School-based Child Sexual Abuse Prevention Research Articles

The effectiveness of school-based child sexual abuse prevention programmes among primary school-aged children: A systematic review

This systematic review provides a comprehensive overview of child sexual abuse prevalence globally, along with an examination of the effectiveness of school-based prevention education programmes for primary school-aged children. These prevention programmes utilise social cognitive learning theories to teach children the importance of identifying and responding to abusive situations. A total of 676 papers were evaluated with 13 Randomised Controlled Trial (RCT) or cluster RCT design studies identified as meeting the study's inclusion criteria. These studies were published in English between January 2000 and May 2022, and focus on outcomes of school-based prevention programmes designed for primary school-aged children (5–12 years old). To ensure a comprehensive and academically rigorous analysis, the following databases were included: Science Direct, Web of Science, Scopus, the American Psychiatric Association (APA) PsycINFO, Ovid Medline, and Embase. The studies reviewed aim to evaluate the effectiveness of various child sexual abuse prevention programmes in improving children's knowledge and recognition of, and response to potentially unsafe situations. In terms of outcomes and results, the interventions have significantly impacted knowledge, skills, confidence, and awareness in the short and long term. These studies used different intervention methods, including mobile applications, personal safety programmes, and protective behaviour programmes, delivered in various formats such as web-based, textbooks, and in-person sessions. This systematic review highlights the importance of child sexual abuse prevention programmes in schools and the need for further research.

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

Piloting an Alternative Implementation Modality for a School-Based Child Sexual Abuse Prevention Curriculum.

In the U.S., the most pervasive child sexual abuse (CSA) prevention strategy involves school-based prevention programs; however, the reach of these programs is limited due to implementation constraints, such as budgets or turnover. This is notable as standard delivery of often requires two facilitators in the classroom. Leveraging a natural experiment in the implementation of Safe Touches, the current study sought to explore the feasibility of implementation with a single facilitator using pre-recorded videos compared to the standard in-person delivery. A six-item CSA-related knowledge questionnaire was delivered to (N = 1480) second-graders post-workshop. An independent-samples t-test was used to compare the mean of CSA-related knowledge item responses for each delivery modality. Student-level data were paired with teacher evaluations and an interview with the facilitator. Across workshops delivered in 25 schools, there was no significant difference in knowledge based on CSA-related questions by workshop modality. Teachers indicated the facilitators responded effectively to the children's questions and comments in both delivery modalities. Input from the facilitator was positive. Triangulation of student knowledge, teacher input, and facilitator experience indicates the viability and feasibility of this implementation strategy for Safe Touches, and potentially other school-based CSA prevention programs. To ensure equitable access to the CSA prevention program, the empirical examination of, and investment in, alternative implementation options for school-based CSA preventive programs is encouraged.

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.

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.

Child abuse prevention education policies increase reports of child sexual abuse

BackgroundIt is well supported that engaging in prevention education increases a child's awareness of child sexual abuse. However, due to methodological limitations, prior research has yet to determine whether this knowledge leads to increases in reporting or substantiation of child sexual abuse. ObjectiveWe examined whether state mandates for school-based prevention education correlate to changes in reports of child sexual abuse. MethodsWe used a quasi-experimental design to investigate the association between child sexual abuse report rates from 2005 to 2019 and presence of state legislation mandating school-based child sexual abuse prevention curricula. Child sexual abuse report data were obtained from the National Child Abuse and Neglect Data System child files. We focused on reports for school-aged children ages 5–17. Data on state laws on prevention curricula were extracted from enoughabuse.org, Prevent Child Abuse America, ErinsLaw.org, and directly from published legislation. ResultsState education mandates were associated with an increase in the incidence of child sexual abuse reports made by education personnel (IRR = 1.22, 95 % CI, 1.01–1.48). Policies were not associated with increases in incidence of child sexual abuse reports made by non-education personnel (IRR = 1.08, 95 % CI, 0.95–1.22) or decreases in likelihood that any given report was confirmed (OR = 1.00; 95 % CI, 0.90–1.12). ConclusionsThere is moderate evidence that adopting state mandates for child sexual abuse prevention education may increase disclosures and reporting of child sexual abuse by school-based sources. There is no evidence that mandates decrease the validity of child sexual abuse reporting by school-based sources.

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.

