Child Sexual Abuse Prevention Programs Research Articles

Engaging Parents in Child-Focused Child Sexual Abuse Prevention Education Strategies: A Systematic Review.

Parents are their children's first teachers and there are long-standing calls for their involvement in child sexual abuse prevention. In this rapid systematic review, we asked the following questions: what rationales are used to justify parental involvement in child-focused child sexual abuse (CSA) prevention programs? what approaches are used for parental engagement in child-focused CSA prevention programs? and what are the facilitators and barriers to parental involvement in child-focused CSA prevention programs? We searched CINAHL, Cochrane, ERIC, Medline, PsycInfo, Scopus, and SocINDEX in May 2021. A total of 57 papers met our inclusion criteria, comprised of 50 empirical studies, and 7 program descriptions. Rationales for parental involvement included monitoring and shaping parental attitudes toward CSA program delivery in schools; reinforcing children's learning at home; promoting parent-child communication about CSA prevention; building parent capacity to respond to child disclosures; and supporting program delivery for preschoolers. Types of parental involvement included the following: communication, learning at home, volunteering, decision-making, and collaboration with the community. Barriers to parent involvement included ineffective program engagement modalities, and parental fears and misconceptions.

Assessment of Effectiveness of School-Based Child Sexual Abuse Prevention Programs: A Meta-Analysis

Assessment of Effectiveness of School-Based Child Sexual Abuse Prevention Programs: A Meta-Analysis

Adapting a selective parent-focused child sexual abuse prevention curriculum for a universal audience: A pilot study.

Parents are an obvious, but underutilized player in the prevention of child sexual abuse (CSA). A handful of universal parent-focused prevention programs have emerged, however, the evidence for these programs is mixed and the programs suffer ubiquitously from barriers to implementation (e.g., poor engagement, low participation) thereby limiting public health impact. To combat these barriers and improve evidence, researchers previously developed and tested a selective parent-focused CSA prevention program. While promising, the selective approach still leaves a gap in the prevention landscape-parents from the universal audience. However, there appear to be no standardized methods to inform this type of adaptation-interventions designed as universal or selective have primarily been delivered as such. This study sought to adapt the selective curriculum for a universal audience and examined the acceptability and feasibility of the program for evaluation in a future trial. Using mixed methods, N = 31 parents (i.e., primary caregiver for a child under 13) completed pre- and post-workshop surveys followed by a brief individual interview conducted via Zoom. Interviews, coded using content analysis methods, focused on three themes: parents as agents of prevention (e.g., prior action, confidence), curriculum (e.g., content, design), and engagement (e.g., future marketing and promotion). Overall participants' mean score on CSA-related awareness and intention to use protective behavioral strategies increased. The participants found the curriculum highly acceptable noting strengths in the content and design. All told, the results of this pilot study suggest the acceptability and feasibility of examining the efficacy of the universal parent-focused curriculum in a larger trial. Procedural challenges, such as bots in recruitment, identify areas of caution in design of the larger trial and a roadmap for others seeking to adapt selective programs for universal audiences.

Child sexual abuse prevention: A qualitative study of teachers' educational needs.

Child sexual abuse (CSA) has emerged as a global concern, particularly affecting children in Indonesia. However, there remains a scarcity of research on CSA within the Indonesian context.Objective: This study aimed to explore the educational needs of primary school teachers in preventing child sexual abuse. A qualitative descriptive study design was employed, with eight teachers and school principals selected through purposive sampling. Data were collected through focus group discussions and analyzed using content analysis. Six categories emerged: 1) The risk of sexual abuse, 2) The necessity for clear CSA preventive regulations and sanctions for abusers, 3) Lack of CSA program socialization, 4) The need for structured CSA prevention education for children, 5) The importance of effective coordination with various relevant stakeholders, and 6) The presence of barriers and obstacles. This study provides valuable insights into the educational prerequisites for teachers to implement CSA prevention measures effectively. The findings emphasize the pressing need for school teachers to develop and implement CSA prevention programs, with the government's and nursing professionals' support, to enhance educators' abilities in combating CSA. Nurses have a pivotal role in preventing and addressing child sexual abuse, and they should actively contribute to improving child safety and well-being through knowledge, collaboration, and advocacy for comprehensive prevention strategies.

