Knowledge and Skills of Sexual Abuse Prevention: A Study on School-Aged Children in Beijing, China

Schools' readiness for child sexual abuse prevention education: Preliminary scale development using a Delphi method

BACKGROUND

This study employed a Delphi method with a panel of experts to collaboratively design a new instrument to assess schools' readiness for school-based child sexual abuse prevention education.

METHODS

An initial item pool was generated based on a review of existing empirical research and theoretical models. We invited researchers and stakeholders in the field of child sexual abuse prevention as experts to participate in a two-round online Delphi study in which they rated item importance and clarity, contributed their views on superfluous and/or missing items, gave rephrasing suggestions, and re-appraised revised items. Following the Delphi study, the instrument was pilot tested with a convenience sample of school staff.

RESULTS

The initial item pool comprised 81 items in five construct sub-scales congruent with Wiener's Organizational Readiness for Change theory: contextual factors, informational assessment, change valence, change commitment, and change efficacy. In the Delphi study, 24 experts participated in round 1, and 13 participated in round 2. Based on Delphi study responses, the instrument was reduced to 56 items in the five construct subscales: contextual factors (28 items), informational assessment (13 items), change valence (6 items), change commitment (3 items), and change efficacy (6 items). The Schools' Readiness for Child Sexual Abuse Prevention Education (SR-CSAPE) was successfully pilot tested with school staff (n = 19) and minor changes to demographic items were incorporated.

CONCLUSIONS

Informed by experts, the Schools' Readiness for Child Sexual Abuse Prevention Education (SR-CSAPE) is a newly-developed 56-item scale that identifies key organizational dimensions to schools' preparedness for CSA prevention education. Psychometric properties of the scale must be determined in future research.

Enhancing Child Sexual Abuse Prevention Knowledge With an Educational Toolkit -Evaluation of the Chinese Doll Program

Objective: In countries with conservative attitudes towards sex and limited resources to prevent child sexual abuse, culturally adapted CSA prevention programs are essential. This study outlines a randomized controlled trial evaluating the effectiveness of the Doll program for preventing CSA in the specific context of China. Method: 181 children were pre-tested and post-tested (5 weeks later) for knowledge of sexual abuse prevention. Children were assigned to one of three groups; 1) child only (n = 60); 2) child and parent (n = 60); and 3) control (n = 61). Results: Children in groups 1 and 2 showed significant increases (p < 0.001) in scores on the Appropriate Touch Scale (ATS) and the Inappropriate Touch Scale (ITS), whereas those in the control group did not show a significant increase in ATS scores, but their scores on ITS significantly increased (p < 0.001). Children in group 2 showed significantly increased ITS scores compared to group 1 (p = 0.016). Conclusion: Doll program effectively enhances children's CSA prevention knowledge, with parental engagement demonstrating a positive impact on the program.

Knowledge of sexual abuse and resistance ability among children with intellectual disability

BACKGROUND

Sexual abuse is a global concern among children with intellectual disabilities. Sexual abuse is frequent and long-lasting when the victim is a child with an intellectual disability. Moreover, the rate of sexual abuse is two to eight times the rate in the general population.

OBJECTIVE

This study aimed to investigate the knowledge of sexual abuse and resistance ability among children with intellectual disabilities.

PARTICIPANTS AND SETTING

The study was conducted among 120 children with mild or moderate intellectual disabilities attending twelve schools for specific purposes.

METHODS

We adopted a cross-sectional design to assess knowledge and resistance ability. Personal Safety Questionnaire and Modified What If Situation Test were administered verbally during individual interviews. Institutional Ethics Committee approved our study.

RESULTS

Current study suggests that children with intellectual disabilities have average knowledge (M = 6.6, SD = 1.6) regarding sexual abuse. More than 90 % of children demonstrated poor reporting skills. Although children exhibited good knowledge in differentiating appropriate from inappropriate touch requests, most children reported they would not disclose this incident to anyone.

CONCLUSIONS

This study strongly suggests the need for a structured training program for children with intellectual disabilities to prevent sexual abuse.

Knowledge, attitudes, and practices of parents toward sexuality education for primary school children in China

This cross-sectional study provides insight into the perceptions of Chinese parents of primary school children with respect to sexuality education. A sample of 19,745 parents was surveyed using an online questionnaire in Beijing, Tianjin, and Hebei, China. SPSS version 23.0 was used for data analysis. In this study, nearly 90% of parents had positive attitudes toward the sexuality education of children in primary schools. However, Chinese parents had limited knowledge of sexuality education. More than 60% of parents were unaware of the sexuality questions that children may encounter at different ages and did not have any accurate information on child sexual abuse prevention education. Although ~ 70% of parents (both fathers and mothers) reported that they had used television and Internet resources to talk with their children about sexuality and 63% reported that they had read books with their children about sexuality, < 30% reported using appropriate terminology with their children on sexuality education and only 40% reported talking to their children about sexuality comfortably. The multivariate linear regression equation showed some factors associated with the practices of parents in sexuality education, including parental knowledge, attitudes, their experience in receiving sex education in childhood, and their educational level. The findings from this study suggest that it is important to develop culturally relevant training programs for parents of primary schools in Chinese society. The implications and limitations of these findings are discussed.

