JMIR RESEARCH PROTOCOLS Mishna et al

Protocol

Prevalence, Motivations, and Social, Mental Health and Health

Consequences of Cyberbullying Among School-Aged Children
and Youth: Protocol of a Longitudinal and Multi-Perspective Mixed
Method Study

Faye Mishna1, PhD; Lauren B McInroy1, MSW; Ashley Lacombe-Duncan1, MSW; Payal Bhole1, MSW; Melissa Van
Wert1, PhD; Kaitlin Schwan1, MA; Arija Birze2, MA; Joanne Daciuk1, BEd; Tanya Beran8, PhD; Wendy Craig3, PhD;
Debra J Pepler4, PhD; Judith Wiener5, PhD; Mona Khoury-Kassabri6, PhD; David Johnston7, PhD
1
University of Toronto, Factor-Inwentash Faculty of Social Work, Toronto, ON, Canada
2
University of Toronto, Dalla Lana School of Public Health, Toronto, ON, Canada
3
Queens University, Department of Psychology, Kingston, ON, Canada
4
York University, Department of Psychology, Faculty of Health, Canada
5
University of Toronto, Ontario Institute for Studies in Education, Toronto, ON, Canada
6
The Hebrew University of Jerusalem Mount Scopus, School of Social Work & Social Welfare, Jerusalem, Israel
7
Seneca College, Toronto, ON, Canada
8
University of Calgary, Cumming School of Medicine, Calgary, AB, Canada

Corresponding Author:
Faye Mishna, PhD
University of Toronto
Factor-Inwentash Faculty of Social Work
246 Bloor Street West
Toronto, ON, M5S1V4
Canada
Phone: 1 416 978 3255
Fax: 1 416 978 7072
Email: [Link]@[Link]

Abstract
Background: While the online environment may promote important developmental and social benefits, it also enables the
serious and rapidly growing issue of cyberbullying. Cyberbullying constitutes an increasing public health problem – victimized
children and youth experience a range of health and mental health concerns, including emotional and psychosomatic problems,
maladaptive behaviors, and increased suicidality. Perpetrators demonstrate a lack of empathy, and may also struggle with health
and mental health issues.
Objective: This paper describes the protocols applied in a longitudinal and multi-perspective mixed-methods study with five
objectives: (1) to explore children/youth’s experiences, and children/youth’s, parents’, and teachers’ conceptions, definitions,
and understanding of cyberbullying; (2) to explore how children/youth view the underlying motivations for cyberbullying; (3)
to document the shifting prevalence rates of cyberbullying victimization, witnessing, and perpetration; (4) to identify risk and
protective factors for cyberbullying involvement; and (5) to explore social, mental health, and health consequences of cyberbullying.
Methods: Quantitative survey data were collected over three years (2012-2014) from a stratified random baseline sample of
fourth (n=160), seventh (n=243), and tenth (n=267) grade children/youth, their parents (n=246), and their teachers (n=103).
Quantitative data were collected from students and teachers during in-person school visits, and from parents via mail-in surveys.
Student, parent, and teacher surveys included questions regarding: student experiences with bullying/cyberbullying; student
health, mental health, and social and behavioral issues; socio-demographics; and information and communication technology
use. In-depth semi-structured qualitative interviews were conducted twice with a sub-sample of students (n=57), purposively
selected based on socio-demographics and cyberbullying experience, twice with their parents (n=50), and once with their teachers
(n=30).

[Link] JMIR Res Protoc 2016 | vol. 5 | iss. 2 | e83 | p. 1

(page number not for citation purposes)
XSL• FO
RenderX
 JMIR RESEARCH PROTOCOLS Mishna et al

Results: Data collection for this study is complete. Planned analyses include transition probabilities and repeated measures
analyses to determine involvement in cyberbullying. Repeated measures analyses, including between-subject factors (eg,
socio-demographics), will be utilized to determine factors that protect or increase risk of involvement in cyberbullying. Qualitative
analysis utilizing grounded theory is planned, to permit rich understanding of participant experiences and perspectives. Results
will be reported in 2016 and 2017.
Conclusions: This study will offer insight into the contemporary phenomenon of cyberbullying while also informing interventions
to curb cyberbullying and address its pervasive social, mental health, and health consequences. Knowledge mobilization strategies
and implications for research and practice are discussed.

(JMIR Res Protoc 2016;5(2):e83) doi: 10.2196/resprot.5292

KEYWORDS
cyberbullying; ICT; children; youth; parents; teachers; victimization; mental health; longitudinal; mixed methods

