Over one billion children experience physical, sexual or emotional violence every year and social inequalities in violence are large. The contexts children live, learn and play in can shape their health, employment, and educational outcomes. This project will generate new evidence on how adverse and protective childhood contexts affect children's use, or experiences of, interpersonal violence as they grow up. We propose to draw on high-quality longitudinal data about children's lives, including experiences of violence, in three independent cohort studies in Brazil (birth to late childhood), England (birth to adulthood) and Uganda (late childhood to adulthood). Our multi-country research team consists of social epidemiologists and social scientists with strong links to the settings of each cohort study. To ensure analyses and findings are informed by a wide range of expertise and experiences we will consult local stakeholders (young people, civil society organisations, health workers and local government staff) in each study setting and researchers from different disciplines during research design and dissemination. The World Health Organisation's (WHO) INSPIRE framework recommends changing laws, social norms, social safety nets, neighbourhood environments, households, and schools to prevent interpersonal violence. To advance such prevention efforts, violence researchers and practitioners need to know how childhood contexts shape violence later in life, and how contexts can interrupt or prevent violence later in life. Further, we need to understand if the adverse or protective effects of contexts differ for marginalised young people. The first phase of this project will define and operationalise contextual measures: we theorise that adverse childhood contexts are homes, schools, and neighbourhoods with violence and deprivation, and protective childhood contexts high social connectedness and support. We will use data collected on contexts to operationalise contextual measures specific to each cohort and refine measures based on input from local stakeholders, young people, and researchers in each context. Findings from this phase will highlight new opportunities to apply advanced statistical methods to improve how contexts are measured and defined in violence research. The second phase will test whether adverse childhood contexts increase the risk of violence later in life, and whether protective childhood contexts can mitigate this risk. We aim to conduct causal analyses of longitudinal data to uncover, for example, whether neighbourhood violence and deprivation in childhood could increase interpersonal physical or sexual violence years later - and whether a protective home environment at the same time, or later in life could prevent or interrupt these associations. Findings from this phase provide evidence for developing and situating contextual interventions to prevent violence as children grow up. The third and final phase of the project will explore how the effects of contexts differ for young people from historically marginalised groups. By applying statistical methods to test if the adverse and protective effects of contexts differ by gender, disability, ethnicity, sexuality, and socioeconomic position, findings will highlight which young people are disproportionately impacted by adverse contexts or less likely to benefit from protective contexts. Our approach offers opportunities to improve the use of contextual measures in research on violence and more broadly. Violence prevention efforts at contextual levels shift the loci of intervention away from the individual and are likely to benefit more people than individual-level behaviour change interventions. This research will generate new evidence from multiple countries that researchers and practitioners can use to realise the WHO INSPIRE framework on violence prevention and the Sustainable Development Goals related to violence.

In thirty years' time there will be half a billion adolescents in Africa. Like youth everywhere, they possess huge potential to thrive. But more than half are trapped in cycles of poor nutrition, poverty, low education, violence and unemployment. They also have the world's highest rates of early fertility, with adverse long-term outcomes for adolescent parents and their children. Such inter-generational disadvantage creates risks not only in the region but also to global stability. The SDGs and African Union's Agenda 2063 challenge us to take a radical new approach. The UK's Global Challenges Research Fund provides a unique opportunity to do this. The Accelerating Advantage Hub will find the combinations of services with the greatest positive impacts for Africa's adolescents and their children. We need to move beyond services focused on single outcomes, towards 'super-accelerator' impacts across multiple SDGs of health, education, violence prevention, gender equality and economic stability. With our government partners we will test combination services - for example of cash transfers, malaria prophylaxis, parenting programs, business skills and violence prevention - to identify the leanest and most effective policy packages. The Hub has been planned with African governments and international agencies including the UN Development Program, African Union, UNICEF and the World Health Organisation. They have told us that 'evidence as usual' is not enough. When we make a personal investment, like buying a computer, we want to know not only whether it is the most efficient, but also whether it is good value for money and whether we will like to use it. Governments need the same information about services: their effectiveness, their cost-effectiveness, whether they can be delivered through existing health, education and welfare systems, and whether they will be accepted by service providers and by adolescents. The Hub will conduct large-scale studies and use existing data in Angola, Cote D'Ivoire, DRC, Ethiopia, Gambia, Ghana, Guinea, Kenya, Lesotho, Liberia, Malawi, Mali, Mozambique, Nigeria, Senegal, Sierra Leone, South Africa, Somalia, South Sudan, Tanzania, Uganda, Zambia & Zimbabwe. All projects will include cost-effectiveness to assist budget decisions. In short, we will provide African policy-makers with the evidence they need and want to do the best for adolescents. The Hub will also train and support frontline workers to improve services for adolescents across Africa. We will turn evidence into training modules, freely accessible manuals and support materials. We will deliver practitioner training in 34 African countries by working with NGO partners selected for wide regional coverage, for example Paediatric Adolescent Treatment for Africa, the International Rescue Committee, Clowns without Borders and the International AIDS Alliance. Skills-building for young researchers in Africa and the UK is built into the Hub's work. We will support 45 promising young academics and dedicated African policymakers to focus their careers on improving the lives of adolescents and their children. The Hub's work is planned with adolescents themselves. Too many services have failed because they do not appeal to teenagers' aspirations and immediate goals. The Hub will work directly with adolescent advisory groups in Eastern, Western and Southern Africa to co-develop approaches that are not only effective, but also meaningful and fun for those who will use them. We aim to reach 20 million adolescents and their children with effective combinations of services to meet their needs. Between our direct countries of research and our NGO partners, the Hub will actively engage with policymakers, practitioners and adolescents across East, West, Southern and Central Africa and including fragile and war-torn states. We have a common goal: to transform the potential of Africa's adolescents into a thriving future for the continent.