Determinants of Sexual Abuse Prevention Knowledge among Children’s Schools in West Java Indonesia: A Cross-Sectional Study

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.

Sex and Urban–Rural Differences in the Relationship between Childhood Sexual Abuse and Mental Health among Chinese College Students

This study aimed to reveal sex and urban–rural differences in the association between childhood sexual abuse (CSA) and mental health among Chinese college students. The study used data from the “National College Student Survey on Sexual and Reproductive Health 2019”, a cross-sectional study conducted in all 31 provinces of mainland China. Weighted logistic regression analysis was conducted to determine the association between CSA (noncontact CSA, contact CSA, and penetrative CSA) and mental health (suicide attempts and mental disorders). Among 49,728 students, 39.42% of the male participants and 43.55% of the female participants had ever experienced CSA. According to the OR results of logistic regression analysis, compared to females, males in the contact CSA group (AOR: 3.49, 95% CI: 1.95–6.23) and the penetrative CSA group (AOR: 8.79, 95% CI: 3.15–24.52) had higher odds of suicide attempts. Participants from rural and suburban areas that were categorized in the penetrative CSA group were more likely to report suicide attempts (rural: AOR: 4.01, 95% CI: 1.51–10.62, suburban AOR: 4.86, 95% CI: 2.52–9.36) and mental disorders (rural: AOR: 4.01, 95% CI: 1.51–10.62, suburban: AOR: 4.86, 95% CI: 2.52–9.36). In conclusion, the findings revealed a high prevalence of CSA in both sexes and reported that males are more vulnerable to the adverse effects of CSA. In addition, we also found that undergraduates growing up in rural and suburban areas are more vulnerable to the adverse psychological effects of CSA. Policymakers should pay more attention to this vulnerable population and implement effective measures to alleviate mental trauma.

News Portrayals of Child Sexual Abuse in China: Changes from 2010 to 2019

This study investigated how the news media in China - a country influenced by collectivism, authoritarianism, and Confucianism - portrayed child sexual abuse to the public over the past decade. A content analysis of 501 newspaper articles published over that time period revealed how news portrayals of child sexual abuse changed following notable abuse cases and refinements in relevant laws in China. The results indicated that media attention to child sexual abuse increased dramatically after 2013, and a trend of shaping child sexual abuse as a social problem began in 2015. This study also found an interesting cultural difference in the application of framing theory. The Chinese news stories of child sexual abuse were more likely to present individual cause frames but societal solution frames. This apparent inconsistency was not seen in previous research with U.S. media and may be attributable to a cultural preference for victim blame and collective solutions. The findings provide insights into news portrayals of child sexual abuse in a developing society. In addition, this study points out potential problems in Chinese news reports on child sexual abuse and offers suggestions for journalists and advocates for children.

Effects of Child Sexual Abuse Prevention Education Program Using Hybrid Application (CSAPE-H) on Fifth-Grade Students in South Korea

The purpose of this study was to test the effects of a child sexual abuse prevention education program using a hybrid application (CSAPE-H) by examining fifth-grade students' (a) knowledge for sexual abuse prevention and (b) self-protective behaviors against sexual abuse. A quasi-experimental, pretest /posttest design was used. Sixty-eight students from two schools participated. The intervention group (n = 48) received six sessions in CSA prevention education using the hybrid app, whereas the control group (n = 35) was taught using a lecture in a classroom environment. Between the two groups, there were significant differences in self-protective behaviors against CSA (t = 2.26, p = .027). In addition, educational satisfaction was significantly higher in the experimental group than the control group (t = 2.41, p = .019). A CSAPE-H may be effective for elementary school students, especially for self-protective behaviors.

Children's Knowledge of Abuse Questionnaires (CKAQ)-Short: Two Brief Ten-Item Measures of Knowledge about Child Sexual Abuse Concepts

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.

College students' recollections of childhood sexual abuse prevention programs and their potential impact on reduction of sexual victimization

BACKGROUND

Child sexual abuse prevention programs are offered in many schools globally, but research is scant on whether or not these programs actually decrease the rates of CSA among youth who participate in them.

OBJECTIVE

This study sought to determine if participation in a CSA prevention program (based on participant recall), in the US or another country, led to lower rates of self-reported past victimization among youth, affected disclosure and effects on sexual satisfaction.

PARTICIPANTS AND SETTING

One thousand five hundred and two students from an ethnically and racially diverse university in the southeast served as participants.

