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Ferragut M, Cerezo MV, Ortiz-Tallo M, Rodríguez-Fernandez R. Effectiveness of child sexual abuse prevention programs on knowledge acquisition: A meta-analytical study. CHILD ABUSE & NEGLECT 2023; 146:106489. [PMID: 37804801 DOI: 10.1016/j.chiabu.2023.106489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 09/24/2023] [Accepted: 09/27/2023] [Indexed: 10/09/2023]
Abstract
BACKGROUND Child sexual abuse (CSA) is a type of maltreatment considered a global health problem. CSA is a traumatic experience with important consequences for the victim's health. It is essential to report the effectiveness of CSA prevention programs to offer society useful tools to combat this abuse. OBJECTIVE We aimed to study the effectiveness of CSA prevention programs on the knowledge acquisition based on comparing pre- and post-treatment changes, and also if their effectiveness is related to program-related and methodological variables. PARTICIPANTS AND SETTINGS Standardised mean change (with studies that report pre-post program measures) of the effectiveness of CSA prevention programs published between 2014 and 2021 was carried out. METHODS The general effectiveness of these programs and whether the results were influenced by program-related variables (the duration, the target population, participants' age, or the type of intervention) or by methodology-related factors (the agent who taught them, the geographical area where they were carried out or the way the programs were evaluated) were analysed. A total of 43 samples analysing knowledge about CSA as a dependent variable were included. RESULTS The results reported a combined effect size considered large (dMR = -0.96, 95 % CI [-1.10, -0.82], p < .001). High inter-study heterogeneity was observed in the meta-analysis, although only the geographic area where the studies were conducted appears as a significant moderator. CONCLUSIONS In conclusion, the prevention programs included in this analysis significantly improved the participants' knowledge acquisition.
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Affiliation(s)
- Marta Ferragut
- Department of Psychobiology and Methodology of Behavioral Sciences, Psychology and Speech Therapy Faculty, University of Malaga, Spain.
| | - M Victoria Cerezo
- Department of Psychobiology and Methodology of Behavioral Sciences, Psychology and Speech Therapy Faculty, University of Malaga, Spain
| | | | - Raquel Rodríguez-Fernandez
- Department of Methodology of Behavioral Sciences, Psychology Faculty, Distance Learning National University (UNED), Spain
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2
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Cohen N, Katz C. What Messages Are Communicated to Children in Maltreatment Prevention Programs? Conclusions of a Scoping Review. TRAUMA, VIOLENCE & ABUSE 2023; 24:15-28. [PMID: 34000916 DOI: 10.1177/15248380211016012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
There is a worldwide consensus that the prevention of child maltreatment (CM) is critical in promoting children's safety. Furthermore, a significant part of the prevention efforts targets the children themselves. This scoping review aimed to map the characteristics of CM prevention programs that targeted children by examining studies that described the relevant implemented programs, published in peer-reviewed journals over the last decade. Thirty-one relevant manuscripts were identified from the online databases. The analysis, guided by scoping review guidelines, examined these programs in terms of content, context of delivery, and practitioners involved. A thematic analysis identified the key messages conveyed to the children. The findings showed that the vast majority of programs are school-based and focused on preventing child sexual abuse (CSA) with considerably less attention given to other forms of maltreatment. In addition, most programs did not promote active parental participation. The content descriptions of the CSA prevention programs revealed several common key messages that focused on children's individual safety skills, specifically recognition, refusal strategies, and disclosure. The discussion addresses the concepts of blame and guilt as crucial to rethinking the CM prevention messages conveyed to children. Key conclusions that were drawn from the current scoping review highlight the need to better align prevention efforts and recent CM research. Additionally, ceiling effects in several studies indicated that children's participation, as information sources and partners in program development, should be promoted, so that prevention efforts will meet their needs within their various relevant life contexts.
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Affiliation(s)
- Noa Cohen
- Bob Shapell School of Social Work, 26745Tel Aviv University, Israel
| | - Carmit Katz
- Bob Shapell School of Social Work, 26745Tel Aviv University, Israel
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3
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Determinants of Sexual Abuse Prevention Knowledge among Children’s Schools in West Java Indonesia: A Cross-Sectional Study. SOCIAL SCIENCES 2022. [DOI: 10.3390/socsci11080337] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Child sexual abuse (CSA) is a severe problem in Indonesia. Adequate knowledge in children about CSA prevention is essential so that children do not become victims. Lack of adequate children’s knowledge of the prevention of CSA may put them at risk for experiencing CSA. This cross-sectional study explores the association factors between knowledge and characteristics regarding the prevention of CSA. The study was conducted in Bandung Regency, West Java, Indonesia. Students from grades two to nine at two elementary schools were eligible for the study. Results showed that as sources of information associated with better knowledge of CSA prevention (p = 0.00), teachers and parents significantly contributed to CSA information. Multivariate analysis showed that teachers (OR: 33.479, 95% (CI: 4.467–250.912)) and parents (OR: 45.336, 95% (CI: 10.886–188.807)) significantly contributed as a source of CSA information among students. The findings are essential important implications for interventions intended at preventing CSA. Sexual education programs should be officially applied at schools for children with the support of their parents and teachers.
