A sexual assault primary prevention model with diverse urban youth

The Primary Prevention of Sexual Violence Against Adolescents in School and Community Settings: A Scoping Review

Sexual Violence (SV) is a public health problem with serious long-term consequences for victims. This scoping review aimed at summarizing the implementation, methodology, characteristics, and efficacy of SV prevention programs conducted in school and community settings with middle and high school students. This study also gathered recommendations for future research. Studies were searched in three databases: EBSCOHOST, SCOPUS and Web of Science. Eighty-six peer-reviewed empirical studies about SV prevention programs applied in school and community settings with samples of middle and high school students were analyzed. Most original studies (46.3%) used sexual violence outcomes, although many approached sexual violence in the context of dating violence (43.3%). Most SV prevention programs were applied in the U.S.A. although studies were identified across the globe. Prevention programs tend to reduce SV attitudes, perpetration, and victimization and to increase SV knowledge, as well as bystander attitudes and behaviors. The evidence reveals the efficacy of these programs, although future studies are needed to clarify the specificities of SV prevention. This article provides recommendations considering the measurement of SV outcomes, the role of technology, the involvement of adults and communities, the timing of interventions, sexual education, and reporting practices.

Perils and Possibilities: Sexual Violence Preventionists' Perspectives on Gathering Community Input on Prevention Practice

There is relatively little research unpacking provider processes or tensions (e.g., leadership decision-making) when attempting to gather and incorporate community feedback into gender-based violence work. Across focus groups with 18 sexual violence preventionists, we explored experiences collecting information and perspectives from or with community members; barriers, and facilitators; and how they navigate possibilities of community-informed sexual violence prevention. We learned that preventionists want to gather input, and they gather it in nonsystematic ways; they face barriers familiar to many community-informed processes; and the topic of sexual violence complicates community-informed processes. Determining boundaries of possibility is central to navigating practice. Further, organizational settings are influential in determining boundaries.

Early Educational Interventions to Prevent Gender-Based Violence: A Systematic Review

BACKGROUND

Gender-based violence is a worldwide public health problem that is increasingly occurring at younger ages. This investigation aims to analyze effective interventions to prevent and to face gender-based violence beginning in early childhood in order to ensure quality education for all children through violence-free schools.

METHODS

This research has conducted a systematic review of interventions that have demonstrated a positive impact on the prevention and reduction of gender-based violence from early ages up to 12 years, inclusive, in schools. An extensive search in scientific databases (WoS, SCOPUS, ERIC, PsycINFO) was conducted from 2007 to 2022.

RESULTS

Thirteen articles were selected and analyzed in-depth to identify the success factors of these interventions, which (a) are integrated into the school curriculum; (b) promote active participation of students and community; (c) are based on scientific evidence; and (d) make relevant adaptations to a specific group and context.

CONCLUSIONS

The programs analyzed have had a positive impact on raising awareness of gender violence, overcoming stereotypes, improving relationships in the classroom and reducing violent behavior, as well as empowering the most vulnerable people.

Effectiveness of school-based child sexual abuse intervention among school children in the new millennium era: Systematic review and meta-analyses

Introduction

School-based child sexual abuse intervention programs were developed to educate the school children to protect them from sexual abuse. The programs were evaluated to make sure the interventions were effective in reducing child sexual abuse cases (CSA). This review aimed to determine the effectiveness of the school-based child sexual abuse intervention programs in the new millennium era (2000-2021) in improving the knowledge, skills, and attitude of school children under 18 years old toward child sexual abuse.

Methods

A systematic search was conducted through MEDLINE (PubMed), EBSCO, and SCOPUS databases to collect full English articles related to school-based CSA intervention programs published from 2000 to 2021.

Results

A total of 29 studies from randomized control trial and quasi-experimental from several countries was analyzed. Comparisons within group of pre-post intervention for knowledge, skills, and attitude were measured by standardized mean difference (SMD) and 95% CI of -1.06 (95% CI: -1.29, -0.84), -0.91 (95% CI: -1.2, -0.61), and -0.51 (95% CI: -3.61, 0.58), respectively. Meanwhile for between intervention and control group comparisons, the SMD of knowledge was 0.9 (95% CI: 0.63, 1.18), skills was 0.39 (95% CI: 0.07, 0.71), and attitude was 1.76 (95% CI: 0.46, 3.07).

Conclusion

The programs were found to be effective in improving the knowledge, skills, and attitude of the students from pre-intervention to post-intervention and between the intervention and control groups.Systematic Review Registration: www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022312383, identifier: CRD42022312383.

The effect of preventive psychosocial interventions directed towards mothers and children on children's knowledge about protection from sexual abuse

PROBLEM

Sexual abuse is a multidimensional public health problem that concerns all communities. Primary-level preventive approaches in the fight against sexual abuse have an important place. However, research involving parents in sexual abuse prevention interventions with children is limited. The aim of this study is to determine the effect of preventive psychosocial interventions directed towards mothers and their children on children's knowledge about protection from sexual abuse.