It’s More Than a Matter of Trust: What Parents and Young Children Need to Know to Prevent Intrafamilial Child Sexual Abuse

ABSTRACT Programs aimed at preventing child sexual abuse typically focus on skilling up young children and, to a lesser extent, parents by imparting a range of protective messages. Many sexual abuse prevention programs include a focus on identifying or vetting “safe” or “trustworthy” people. The authors qualitatively analyzed the content of narratives from individuals with childhood experience of intrafamilial sexual abuse, an under-represented voice in the development of child sexual abuse prevention programs. The analysis of impediments to protection indicated that, within the family context, reductionistic judgments of familiar individuals’ perceived safety or trustworthiness impaired child safety. In addition to adults and children being unable to recognize sexually abusive behavior and warning signs, child-victim survivor narratives highlighted the barriers for prevention in family environments characterized by maltreatment, a lack of child rights or that were unsupported by external authorities. Implications for the content of messages young children and their parents need to prevent child sexual victimization in the context of everyday family life are discussed.

How Do Survivor and Mandatory Reporter Status Correlate with Program Outcomes for an Adult-Focused Child Sexual Abuse Prevention Program?

ABSTRACT This exploratory study investigated group differences and pre-post changes in knowledge, beliefs, and behavior by mandatory reporters and Child Sexual Abuse (CSA) survivor status for a CSA prevention training designed for the general public. Of the 8,114 study participants, 32% identified as having experienced CSA, and 77% indicated they were mandatory reporters for child abuse and neglect. Mandatory reporters had higher baseline knowledge about CSA than those who were not mandatory reporters and reported more CSA preventative behaviors. Mandatory reporters continued to have higher levels of knowledge following the training. Survivors of CSA also had higher baseline knowledge about CSA and preventative behavior scores than individuals who are not survivors of CSA. Unlike mandatory reporters, they experienced fewer increases in knowledge. At posttest, there was no evidence of a difference in knowledge between CSA survivors and non-CSA survivors. For items related to beliefs, mandatory reporters had higher baseline scores than other participants. However, they had smaller gains, so mandatory reporters and non-mandatory reporters had more similar beliefs related to CSA after the training. There were few differences between CSA survivors and non-survivors on baseline beliefs related to CSA, though CSA survivors reported greater increases in beliefs that CSA prevention is their responsibility and in the idea that they know what to do to prevent CSA. These results have significant results for the development and evaluation of trauma-informed prevention programming.

Applying an Implementation Framework to the Dissemination of a School-Based Child Sexual Abuse Prevention Program.

Since the 1980s, school-based child sexual abuse (CSA) prevention programs have been the prevailing prevention strategy in the United States. Despite demonstrated effectiveness, there is a lack of infrastructure and educational policy ensuring all students receive these programs. A pragmatic application of the RE-AIM implementation framework, this study provides an overview of a multi-county implementation effort of the school-based CSA prevention program, Safe Touches. Implementation efforts across five counties in a Mid-Atlantic state are described at three levels: organizational (school districts), child, and program facilitator. Children's CSA-related knowledge was measured at four time points: pre-workshop, immediately post-workshop, and then 6 and 12 months post-workshop. Facilitators completed an anonymous survey post-implementation. Over the course of one and a half academic years, Safe Touches was implemented in 718 public school districts, reaching in total 14,235 second-grade students. Students' significantly increased knowledge from pre- to post-workshop and gains were maintained at 6 and 12 months (ps <.001). A total of 29 disclosures of maltreatment were made by students to facilitators during or after the workshop. Facilitators generally adopted Safe Touches and attested to the feasibility and benefits of its large-scale implementation as well as the negligible negative impacts for children. When implemented systematically, school-based CSA prevention is able to reach a high number of students, effectively increase CSA-related knowledge, and facilitates disclosures. To maximize the potential public health impact, it is suggested that state funds be allocated to support the implementation of such programs as part of standard education costs.