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Guastaferro K, Holloway JL, Trudeau J, Lipson LB, Sunshine S, Noll JG, Pulido ML. Virtual Delivery of A School-Based Child Sexual Abuse Prevention Program: A Pilot Study. JOURNAL OF CHILD SEXUAL ABUSE 2022; 31:577-592. [PMID: 35959797 PMCID: PMC9421613 DOI: 10.1080/10538712.2022.2112347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 05/06/2022] [Accepted: 07/09/2022] [Indexed: 06/15/2023]
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.
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Affiliation(s)
- Kate Guastaferro
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park, PA, USA
| | | | - Jessica Trudeau
- The New York Society for the Prevention of Cruelty to Children, New York, NY, USA
| | - Lauren B Lipson
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park, PA, USA
| | - S Sunshine
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park, PA, USA
| | - Jennie G Noll
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park, PA, USA
| | - Mary L Pulido
- The New York Society for the Prevention of Cruelty to Children, New York, NY, USA
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Thompson EL, Garg A, Esser KC, Caddy D, Matthes S, Rohr D, Spence EE. Development and Validation of a Child Physical and Sexual Abuse Prevention Scale. Am J Health Behav 2021; 45:947-955. [PMID: 34702441 DOI: 10.5993/ajhb.45.5.14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Objective: School-based child abuse primary prevention programs are delivered across the country; however, a validated measurement tool that is feasible to deliver to students is unavailable. The purpose of this study was to describe the development and validation of a measurement tool for knowledge and skills related to the primary prevention of child physical and sexual abuse. Methods: Two elementary schools and 404 students participated. Students completed 5 instruments: the Play it Safe!® scale, 2 scales related to abuse prevention, and 2 unrelated scales. For assessment of the convergent and divergent validity, correlations were estimated and corresponding p-values in SAS version 9.4. Results: For the Play it Safe!® scale, the mean score was 10.87 out of 14 potential points (SD = 2.73; higher scores = higher knowledge). The internal consistency of the scale was adequate with a Cronbach's alpha of 0.77. We found strong correlations for the 2 convergent validity scales, and weak correlations for the 2 divergent validity scales. Conclusions: This study demonstrates the divergent and convergent validity of a child abuse primary prevention knowledge scale that can be used in school-settings and can assist in the measurement of primary prevention knowledge.
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Affiliation(s)
- Erika L. Thompson
- Erika L. Thompson, Assistant Professor, Department of Health Behavior and Health Systems, School of Public Health, University of North Texas Health Science Center, Fort Worth, TX, United States;,
| | - Ashvita Garg
- Ashvita Garg, Graduate Research Assistant, Department of Biostatistics and Epidemiology, School of Public Health, University of North Texas Health Science Center, Fort Worth, TX, United States
| | - Katharine Collier Esser
- Katharine Collier-Esser, Assistant Director of Research & Training Services, The Women's Center of Tarrant County, Fort Worth, TX, United States
| | - Deborah Caddy
- Deborah Caddy, Director of Rape Crisis & Victim Services, The Women's Center of Tarrant County, Fort Worth, TX, United States
| | - Sarah Matthes
- Sarah Matthes, Graduate Research Assistant, Department of Biostatistics and Epidemiology, School of Public Health, University of North Texas Health Science Center, Fort Worth, TX, United States
| | - Danielle Rohr
- Danielle Rohr, Senior Program Manager, School of Public Health, University of North Texas Health Science Center, Fort Worth, TX, United States
| | - Emily E. Spence
- Emily E. Spence, Associate Professor, School of Public Health, University of North Texas Health Science Center, Fort Worth, TX, United States
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Diaz MJ, Moreland D, Wolfersteig W. Assessing the Effects of Childhelp's Speak Up be Safe Child Abuse Prevention Curriculum for High School Students. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2021; 14:425-432. [PMID: 33968290 PMCID: PMC8090909 DOI: 10.1007/s40653-021-00353-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 04/12/2021] [Indexed: 06/12/2023]
Abstract
PURPOSE This study examined the Childhelp Speak Up Be Safe (CHSUBS) child abuse prevention curriculum for high school students and addressed a gap in evidence-based child maltreatment prevention programs. CHSUBS is grounded in theory and was developed to 1) provide students with the skills they need to prevent or interrupt child abuse, bullying, and neglect, and 2) increase student knowledge about safety related to abuse. METHODS Utilizing a cluster-randomized controlled trial design, the three high schools were randomly assigned to participate in the CHSUBS curriculum or the control group. Survey items measured the efficacy of the curriculum in grades 9 through 12. Surveys were implemented at baseline, immediately after the intervention, and after 6 months for a follow-up. Analyses included exploratory factor analyses and a paired samples t-test to determine whether increases in child maltreatment knowledge and resistance skills were gained. RESULTS Findings showed positive significant results that child maltreatment knowledge and resistance skills were significantly different from pre to post for the CHSUBS group and showed no significant control group changes. CONCLUSIONS High school students in the CHSUBS group appeared to gain both child maltreatment knowledge and resistance skills. Future studies on prevention programming for high school students might show results that lead to a reduction in child maltreatment and an increase in better health outcomes for adolescents.