METHODS

The study has a quasi-experimental, comparative design with a control group and a pretest/posttest. The participants were assigned into four groups; namely, control, mother psychoeducation, child psychoeducation and mother-child psychoeducation.

FINDINGS

Significant difference was determined within and between the groups in the mean scores of the Good Touch Bad Touch Curriculum test (p < 0.001).

CONCLUSION

The preventive psychosocial intervention simplemented to mothers and their children increase children's knowledge about protection from sexual abuse.

Actions to prevent sexual violence against adolescents: an integrative literature review

OBJECTIVE

to identify actions to prevent adolescent sexual violence.

METHOD

an integrative literature review of five databases, Medline/Pubmed, Scopus, Lilacs, Bdenf, Cinahl using the following descriptors "adolescent" "adolescence" "youth" "primary prevention" "prevention" "primary" "sexual violence", plus the Boolean operators AND and OR, with a final sample of 24 articles; the evidence was assessed by the Grading of Recommendations Assessment, Development and Evaluation.

RESULTS

the review identifies different structures of the study object, classified in the categories "Interventions with programs created by authors" and "Interventions with standard programs".

CONCLUSION

there are actions to prevent sexual violence against adolescents; the participants' knowledge was assessed immediately after the intervention, but the assessment of the participants' acquisition of habits and behavioral changes was to a lesser extent; health prevention is crucial for society's healthy development, which demonstrates that its applicability in the environment directly favors human health.

Child Sexual Abuse Victimization Prevention Programs in Preschool and Kindergarten: Implications for Practice

With the alarming rates of child sexual abuse in the United States, there have been several attempts to develop and implement child abuse victimization programs in elementary schools across the country. Many programs have targeted older school-age children, but research shows that these programs can be effective for children of preschool and kindergarten age. This paper will review the literature that provides the rationale behind offering these types programs to the youngest of school-children, what these programs can offer, and describe specific programs that have been validated for preschool and kindergarten-aged children, using the best practice guidelines in the field of early childhood education. Recommendations for future programs and research needs are also offered.

Public health nursing and the issue of trust in campus sexual assault

Public Health Nurses are the largest group of public health practitioners in both local and state health departments across the United States. Essential for the delivery of health services in the community, Public Health Nurses frequently provide care for underserved and vulnerable populations. Among these populations are the victims of campus sexual assault, a growing problem on college and university campuses. Both nationally and internationally, sexual assault has been described as a public health and human rights concern. With the signing of the Senate Bill 967 in California, affirmative consent, known as "yes means yes," requires both parties in a sexual encounter to give voluntary and affirmative consent. Many colleges and universities across the country have adopted similar standards. However, students may choose not to seek health care after an assault at the Student Health Center, preferring to obtain care in community clinics or health departments. Students must be able to be safe on and off campus, and must be able to trust they will be heard by campus authorities and the health care community, and be treated with respect. Public health nurses need to be prepared to work with victims of campus sexual assault and have a solid foundation in the issues surrounding assault, and the needs of the student to trust their caregivers. This paper presents an overview of the vulnerability and risk factors in sexual assault, presents legislation on campus and institutional responsibility, and provides a foundation for Public Health Nurses working with victims of sexual assault.

Community-level moderators of a school-based childhood sexual assault prevention program

Childhood sexual abuse (CSA) is highly prevalent and associated with a wide variety of negative mental and physical health outcomes. School-based CSA education and prevention programs have shown promise, but it is unclear to what extent community-level characteristics are related to their effectiveness. The present cluster randomized controlled trial evaluated community-level moderators of the Safe@Lastprogramcomparedtoawaitlistcontrolcondition.(*) Knowledge gains from pre- to post-intervention were assessed in 5 domains: safe versus unsafe people; safe choices; problem-solving; clear disclosure; and assertiveness. Participants were 1177 students (46% White, 26% African American, 15% Hispanic, 4% Asian American, 6% Other) in grades 1 through 6 from 14 public schools in Tennessee. Multilevel models accounting for the nesting of children within schools revealed large effect sizes for the intervention versus control across all knowledge domains (d's ranged from 1.56 to 2.13). The effectiveness of the program was moderated by mean per capita income and rates of substantiated cases of child abuse and neglect in the community. Intervention effects were stronger for youth living in lower as compared to higher income counties, and for youth attending schools in counties with lower as compared to higher abuse/neglect rates. Child characteristics (sex, race) did not moderate intervention effects. This research identified two community-level factors that predicted the effectiveness of a CSA education and prevention program designed to improve children's knowledge of personal safety skills. School-based CSA prevention programs may require modification for communities with higher rates of child abuse and neglect.

School-based education programmes for the prevention of child sexual abuse

BACKGROUND

Child sexual abuse is a significant global problem in both magnitude and sequelae. The most widely used primary prevention strategy has been the provision of school-based education programmes. Although programmes have been taught in schools since the 1980s, their effectiveness requires ongoing scrutiny.

OBJECTIVES

To systematically assess evidence of the effectiveness of school-based education programmes for the prevention of child sexual abuse. Specifically, to assess whether: programmes are effective in improving students' protective behaviours and knowledge about sexual abuse prevention; behaviours and skills are retained over time; and participation results in disclosures of sexual abuse, produces harms, or both.