bullying [22]. Occurrence of bullying and cyberbullying are

Introduction also highly correlated [14]. Research suggests that regardless
Information and Communication Technology Use of the role played in cyberbullying incidents, all children and
youth can experience serious negative social, mental health,
Among North American Youth
and health consequences as a result of involvement [19-25].
Information and communication technologies (ICTs) are
pervasive among socio-demographically diverse populations Cyberbullying constitutes a mounting public health problem,
of young people in North America. Use of these technologies as both victimized youth and perpetrators may experience
is increasingly mobile (eg, cell phones, smartphones, tablets). significant and prolonged distress [14,17], as well as an array
In the United States in 2014, 92% of adolescents (13-17 years) of mental health concerns and problem behaviors. Victimized
were online daily (56% several times per day), while 91% of children and youth are at risk of developing depression, anxiety,
youth went online occasionally, at minimum, through a mobile poor self-esteem, eating disorders, sleep difficulties, emotional
device [1,2]. The recent advances in ICTs offer immense problems (eg, fear, sadness, loneliness), psychosomatic problems
benefits for children and youth, including innumerable and (eg, abdominal pains, headaches), and suicidal ideation and
unprecedented opportunities for education, growth, and behavior [26-28]. Victimized youth may also be at increased
development [3-7], as well as facilitating their health and mental risk of using substances, experiencing difficulties in school,
health [8]. The ever-growing ubiquity of ICTs has, however, participating in delinquent behavior, and engaging in unsafe
inevitably brought new challenges [9,10]. Despite their technical sexual practices [29-31]. Youth who are perpetrators similarly
proficiency, children and youth do not typically possess the experience increased risk of problems including depressive
critical thinking and decision-making abilities required to use symptoms, substance use, aggression, and suicidal ideation, and
technology safely [11], and may be exposed to significant risks may demonstrate less empathy and more conduct problems
in ICT environments, including cyberbullying. [23,32,33]. Students who are marginalized due to particular
social markers (such as race/ethnicity, gender, religion,
Cyberbullying: A Growing Public Health Problem appearance, sexual orientation, socioeconomic status, or
In the past few years, there has been an explosion in research disability) may be disproportionately vulnerable to experiencing
on cyberbullying, documenting it as a serious, prevalent, and cyberbullying and associated negative social, mental health,
growing problem. Prevalence rates for cyberbullying vary due and health consequences [34,35].
to definitional inconsistencies, the population studied, and the While research to date has illuminated a great deal about the
time frames and methodologies used [12,13,14]. It has been nature and consequences of cyberbullying, several areas require
established, however, that between 10-40% of youth report further examination. Additionally, few studies have employed
being cyberbullied, while 50% know someone who has a longitudinal study design to assess trends in cyberbullying
experienced cyberbullying [15]. Bullying is generally defined over time. The purpose of this paper is to describe the protocols
as a form of aggression that can be direct or indirect, and implemented in a longitudinal and multi-perspective
includes hostile physical, verbal, psychological, or relational mixed-methods cohort study that contributes to the existing
behaviors. Bullying is characteristically intentional, commonly research by investigating several of these underdeveloped areas.
occurring in the context of a relationship, and comprising a
power imbalance among those involved. The aggressive Study Objectives
behavior is typically repeated over time, resulting in harm or This study had five objectives: (1) to explore children/youth’s
negative consequences for the victimized child or youth [2]. experiences, and children/youth’s, their parents’, and their
Although consensus on the definition of cyberbullying has been teachers’ conceptions, definitions, and understanding of
difficult to establish, it may be generally defined as the use of cyberbullying; (2) to explore how children/youth view the
ICTs to bully another person [15-21]. Young people may be underlying motivations for cyberbullying; (3) to document the
involved in cyberbullying as victim, perpetrator, and/or witness. shifting prevalence rates of cyberbullying victimization,
These roles appear to be more fluid and difficult to distinguish witnessing, and perpetration; (4) to identify risk and protective
in the case of cyberbullying compared to traditional offline factors for cyberbullying involvement; and (5) to explore social,

[Link] JMIR Res Protoc 2016 | vol. 5 | iss. 2 | e83 | p. 2

(page number not for citation purposes)
XSL• FO
RenderX
 JMIR RESEARCH PROTOCOLS Mishna et al

mental health, and health consequences of cyberbullying among socioeconomic diversity - factors that potentially impact access
children/youth. In this paper, the methods of the study are clearly to ICTs, experiences of cyberbullying, and the manifestation
outlined, and future quantitative and qualitative data analysis of negative outcomes [1,38,39]. In year three of the study, 10
plans are discussed. additional schools were recruited for participation in order to
follow those students transitioning from elementary/middle
Methods school to middle/secondary school. A total of 29 schools
participated in the study. All students in the selected grades at
Sample the original participating schools were offered the opportunity
Three participant groups were included in the baseline study to participate, as were their parents and teachers.
sample: (1) students in 4th (n=160), 7th (n=243), and 10th (n=267) Participating students and their parents provided data in all three
grades; (2) their teachers (n=103); and (3) their parents (n=246). years of the study, while matching teachers provided data in
A stratified random sampling strategy was utilized to select year one only (as student participants’ teachers changed each
participants. First, a random sample of 19 schools was drawn year). All three participant groups completed quantitative
from one of the largest school boards in North America [36], questionnaire packages, and a sub-sample of each group
situated in Toronto, Canada, which is a large metropolitan city. participated in qualitative interviews. Quantitative data were
Schools were stratified into three categories of need (low, collected from students and parents in each year of the study,
medium, and high) based on an index developed by the school while qualitative data were collected only during years one and
board that ranked schools on external challenges to student three, in order to allow for enough time to elapse for any changes
achievement. The school board developed this index using in beliefs, perceptions, attitudes, and understanding of
census data associated with the postal code of students attending cyberbullying to emerge (Figure 1). Sub-samples of students,
each school. Neighborhood-level census data used to develop parents, and teachers were purposefully selected to participate
the index included income and education levels, ratio of in interviews based on level of school need, and were
households receiving social assistance, and ratio of single parent representative of gender, grade, and bullying/cyberbullying
families [37]. The stratification of the sample based on this involvement.
index ensured representation of ethno-cultural and
Figure 1. Study timeline.

the school setting, collecting interview data in the school setting

Study Team and Training of Research Assistants or by phone, following up with students in distress, and assisting
The research team consisted of a principal investigator and five with administrative tasks. Most RAs were in progress towards
co-investigators (responsible for general study oversight), one (or held) a Master of Social Work degree, while several were
research manager responsible for data management (including from other related professional faculties, such as public health
entry and cleaning), and four research coordinators. The research and education.
coordinators worked in collaboration, but were responsible for
separate aspects of the project: (1) survey administration and Prior to working on the project, all RAs participated in a
overall coordination, (2) consent and maintenance of two-hour general training on study methods and procedures.
administrative databases, (3) qualitative interview coordination, RAs were then trained for specific roles and duties depending
and (4) coordination of supports for students identified as on their educational background, clinical experience, and
experiencing distress. Coordinators managed a team of interests. Training was provided for administering quantitative
approximately 10-15 research assistants (RAs) who held diverse surveys in the school setting, conducting qualitative interviews
and often multiple roles, including: collecting survey data in in person or on the phone, completing assessments to evaluate