Knowledge Gains from the Implementation of a Child Sexual Abuse Prevention Program and the Future of School-Based Prevention Education

ABSTRACT School-based child sexual abuse (CSA) programs effectively increase students’ CSA-related knowledge. This study focuses on an implementation trial of Safe Touches, an empirically supported, school-based CSA prevention program, that was disrupted by the COVID-19 pandemic. We sought to demonstrate gains in CSA-related knowledge following Safe Touches but were limited to a pre-post design. A total of 2,210 students across five counties in a Mid-Atlantic state received the Safe Touches workshop between September 2019 and March 2020. McNemar’s chi-square test was used to assess changes in the proportion of correct responses pre-workshop (Time 1) and one-week post-workshop (Time 2). Students’ CSA-related knowledge increased significantly based on changes in mean CSA knowledge scores and the number of correct item-level responses assessed at Time 1 and Time 2 (p < .000). Leveraging the experience of the facilitators’ who delivered these workshops prior to the disruption of implementation, we gathered facilitators’ perspectives to explore the viability of offering Safe Touches virtually. In July 2020, 16 facilitators completed an electronic survey designed to understand the viability of a virtual Safe Touches workshop. Three themes emerged from facilitator feedback on virtual programming: student engagement concerns, handling disclosures, and technology access to a virtual program. The findings of this study indicate that the Safe Touches workshop significantly increased CSA-related knowledge and, overall, facilitators supported further exploration and development of a virtual Safe Touches workshop. The transition of empirically supported school-based CSA prevention programs to a virtual delivery modality is necessary to maintain an effective means of primary prevention and opportunity for disclosure.

Evaluating the Effectiveness of a Live Musical Theater-Based Approach to Child Sexual Abuse Prevention in Elementary Schools

ABSTRACT Hugs and Kisses is a theater-based child sexual abuse (CSA) prevention program designed for children in kindergarten through fifth grades. The purpose of this cross-sectional case study is to evaluate how a comprehensive live musical theater program can prepare teachers to discuss and identify the signs of CSA, help children increase their knowledge, and learn prevention strategies to stop CSA in the future. A total of 154 teachers and 2,700 children from 31 schools participated in this program during 2016. Findings show this program increases children’s awareness of touch and action knowledge through five primary safety lessons taught during the program and reinforced by a teacher led in-person discussion after the play. Nearly 85% of the students across all grade levels in this sample understood the lessons taught in the play, and students whose teachers held an in-class discussion after the play scored better than those students whose teachers did not hold a discussion. Teachers who were prepared with training resources also held longer in-class discussions compared to those who were not prepared. The Hugs play has the potential to be a national model for evidence-based CSA programs.

Implementation of a Universal School-Based Child Sexual Abuse Prevention Program: A Longitudinal Cohort Study.

Child sexual abuse (CSA) is a public health problem of considerable magnitude. The prevailing primary prevention strategies are universal, school-based CSA prevention programs, some of which have been designated as evidence-based, such as Safe Touches. However, to reach their public health impact potential, effective universal school-based CSA prevention programs require effective and efficient dissemination and implementation strategies. The purpose of this study was to demonstrate the reach and effectiveness of a school-based CSA prevention curriculum, Safe Touches, when implemented on a wide scale. Using a longitudinal cohort design, children in second grade classrooms in public elementary schools in five counties received the Safe Touches workshop and completed surveys designed to assess gains in knowledge at four timepoints (one week prior, immediately post-workshop, 6- and 12-months post-workshop). In total, the Safe Touches workshop was delivered in 718 classrooms in 92% of school districts, reaching ~14,235 second graders. Multilevel models (n = 3,673) revealed that Safe Touches significantly increased CSA-related knowledge, and that these gains were maintained 12-months post-workshop (ps < .001). There were some small but significant time-varying effects among participants in schools with a greater percentage of low income and minority students, but these effects largely disappeared 12-months post workshop. This study demonstrates that a single-session, universal school-based CSA prevention program can effectively increase children's knowledge when implemented and disseminated on a wide scale and knowledge gains can be retained 12-months post intervention.