METHODS

Participants completed measures on line (Qualtrics). This included demographic information and participation in CSA prevention programs in schools, concepts that were covered, and recollections of sexual victimization. The second measure was a revised version of the sexual satisfaction scale (Derogatis Sexual Functioning Inventory).

RESULTS

Students who had not participated in a CSA prevention program were significantly more likely to be abused than those who did participate, regardless of the program or location (χ2 (1,1498) = 19.01, p < .001). Those participating in programs in the US were more likely to disclose abuse than those participating in the programs in other countries (χ2 (1,212) = 5.49, p = .019). No significant difference was found between those who participated in prevention programming and those who did not on sexual satisfaction (χ2 (1,1469) = 1.76, p = .184).

CONCLUSION

These results highlight the importance of universal CSA prevention programs in schools worldwide as one part of comprehensive prevention.

Preventing Child Sexual Abuse Using Picture Books: The Effect of Book Character and Message Framing

The aim of this study was to investigate whether and how a picture book preventing child sexual abuse can improve children's self-protection skills. The study was conducted in China with Chinese children. In a 2 × 2 between-subjects design, character in the book (human versus animal) and message framing (gain versus loss) were manipulated. Compared to a baseline group who were not exposed to the prevention book, children in the experimental groups significantly enhanced their ability to recognize a potential abuse situation and refuse an inappropriate touch request. Results suggest that the prevention picture books are more effective when using a human character and a gain-framed message. The explanation for this was that human characters simulated children's perceived norm and gain-framed messages increased children's message recall, perceived self-efficacy and positive attitude toward the message, all of which in turn positively affected children's self-protection skills.

The "Who Do You Tell?"™ Child Sexual Abuse Education Program: Eight Years of Monitoring

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.

Violence prevalence and prevention status in China

Objectives

To describe the prevalence status of violence and its prevention in China, and to provide reference for the development of strategies regarding violence prevention.

Methods

Violence mortality data between 2006 and 2015 were obtained from the national disease/death surveillance data set in 2006–2015. Data on violence-related medical cases were collected from the 2015 National Injury Surveillance System. The laws and policies about violence prevention and violence prevention programmes in China were described.

Results

Violence mortality declined by 57.02% during 2006–2015 from 1.21/100 000 to 0.52/100 000. Violent death rate in males peaked in the age group 25–29 years (1.05/100 000) and it was low in the age group <15 years. Female violence mortality rate peaked during infancy (0.54/100 000), aged 25–29 (0.53/100 000) and age above 85 (0.98/100 000). The laws and policies about violence prevention were more perfect, while most prevention programmes were limited in scale and duration.

Conclusions

The mortality of violence declined in China during 2006–2015. It is necessary to conduct gender-specific prevention strategies and improve the data collection and prevention service.

Evaluation of a sexual abuse prevention education program for school-age children in China: a comparison of teachers and parents as instructors

The aim of this present study was to evaluate the effectiveness of a child sexual abuse (CSA) prevention curriculum toward children and to compare the knowledge gains between children who were taught by teachers and their parents. Four hundred and eighty-four school-age children recruited from one primary school in Beijing, China, were randomly assigned to a CSA prevention program administered by teachers or their parents or to a wait-list control group. The findings reveal that children in the teacher education group demonstrated the highest level of CSA prevention knowledge and skills, followed by the parent education group, while children in the control group showed the least improvements. The knowledge and skills gains were retained at a 12-week follow-up. The present study shows that Chinese school-age children can benefit from CSA prevention program with increased knowledge and skills of personal safety. School-based CSA prevention education should be improved and implemented in other regions of China.

The knowledge and skills related to sexual abuse prevention among Chinese children with hearing loss in Beijing

BACKGROUND

The prevalence of any child sexual abuse (CSA) experience before the age of 16 years ranges from 10.2 to 35.2% in China,^1-5 but there has been no research so far exploring the level of awareness of CSA prevention and self-protection skills among Chinese children with hearing loss.

OBJECTIVE

The school based survey examines the CSA prevention knowledge and self-protection skills in Chinese children with hearing loss.

METHODS

Fifty-one students (30 boys, 21 girls) from 10 to 16 years old participated in the study. Children's CSA prevention knowledge and self-protection skills were tested by using anonymous self-administered questionnaire which was mainly designed based on previous Chinese CSA research questionnaires, the Personal Safety Questionnaire, and the 'What If' Situations Test (WIST).

RESULTS

There were ten questions assessing the knowledge of CSA but none of the children could correctly answer all and seventy percent of the students could not answer more than five questions correctly. Only three students got the maximum skills score. If sexual abuse occurs, about fifty two percent of the children would report it to trusted adults and most of them would report it to their relatives. Girls received significantly higher scores than boys.

CONCLUSION

Chinese children with hearing loss lack knowledge regarding child sexual abuse and the way to protect themselves. There is an urgent need to develop CSA prevention programs in the school for children with hearing loss in China. Parental training and parent-child interaction on CSA prevention should be developed and promoted as well.