[Link] JMIR Res Protoc 2016 | vol. 5 | iss. 2 | e83 | p. 3

(page number not for citation purposes)
XSL• FO
RenderX
 JMIR RESEARCH PROTOCOLS Mishna et al

whether a student was in distress, and accomplishing various help and would like to speak to a researcher; (2) endorsed item
administrative study tasks. related to fire-setting on the Youth Self Report (YSR); (3)
endorsed items related to self-harm/suicide on the YSR; (4)
Ethics and Consent Process scored above the 85th percentile on the YSR, which is indicative
Ethics approval was sought and received from the University of experiencing numerous behavioral problems; and/or (5)
of Toronto Research Ethics Board (Protocol #26753). The indicated during qualitative interviews that they were highly
External Research Review Committee at the partnering school stressed and in need of support. All children and youth identified
board also provided ethics approval for this project. as in distress were individually interviewed in a private and
Consent to participate in the study was obtained actively in year confidential school setting by a clinically trained researcher,
one and, with approval of the school board, passively in years who was a Master of Social Work student or who possessed
equivalent education and experience [40]. Children and youth
two and three. In year one, RAs visited each 4th, 7th, and 10th
were interviewed regardless of whether the nature of their
grade classroom from the 19 selected schools to explain the
distress was bullying related. Participants were then connected
study and distribute consent forms. Parents/guardians were
to appropriate services established within the school board. This
asked to sign the form if they agreed to allow their child to
attention to the distress of participants was particularly salient
participate, if they were interested in participating themselves,
in the research context, as access to mental health services in
and/or if they permitted the research team to ask their child’s
Canada remains problematic [41].
teacher to participate. After collection of the parent/student
consent forms, teachers were asked if they would like to Data Collection
participate, and completed a consent form. In years two and
three (passive consent), parents/guardians were mailed a letter Quantitative Data Collection Methods
reminding them that they had consented for their child and/or In year one, students in 4thgrade (n=160), 7th grade (n=243),
themselves to participate in the study, and that the next year of and 10th grade (n=267) completed a 45-60 minute survey in the
the study was ready to commence. The letter also provided school setting, while parents (n=246) completed a 30-45 minute
detailed instructions on how to withdraw from the study if survey by mail. This procedure changed somewhat for years
desired. two and three of the study, with some students completing
A $5 gift card was offered to all students, teachers, and parents questionnaire packages by mail due to changing schools.
who participated in the quantitative survey portion of the Questionnaires for teachers (n=103), which took approximately
research in each of the three years. A $10 gift card was offered 45-60 minutes to complete, were administered in the
to all participants who took part in an interview (in person or participating schools. Teachers were given approximately two
by telephone) in years one and three. weeks to complete the questionnaires about their students
participating in the study, which were then collected by the
In anticipation that some questions could lead to distress or research team.
disclosure of information of a potentially sensitive or distressing
nature, a Research Ethics Board-approved protocol (agreed Quantitative Data Collection Measures
upon by both the University and school board) was established This study utilized a variety of quantitative measures, including
to identify and assist students categorized as being in distress both standardized measures as well as measures developed
through their questionnaire and/or qualitative interview specifically for the study (Table 1). Student, parent, and teacher
responses. Student participants were classified as in distress if surveys collected information regarding experiences with
they met one (or more) of the following five criteria: (1) bullying/cyberbullying, socio-demographics, ICT use, and
indicated on the Bullying & Cyberbullying: Perpetrators, student mental health, health, social, and behavioral issues.
Victims & Witnesses Survey (B&C:PVWS) that they needed

[Link] JMIR Res Protoc 2016 | vol. 5 | iss. 2 | e83 | p. 4

(page number not for citation purposes)
XSL• FO
RenderX
 JMIR RESEARCH PROTOCOLS Mishna et al

Table 1. Measures completed by students, parents, and teachers.

Students Parents Teachers
Grade
Level
Area Measure Captures 4 7 10
Experiences with Bullying/ Bullying & Cyberbully- Experiences as victims, perpetrators, and/or witnesses ✓ ✓ ✓
Cyberbullying ing: Perpetrators, Vic- of both bullying/cyberbullying; Experiences with
tims & Witnesses Sur- bullying/cyberbullying types (eg, physical, verbal,
vey(B&C:PVWS) social, sexual); Experiences with (and content of)
bullying/cyberbullying specific to a variety of socio-
demographic factors (eg, race, sexual orientation,
gender, disability, appearance, religion); Responses
to bullying/cyberbullying; Thoughts about potential
interventions to address bullying/cyberbullying.
Measure used to identify distress.
Mental Health, Health, Youth Self-report(YSR) Youth’s self-reported anxiety/depression, suicidal ✓ ✓
Social, & Behavioral Is- [ 42] ideation, self-harm, somatic complaints, social,
sues thought and attention problems, delinquent (eg setting
fires) and aggressive (eg hurting others) behaviors;
Measure used to identify distress.
Child Behavior Check- Parent counterpart to YSR. ✓
list(CBCL) [ 43]
Teacher Report Educator counterpart to YSR. ✓
Form(TRF) [ 44]
Self-Perception Profile Self-esteem. ✓ ✓
for Children(SPPC) [45]
Self-Perception Profile Self-concept. ✓
for Adolescents(SPPA) [
46]
Social Support Scale for Children’s perceived support and regard from parents, ✓ ✓
Children[ 47] teachers, close friends, and classmates.
Social Support Behaviors Youth’s perceived support from family members and ✓
Scale[ 48] peers with subscales: emotional, socializing, practical
assistance, financial, advice/guidance.
Socio-Demographics Developed for the pur- Gender, age, country of birth, country of parents’ ✓ ✓ ✓ ✓ ✓
pose of this study (Multi- birth, main language spoken at home, race/ethnicity,
ple Versions) sexual orientation, disability, family composition,
grades, and other socio-demographic characteristics.
Four versions: (1) 4thGrade; (2) 7thand 10thGrade;
(3) Parents; (4) Teachers.
Access to ICTs at home, activities while using ICTs,
frequency of activities, online friends and connec-
Developed for the pur- th th
Information & Communi- pose of this study (Multi- tions. Four versions: (1) 4 Grade; (2) 7 and
th
cation Technology Use ple Versions) 10 Grade; (3) Parents; (4) Teachers. ✓ ✓ ✓ ✓ ✓