Violence against children in schools is common practice in many countries, and research into prevention and treatment has been outlined as a priority in the World Report on Violence against Children. In most countries, children spend more time at school than anywhere else besides their family home, and can suffer violence from teachers and other school staff, and other children. Despite this, in most countries evidence is lacking from rigorously conducted studies on the prevalence, epidemiology and consequences of this violence. Existing studies tend to come from North America, where corporal punishment from teachers is far less common. In Uganda, no rigorous, representative prevalence data exist, but one survey indicated more than 80% of children have experienced physical punishments such as caning and slapping by teachers. More research exists on sexual violence in schools suffered by girls in African schools, and qualitative studies indicate girls in Ugandan secondary schools experience sexual violence and harassment from teachers and fellow students but are not able to report it for fear of reprisals. The Good School Toolkit has been developed and refined for 6 years in Uganda by Raising Voices. The Toolkit takes a systemic approach, involving an entire school in a process of change to reduce violence and improve teaching techniques. The Toolkit draws on the Transtheoretical Model and incorporates standard behaviour change techniques such as setting a goal and making an action plan, which are effective in modifying behaviour. This study aims to determine whether use of the Good School Toolkit reduces children's experience of violence by school staff. We will also examine the effects of the Toolkit on children's mental health, well-being, and educational outcomes. The study will include a trial, which will be complemented by a qualitative study, a process evaluation, and an economic evaluation. We will also follow a sub-group of trial participants over time. We will conduct a cluster randomised controlled trial in 42 primary schools in Luwero District, Uganda. Half of the schools will receive the Toolkit, and other half will be put on a waiting list to receive the Toolkit at the end of the study if it is shown to be effective. School staff, and children in Primary 5, 6 and 7 will be surveyed (aged about 11-14 years) at the beginning and the end of the study, and schools which received the Toolkit will be compared with those which did not. A qualitative study will also be conducted to explore mechanisms by which the Toolkit might be affecting violence, mental health and educational outcomes. In-depth work will focus on how school staff and children have experienced the Toolkit intervention, and what aspects of it may be refined to be more effective. The Toolkit is specifically designed to be implemented at very low cost, appropriate for low income settings. An economic evaluation will be performed to explore the economic and financial costs of this intervention, with the aim of informing possible scale-up of the Toolkit. All students in Primary 5 at baseline will be followed longitudinally until follow-up, when most will be in Primary 7. This will enable exploration of trajectories of change in mental health and educational outcomes over time, and how violence experience impacts this. We will also be able to follow school staff over time. The results from this evaluation will be used to brief policy-makers within the Ministry of Education and Sports involved in developing country-wide policy and practice around violence against children in schools.