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Affiliation(s)
- Marisol Juarez Diaz
- Southwest Interdisciplinary Research Center (SIRC), Watts College of Public Service and Community Solutions, School of Social Work, Arizona State University, Phoenix, AZ 85004 USA
| | - Diane Moreland
- Southwest Interdisciplinary Research Center (SIRC), Watts College of Public Service and Community Solutions, School of Social Work, Arizona State University, Phoenix, AZ 85004 USA
| | - Wendy Wolfersteig
- Southwest Interdisciplinary Research Center (SIRC), Watts College of Public Service and Community Solutions, School of Social Work, Arizona State University, Phoenix, AZ 85004 USA
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7
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Diaz MJ, Wolfersteig W, Moreland D, Yoder G, Dustman P, Harthun ML. Teaching Youth to Resist Abuse: Evaluation of a Strengths-Based Child Maltreatment Curriculum for High School Students. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2021; 14:141-149. [PMID: 33692874 PMCID: PMC7900375 DOI: 10.1007/s40653-020-00304-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
Child maltreatment (CM) is a serious and prevalent public health problem in the United States (U.S.) yet programming to combat the issue often overlooks high school aged youth (those aged 14-17). In 2017, over 90,000 youth in the U.S. experienced CM during their high school years (U.S. Department of Health and Human Services 2019). This manuscript will highlight the importance of prevention programs for youth affected by child maltreatment and report the findings of a pilot study that examined the effectiveness of the Childhelp Speak Up Be Safe Prevention Education Curriculum among high school students. The purpose of the pilot study was to determine if the revised and expanded curriculum for grades 9-12 was feasible and to examine the validity of the new survey items, including the RESIST strategy questions. The pilot study utilized a two-phase non-probability convenience sample to evaluate high school student gains in knowledge of safety related resistance strategies. High school students (N = 269) attending one urban charter public high school (grades 9-12) in the Southwest who completed pre- and post-survey RESIST strategy items participated in the pilot. The results indicated that students receiving the Childhelp Speak Up Be Safe Prevention Education Curriculum increased their identification and knowledge of safety related resistance strategies.
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Affiliation(s)
- Marisol J. Diaz
- Southwest Interdisciplinary Research Center, School of Social Work, Watts College of Public Service and Community Solutions, Arizona State University, Downtown Phoenix Campus, 201 N. Central Ave., 33rd floor, Phoenix, AZ 85004 USA
| | - Wendy Wolfersteig
- Southwest Interdisciplinary Research Center, School of Social Work, Watts College of Public Service and Community Solutions, Arizona State University, Downtown Phoenix Campus, 201 N. Central Ave., 33rd floor, Phoenix, AZ 85004 USA
| | - Diane Moreland
- Southwest Interdisciplinary Research Center, School of Social Work, Watts College of Public Service and Community Solutions, Arizona State University, Downtown Phoenix Campus, 201 N. Central Ave., 33rd floor, Phoenix, AZ 85004 USA
| | - Grant Yoder
- Southwest Interdisciplinary Research Center, School of Social Work, Watts College of Public Service and Community Solutions, Arizona State University, Downtown Phoenix Campus, 201 N. Central Ave., 33rd floor, Phoenix, AZ 85004 USA
| | - Patricia Dustman
- Southwest Interdisciplinary Research Center, School of Social Work, Watts College of Public Service and Community Solutions, Arizona State University, Downtown Phoenix Campus, 201 N. Central Ave., 33rd floor, Phoenix, AZ 85004 USA
| | - Mary L. Harthun
- Southwest Interdisciplinary Research Center, School of Social Work, Watts College of Public Service and Community Solutions, Arizona State University, Downtown Phoenix Campus, 201 N. Central Ave., 33rd floor, Phoenix, AZ 85004 USA
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8
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Thompson EL, Zhou Z, Garg A, Rohr D, Ajoku B, Spence EE. Evaluation of a School-Based Child Physical and Sexual Abuse Prevention Program. HEALTH EDUCATION & BEHAVIOR 2021; 49:584-592. [PMID: 33605168 DOI: 10.1177/1090198120988252] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND 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. AIMS To evaluate a school-based child sexual and physical abuse prevention intervention Play it Safe! among elementary school students using a cluster randomized design. METHOD 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. RESULTS 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). CONCLUSION 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.
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Affiliation(s)
- Erika L Thompson
- University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Zhengyang Zhou
- University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Ashvita Garg
- University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Danielle Rohr
- University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Brittany Ajoku
- University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Emily E Spence
- University of North Texas Health Science Center, Fort Worth, TX, USA
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9
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Ocaña JM, Morales-Urrutia EK, Pérez-Marín D, Pizarro C. Can a Learning Companion Be Used to Continue Teaching Programming to Children Even During the COVID-19 Pandemic? IEEE ACCESS : PRACTICAL INNOVATIONS, OPEN SOLUTIONS 2020; 8:157840-157861. [PMID: 34812353 PMCID: PMC8545312 DOI: 10.1109/access.2020.3020007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 08/21/2020] [Indexed: 06/13/2023]
Abstract
Learning how to program in Primary Education has attracted significant research in recent years. It is unclear though how programming environments and languages should be adapted to children to achieve better learning and use, but one trend seems to be the use of Scratch. The question in this paper is what programming environment can be used to continue teaching programming to children who have already been taught Scratch for years. This paper's proposal is that students aged between 10 and 12 can benefit from interacting with a friendly learning companion using p-code such as Alcody. The hypothesis is that students (aged between 10 and 12) with a knowledge of Scratch will be able to significantly improve their scores by using a learning companion to teach them how to program even during the COVID-19 pandemic. To check the hypothesis, an experiment was carried out during the 2019/2020 academic year with 137 students in Ecuador. A significant improvement in the scores of the students was recorded together with high satisfaction.