Children/youth’s experiences with bullying and cyberbullying captured mental health, health, and behavioral issues using the
were measured using the B&C:PVWS, which is a compilation YSR, intended for children aged eleven and older [42]. Parents
of survey questions developed from the research team’s previous completed the Child Behavior Checklist (CBCL), which is the
studies. The bullying and cyberbullying literature was reviewed parental counterpart to the students’ YSR [43], while teachers
and feedback was sought from the participating school board completed the Teacher Report Form (TRF), which is the
in order to ensure age-appropriate language. Specific questions educator counterpart to the YSR and CBCL [44]. These surveys
were adapted or removed based on the feedback from the school are widely used measures with excellent reported test-retest
board (eg, questions regarding online sex). For the questions reliability [42-44]. We captured children/youth’s social issues,
measuring experiences of being bullied and bullying others, the including self-esteem, using subscales from the Self-Perception
Cronbach alphas were .77 and .71, respectively, indicating good Profile for Children (SPPC) [45] and the Self-Perception Profile
internal consistency. for Adolescents (SPPA) [46]. These scales have adequate
internal consistency, and both measures have a stable factor
Children/youth’s mental health, health, social, and behavioral
structure [45,46]. We measured social support for students in
issues were captured for 4th, 7th and 10th grade cohorts. We

[Link] JMIR Res Protoc 2016 | vol. 5 | iss. 2 | e83 | p. 5

(page number not for citation purposes)
XSL• FO
RenderX
 JMIR RESEARCH PROTOCOLS Mishna et al

the 4th and 7th grade cohorts using the Social Support Scale for included views and understanding of cyberbullying and how it
Children, a 24-item instrument which assesses children’s compares with traditional offline bullying, experiences of online
perceived support and regard from parents, teachers, close aggression, and others’ attitudes and responses to the issue.
friends, and classmates [47]. The internal consistencies of the Questions were guided by existing literature and the research
four subscales range from .72 to .88 using Cronbach alphas team’s considerable experience. Parent and teacher interviews
[47]. Adolescents in the 10th grade cohort completed the Social included questions about their awareness and understanding of
Support Behaviors Scale to assess perceived support from family cyberbullying, their child or student’s involvement in
members and peers (emotional, social, practical assistance, cyberbullying, links between cyber and traditional bullying,
financial, and advice/guidance) [48]. Strong internal consistency supports, and their responses to cyberbullying.
(Cronbach alpha exceeding .85) has been reported for this scale, Data Management
which includes several college samples [48,49].
All participants were assigned a unique code to maintain
Socio-demographics were collected using two versions of the anonymity. Participants’ names do not appear anywhere in the
student demographic questionnaire, capturing characteristics quantitative survey packages or qualitative transcripts. Paper
such as age, gender, and country of birth, which were developed surveys were scanned using Cardiff Teleform software, and
by the research team with feedback from the school board (one entered into a project-specific IBM SPSS Statistics 22 database.
for the 4th grade cohort and one for 7th and 10th grade cohorts). Entry and cleaning of quantitative data took place throughout
The questionnaires included similar items for both age groups the study, and all cases were cross-referenced by hand twice
and were based on previous instruments administered by the (during entry and after preliminary data sets were compiled) to
school board, instruments developed by co-investigators for ensure accuracy of entries. Qualitative data were transcribed
similar studies, and a review of the literature. The questionnaire verbatim, anonymized, and prepared for analysis. The same
for the older cohorts included items regarding sexuality, which unique identifiers were used to identify the qualitative interviews
and quantitative surveys, in order to facilitate matching these
were not included in the version for 4th grade students. Similar
two data sources for individual participants.
questionnaires (two versions) were developed for parents and
teachers.
Results
Lastly, we collected data on ICT use, using two versions of the
student ICT usage questionnaire (one for the 4th grade cohort Data collection for this study is complete. Results of the
proposed analyses, outlined below, will be reported in 2016 and
and one for 7th and 10th grade cohorts), developed by the
2017.
research team. Again, both included similar questions, soliciting
information on access to ICTs at home, activities while using Proposed Quantitative Data Analyses
ICTs, frequency of activities (6-point scale, ranging from never Descriptive analyses will be conducted to calculate frequencies
to more than once a day), and online friends and connections. for categorical variables, and means and standard deviations
The questionnaire for older cohorts included items related to for continuous variables. We will summarize socio-demographic
taking and distributing intimate and/or sexual photos, which variables among participants in each grade level (4, 7, 10) and
were not included in the 4th grade version. These questionnaires differences between grades will be assessed using Student t-tests
were adapted from two previous studies. Parents and teachers for continuous variables, and χ2 analyses or Fisher’s exact tests
also completed ICT usage questionnaires (two versions) similar for categorical variables. Items for each outcome scale (eg,
to those filled out by students. Social Support Scale for Children) will be summed to calculate
total or subscale scores for each measure. Reliability of scaled
Qualitative Data Collection Methods
measures will be described using Cronbach alphas. Advanced
Student participants from 4th grade (n=20), 7th grade (n=21), statistical analyses are also planned. An example of a more
and 10th grade (n=16) in the qualitative sub-sample were advanced analysis that will be conducted is transition
purposefully selected from the larger quantitative sample for probabilities, which will determine involvement in
qualitative interviews based on diversity of gender, grade, school cyberbullying, consistent with our objective of documenting
need level, and whether they reported bullying/cyberbullying the shifting prevalence rates of cyberbullying victimization,
victimization, perpetration, and/or witnessing. Subsequent to witnessing, and perpetration. To meet our objective of
selecting student participants, their teachers (n=30), and their identifying factors that protect against (or increase risk of)
parents (n=50) were also invited to participate in in-depth involvement in cyberbullying, between-subject factors will be
interviews. Interviews lasted approximately one hour, ranging included in a repeated measures analysis. These factors include
in length from thirty to ninety minutes. All year one interviews demographic variables, CBCL scales, self-esteem, and social
(with students, parents, and teachers) took place in the school support to determine their individual and combined contribution
setting, and utilized a semi-structured interview guide. Following to cyberbullying experiences. Considering participants are
preliminary analysis, this interview guide was expanded and clustered in classrooms, independence of the data cannot be
refined for use in the year three follow-up phone interviews assumed, and the data are dependent to some degree. Thus,
with the students and parents (Multimedia Appendix 1). classroom will be included as a dummy variable in the
Interviews provided nuance and context to the information regressions. Multilevel analysis will be used to assess the
obtained through the quantitative measures. Areas explored contribution of school need level (low, high, and medium) on
individual cyberbullying experience.
[Link] JMIR Res Protoc 2016 | vol. 5 | iss. 2 | e83 | p. 6
(page number not for citation purposes)
XSL• FO
RenderX
 JMIR RESEARCH PROTOCOLS Mishna et al