Moving school-based CSA prevention education online: Advantages and challenges of the “new normal”

One of the many outcomes of the COVID-19 pandemic was a shift in the delivery of elementary (primary) education. Schools transitioned swiftly to e-learning and prioritized education that was already or could be easily adapted to virtual formats. Given the paucity of online content available, it is not likely that child sexual abuse (CSA) prevention education was prioritized.Given that CSA prevention education has demonstrated success in increasing knowledge, protective behaviors, and disclosures, and the potential long-term need for e-learning options, there is a demand for an exploration of how CSA prevention can be implemented using e-learning strategies. In the current discussion, we explore how school-based CSA prevention education could be implemented in a “new normal” context of e-learning. We first present the existing e-learning content for CSA prevention education. We then describe how best practices for prevention education can be applied to e-learning. Finally, we present considerations for the use of e-learning specifically for CSA prevention education.In short, implementing CSA prevention programs through e-learning offers many affordances for program accessibility and reach, flexibility in implementation and opportunities for greater exposure to content, and a wide range of ways to demonstrate effective skills and engage children in cycles of practice and feedback. E-learning, may also, however, limit important conversations between children and trained instructors that lead to disclosures.The extant literature leaves us unsure as to whether implementing CSA prevention programs through e-learning will result in better or worse outcomes for children. However, given the increasing demand for e-learning options, and the promise of some new e-learning programs, further research on the effectiveness of e-learning CSA prevention programs is warranted.

Taking a School-Based Child Sexual Abuse Prevention Program to Scale: a Cost Analysis.

Cost analyses are used to determine overall costs of implementing evidence-based programming and may help decision makers determine how best to allocate finite resources. Child sexual abuse (CSA), regularly viewed as a human rights violation, is also a public health concern estimated to impact 27% of females and 5% of males by age 18. Universal, school-based CSA programs are one prevailing prevention strategy. However, there are no known cost analyses of school-based CSA prevention programming, thereby limiting potential scalability. Using the ingredients method, this cost analysis presents the findings of implementing Safe Touches, an evidence-based universal prevention program, across four sites (i.e., counties) in one mid-Atlantic state. Reaching a total of 14,235s grade students, results indicate an average cost of $43 per student, an average classroom cost of $859, an average district cost of $10,637, and an average site cost of $154,243. There was a noted decrease in costs when more students were reached, suggesting a need to focus efforts on bolstering the reach of implementation efforts. Sensitivity analyses explored variations in implementation constraints such as personnel and facilities suggesting a range of per-student costs (lower-bound per-student cost = $34; upper-bound per-student cost = $64). Findings presented herein may be used to inform future universal CSA prevention efforts by providing detailed information about the costs of large-scale implementation of an evidence-based program among elementary-aged children.

Virtual Delivery of A School-Based Child Sexual Abuse Prevention Program: A Pilot Study

ABSTRACT Universal child sexual abuse (CSA) prevention is a public health priority. The prevailing prevention strategy is school-based CSA prevention programming. School closures during the COVID-19 pandemic highlighted the need for flexible modes of delivery, including virtual programs. This pilot examined the virtual delivery of an evidence-based, school-based CSA prevention program, Safe Touches, designed to teach CSA-related knowledge and concepts. Using mixed methods, the pilot sought to determine the feasibility of the virtually delivered CSA prevention program. One school district that had previously received Safe Touches in-person participated. A total of 176 second grade students participated in the virtual workshop. Post-workshop survey responses from virtual (N = 37) and in-person workshops (N = 60) were compared descriptively. Mean item scores and response patterns from students who received the virtual workshop were nominally comparable to the student scores from the in-person workshop. Following the virtual workshop, one teacher notified the research team of a disclosure of CSA. Qualitative input from the facilitator and school staff was positive, indicating high student engagement. Results suggest the viability and feasibility of virtual school-based CSA preventive programs. Investment in virtual modes of delivery would ensure all students have access to CSA prevention programming in the future.