Recall of sexual abuse prevention education at school and home: Associations with sexual abuse experience, disclosure, protective parenting, and knowledge

BackgroundChild sexual abuse (CSA) prevention is dominated by a focus on child education. However, evidence that this education reduces CSA risk is limited and mixed. ObjectiveWe investigated whether participants' history of receiving school-based child sexual abuse prevention (CSAPP) was associated with experiencing CSA. Uniquely, we also investigated whether parent-led CSA education (PLSAE) and received protective parenting were associated with CSA. CSA knowledge was also considered. MethodsAustralian university students (N = 1265, Mage = 22.8, SD = 7.7, Moage = 18, Mdage = 20, 75% female) reported their history of CSAPP and PLSAE, experience of CSA, disclosure of CSA, parenting, and CSA knowledge. ResultsCSAPP attendance was reported by 29% of respondents, 72% reported PLSAE, and 24% reported CSA. PLSAE was significantly associated with lower risk of CSA, but was CSAPP attendance was not. PLSAE was significantly associated with higher levels of parental involvement/care and monitoring/supervision. In a multivariate logistic regression model, involvement/care and monitoring/supervision were associated with lower risk of CSA, but PLSAE was not. Neither CSAPP attendance nor PLSAE was associated with CSA disclosure or CSA knowledge. ConclusionsThese findings add to the small body of literature using reports of real-life experiences. Results call into question the over-reliance of child-education in CSA prevention and highlight the role of protective parenting. Building parenting capacity to include parenting practices is most likely to be effective for CSA prevention, such as monitoring and involvement, and should be included in CSA prevention efforts.

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.

Mothers Attitudes Toward Child Sexual Abuse Prevention in Schools: A Preliminary Examination.

Providing school-based child sexual abuse (CSA) prevention programs ensures that the majority of children will participate in programming. Since many parents may feel ill equipped to have such discussions with their children, programs offered in education settings can bring awareness to this issue. A sample of mothers (N = 268) from across the United States completed an online survey related to their experiences with and attitudes toward school-based CSA prevention programs. Most mothers (70%) had no exposure to prevention programs during their childhood, but the majority (95%) had a positive attitude toward programming for their children. Most mothers believed that offering CSA prevention in schools was important and could provide a safety net. Mothers desired programming that was age appropriate, involved parents and was activity based. These results can help inform schools' prevention programming.

Evaluation of a School-Based Child Physical and Sexual Abuse Prevention Program.

Evidence-based child sexual and physical abuse prevention programs delivered in schools are needed and require rigorous evaluation of program effects prior to widespread dissemination. The Play it Safe! program is a one-time session delivered by trained facilitators to teach students about recognizing, resisting, and reporting abuse. To evaluate a school-based child sexual and physical abuse prevention intervention Play it Safe! among elementary school students using a cluster randomized design. Six elementary schools in Texas were matched on demographic characteristics, and then randomized to intervention or wait-list control groups. Participants included third to fifth graders (n = 539). Participants received the pretest assessing vignette-based knowledge of physical and sexual abuse prevention (14 items). The intervention group immediately had the program. One month later, both groups received a posttest using the same validated scale. Multilevel linear regression analyses were estimated, and interaction effects were used to evaluate the effect of Play it Safe! while controlling for other factors. A statistically significant interaction between the treatment group and time (b = 1.30, p < .01) indicated a greater increase in the knowledge score over time in the intervention group. Moderating effect of grade was also observed as the intervention tended to have less effect for fifth grade compared with third grade (b = -1.04, p = .01). This study provides evidence to support the efficacy of the Play it Safe! program for increasing children's physical and sexual abuse prevention knowledge and skills among a racially and ethnically diverse sample of elementary school students.

Responsible Behavior with Younger Children: Examining the Feasibility of a Classroom-Based Program to Prevent Child Sexual Abuse Perpetration by Adolescents

ABSTRACT Child sexual abuse (CSA) is a preventable public health problem typically addressed with either after-the-fact interventions or prevention programs focused on teaching children to protect themselves and report abuse. Such responses do little to prevent CSA victimization, leading to calls for prevention efforts targeting individuals most at risk of perpetrating CSA. These individuals include young adolescents, who are prone to making mistakes and bad decisions when it comes to their sexual behaviors. To begin to address this call to action, we developed Responsible Behavior with Younger Children (RBYC), a universal school-based prevention program to provide sixth and seventh grade students (and their parents and educators) with the knowledge, skills, and tools to prevent engaging younger children in sexual behaviors. School-based CSA prevention interventions are often met with feasibility and acceptability concerns including that (a) people at risk of offending are impervious to prevention efforts, (b) schools do not have the resources to take on additional programs, and (c) the content is too sensitive for educators, parents, and students. The goal of this article is to describe how the RBYC program was developed to address these concerns. We also summarize data on the feasibility of the RBYC program obtained from focus groups with educators, parents, and students during the development of the program and interviews with educators after a pilot randomized controlled trial (RCT). Feedback received during program development and after the pilot RCT suggests that RBYC is relevant, salient, palatable, and feasible for implementation in middle schools.