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Affiliation(s)
| | | | - Diana Pérez-Marín
- Ciencias de la Computación, Arquitectura de Computadores, Lenguajes y Sistemas Informáticos y Estadística e Investigación OperativaUniversidad Rey Juan Carlos28933MadridSpain
| | - Celeste Pizarro
- Matemática Aplicada, Ciencia e Ingeniería de los Materiales y Tecnología ElectrónicaUniversidad Rey Juan Carlos28933MadridSpain
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Tutty LM. Children's Knowledge of Abuse Questionnaires (CKAQ)-Short: Two Brief Ten-Item Measures of Knowledge about Child Sexual Abuse Concepts. JOURNAL OF CHILD SEXUAL ABUSE 2020; 29:513-530. [PMID: 31751187 DOI: 10.1080/10538712.2019.1688443] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Revised: 10/17/2019] [Accepted: 10/23/2019] [Indexed: 06/10/2023]
Abstract
Child-focused sexual abuse prevention programs were developed in the 1970s in response to significant concerns across North America with respect to children being sexually abused. While program evaluations are common, measures to evaluate these programs, most of which are offered to children in elementary schools, are not widely available. This article reviews the key concepts covered in CSA prevention education programs that comprise the constructs used to measure knowledge/attitude gains post-program. Available measures are reviewed and the psychometrics of two new 10-item versions (one for students in grades 1-2; the other for grades 3-6) of the CKAQ-33, a commonly used tool, are presented and psychometrically assessed with a sample of 7646 elementary school students.
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Affiliation(s)
- Leslie M Tutty
- Faculty of Social Work, University of Calgary , Calgary, Alberta, Canada
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11
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Tutty LM, Aubry D, Velasquez L. The "Who Do You Tell?"™ Child Sexual Abuse Education Program: Eight Years of Monitoring. JOURNAL OF CHILD SEXUAL ABUSE 2020; 29:2-21. [PMID: 31525148 DOI: 10.1080/10538712.2019.1663969] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Revised: 08/22/2019] [Accepted: 08/22/2019] [Indexed: 06/10/2023]
Abstract
School-based programs have been the central strategy to educate children about the serious nature of child sexual abuse (CSA) in the hope of prevention or early intervention. While program evaluations consistently show significant improvement in children's knowledge and skills, it behooves programs to monitor their impacts. Monitoring, or on-going assessments, can take several forms but in the current study refers to monitoring the outcome of knowledge of CSA prevention concepts. The "Who Do You Tell?"™ child sexual abuse education program has been offered for 35 years in Calgary, Canada and was previously evaluated in a randomized pre-test-post-test comparison study with strong positive findings. This article presents the results of subsequently monitoring program outcomes over an eight-year period (2010-2017), examining knowledge/attitudes in 6198 students in 50 schools in a Western Canadian city. All students significantly increased their CSA knowledge/attitudes with large effect sizes. Practice and policy implications are discussed.
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Affiliation(s)
- Leslie M Tutty
- Faculty of Social Work, University of Calgary, Calgary, Canada
| | - Danielle Aubry
- Calgary Communities Against Sexual Abuse, Calgary, Alberta, Canada
| | - Laura Velasquez
- Calgary Communities Against Sexual Abuse, Calgary, Alberta, Canada
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12
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Blakey JM, Glaude M, Jennings SW. School and program related factors influencing disclosure among children participating in a school-based childhood physical and sexual abuse prevention program. CHILD ABUSE & NEGLECT 2019; 96:104092. [PMID: 31425883 DOI: 10.1016/j.chiabu.2019.104092] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2018] [Revised: 07/10/2019] [Accepted: 07/15/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND School-based child abuse prevention programs were created to provide knowledge so that children can recognize abuse, teach skills that decrease children's risk for abuse, normalize the disclosure process, and provide a pathway for children who may be experiencing abuse to report the abuse. OBJECTIVE The purpose of this study was to explore school and program factors that trainers in a school-based prevention program believed were associated with disclosure among youth from kindergarten through 12th grade. PARTICIPANTS AND SETTING This study is based on eighteen trainers and administrators who work with the Play it Safe!® school-based program in Dallas-Fort Worth area. METHODS Using the qualitative case study method, in-depth interviews were conducted. RESULTS Data analysis revealed three factors that influenced disclosure: school, school personnel, and program features. The school-related factor was time allotted to the training. The school personnel-related factors were disengagement, ambiguity concerning abuse, prior history with children, and professionals' personal history of abuse. Finally, the program-related factors were the core messages of the training, providing specific examples, and repetition of the program. To date, there is a dearth of studies that explore the role that schools and school personnel play in the disclosure process. CONCLUSION Child abuse has devastating effects on children's physical, social, emotional, and psychological well-being. Understanding more about schools, personnel, and program-related factors that lead to disclosure, which are more amenable to change, is critical to ensuring the safety of children.