Proposed Qualitative Data Analyses how they experience and judge the underlying motivations for
Using the systematic procedures of a rigorous grounded theory involvement. This inquiry addresses the lack of research
inquiry, a theory about children/youth’s, parents’, and teachers’ capturing children and youth’s experiences, feelings, and
conceptions of cyberbullying and underlying motivations will conceptions of cyberbullying, and uniquely examines the
be generated. Using this approach, researchers concurrently congruence or incongruence of children and youth’s views with
collect, analyze, and theorize about data in a reciprocal process those of significant adults in their lives. Identifying how
of constant comparison to inductively construct empirically children, youth, and adults conceptualize cyberbullying is critical
corroborated, explanatory theories [50-53]. The iterative process to ensuring the understanding of its extent and impact, and
permits the analytical and theoretical categories developed by developing effective prevention and intervention strategies [15].
previously collected data to inform, as well as refine and focus, Developing informed strategies relevant to contemporary young
subsequent collection of data [52,54,55]. This refining and people’s lives and contexts is especially salient, as increasing
focusing commenced during data collection for this study, recognition of the negative consequences of cyberbullying “has
particularly between the qualitative interview phases (years 1 lead parents, educators, and policymakers to embrace
and 3), and is ongoing. With future analyses, emergent themes intervention efforts, and there is now substantial educational
among youth, parents, and teachers over time will continue to and clinical interest in programs that help to mitigate… harmful
be identified, and children’s and adults’ views compared. outcomes” [58]. For emerging findings based upon study
objectives, please refer to Multimedia Appendix 2 .
While the intent is to develop a theoretical model, grounded
theory methods will simultaneously allow for further exploration Knowledge translation and exchange activities will be a priority
of interpersonal processes and experiences in a process of in order to translate study findings for study participants,
reciprocal analysis. Line-by-line and open coding of transcripts educators, helping/healthcare professionals, and the broader
were, and will continue to be, conducted to establish preliminary community. Presentations will be made to the partner school
analytic focuses, and subsequently emerging categories will be board and a report will be provided to schools, participants, and
built and expanded. Axial coding will promote connections both community members. Any requests by individual schools for
within and between categories and sub-categories, and facilitate presentations will be accommodated by a member of the
synthesis and explanation [50,51,56]. Several measures have research team. Findings will be disseminated within the
been employed to ensure trustworthiness and authenticity. The academic community through refereed journals and
researchers’ prolonged engagement through many years of presentations at juried Canadian and international conferences.
research and practice in this area will guide development of the We will publish in relevant academic journals, and results will
grounded theory. Theory development will continue until be disseminated to policy makers and practitioners, and
saturation occurs. Reflexive journaling, bracketing, an audit presentations will be made to professional organizations and to
trail, and dense descriptions will further ensure trustworthiness the community.
and transferability [50,51,54]. Most importantly, these findings can inform interventions to
curb cyberbullying among young people in an effort to prevent
Discussion the negative social, mental health, and health consequences. In
keeping with the preliminary findings of this study, previous
The study described in this paper provides one of the first research has indicated that most children and youth do not
assessments of the understanding and experiences of children disclose their experience with cyberbullying to parents, and are
and youth involved in cyberbullying as victims, perpetrators, even less likely to disclose cyberbullying experiences to
and/or witnesses, and involved the investigation of their school-based adults (eg, teachers, administrators) [12]. Such
perceptions, as well as those of their parents and teachers. We lack of disclosure indicates a critical need to provide prevention
followed a baseline sample of 4th (n=160), 7th (n=243), and 10th and intervention efforts in school settings as a way to promote
(n=267) grade children/youth and their parents (n=246), for disclosure [12]. Further, little evidence for best practices in
three years (2012-2014), along with collecting baseline data intervention efforts exists [13]. The study described in this paper
from their teachers (n=103). This study’s multi-perspective can inform intervention efforts by offering insight into student
approach allows for triangulated analysis of cyberbullying perceptions of what is helpful or not helpful when experiencing,
issues, and the design was strengthened by tracking participants perpetrating, and/or witnessing cyberbullying, as well as the
longitudinally, during a period in which ICT use has continued contexts in which prevention and intervention efforts may be
to expand rapidly [57]. Recruiting students across most effective (including via ICTs) [12]. Results of our
grades/ages/socio-economic status permits the comparison of quantitative data analysis exploring the social, mental health,
experiences across diverse socio-demographic groups and allows and health consequences of cyberbullying can inform the
for an examination of trends in primary, middle, and secondary development of resources at the school-level. Moreover, future
schools. Data collection for this study is complete, with results papers focusing on the research process of this study may glean
of proposed analyses anticipated in 2016 and 2017. important insights into the challenges of conducting longitudinal
This research will elucidate the complex dynamics of studies with children and youth in a school-based setting (ie,
cyberbullying incidents and contributes to the growing body of participant retention), and potential strategies to mitigate these
literature on the rates of cyberbullying, as well as risk and challenges (ie, the use of passive consent). Future research may
protective factors of involvement. In addition, this study will also focus on mechanisms, beyond built-in research study
explicate how children/youth understand cyberbullying and protocols, to support students in distress.