"Prevention Alone Is Not Enough:" Stakeholders' Perspectives About School-based Child Sexual Abuse (CSA) Prevention Programs and CSA Research in China.

While existing studies have examined the effectiveness of school-based child sexual abuse (CSA) prevention programs in China, there is currently little qualitative evidence on how stakeholders view these programs and research on CSA in China more generally. To address this research gap, the aims of this study were to explore stakeholders’ perspectives on: (a) school-based CSA prevention programs in China; (b) the components of these programs; (c) CSA research in China. Qualitative semi-structured interviews were conducted with 21 participants in Beijing and a county under Lanzhou City, China. Interview transcripts were systematically coded and emerging themes were developed from the codes. An inductive thematic analysis approach was utilized to analyze the interview data. Participants’ perspectives on school-based CSA prevention programs included: (a) recognition of the importance of school-based CSA prevention programs; (b) fear about a possible negative impact on children participating in such programs; (c) assessment that school-based CSA prevention programs alone are not enough to prevent CSA. Components that participants thought needed to be part of Chinese school-based CSA prevention programs were: (a) content regarding online-facilitated CSA; (b) the use of a rights-based approach; and (c) greater parental and community involvement. Participants also identified factors that have both fostered the implementation of CSA research (e.g., the growing awareness of CSA in the central government) and prevented researchers from effectively conducting CSA research: (a) lack of national data; (b) inadequate government support; and (c) barriers to research collaboration among organizations. The findings indicate that while CSA prevention programs are on the whole regarded positively by key stakeholders in China, a number of important concerns were identified. Our study highlighted a number of ways in which future CSA prevention programs and research on CSA could be strengthened in the Chinese context.

Child Sexual Abuse Prevention Education: A Qualitative Study of Teachers’ Experiences Implementing the Second Step Child Protection Unit

This study explored teachers’ reactions to implementing a Pre-K-Grade 5 school-based child sexual abuse prevention education program. Fifty-seven classroom teachers and two school counselors attended one of nine focus groups conducted after the implementation of the Committee for Children’s Second Step Child Protection Unit. Teachers discussed their feelings about teaching the unit before and after implementation, their students’ reactions to the lessons, and parental feedback. Initially, teachers were anxious and apprehensive about teaching the six-lesson curriculum but found the experience to be positive and rewarding. Students engaged enthusiastically with the lessons, and parental pushback was minimal. Challenges and recommendations for implementing teacher-led personal safety education are discussed.

Sexual Abuse Prevention Education in Australian Primary Schools: A National Survey of Programs

In the 2017 final report of the Australia’s Royal Commission Into Institutional Responses to Child Sexual Abuse, recommendations noted the importance of school-based prevention efforts to create child-safe communities. In this study, we report on a national evaluation of the nature and availability of child sexual abuse prevention programs delivered in Australian primary schools. A survey instrument, anchored in empirical evidence, was distributed to all providers of child sexual abuse prevention programs in Australian primary schools serving children aged 4 to 13 years. Respondents were program coordinators or facilitators who provided data on 35 school-based child sexual abuse prevention programs that reached 631,720 children (approximately 26% of the Australian primary school student population) in 1 year. On average, each program reached 18,049 children in a calendar year (ranging from 200 to 80,000 children). Median child age for program exposure was 8 years. However, program duration was poorly reported so it was difficult to establish what program dosage was received. Most programs (80%-94%) covered specific item content, “always or often,” for 13 important areas of content, including five of seven items that had the strongest evidence of effectiveness, derived from a recent Cochrane Review (e.g., distinguishing appropriate and inappropriate touching). Programs less frequently addressed such content as safety in using technology and perpetrator strategies (e.g., grooming). The findings provide important information about the scope and nature of child sexual abuse prevention programs, and baseline data against which future program advancements can be tracked.

School-Based Child Sexual Abuse Prevention: Implications for Professional School Counselors

School-Based Child Sexual Abuse Prevention: Implications for Professional School Counselors