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Affiliation(s)
- Joan M Blakey
- Tulane University, School of Social Work, 127 Elk Place, Room 324, Mail Code 8906, New Orleans, LA 70112, United States.
| | - Maurya Glaude
- Tulane University, School of Social Work, 127 Elk Place, Room 324, Mail Code 8906, New Orleans, LA 70112, United States.
| | - Sheara Williams Jennings
- University of Houston, Graduate College of Social Work, 3511 Cullen Blvd., Room 110HA, Houston, Texas 77204-4013, United States.
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White C, Shanley DC, Zimmer-Gembeck MJ, Walsh K, Hawkins R, Lines K. Outcomes of In Situ Training for Disclosure as a Standalone and a Booster to a Child Protective Behaviors Education Program. CHILD MALTREATMENT 2019; 24:193-202. [PMID: 30526001 DOI: 10.1177/1077559518816877] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
In this study, the effectiveness of the Observed Protective Behaviors behaviors test, a single-session, disclosure-focused, in situ skills training (IST), was evaluated as a standalone program (IST only) or as a booster to the child protective education program, Learn to be safe with Emmy and friends ™ (program + IST). Participants included 281 Year 1 children (5-7 years; 52% male), randomly assigned to IST only, program + IST, program only or waitlist, and followed across 6 months. At each assessment, children completed interviews to assess their intention and confidence to disclose unsafe situations (disclosure intentions and confidence) and their ability to identify unsafe situations (safety identification skills). Children also reported their anxiety symptoms to assess for a possible iatrogenic effect. The IST-only condition was effective, with children showing increased disclosure intentions relative to waitlist children. The program + IST condition was also effective, with children showing increased disclosure intentions relative to children in the waitlist or program-only conditions as well as greater increases in disclosure confidence relative to waitlist children. No differences were observed between conditions in children's safety identification skills, and no iatrogenic effect on anxiety was found. Future research may seek to develop an IST that will also boost children's safety identification skills.
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Affiliation(s)
- Codi White
- 1 School of Applied Psychology, Menzies Health Institute of Queensland, Griffith University, Gold Coast, Australia
| | - Dianne C Shanley
- 1 School of Applied Psychology, Menzies Health Institute of Queensland, Griffith University, Gold Coast, Australia
| | - Melanie J Zimmer-Gembeck
- 1 School of Applied Psychology, Menzies Health Institute of Queensland, Griffith University, Gold Coast, Australia
| | - Kerryann Walsh
- 2 Faculty of Education, Queensland University of Technology, Brisbane, Australia
| | - Russell Hawkins
- 3 College of Healthcare Sciences, James Cook University, Cairns, Australia
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Rudolph J, Zimmer-Gembeck MJ. Reviewing the Focus: A Summary and Critique of Child-Focused Sexual Abuse Prevention. TRAUMA, VIOLENCE & ABUSE 2018; 19:543-554. [PMID: 27789611 DOI: 10.1177/1524838016675478] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Due to the high incidence, and widespread detrimental health consequences, of child sexual abuse (CSA), effective prevention remains at the forefront of public and mental health research, prevention and intervention agendas. To date much of the focus of prevention has been on school-based education programs designed to teach children skills to evade adult sexual advances, and disclose past or ongoing abuse. Evaluation of sexual abuse prevention programs demonstrate their effectiveness in increasing children's knowledge of CSA concepts and protection skills, but little is known about their effects on children's capacity to prevent abuse. Moreover, concerns persist about the unintended side-effects for young children such as anxiety, worry and wariness of touch. This paper summarizes the recent history of CSA prevention and the critique of child-focused protection programs in order to demonstrate the need to compliment or replace these programs by focusing more on protectors in the children's ecology, specifically parents, in order to create safer environments in which abuse is less likely to occur.
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Affiliation(s)
- Julia Rudolph
- 1 School of Applied Psychology, Griffith University, Southport, Queensland, Australia
- 2 Menzies Health Institute of Queensland, Griffith University, Southport, Queensland, Australia
| | - Melanie J Zimmer-Gembeck
- 1 School of Applied Psychology, Griffith University, Southport, Queensland, Australia
- 2 Menzies Health Institute of Queensland, Griffith University, Southport, Queensland, Australia
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White C, Shanley DC, Zimmer-Gembeck MJ, Walsh K, Hawkins R, Lines K. "Tell, tell, tell again": The prevalence and correlates of young children's response to and disclosure of an in-vivo lure from a stranger. CHILD ABUSE & NEGLECT 2018; 82:134-143. [PMID: 29902696 DOI: 10.1016/j.chiabu.2018.06.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2018] [Revised: 05/28/2018] [Accepted: 06/01/2018] [Indexed: 06/08/2023]
Abstract
Despite being a key target outcome to prevent child maltreatment, little research has been conducted to examine the prevalence and predictors of interpersonal safety skills in a standardised manner. In this study, interpersonal safety skills were measured in a Year 1-2 student sample through use of a standardised simulated risk scenario, with three primary skills examined: withdrawal from an unknown confederate (motor safety response), verbal refusal of an abduction lure (verbal safety response) and disclosure of confederate presence. Children who participated in this study had not completed any prior behavioural skills training or child protective education programs. Overall, the prevalence of interpersonal safety skills varied, with 27% children withdrawing from the confederate, 48% refusing the lure and 83% disclosing the confederate's presence. For correlates, motor and verbal safety responses were positively associated with each other. However, the only other correlate of interpersonal safety skills was anxiety, with children who had greater anxiety disclosing earlier but also being more likely to agree to leave with the confederate. Future research may seek to examine whether these correlates remain present with different types of interpersonal safety risk (e.g., bullying) and to identify other potential predictors of interpersonal safety skill use.
