behavior subtypes. Each subscale had moderate to good reliability (Cronbach α = 0.76-0.91; see Table 3).

Table 3.

Proportion of Victimization and Bullying by Subtype Within Study Sub-Sample.1

Victimization Bullying
Bullying Experience Type N = 164 % N = 164 %
Physical only n = 5 3 n = 3 2
Relational only n = 3 2 n = 3 3
Verbal/Emotional only n = 21 13 n = 30 13
Physical and Relational n = 0 <1 n = 1 <1
Physical and Verbal/Emotional n = 15 9 n = 5 7
Verbal/Emotional and Relation n = 23 14 n = 3 14
Verbal/Emotional Relational and Physical n = 22 13 n = 4 15
No Victimization n = 96 38 n = 96 29
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Note. % may not sum to 100 due to rounding and missing data.

For purpose of the analyses reported here, participant responses to the CADRI items were used to create dichotomous variables, bullying perpetration (yes, no) and experiencing victimization (yes, no) overall and then by each of the bullying behavior subtype. Specifically, any experience of being bullied at least 1-2 times was considered experiencing victimization, and any report of engaging in a bullying behavior at least 1-2 times was considered perpetration. This approach is consistent with the approach used by the National Center for Educational Statistics in the National Crime Victimization Survey in their analyses examining factors related to bullying perpetration and victimization.

Data Analysis

The data sets for each study were integrated creating 164 parent-child pairs of data, for analysis, and enabling creation of the acculturation gap variable. Creation of this variable was based on the dichotomized parent and child acculturation measure. Any parent child dyad whose acculturation level did not match (i.e. child high acculturation and parent low acculturation) was coded as having an acculturation gap and assigned a value of 1. If the parents and child’s acculturation level matched (either both low acculturation or both high acculturation) the dyad was not considered to have an acculturation gap and was assigned a value of 0.

All data were analyzed with SPSS version 22 (IBM Corp, 2017). Descriptive statistics were used to determine the frequency of the acculturation gap variable, victimization, perpetration, and parent-child conversations regarding bullying. We conducted Logistic Regression analysis to assess the association between frequency of parent communication regarding bullying in general and daughters’ self-report of physical bullying perpetration and victimization experiences. When testing moderation, the parent communication variable was dummy coded in order to create interaction terms for assessing the moderating effect of an acculturation gap on parent communication regarding bullying and the daughter’s experiences.

The sample of 164 parent-child pairs for analysis created by pairing parent reports of communication about bullying with their daughter’s reports of bullying perpetration and victimization experiences provides sufficient power to detect relatively small odds ratios (i.e., those within ± .50 of 1.00), assuming a power of .80 and an alpha of .05. Specifically, the number of pairs (N = 164) provided sufficient power to detect an odd’s ratio (OR) of 1.58 (positive association) or 0.63 (negative effect) for victimization. Moreover, this sample size (N = 164) provided sufficient power to detect an OR of 1.64 or 0.61 for perpetration.

Results

Frequency of parent communication and bullying

About 57% of the sample of girls whose parent completed the parents study survey reported experiencing any type of victimization and 37% reported engaging in some form of perpetration. Overall, the most common behavior reported was verbal/emotional victimization (36%), and 22% of the sample reported perpetrating this type of bullying. Relational and physical types of bullying were less common, with approximately 29% and 25% of participants, respectively, experiencing these types of victimization. Similarly, perpetrating these two types of bullying was also lower with relational bullying (5%) being far less common than physical (13%). Table 2 provides additional information about the percentages of experiencing and perpetrating the three types of bullying behaviors solely and in combination. As data in the table indicate, verbal/emotional bullying was also the most common behavior among girls that reported experiencing and perpetrating only one type of bullying.

Table 2.