[Link] JMIR Res Protoc 2016 | vol. 5 | iss. 2 | e83 | p. 7

(page number not for citation purposes)
XSL• FO
RenderX
 JMIR RESEARCH PROTOCOLS Mishna et al

The burgeoning body of literature on the phenomenon of frequency of ICT use is constantly growing, and with younger
cyberbullying is a relatively recent scholarly development, and younger children increasingly using ICTs, understanding
highlighting the crucial need to engage in discourse regarding the social, mental health, and health consequences of
this emerging field of research. This unique study offers insight cyberbullying across grade levels may point to differing
into cyberbullying and provides a foundation for future research developmental impacts and inform targeted interventions.
in this important and flourishing field. Importantly, as the

Acknowledgments
This study was funded by a Social Sciences and Humanities Research Council Grant (Grant #410-2011-1001). We would like to
acknowledge first and foremost the Toronto District School Board for their utmost commitment to participating in the study, as
well as each school for their dedication to both data collection and ensuring the mental health needs of students identified through
the study were addressed. Thank you to the students, parents, and teachers for sharing your experiences with us. Thank you to
the research assistants, without whom we could not have completed this large study.

Authors' Contributions
FM, WC, TB, DJP, JW, and DJ, KS, JD conceived of the study and developed the initial study protocol. FM, ALD, LBM, KS,
PB, and AB and MVW contributed to writing the protocol for publication and provided ongoing data collection oversight during
the duration of the study. JD managed the data throughout the duration of the study and contributed to writing the protocol for
publication. All authors read and approved the final protocol for publication.

Conflicts of Interest
None declared.

Multimedia Appendix 1
Qualitative interview guide.
[PDF File (Adobe PDF File), 45KB-Multimedia Appendix 1]

Multimedia Appendix 2
Preliminary results.
[PDF File (Adobe PDF File), 43KB-Multimedia Appendix 2]

References
1. Lenhart A, Duggan M, Perrin A, Stepler R, Rainie L, Parker K. Pew Research Center. Washington, DC; 2015. Teens, social
media & technology overview 2015 URL: [Link]
pdf [accessed 2016-02-13] [WebCite Cache ID 6fH8k4Hz4]
2. Mishna F, Cook C, Gadalla T, Daciuk J, Solomon S. Cyber bullying behaviors among middle and high school students.
Am J Orthopsychiatry 2010 Jul;80(3):362-374. [doi: 10.1111/j.1939-0025.2010.01040.x] [Medline: 20636942]
3. Blumenfeld W, Cooper R. LGBT and allied youth responses to cyberbullying: policy implications. IJCP 2010;31:114-133.
4. Craig S, McInroy L. You can form a part of yourself online: the influence of new media on identity development and
coming out for LGBTQ youth. J Gay Lesbian Mental 2014;18:95-109.
5. Elwell L, Grogan S, Coulson N. Adolescents living with cancer: the role of computer-mediated support groups. J Health
Psychol 2011 Mar;16(2):236-248. [doi: 10.1177/1359105310371398] [Medline: 20733012]
6. Johnson G, Puplampu K. Canadian Journal of Learning & Technology. 2008. Internet use during childhood and the ecological
techno-subsystem URL: [Link] [accessed 2016-02-13] [WebCite
Cache ID 6fH9DUzUN]
7. Strom P, Strom R. Growing up with social networks and online communities. The Education Digest 2012;78:48-51.
8. Ammerlaan JJ, Scholtus LW, Drossaert CH, van Os-Medendorp H, Prakken B, Kruize AA, et al. Feasibility of a website
and a hospital-based online portal for young adults with juvenile idiopathic arthritis: views and experiences of patients.
JMIR Res Protoc 2015;4(3):e102 [FREE Full text] [doi: 10.2196/resprot.3952] [Medline: 26276373]
9. Gasser U, Maclay C, Palfrey Jr JG. Berkman Center Research Publication. 2016 Jun 16. Working towards a deeper
understanding of digital safety for children and young people in developing nations URL: [Link]
uploads/files/[Link] [accessed 2016-02-13] [WebCite Cache ID 6fHC6NF3e]
10. Livingstone S, Haddon L. Risky experiences for children online: charting European research on children and the Internet.
Child Soc 2008;22:314-323.

[Link] JMIR Res Protoc 2016 | vol. 5 | iss. 2 | e83 | p. 8

(page number not for citation purposes)
XSL• FO
RenderX
 JMIR RESEARCH PROTOCOLS Mishna et al