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Affiliation(s)
- Codi White
- School of Applied Psychology and Menzies Health Institute of Queensland, Griffith University, Gold Coast, Australia.
| | - Dianne C Shanley
- School of Applied Psychology and Menzies Health Institute of Queensland, Griffith University, Gold Coast, Australia
| | - Melanie J Zimmer-Gembeck
- School of Applied Psychology and Menzies Health Institute of Queensland, Griffith University, Gold Coast, Australia
| | - Kerryann Walsh
- Faculty of Education, Queensland University of Technology, Brisbane, Australia
| | - Russell Hawkins
- College of Healthcare Sciences, James Cook University, Cairns, Australia
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White C, Shanley DC, Zimmer-Gembeck MJ, Walsh K, Hawkins R, Lines K, Webb H. Promoting young children's interpersonal safety knowledge, intentions, confidence, and protective behavior skills: Outcomes of a randomized controlled trial. CHILD ABUSE & NEGLECT 2018; 82:144-155. [PMID: 29902697 DOI: 10.1016/j.chiabu.2018.05.024] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Revised: 05/18/2018] [Accepted: 05/27/2018] [Indexed: 06/08/2023]
Abstract
Promoting young children's interpersonal safety knowledge, intentions confidence and skills is the goal of many child maltreatment prevention programs; however, evaluation of their effectiveness has been limited. In this study, a randomized controlled trial was conducted examining the effectiveness of the Australian protective behaviors program, Learn to be safe with Emmy and friends™ compared to a waitlist condition. In total, 611 Australian children in Grade 1 (5-7 years; 50% male) participated, with assessments at Pre-intervention, Post-intervention and a 6-month follow-up. This study also included a novel assessment of interpersonal safety skills through the Observed Protective Behaviors Test (OPBT). Analyses showed participating in Learn to be safe with Emmy and friends™ was effective post-program in improving interpersonal safety knowledge (child and parent-rated) and parent-rated interpersonal safety skills. These benefits were retained at the 6-month follow-up, with participating children also reporting increased disclosure confidence. However, Learn to be safe with Emmy and friends™ participation did not significantly impact children's disclosure intentions, safety identification skills, or interpersonal safety skills as measured by the OPBT. Future research may seek to evaluate the effect of further parent and teacher integration into training methods and increased use of behavioral rehearsal and modelling to more effectively target specific disclosure intentions and skills.
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Affiliation(s)
- Codi White
- School of Applied Psychology and Menzies Health Institute of Queensland, Griffith University, Gold Coast, Australia.
| | - Dianne C Shanley
- School of Applied Psychology and Menzies Health Institute of Queensland, Griffith University, Gold Coast, Australia
| | - Melanie J Zimmer-Gembeck
- School of Applied Psychology and Menzies Health Institute of Queensland, Griffith University, Gold Coast, Australia
| | - Kerryann Walsh
- Faculty of Education, Queensland University of Technology, Brisbane, Australia
| | - Russell Hawkins
- College of Healthcare Sciences, James Cook University, Cairns, Australia
| | | | - Haley Webb
- School of Applied Psychology and Menzies Health Institute of Queensland, Griffith University, Gold Coast, Australia
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Rudolph J, Zimmer-Gembeck MJ, Shanley DC, Hawkins R. Child Sexual Abuse Prevention Opportunities: Parenting, Programs, and the Reduction of Risk. CHILD MALTREATMENT 2018; 23:96-106. [PMID: 28920456 DOI: 10.1177/1077559517729479] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
To date, child sexual abuse (CSA) prevention has relied largely on child-focused education, teaching children how to identify, avoid, and disclose sexual abuse. The purpose of this article is to explore how prevention opportunities can include parents in new and innovative ways. We propose that parents can play a significant role as protectors of their children via two pathways: (i) directly, through the strong external barriers afforded by parent supervision, monitoring, and involvement; and (ii) indirectly, by promoting their children's self-efficacy, competence, well-being, and self-esteem, which the balance of evidence suggests will help them become less likely targets for abuse and more able to respond appropriately and disclose abuse if it occurs. In this article, we first describe why teaching young children about CSA protective behaviors might not be sufficient for prevention. We then narratively review the existing research on parents and prevention and the parenting and family circumstances that may increase a child's risk of experiencing sexual abuse. Finally, we make a number of recommendations for future approaches to prevention that may better inform and involve parents and other adult protectors in preventing CSA.