School-based Child Sexual Abuse Interventions: A Systematic Review and Meta-analysis

Purpose The purposes of this systematic review were to systematically summarize components in existing school-based child sexual abuse (CSA) prevention programs and identify predictors for program effectiveness. Method Building upon the most comprehensive systematic review on this topic, we conducted systematic searches in both English-language from September 2014 to October 2020 and Chinese-language from inception to October, 2020. Meta-regressions were performed to identify predictors for program effectiveness. Results Thirty-one studies were included with a total sample size of 9049 participants. Results from meta-analyses suggested that interventions are effective in increasing participants’ CSA knowledge as assessed via questionnaires ( g = 0.72, 95% CI [0.52–0.93]) and vignette-based measures ( g = 0.55, 95% CI [0.35–0.74]). Results from meta-regression suggested that interventions with more than three sessions are more effective than interventions with fewer sessions. Interventions appear to be more effective with children who are 8 years and older than younger children. Discussion CSA is a global issue that has significant negative effects on victims’ physical, psychological, and sexual well-being. Our findings also provide recommendations for future research, particularly in terms of optimizing the effectiveness of school-based CSA prevention programs, and the better reporting of intervention components as well as participant characteristics.

An Evaluation of the “I am Learning to Protect Myself with Mika” Program Using the “What If” Situations Test

ABSTRACT Despite the recent development of a plethora of child sexual abuse prevention programs in recent years, few studies have attempted to evaluate their effectiveness using a standardized measure. Therefore, we attempted to test the effectiveness of the “I am learning to protect myself with Mika” program using a valid and reliable tool: the “What If” Situations Test (WIST). Eighty-one preschool children and their parents and teachers participated in this study. Ultimately, we compared the data of 43 children (M = 66.78, SD = 8.84) in the intervention group and 38 children (M = 69.28, SD = 6.78) in the wait-list group. The findings revealed that the intervention group had increased knowledge of inappropriate touching recognition and personal safety. The say, tell, report, and WIST total skill scores also increased in the intervention group. These findings are promising and may pave the way for disseminating the program in Turkish preschools.

Child Sexual Abuse Prevention Program Based on Creative Drama: An Example of an Implementation Plan

Çocuk cinsel istismarında temel hedef istismarın önlenmesidir. Bu makalede okul öncesi çocuklarda cinsel istismarı önlemeye yönelik yaratıcı dramaya temellendirilerek hazırlanan “Bedenim Benim Özelimdir Eğitim Programının” uygulama planı örneği verilmiştir. Son yıllarda aktif olarak kullanılmaya başlanan yaratıcı dramanın özellikle okul öncesi dönem çocuklarında yaratıcı düşünmeyi teşvik etme, öğrenilenlerin kalıcı olmasını sağlama, dil ve iletişim becerileri kazanma, kendine güven duyma, karar verme becerileri kazanma ve bildiklerini hayata geçirebilme gibi birçok yararının olduğu bilinmektedir. Bu makalenin çocuk cinsel istismarını önlemek için bu alanda çalışan tüm eğitim, sağlık çalışanları ve ebeveynlere önemli bir kaynak olacağı düşünülmektedir

The impact of using creative drama in the delivery of Body Safety Training Programs for preschool children on preventing sexual abuse in Turkey

AbstractThe study focuses on the impact of the creative drama method on child sexual abuse (CSA) prevention program in Turkey. A pretest–posttest experimental design with a control group was used in the study. The research was carried out with a total of 72 preschool children aged 3–6 years. Data were collected by What If Situations Test (WIST). A creative drama activity was conducted for the experimental group before training. Body Safety Training (BST) was used in both groups. The average WIST posttest scores were statistically significantly higher compared to pretest scores for the children in both groups (p &lt; .05). A comparison of pretest and posttest assessment found that there was no statistically significant difference (p &gt; .05) between the two groups in regard to the WIST assessment averages. BST Program has a positive impact on increasing personal safety skills when implemented together with creative drama activities.