11. Burrow-Sanchez J, Call M, Zheng R, Drew C. How school counselors can help prevent online victimization. J Couns Dev
2011;89:3-10.
12. DePaolis K, Williford A. The nature and prevalence of cyber victimization among elementary school children. Child Youth
Care Forum 2015;44(3):377.
13. Faucher C, Jackson M, Cassidy W. Cyberbullying among university students: gendered experiences, impacts, and perspectives.
Educ Res Int 2014:1.
14. Modecki KL, Minchin J, Harbaugh AG, Guerra NG, Runions KC. Bullying prevalence across contexts: a meta-analysis
measuring cyber and traditional bullying. J Adolesc Health 2014 Nov;55(5):602-611. [doi: 10.1016/[Link].2014.06.007]
[Medline: 25168105]
15. Kowalski RM, Giumetti GW, Schroeder AN, Lattanner MR. Bullying in the digital age: a critical review and meta-analysis
of cyberbullying research among youth. Psychol Bull 2014 Jul;140(4):1073-1137. [doi: 10.1037/a0035618] [Medline:
24512111]
16. Ahlfors R. Many sources, one theme: analysis of cyberbullying prevention and intervention websites. J Soc Sci 2010 Apr
01;6(4):515-522. [doi: 10.3844/jssp.2010.515.522]
17. Cassidy W, Faucher C, Jackson M. Cyberbullying among youth: a comprehensive review of current international research
and its implications and application to policy and practice. Sch Psychol Int 2013;34:575-612.
18. Collier A. Living Internet: some context for the cyberbullying discussion. In: Patchin JW, Hinduja S, editors. Cyberbullying
Prevention and Response: Expert Perspectives. New York: Routledge; 2012:1-12.
19. Hinduja S, Patchin J. Bullying beyond the schoolyard: preventing and responding to cyberbullying. 2nd ed. Thousand Oaks,
CA: Sage Publications; 2009.
20. Mishna F, Van Wert M. Bullying in Canada. Toronto: Oxford University Press Canada; 2015.
21. Smith P, del Barrio C, Tokunaga R. Definitions of bullying and cyberbullying: how useful are the terms? In: Bauman S,
Cross D, Walker J, editors. Principles of cyberbullying research: definition, methods, and measures. New York: Routledge;
2013:26-40.
22. Barlińska J, Szuster A, Winiewski M. Cyberbullying among adolescent bystanders: role of the communication medium,
form of violence, and empathy. J Community Appl Soc Psychol 2013;23:37-51.
23. Ang RP, Goh DH. Cyberbullying among adolescents: the role of affective and cognitive empathy, and gender. Child
Psychiatry Hum Dev 2010 Aug;41(4):387-397. [doi: 10.1007/s10578-010-0176-3] [Medline: 20238160]
24. Beran TN, Li Q. The relationship between cyberbullying and school bullying. J Stud Wellbeing 2007;1:16-33.
25. Beran T, Stanton L, Hetherington R, Mishna F, Shariff S. Development of the bullying and health experiences scale. Interact
J Med Res 2012;1(2):e13 [FREE Full text] [doi: 10.2196/ijmr.1835] [Medline: 23612028]
26. Campbell M, Spears B, Slee P, Butler D, Kift S. Victims' perceptions of traditional and cyberbullying, and the psychosocial
correlates of their victimisation. J Emot Behav Diff 2012;17:389-401.
27. Bonanno RA, Hymel S. Cyber bullying and internalizing difficulties: above and beyond the impact of traditional forms of
bullying. J Youth Adolesc 2013 May;42(5):685-697. [doi: 10.1007/s10964-013-9937-1] [Medline: 23512485]
28. Dehue F, Bolman C, Völlink T. Cyberbullying: youngsters' experiences and parental perception. Cyberpsychol Behav 2008
Apr;11(2):217-223. [doi: 10.1089/cpb.2007.0008] [Medline: 18422417]
29. Litwiller BJ, Brausch AM. Cyber bullying and physical bullying in adolescent suicide: the role of violent behavior and
substance use. J Youth Adolesc 2013 May;42(5):675-684. [doi: 10.1007/s10964-013-9925-5] [Medline: 23381779]
30. Mitchell KJ, Ybarra M, Finkelhor D. The relative importance of online victimization in understanding depression, delinquency,
and substance use. Child Maltreat 2007 Nov;12(4):314-324. [doi: 10.1177/1077559507305996] [Medline: 17954938]
31. Ybarra ML, Diener-West M, Leaf PJ. Examining the overlap in internet harassment and school bullying: implications for
school intervention. J Adolesc Health 2007 Dec;41(6 Suppl 1):S42-S50. [doi: 10.1016/[Link].2007.09.004] [Medline:
18047944]
32. Calvete E, Orue I, Estevez A, Villardon L, Padilla P. Cyberbullying in adolescents: modalities and aggressors' profile.
Comput Human Behav 2010;26:1128-1135.
33. Ybarra ML, Mitchell KJ. Prevalence and frequency of Internet harassment instigation: implications for adolescent health.
J Adolesc Health 2007 Aug;41(2):189-195. [doi: 10.1016/[Link].2007.03.005] [Medline: 17659224]
34. Cappadocia MC, Weiss JA, Pepler D. Bullying experiences among children and youth with autism spectrum disorders. J
Autism Dev Disord 2012 Feb;42(2):266-277. [doi: 10.1007/s10803-011-1241-x] [Medline: 21499672]
35. Kosciw J, Bartkiewicz M, Greytak EA. Promising strategies for prevention of the bullying of lesbian, gay, bisexual, and
transgender youth. Prev Res 2012;19:10-13.
36. Toronto District School Board. 2014. Quick facts URL: [Link] [accessed
2016-02-13] [WebCite Cache ID 6fH9PvbV6]
37. Toronto District School Board. 2014. The 2014 Learning opportunities index: questions and answers URL: [Link]
[Link]/Portals/0/AboutUs/Research/[Link] [accessed 2016-02-13] [WebCite Cache ID 6fH9XXntM]
38. Roberts DF, Foehr UG. Trends in media use. Future Child 2008;18(1):11-37. [Medline: 21338004]
39. Steeves V. MediaSmarts. 2014. Young Canadians in a wired world, phase III URL: [Link]
young-canadians-wired-world-phase-iii-0 [accessed 2016-02-13] [WebCite Cache ID 6fHCxA4pv]

[Link] JMIR Res Protoc 2016 | vol. 5 | iss. 2 | e83 | p. 9

(page number not for citation purposes)
XSL• FO
RenderX
 JMIR RESEARCH PROTOCOLS Mishna et al

