Bullying victimization and its associated factors among adolescents in Kozhikode district, Kerala, India: a mixed-methods study

Background : Bullying victimization among adolescents is a serious concern as it leads to poor psycho-social adjustments in the future. Literature on bullying at schools in Kerala is limited. This study aimed to investigate the magnitude of bullying and the factors associated with it among adolescents. Methods: A sequential explanatory study design was used. A cross-sectional study among 764 adolescents (mean age 13.3 years, males 58.5%) selected through multistage cluster sampling was done. We used the Olweus Bully-Victim Questionnaire, Global School Health Survey, and Patient Health Questionnaire 9 for data collection. Binary logistic regression was performed to identify predictors of bullying victimization. After this, in-depth interviews were carried out among key stakeholders. Results: About 117 (15.3%) respondents reported being bullied at least twice a month. Verbal bullying was reported by 30% (n=229), physical bullying by 23.3% (n=178), sexual bullying by 11% (n=89) and cyber-bullying by 3.3% (n=25). Adolescents aged 14 years and above (OR 2.09, 95% CI: 1.34-3.26), being male (OR 3.50, 95% CI: 1.97-5.87), the parent's response to bullying (OR 5.27, 95% CI: 2.44-11.36), the victim's reaction to being bullied (OR 8.101, CI: 4.53-14.36) and the teacher's action against the bully (OR 3.59, CI: 1.91-6.73) were major predictors of bullying. Qualitative exploration of pathways of bullying phenomena revealed the influence of parenting on a child being a victim or a bully, and a lack of competence and training among teachers to address bullying at school. Conclusions: Bullying is highly prevalent among adolescents in schools and has short- and long-term implications. Targeted interventions for bullying prevention should focus on older adolescent boys and those who report being bullied. Anti-bullying policies at school are vital to sensitize teachers, parents, and students to bullying.