15.5 How Should Child and Adolescent Psychiatrists be Culturally Responsive to Child Sexual Abuse (CSA) Including Unwanted Sexual Touching? An Ethnographic Study in Cambodia

Prevention of child sexual abuse (CSA), including unwanted sexual touching, is of critical significance, and interventions with culturally diverse groups pose significant challenges to child and adolescent psychiatry. The objective, using Cambodia as a case study, is to provide a framework for a culturally responsive program to prevent CSA. Fieldwork between 2014 and 2021 involved 380 informants: 1) child abuse generally, 86 relatives of abused children, 62 Buddhist monks and officiants; 2) abuse by monks, 196 informants (104 female, 92 male); and 3) genital touching, 36 informants (22 female, 14 male). We were guided by United Nations Children’s Emergency Fund (UNICEF) Ethical Research Involving Children (ERIC) criteria. We explored cultural constructions of all forms of CSA and how people reconciled their ideas with those brought by Western mental health professionals. Through content analysis, we noted the cultural registers and the use of popular cultural references. There were at least 150 defined cases of sexual abuse across the 3 groups, mainly in the first 2 groups. Most informants viewed CSA as stemming from “cultural attractors,” including blighted endowment from a previous life, a bad character, astrological vulnerability to abuse, preordained entanglement between the child and the abuser (they are “fated” to meet), sexual craving, “entering the road to ruin,” and a moral blindness that portrays the abuser as blameless. CSA prevention programs in developing countries often strive to change the local cultural values through education. We argue that a better strategy is to leverage—rather than eradicate—these beliefs to overcome misbeliefs about CSA including unwanted sexual touching. The findings provide a template to enable child and adolescent psychiatrists, working with police, counselors, educators, and rights-based organizations, to provide better services to those affected by CSA. There are implications for child and adolescent psychiatrists working with immigrants who resettle in Western countries.

Zero Tolerance of Children’s Sexual Abuse from Interreligious Dialogue

Child sexual abuse is a social problem that concerns our societies. The sustainable development goals have highlighted the eradication of child sexual abuse as one of the highest-priority goals of this century. Breaking the silence within religious communities is an essential step going forward. Therefore, establishing a dialogue between people of different religions is crucial to achieving this goal. The purpose of this article is to explore whether there are current interreligious dialogue initiatives based on scientific recommendations to prevent child sexual abuse. The method used herein is a qualitative document analysis of the selected initiatives. The results indicate that interreligious dialogue initiatives include scientific recommendations in their prevention programs. Furthermore, these successful initiatives connect religious values and the need to support victims and to break their silence. Based on these results, it can be concluded that interreligious initiatives for child sexual abuse prevention programs based on scientific evidence are crucial in order to eradicate child sexual abuse.

Effectiveness of School-Based Child Sexual Abuse Prevention Programs in China: A Meta-Analysis

Purpose: Although the number of school-based education programs for child sexual abuse (CSA) prevention has recently increased in China, little is known about their effectiveness. This meta-analysis aimed to examine the effectiveness of school-based CSA prevention programs on improving children’s knowledge and skills, which can prevent them from being sexually abused. Method: Systematic searches were conducted based on five English-language databases (PubMed, Web of Science, ScienceDirect, MEDLINE, and PsycINFO) and three Chinese databases (CNKI, Wan Fang Data, and CQVIP). Seven studies with 2,593 participants finally met the quality criteria of this review, and the meta-analysis was conducted using a random effect model. Results: The overall effect sizes of school-based CSA prevention education showed a significant improvement in children’s knowledge ( d = 2.53, 95% CI [2.03, 3.04]) and skills ( d = 2.00, 95% CI [1.39, 2.60]). Programs instructed by researchers were more effective than those instructed by teachers, and preschoolers had a larger increase in both knowledge and skills than elementary and middle school students. Discussion: This study provides empirical evidence for further implementation of school-based CSA prevention programs, especially under the guidance of experienced researchers and conducted for students at an early age.