40. Mishna F, Schwan K, Lefebvre R, Bhole P, Johnston D. Students in distress: unanticipated findings in a cyber bullying
study. Child Youth Serv Rev 2014;44:341-348.
41. Ewen V, Mushquash AR, Bailey K, Haggarty JM, Dama S, Mushquash CJ. Same-day counseling: study protocol for the
evaluation of a new mental health service. JMIR Res Protoc 2016;5(1):e22 [FREE Full text] [doi: 10.2196/resprot.5206]
[Medline: 26842891]
42. Achenbach T. Achenbach System of Empirically Based Assessment (ASEBA). 2001. Youth self-report URL: [Link]
[Link]/forms/[Link] [accessed 2016-04-25] [WebCite Cache ID 6h1Ks0uZm]
43. Achenbach T. Achenbach System of Empirically Based Assessment (ASEBA). 2001. The child behavior checklist URL:
[Link] [accessed 2016-02-13] [WebCite Cache ID 6h1KvivYP]
44. Achenbach T. University of Vermont. 2001. Teacher report form URL: [Link] [accessed
2016-02-13] [WebCite Cache ID 6h1L1FhEh]
45. Harter S. University of Denver. 2012. The self-perception profile for children URL: [Link]
page/44210 [accessed 2016-02-13] [WebCite Cache ID 6fH9sAYGT]
46. Harter S. University of Denver. 2012. Manual for the self-perception profile for adolescents URL: [Link]
SusanHarter/page/44210 [accessed 2016-02-13] [WebCite Cache ID 6fH9sAYGT]
47. Harter S. University of Denver. 2012. Manual for the social support scale for children URL: [Link]
SusanHarter/page/44343 [accessed 2016-02-13] [WebCite Cache ID 6fH9yldNw]
48. Vaux A, Riedel S, Stewart D. Modes of social support: the social support behaviors (SS-B) scale. Am J Community Psychol
1987;15:209-237.
49. Hogan M, Parker J, Wiener J, Watters C, Wood L, Oke A. Academic success in adolescence: relationships among verbal
IQ, social support and emotional intelligence. Aust J Psychol 2010;62:30-41.
50. Birks M, Mills J. Grounded theory: a practical guide. 1st Ed. Thousand Oaks, CA: Sage Publications Inc; 2011.
51. Corbin J, Strauss A. Basics of qualitative research: techniques and procedures for developing grounded theory. 3rd ed.
Thousand Oaks, CA: Sage Publications Inc; 2008.
52. Patton M. Qualitative research and evaluation methods. 3rd ed. Thousand Oaks, CA: Sage Publications Inc; 2002.
53. Strauss A, Corbin J. Basics of qualitative research: techniques and procedures for developing grounded theory. 2nd ed.
Thousand Oaks, CA: Sage Publications Inc; 1998.
54. Bowen G. Grounded theory and sensitizing concepts. Int J Qual Methods 2006;5:12-23.
55. Charmaz K. Constructing grounded theory: a practical guide through qualitative analysis. Thousand Oaks, CA: Sage
Publications Inc; 2006.
56. Charmaz K. Grounded theory. In: Smith JA, editor. Qualitative psychology: a practical guide to research methods. Thousand
Oaks, CA: Sage Publications Inc; 2008:81-110.
57. Pew Research Center. 2015. Device ownership over time URL: [Link]
device-ownership/ [accessed 2016-02-13] [WebCite Cache ID 6fHA64Fep]
58. Modecki KL, Barber BL, Vernon L. Mapping developmental precursors of cyber-aggression: trajectories of risk predict
perpetration and victimization. J Youth Adolesc 2013 May;42(5):651-661. [doi: 10.1007/s10964-012-9887-z] [Medline:
23242509]

Abbreviations
B&C: PVWS: Bullying & Cyberbullying: Perpetrators, Victims & Witnesses Survey
CBCL: Child Behavior Checklist
ICT: Information and communication technology
RA: Research assistant
SPPA: Self-Perception Profile for Adolescents
SPPC: Self-Perception Profile for Children
TRF: Teacher Report Form
YSR: Youth Self-Report

[Link] JMIR Res Protoc 2016 | vol. 5 | iss. 2 | e83 | p. 10

(page number not for citation purposes)
XSL• FO
RenderX
 JMIR RESEARCH PROTOCOLS Mishna et al

Edited by G Eysenbach; submitted 28.10.15; peer-reviewed by M van Geel, H Na, M Campbell; comments to author 03.02.16; revised
version received 15.02.16; accepted 20.02.16; published 24.05.16
Please cite as:
Mishna F, McInroy LB, Lacombe-Duncan A, Bhole P, Van Wert M, Schwan K, Birze A, Daciuk J, Beran T, Craig W, Pepler DJ,
Wiener J, Khoury-Kassabri M, Johnston D
Prevalence, Motivations, and Social, Mental Health and Health Consequences of Cyberbullying Among School-Aged Children and
Youth: Protocol of a Longitudinal and Multi-Perspective Mixed Method Study
JMIR Res Protoc 2016;5(2):e83
URL: [Link]
doi: 10.2196/resprot.5292
PMID: 27220556

©Faye Mishna, Lauren B McInroy, Ashley Lacombe-Duncan, Payal Bhole, Melissa Van Wert, Kaitlin Schwan, Arija Birze,
Joanne Daciuk, Tanya Beran, Wendy Craig, Debra J Pepler, Judith Wiener, Mona Khoury-Kassabri, David Johnston. Originally
published in JMIR Research Protocols ([Link] 24.05.2016. This is an open-access article distributed
under the terms of the Creative Commons Attribution License ([Link] which permits
unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Research
Protocols, is properly cited. The complete bibliographic information, a link to the original publication on
[Link] as well as this copyright and license information must be included.

[Link] JMIR Res Protoc 2016 | vol. 5 | iss. 2 | e83 | p. 11

(page number not for citation purposes)
XSL• FO
RenderX