JUEGA Bullying and Victimization Assessment Items

Victimization Bullying
During the past 3 months, how many times has someone
done the things in this list to you?		 During the 3 past months, how many times
have you done the things in this list to
someone?
Physical Kicked, hit or punched you Kicked, hit or punched someone
Slapped, you or pulled your hair Slapped, you or pulled their hair
Pushed, shoved, or shook you Pushed, shoved, or shook someone
Threw something at you that could hurt you Threw something at someone that could hurt them
(Cronbach α = 0.88) (Cronbach α = 0.92)
Relational Tried to turn your friends against you Tried to turn someone’s friends against them
Said things to your friends about you to turn them against you Said things to someone’s friends about them to turn their friends against them
Spread rumors about you Spread rumors about someone
(Cronbach α = 0.82 (Cronbach α = 0.84)
Emotional Said things just to make you angry Said things just to make someone angry
Spoke to you in a mean tone of voice Spoke to someone in a mean tone of voice
Insulted you with put downs Insulted someone with put downs
Made fun of you in front of other people Made fun of someone in front of other people
(Cronbach α = 0.88) (Cronbach α = 0.76)
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In terms of parent communication, 96% (n = 157) of parents either agreed or strongly agreed to speaking with their daughter about how to handle being hit, pushed, or shoved. Furthermore, 95% of parents either “agree” or “strongly agreed” to warning their daughters about the dangers of hitting, pushing, or shoving. Both of these parents study survey questions were excluded from further logistic regression analysis due to ceiling effects. There was more variability in the frequency with which these conversations occurred. About 61% of parents reported that the conversation occurred many times, 25% responded a few times or once, and 14% stated they never spoke with their daughters about pushing, hitting, or shoving during the past year.

Associations between Parent communication, Perpetration, Victimization, and Acculturation Gap

There was no association between the frequency with which parents spoke with their daughters about pushing, hitting, or shoving and whether the daughter was a perpetrator of physical bullying ( p=.642). Furthermore, there was no significant association between the frequency of communication and physical victimization (p>.873). Almost half of the subsample (48%) presented with an acculturation gap. However, the acculturation gap did not moderate the association between parent communication frequency and daughters’ reported perpetration or victimization within this sample (p>.545).

Discussion

This study constitutes one of the first studies to examine associations between parent communication and bullying among Hispanic parent-daughter dyads living in South Florida. More than a third of these participants reported engaging in bullying, and more than half reported experiencing victimization. Nearly all parents reported that they had spoken with their daughters about the dangers of bullying (i.e., being a perpetrator) and how to handle being the victim, but there was no association between the frequency with which parents spoke with their daughters about bullying and the child’s reported experiences.

The rate of victimization (59%) among our participants is much higher than what has been reported nationally by the National Center for Educational Statistics (NECS) for 7th grade girls in general (25%; rate for 7th grade Hispanic girls not reported). However, these data are from the National Crime Victimization Survey. Methodological differences between those survey methods and the ones used here may be more responsible for this difference than cultural or ethnic factors. For example, the rate NECS reported for Hispanic girls and boys between the ages 12-18 (17%) is fairly similar to the rate for all boys and girls in this same age range (21%). Instead of culture or ethnicity, it may be that the National Crime Victimization Survey methods contributed to under-reporting of the experience of bully victimization. For example, the items used to assess this experience are similar in content to the ones used in the present study, but limited in number to 7 (we used 12 items). The operational definition of bully victimization (similar to the definition used in the present study) was endorsing at least one of these items. Thus, respondents had fewer experiences to endorse in the National Crime Victimization Survey. Moreover, the National Crime Victimization Survey data were collected in a face to face interview, and youth are often reluctant to disclose to an adult that they have been victimized (Mishna & Allegia, 2005). In contrast, our participants used a computer to complete an electronic survey, an approach that has been shown to encourage greater self-disclosure due to feelings of anonymity (Turner et al, 1998).

Our failure to find an association between parent communication and a daughter’s bullying perpetration and/or victimization experiences is somewhat at odds with the results from two other studies linking parent communication and child behaviors regarding bullying (Lee et. al., 2009; Offrey & Rinaldi, 2017). However, these are the only studies we could find that examined this association and both were conducted outside the US (Canada, Hong Kong) where the cultural norms regarding bullying may differ from those in the US. Also, neither study involved Hispanic families. Further, the authors each used different items or approaches to measuring bullying perpetration and victimization from those used in the current study. For example, the Canadian study (Offrey & Rinaldi) used responses to hypothetical scenarios as a proxy for behavior, and the Hong Kong study (Lee, et al) did not assess behaviors that occur in a more relational context, such as making someone jealous, or turning their friends against them. Additionally, the Hong Kong study included items that assessed intimidation behaviors which were not assessed in the present study. In sum, available literature is limited and methodological differences make it difficult to compare results across studies. Hence, additional research is needed to clarify the circumstances under which parent communication is influenced by or associated with the child’s behaviors and experiences.

Our failure to find an association between parent communication and reported bullying perpetration and victimization experiences may be a limitation of our measurement approach or unidentified moderating influences present in our study sample. Our parent communication items referenced only three specific physical forms of bullying (pushing, hitting, and shoving) due to concerns about the length of the parents’ study survey. There were no items referencing verbal/emotional forms of bullying or bullying behaviors occurring in a relational context. Hence, it could be argued that the degree of conceptual overlap between the items that parents and daughters completed was very small, making it extremely hard to find an association between parent communication and daughter’s reported behaviors and experiences.