SEARCH METHODS

In September 2014, we searched CENTRAL, Ovid MEDLINE, EMBASE and 11 other databases. We also searched two trials registers and screened the reference lists of previous reviews for additional trials.

SELECTION CRITERIA

We selected randomised controlled trials (RCTs), cluster-RCTs, and quasi-RCTs of school-based education interventions for the prevention of child sexual abuse compared with another intervention or no intervention.

DATA COLLECTION AND ANALYSIS

Two review authors independently assessed the eligibility of trials for inclusion, extracted data, and assessed risk of bias. We summarised data for six outcomes: protective behaviours; knowledge of sexual abuse or sexual abuse prevention concepts; retention of protective behaviours over time; retention of knowledge over time; harm; and disclosures of sexual abuse.

MAIN RESULTS

This is an update of a Cochrane Review that included 15 trials (up to August 2006). We identified 10 additional trials for the period to September 2014. We excluded one trial from the original review. Therefore, this update includes a total of 24 trials (5802 participants). We conducted several meta-analyses. More than half of the trials in each meta-analysis contained unit of analysis errors.1. Meta-analysis of two trials (n = 102) evaluating protective behaviours favoured intervention (odds ratio (OR) 5.71, 95% confidence interval (CI) 1.98 to 16.51), with borderline low to moderate heterogeneity (Chi² = 1.37, df = 1, P value = 0.24, I² = 27%, Tau² = 0.16). The results did not change when we made adjustments using intraclass correlation coefficients (ICCs) to correct errors made in studies where data were analysed without accounting for the clustering of students in classes or schools.2. Meta-analysis of 18 trials (n = 4657) evaluating questionnaire-based knowledge favoured intervention (standardised mean difference (SMD) 0.61, 95% CI 0.45 to 0.78), but there was substantial heterogeneity (Chi² = 104.76, df = 17, P value < 0.00001, I² = 84%, Tau² = 0.10). The results did not change when adjusted for clustering (ICC: 0.1 SMD 0.66, 95% CI 0.51 to 0.81; ICC: 0.2 SMD 0.63, 95% CI 0.50 to 0.77).3. Meta-analysis of 11 trials (n =1688) evaluating vignette-based knowledge favoured intervention (SMD 0.45, 95% CI 0.24 to 0.65), but there was substantial heterogeneity (Chi² = 34.25, df = 10, P value < 0.0002, I² = 71%, Tau² = 0.08). The results did not change when adjusted for clustering (ICC: 0.1 SMD 0.53, 95% CI 0.32 to 0.74; ICC: 0.2 SMD 0.60, 95% CI 0.31 to 0.89).4. We included four trials in the meta-analysis for retention of knowledge over time. The effect of intervention seemed to persist beyond the immediate assessment (SMD 0.78, 95% CI 0.38 to 1.17; I² = 84%, Tau² = 0.13, P value = 0.0003; n = 956) to six months (SMD 0.69, 95% CI 0.51 to 0.87; I² = 25%; Tau² = 0.01, P value = 0.26; n = 929). The results did not change when adjustments were made using ICCs.5. We included three studies in the meta-analysis for adverse effects (harm) manifesting as child anxiety or fear. The results showed no increase or decrease in anxiety or fear in intervention participants (SMD -0.08, 95% CI -0.22 to 0.07; n = 795) and there was no heterogeneity (I² = 0%, P value = 0.79; n=795). The results did not change when adjustments were made using ICCs.6. We included three studies (n = 1788) in the meta-analysis for disclosure of previous or current sexual abuse. The results favoured intervention (OR 3.56, 95% CI 1.13 to 11.24), with no heterogeneity (I² = 0%, P value = 0.84). However, adjusting for the effect of clustering had the effect of widening the confidence intervals around the OR (ICC: 0.1 OR 3.04, 95% CI 0.75 to 12.33; ICC: 0.2 OR 2.95, 95% CI 0.69 to 12.61).Insufficient information was provided in the included studies to conduct planned subgroup analyses and there were insufficient studies to conduct meaningful analyses.The quality of evidence for all outcomes included in the meta-analyses was moderate owing to unclear risk of selection bias across most studies, high or unclear risk of detection bias across over half of included studies, and high or unclear risk of attrition bias across most studies. The results should be interpreted cautiously.

AUTHORS' CONCLUSIONS

The studies included in this review show evidence of improvements in protective behaviours and knowledge among children exposed to school-based programmes, regardless of the type of programme. The results might have differed had the true ICCs or cluster-adjusted results been available. There is evidence that children's knowledge does not deteriorate over time, although this requires further research with longer-term follow-up. Programme participation does not generate increased or decreased child anxiety or fear, however there is a need for ongoing monitoring of both positive and negative short- and long-term effects. The results show that programme participation may increase the odds of disclosure, however there is a need for more programme evaluations to routinely collect such data. Further investigation of the moderators of programme effects is required along with longitudinal or data linkage studies that can assess actual prevention of child sexual abuse.