More than one in three adult women globally have experienced physical or sexual violence by their intimate partner. We know that risk of intimate partner violence in adulthood for both women and men is linked to childhood and adolescent experiences of violence. However, less is known about why this is, particularly in low and middle-income countries. Most research on why comes from North America and Europe, where the basic patterns of childhood and adolescent violence exposure are different to many low and middle income country settings, including Uganda. It is important to study why violence in childhood and adolescence and intimate partner violence in adulthood violence are linked so that we can figure out how to more effectively prevent violence across these time periods. Our study has three goals. The first is to get a better understanding of the patterns of prior violence exposure among young adolescents in Uganda, a low-income country setting. The second goal is to understand in more detail which types of violence exposure in early adolescence are associated with violence in later adolescence and young adulthood. The third is to explore how and why these associations occur, with a view to understanding how both characteristics of the individual, and characteristics of the contexts in which individuals find themselves, might amplify or interrupt these associations. In order to do this, we are intending to follow 3438 young adolescents over time. We plan to use a mixture of both survey methods with more in-depth interviews and observations to understand participants' views and practices in relation to violence and experiences of growing up in Uganda. We have already done one survey with young adolescents, their teachers and some of their caregivers in 2014, when the adolescents were aged 11-14 years. We will do a second survey in 2018, when the adolescents are aged 15-18 years, and a third survey in 2021 when they are 18-21 years. In our survey, we ask detailed questions about the use and experience of different forms of violence, the mental health of our participants, and about participants' relationships with different types of people, including romantic relationships. We will gather extensive data on participants' family, school, and other contexts where they spend time, and will analyse how these contexts can support the development of non-violent behaviour and relationships over time. Our qualitative study will involve in-depth work with a sub-sample of about 36 girls and boys, who reported varying experiences of violence in the 2014 survey, when they were 11-14 years, and who will also be followed up over time from 2018 until 2021. We will speak with these core participants individually, and with groups of friends, and conduct observations in and around the schools and communities where participants find themselves. Through building detailed biographical case studies with these young people, we hope to gain insight into how adolescents experience different forms of violence, and the ways in which their social relationships and networks influence their safety and perspectives and practices on violence. As well as working with this core group, we will collect data from a broader sample of young people, school staff, parents, community members and officials, as well as the broader political and socio-economic landscape, in order to analyse the ways in which the contexts in which young people live enhance risks or help protect young people from violence. This research will improve understanding of what types of mechanisms we can target to help effectively prevent violence across adolescence and into adulthood. Our findings will be new and interesting because very few longitudinal studies have been conducted across this age group, and even fewer in low income country settings. We plan to use these results directly to develop programming in Uganda.

Over one billion children experience physical, sexual or emotional violence every year and social inequalities in violence are large. The contexts children live, learn and play in can shape their health, employment, and educational outcomes. This project will generate new evidence on how adverse and protective childhood contexts affect children's use, or experiences of, interpersonal violence as they grow up. We propose to draw on high-quality longitudinal data about children's lives, including experiences of violence, in three independent cohort studies in Brazil (birth to late childhood), England (birth to adulthood) and Uganda (late childhood to adulthood). Our multi-country research team consists of social epidemiologists and social scientists with strong links to the settings of each cohort study. To ensure analyses and findings are informed by a wide range of expertise and experiences we will consult local stakeholders (young people, civil society organisations, health workers and local government staff) in each study setting and researchers from different disciplines during research design and dissemination. The World Health Organisation's (WHO) INSPIRE framework recommends changing laws, social norms, social safety nets, neighbourhood environments, households, and schools to prevent interpersonal violence. To advance such prevention efforts, violence researchers and practitioners need to know how childhood contexts shape violence later in life, and how contexts can interrupt or prevent violence later in life. Further, we need to understand if the adverse or protective effects of contexts differ for marginalised young people. The first phase of this project will define and operationalise contextual measures: we theorise that adverse childhood contexts are homes, schools, and neighbourhoods with violence and deprivation, and protective childhood contexts high social connectedness and support. We will use data collected on contexts to operationalise contextual measures specific to each cohort and refine measures based on input from local stakeholders, young people, and researchers in each context. Findings from this phase will highlight new opportunities to apply advanced statistical methods to improve how contexts are measured and defined in violence research. The second phase will test whether adverse childhood contexts increase the risk of violence later in life, and whether protective childhood contexts can mitigate this risk. We aim to conduct causal analyses of longitudinal data to uncover, for example, whether neighbourhood violence and deprivation in childhood could increase interpersonal physical or sexual violence years later - and whether a protective home environment at the same time, or later in life could prevent or interrupt these associations. Findings from this phase provide evidence for developing and situating contextual interventions to prevent violence as children grow up. The third and final phase of the project will explore how the effects of contexts differ for young people from historically marginalised groups. By applying statistical methods to test if the adverse and protective effects of contexts differ by gender, disability, ethnicity, sexuality, and socioeconomic position, findings will highlight which young people are disproportionately impacted by adverse contexts or less likely to benefit from protective contexts. Our approach offers opportunities to improve the use of contextual measures in research on violence and more broadly. Violence prevention efforts at contextual levels shift the loci of intervention away from the individual and are likely to benefit more people than individual-level behaviour change interventions. This research will generate new evidence from multiple countries that researchers and practitioners can use to realise the WHO INSPIRE framework on violence prevention and the Sustainable Development Goals related to violence.