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Affiliation(s)
- Julia Rudolph
- 1 School of Applied Psychology, Griffith University, Southport, Queensland, Australia
- 2 Menzies Health Institute of Queensland, Griffith University, Southport, Queensland, Australia
| | - Melanie J Zimmer-Gembeck
- 1 School of Applied Psychology, Griffith University, Southport, Queensland, Australia
- 2 Menzies Health Institute of Queensland, Griffith University, Southport, Queensland, Australia
| | - Dianne C Shanley
- 1 School of Applied Psychology, Griffith University, Southport, Queensland, Australia
- 2 Menzies Health Institute of Queensland, Griffith University, Southport, Queensland, Australia
| | - Russell Hawkins
- 3 College of Healthcare Sciences, James Cook University, Cairns, Queensland, Australia
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18
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Orton E, Whitehead J, Mhizha‐Murira J, Clarkson M, Watson MC, Mulvaney CA, Staniforth JUL, Bhuchar M, Kendrick D. School-based education programmes for the prevention of unintentional injuries in children and young people. Cochrane Database Syst Rev 2016; 12:CD010246. [PMID: 28026877 PMCID: PMC6473192 DOI: 10.1002/14651858.cd010246.pub2] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Unintentional injuries are the leading cause of death in children aged four to 18 years and are a major cause of ill health. The school setting offers the opportunity to deliver preventive interventions to a large number of children and has been used to address a range of public health problems. However, the effectiveness of the school setting for the prevention of different injury mechanisms in school-aged children is not well understood. OBJECTIVES To assess the effects of school-based educational programmes for the prevention of injuries in children and evaluate their impact on improving children's safety skills, behaviour and practices, and knowledge, and assess their cost-effectiveness. SEARCH METHODS We ran the most recent searches up to 16 September 2016 for the following electronic databases: Cochrane Injuries Group Specialised Register; Cochrane Central Register of Controlled Trials; Ovid MEDLINE(R), Ovid MEDLINE(R) In-Process & Other Non-Indexed Citations; Ovid MEDLINE(R) Daily and Ovid OLDMEDLINE(R); Embase and Embase Classic (Ovid); ISI Web of Science: Science Citation Index Expanded; ISI Web of Science Conference Proceedings Citation Index-Science; ISI Web of Science: Social Sciences Citation Index; ISI Web of Science: Conference Proceedings Citation Index - Social Sciences & Humanities; and the 14 October 2016 for the following electronic databases: Health Economics Evaluations Database (HEED); Health Technology Assessment Database (HTA); CINAHL Plus (EBSCO); ZETOC; LILACS; PsycINFO; ERIC; Dissertation Abstracts Online; IBSS; BEI; ASSIA; CSA Sociological Abstracts; Injury Prevention Web; SafetyLit; EconLit (US); PAIS; UK Clinical Research Network Study Portfolio; Open Grey; Index to Theses in the UK and Ireland; Bibliomap and TRoPHI. SELECTION CRITERIA We included randomised controlled trials (RCTs), non-randomised controlled trials (non-RCTs), and controlled before-and-after (CBA) studies that evaluated school-based educational programmes aimed at preventing a range of injury mechanisms. The primary outcome was self-reported or medically attended unintentional (or unspecified intent) injuries and secondary outcomes were observed safety skills, observed behaviour, self-reported behaviour and safety practices, safety knowledge, and health economic outcomes. The control groups received no intervention, a delayed injury-prevention intervention or alternative school-based curricular activities. We included studies that aimed interventions at primary or secondary prevention of injuries from more than one injury mechanism and were delivered, in part or in full, in schools catering for children aged four to 18 years. DATA COLLECTION AND ANALYSIS We used standard methodological procedures expected by Cochrane. Two review authors identified relevant trials from title and abstracts of studies identified in searches and two review authors extracted data from the included studies and assessed risk of bias. We grouped different types of interventions according to the outcome assessed and the injury mechanism targeted. Where data permitted, we performed random-effects meta-analyses to provide a summary of results across studies. MAIN RESULTS The review included 27 studies reported in 30 articles. The studies had 73,557 participants with 12 studies from the US; four from China; two from each of Australia, Canada, the Netherlands and the UK; and one from each of Israel, Greece and Brazil. Thirteen studies were RCTs, six were non-RCTs and eight were CBAs. Of the included studies, 18 provided some element of the intervention in children aged four to 11 years, 17 studies included children aged 11 to 14 years and nine studies included children aged 14 to 18 years.The overall quality of the results was poor, with the all studies assessed as being at high or unclear risks of bias across multiple domains, and varied interventions and data collection methods employed. Interventions comprised information-giving, peer education or were multi-component.Seven studies reported the primary outcome of injury occurrence and only three of these were similar enough to combine in a meta-analysis, with a pooled incidence rate ratio of 0.73 (95% confidence interval (CI) 0.49 to 1.08; 2073 children) and substantial statistical heterogeneity (I2 = 63%). However, this body of evidence was low certainty, due to concerns over this heterogeneity (inconsistency) and imprecision. This heterogeneity may be explained by the non-RCT study design of one of the studies, as a sensitivity analysis with this study removed found stronger evidence of an effect and no heterogeneity (I2 = 0%).Two studies report an improvement in safety skills in the intervention group. Likewise, the four studies measuring observed safety behaviour reported an improvement in the intervention group relative to the control. Thirteen out of 19 studies describing self-reported behaviour and safety practices showed improvements, and of the 21 studies assessing changes in safety knowledge, 19 reported an improvement in at least one question domain in the intervention compared to the control group. However, we were unable to pool data for our secondary outcomes, so our conclusions were limited, as they were drawn from highly diverse single studies and the body of evidence was low (safety skills) or very low (behaviour, safety knowledge) certainty. Only one study reported intervention costs but did not undertake a full economic evaluation (very low certainty evidence). AUTHORS' CONCLUSIONS There is insufficient evidence to determine whether school-based educational programmes can prevent unintentional injuries. More high-quality studies are needed to evaluate the impact of educational programmes on injury occurrence. There is some weak evidence that such programmes improve safety skills, behaviour/practices and knowledge, although the evidence was of low or very low quality certainty. We found insufficient economic studies to assess cost-effectiveness.