Our measure of parent child communication was limited to communication about bullying and did not assess general properties of parent communication (i.e. family openness, barriers to communication) which could moderate the association between parent communication regarding bullying and the child’s self-reported bullying experiences. It is possible that these general properties could impact a child’s willingness to disclose perpetration or victimization related experiences and/or serve as an indicator for the moderating effect of parent-child relationship quality on the child’s willingness to disclose. It would be advantageous in future studies attempting to link parent-child communication to child-behavior to include measures (or key items from established measures) that assess these general properties. For example, McNaughton, Cowell, and Fogg, (2015) found an intervention designed to improve these general properties of mother-child communication resulted in child reports of lower depression scores and improved health self-concept, a measure which included a subscale related to peer relationships.

Our failure to find a moderating effect for an acculturation gap on the association between parent communication and daughter bullying perpetration and/or victimization experiences is at odds with the literature and may reflect either of two measurement problems. First, we used a language based measure of acculturation whereas other studies have used measures that assess food, music, media, in addition to language preferences. For instance, Schwartz and colleagues (2012) used the Bicultural Involvement Questionnaire (Szapocznik et al., 1980) which consisted of 24 items to assess Hispanic and American cultural practices, and Cowell, McNaughton, Ailey, Gross, and Fogg (2009) used the Acculturation and Structural Assimilation scale (ASAS) which includes five subscales of acculturation and two subscales of assimilation.

Second, the range of parent responses to questions about physical bullying communication was limited with most parents (61%) reporting speaking with their daughter many times. Clearly, more research is needed to examine the influence of an acculturation gap on parent-child communication to understand how this gap influences the child’s reported bullying and victimization experiences.

Limitations

There are five limitations to this study. First, the sample consisted of a large, low income, predominately Cuban-American, sample living in South Florida This may limit generalizability of study results to other parts of the country where the Hispanic sample may be predominately Mexican American or Puerto Rican. Second, the data were cross-sectional preventing us from looking at cause-effect relationships. Third, the data were all self-report and subject to errors in recall and social desirability concerns. Disclosing information that reflects negatively or positively upon the self may limit the participant’s reporting of a non-socially desirable response (e.g. “No, I don’t talk with my daughter about the dangers of pushing, hitting or shoving other kids;” Holtgraves, 2004). We attempted to minimize errors in recall and minimize social desirability concerns by asking about behaviors that occurred in the past 3 months and collecting data over the computer. However, it is still possible that these effects were present. Fourth, as discussed previously, the parents study survey used a much narrower list of bullying behaviors than the survey that their daughters completed and most likely made it difficult to find an association between parent communication and the daughter’s reported experience. Lastly, our sample contained parents with a college education or higher, but the size of our parent education subgroups and the size of our parent subgroup reporting little or no talking with their child about bullying were too limited to examine the effect of parent education on parent-child communication regarding bullying. This is unfortunate because little evidence exists regarding the effect of parent education on parent-child communication about bullying. Moreover, the effect of parent education on parent communication about other topics is quite mixed (Musa, Akande, Salaudeen, & Soladoye, 2008; Jerman, Petra, Constantine, Norman, 2010; Ennett, Bauman, Foshee, Pemberton, & Hicks, 2001), suggesting that this is clearly an issue that merits further research.

School Nursing Implications

Despite these limitations, this study has six implications for nursing practice and research. First, the relatively high incidence of self-reported bullying perpetration and victimization underscore the need for school nurses to work with parents and school personnel to address this problem. Nursing intervention is critical given the vast literature linking bullying to negative health outcomes (Esbensen & Carson, 2009). Only one evidenced-based, parent communication school program, which has been evaluated with a clinical trial in the US, could be identified at the present time (Lester et. al., 2017; Friendly Schools Friendly Families). This program improved parent communication, but the effects on bullying behavior were not evaluated. In contrast, two evidenced based school programs that focus on children but not parents have produced positive changes in school climate and reduced bullying behavior in US early adolescent populations (positive effects also observed for elementary school children, see Brown, Low, Smith, & Haggerty, 2011; Frey et. al. 2005). These programs are: Steps to Respect developed in the US (Brown, Low, Smith, & Haggerty, 2011; Frey et. al. 2005) and The Bullying Prevention Program, developed in Norway (Olweus & Limber, 2010). School nurses could work to (a) implement strategies outlined within these established bully intervention programs to reduce the incidence and change student attitudes regarding bullying and victimization; and (b) share the strategies that are being taught to children with their parents. For example, with minimal direction, parents could use strategies provided from school nurses as talking points and support their child in their effort to implement them.

Second, the elevated frequency of verbal/emotional bullying within our sample highlights the need to address this form of bullying in a broader context. Verbal/emotional bullying can be easily overlooked in school and community settings because unlike physical bullying, it leaves no physical mark and may be more obscure. Also, parents and teachers often perceive verbal/emotional bullying to be less harmful than physical bullying and are less likely to consider this behavior serious or to intervene when it occurs (Bauman & Del Rio, 2006). Nevertheless, verbal/emotional bullying has been linked to increased levels of hopelessness, depression, and suicide (Alavi et. al., 2017; Cheng et. al., 2011; Kodish et. al., 2016). This argues for verbal/emotional bullying being seen as a major public health issue given that suicide is the second leading cause of death for early adolescent youth (Kann et. al., 2018). More research is needed to understand risk and protective factors for this type of bullying perpetration and victimization to inform interventions purposed to reduce its occurrence. Parents, teachers, and school nurses can assist in preventing the occurrence of verbal/emotional bullying by acknowledging the negative consequences that result from this behavior, spreading awareness regarding the unhealthy nature of this form of aggression, and intervening when youth engage in this form of behavior.

Third, our effort to discuss our findings in the broader context of available literature underscores the need for nurses to pay attention to how bullying behaviors are assessed. Relying on students to disclose that they are being bullied to a school nurse, counselor, or teacher is likely to result in an underestimate of the incidence of actual bullying behavior. Asking students directly during a face to face interaction may also lead to under reporting and a false impression of actual bullying rates. Perhaps a locked box for depositing suggestions, complaints and concerns could provide a way for students to disclose bullying without fear of peer retaliation. However, the most accurate assessment could occur by assessing bullying perpetration and victimization using electronic surveys. These surveys could be delivered over the cell phone for ease of access, privacy, and include items that assess physical, and psychological forms of bully, and/or bullying occurring in relational context.

Fourth, issues in assessment of these behaviors argue for care in reading and evaluating research evidence for guiding practice. Study results may appear inconsistent across studies due to differences in how bullying perpetration and victimization experiences are assessed. Hence, the results of interventions studies need to be considered within the context of how intervention outcomes are being measured, and how the data are being collected. Unfortunately, much is still unknown about the role of gender, culture, and ethnicity with respect to bullying and the effectiveness of interventions that target this behavior. Therefore, we recommend having parents, educators, and students review and critique the intervention described in literature to determine whether the intervention should be piloted for implementation with their school setting. Experiences with the pilot can then be used to guide wide scale implementation. Results of a recent meta-analysis of clinical trials of anti-bullying school programs indicate that problems with implementation tend to produce small changes at best in bullying behavior (Jiménez-Barbero, Ruiz-Hernández, Llor-Zaragoza, Pérez-García, & Llor-Esteban, 2016). Therefore, careful attention to implementation is critical to ensure effectiveness of an anti-bullying program.

Fifth, an important question for future research is whether a parent-child acculturation gap contributes to decreased effectiveness of parent communication regarding bullying, impact parent perceptions of the child’s reported of experiences with bullying in the school setting, and influences a child’s reluctance to disclose bullying. Nearly 70% of the daughters in our subsample were born in the US as compared to 12% of the parent sample. A large majority of these girls (82%) reported a high level of acculturation to U.S. culture as compared to their parents (30%). Parent-child acculturation gap create stress on parent-child relationships and can contribute to aggressive behavior (Le et. al., 2008). In addition, the protective aspects of Hispanic culture including strong parent-child relationships can be weakened as immigrant children acculturate (Marsiglia et. al., 2009). This could influence parent communication even more.

Lastly, future research should employ different assessment questions or approaches to minimize social desirability bias and better differentiate the level of communication that occurs between the parent-child dyad regarding bullying perpetration and victimization experiences. Examining cultural differences existing between native born children and foreign born parents, as it pertains to communication and bullying, will assist in developing measures suitable for specific populations. Bridging the gap between child experiences of bullying, parental knowledge, and effective communication regarding those experiences will promote effective interventions and increase youth mental, physical, and social health outcomes.

Acknowledgments

Funding for this study was provided by the University of Miami School of Nursing and Health Studies and NINR (R01NR014851).

Contributor Information

Ariel Uniqua Smith, School of Nursing and Health Studies, University of Miami.

Anne E. Norris, School of Nursing and Health Studies, University of Miami.

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