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Affiliation(s)
- Elizabeth Orton
- University of NottinghamDivision of Primary CareRoom 1313, Tower BuildingUniversity ParkNottinghamUKNG7 2RD
| | - Jessica Whitehead
- University of NottinghamDivision of Primary CareRoom 1313, Tower BuildingUniversity ParkNottinghamUKNG7 2RD
| | - Jacqueline Mhizha‐Murira
- University of NottinghamDivision of Primary CareRoom 1313, Tower BuildingUniversity ParkNottinghamUKNG7 2RD
| | - Mandy Clarkson
- University of NottinghamDivision of Primary CareRoom 1313, Tower BuildingUniversity ParkNottinghamUKNG7 2RD
| | - Michael C Watson
- The University of NottinghamSchool of Health SciencesB Floor, South Block LinkQueens Medical CentreNottinghamUKNG7 2HA
| | - Caroline A Mulvaney
- Lancaster UniversityLancaster Health HubLancasterUKLA1 4YR
- University of NottinghamFaculty of Medicine & Health SciencesNottinghamUK
| | - Joy UL Staniforth
- University of NottinghamDivision of Primary CareRoom 1313, Tower BuildingUniversity ParkNottinghamUKNG7 2RD
| | - Munish Bhuchar
- University of NottinghamDivision of Primary CareRoom 1313, Tower BuildingUniversity ParkNottinghamUKNG7 2RD
| | - Denise Kendrick
- The University of NottinghamDivision of Primary Care, School of MedicineFloor 13, Tower BuildingUniversity ParkNottinghamUKNG7 2RD
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White C, Shanley DC, Zimmer-Gembeck MJ, Lines K, Walsh K, Hawkins R. Cluster randomised-control trial for an Australian child protection education program: Study protocol for the Learn to be safe with Emmy and friends™. BMC Public Health 2016; 16:72. [PMID: 26809257 PMCID: PMC4727321 DOI: 10.1186/s12889-016-2721-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2015] [Accepted: 01/11/2016] [Indexed: 03/26/2024] Open
Abstract
BACKGROUND Child maltreatment has severe short-and long-term consequences for children's health, development, and wellbeing. Despite the provision of child protection education programs in many countries, few have been rigorously evaluated to determine their effectiveness. We describe the design of a multi-site gold standard evaluation of an Australian school-based child protection education program. The intervention has been developed by a not-for-profit agency and comprises 5 1-h sessions delivered to first grade students (aged 5-6 years) in their regular classrooms. It incorporates common attributes of effective programs identified in the literature, and aligns with the Australian education curriculum. METHODS/DESIGN A three-site cluster randomised controlled trial (RCT) of Learn to be safe with Emmy and friends™ will be conducted with children in approximately 72 first grade classrooms in 24 Queensland primary (elementary) schools from three state regions, over a period of 2 years. Entire schools will be randomised, using a computer generated list of random numbers, to intervention and wait-list control conditions, to prevent contamination effects across students and classes. Data will be collected at baseline (pre-assessment), immediately after the intervention (post-assessment), and at 6-, 12-, and 18-months (follow-up assessments). Outcome assessors will be blinded to group membership. Primary outcomes assessed are children's knowledge of program concepts; intentions to use program knowledge, skills, and help-seeking strategies; actual use of program material in a simulated situation; and anxiety arising from program participation. Secondary outcomes include a parent discussion monitor, parent observations of their children's use of program materials, satisfaction with the program, and parental stress. A process evaluation will be conducted concurrently to assess program performance. DISCUSSION This RCT addresses shortcomings in previous studies and methodologically extends research in this area by randomising at school-level to prevent cross-learning between conditions; providing longer-term outcome assessment than any previous study; examining the degree to which parents/guardians discuss intervention content with children at home; assessing potential moderating/mediating effects of family and child demographic variables; testing an in-vivo measure to assess children's ability to discriminate safe/unsafe situations and disclose to trusted adults; and testing enhancements to existing measures to establish greater internal consistency. TRIAL REGISTRATION Australian and New Zealand Clinical Trials Register (ACTRN12615000917538). Registered (02/09/2015).
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Affiliation(s)
- Codi White
- School of Applied Psychology and Menzies Health Institute of Queensland, Griffith University, Gold Coast, Australia.
| | - Dianne C Shanley
- School of Applied Psychology and Menzies Health Institute of Queensland, Griffith University, Gold Coast, Australia.
| | - Melanie J Zimmer-Gembeck
- School of Applied Psychology and Menzies Health Institute of Queensland, Griffith University, Gold Coast, Australia.
| | | | - Kerryann Walsh
- Faculty of Education, Queensland University of Technology, Brisbane, Australia.
| | - Russell Hawkins
- College of Healthcare Sciences, James Cook University, Cairns, Australia.
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