An assessment of outcomes following parents' participation in a child abuse prevention program

Engagement Measures in Maltreatment Prevention Studies: A Scoping Review

Prevention services can promote public health by building protective factors and reducing maltreatment risk. Yet, engaging caregivers in prevention services presents a unique set of challenges. Measurement studies are important first steps to increase the knowledge of caregiver engagement in prevention services. The purpose of this scoping review was to investigate how family engagement has been measured and operationalized in the studies of maltreatment prevention/positive parenting programs. The review examined quantitative and mixed methods studies conducted in the U.S., which measured multiple dimensions of client engagement, including behavioral, attitudinal, and relational domains. A total of 88 studies selected from PubMed, CINAHL, ERIC, PsycINFO, Social Work Abstracts, Academic Search Premier, and Web of Science were included in this review. Results indicated that studies examine engagement constructs in all three domains of engagement with a primary focus on behavioral engagement. The attitudinal and relational engagement was mostly assessed through general satisfaction surveys, and a limited number of studies utilized validated measures to assess those constructs. While most studies reported acceptable internal reliabilities, only two studies reported other dimensions of psychometric qualities. Only one validated measure was found, which assessed client perceptions of provider cultural competence. More measurement studies are needed to further incorporate multiple dimensions of engagement into the studies of maltreatment prevention programs, which can inform the effort to develop tailored implementation strategies to fully engage various groups of parents in maltreatment prevention programs.

Parental Involvement in Programs to Prevent Child Sexual Abuse: A Systematic Review of Four Decades of Research

This systematic review is the first to synthesize knowledge of parental involvement in child sexual abuse (CSA) prevention programs. Guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria, 24 intervention evaluations met the inclusion criteria of aiming to change parental knowledge, attitudes, behaviors, behavioral intentions, self-efficacy, response-efficacy, or capabilities for prevention of CSA. Included papers were identified via a combination of electronic database searches (PsycINFO, Web of Science, Scopus, Google Scholar, Cochrane Library, World Health Organization's International Clinical Trials Registry Platform, google.com.au, open.grey.eu, Global ETD, Open Access Theses & Dissertations, EThOS, and Trove) and direct communication with researchers. Improvement post intervention was found most commonly for parental behavioral intentions and response-efficacy, closely followed by parental behaviors, then capabilities, self-efficacy, knowledge, and lastly, parental attitudes. Improvements in behaviors, intentions, and response-efficacy occurred in 88 to 100% of the studies in which they were addressed, improvements in self-efficacy and capabilities occurred in 67 to 75%, and improvements in knowledge and attitudes occurred in only 50 to 56%. Many of the included evaluation studies suffered from methodological and reporting flaws, such as high participant attrition, lack of control group, lack of statistical tests, missed testing time points, and a lack of (or short) follow-up. Future parent-focused CSA prevention evaluations must address these concerns by conducting rigorous empirical research with sound methodologies and comprehensive reporting. Furthermore, study designs should consider measuring the real-world impact of increases in assessed parent variables, including their ability to prevent sexual victimization of children.

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.

Parents as protectors: A qualitative study of parents' views on child sexual abuse prevention

Although parents are essential to child sexual abuse (CSA) prevention efforts, their views on prevention and protection are not always represented in the research literature. In this qualitative study of 24 Australian parents, beliefs about CSA, its risk factors, prevention methods, and parents' role in CSA protection, and parents' approaches to protection of their own children, are examined. Findings were condensed into five themes: (a) parents' understanding of child sexual abuse, grooming and risk; (b) parent-led CSA education; (c) parents' beliefs about CSA education; (d) children recognizing and resisting CSA; and (e) parent responsibility for protection. Findings suggest that parents have a good knowledge of CSA and its risks. However, they do not provide their children with the comprehensive prevention messages recommended by prevention campaigns and many concentrate on abduction dangers. This gap between knowledge and parental communication with children could be due to parents' beliefs that there may be harms associated with education of children about CSA (e.g., such as inciting new fears and worries or reducing trust in others) and that the method may not be effective in protecting children from CSA. This study adds to the existing literature by presenting information that could be useful in designing programs to include parents in CSA protection and by approaching CSA research with parents as the key agents in the protection of children.

Mothers' knowledge & perception about child sexual abuse in Jordan

Child sexual abuse (CSA) is a serious problem causing physical, social and psychosocial harm. To understand the Jordanian mothers' efforts to prevent CSA, we assessed the mothers' general knowledge about CSA, their perceptions, knowledge about signs and symptoms of CSA and their knowledge about prevention practices of CSA in relation to their demographics. A cross- sectional descriptive design was used with a convenient sample of 488 mothers. The data was collected using a self-reported questionnaire consisting of 52 items. Descriptive and parametric and non-parametric statistical procedures were employed. Almost all mothers in the study were Muslim and married. Half of the mothers had post-secondary education and only 36% were employed. The study revealed that the majority of mothers were knowledgeable about CSA and its prevention practices. Though only 17% of mothers had started practicing some of the CSA preventive measures when their children were young (1-4 years of age) and less than half (48.8%) had started when their children were 4-6 years of age. Three quarters (74%) of the mothers indicated that educating children about CSA can prevent it. Only 37.7% knew about laws regarding CSA in Jordan and less than half of mothers knew about social organizations that provide services for children who suffered from sexual abuse. Mothers who had a high income or a high level of education or were employed had a higher awareness of CSA and recognized signs and symptoms of CSA more than other mothers.

Violência sexual na adolescência, perfil da vítima e impactos sobre a saúde mental

Resumo Este trabalho objetiva analisar os impactos do abuso sexual na adolescência sobre variáveis relacionadas à saúde mental e identificar as características das vítimas. Para tanto, utiliza-se a metodologia do Propensity Score Matching a partir dos microdados da Pesquisa Nacional de Saúde do Escolar 2015. Os resultados mostram que o jovem violentado tem um perfil comportamental, familiar e socioeconômico singular, a destacar pelo fato de que tem mais chances de já ter utilizado álcool e drogas, de ser alvo de bullying, estar em distorção idade-série, encontrar-se empregado e não ter pretensão de continuar estudando. Do ponto de vista familiar, tem pouco acompanhamento dos pais e menos chance de morar com a mãe. As estimativas revelam que o abuso sexual na adolescência pode aumentar em 13,3% a chance do jovem reportar sentimento frequente de solidão, em 7,5% a chance de ter poucos ou nenhum amigo e em 9,5% a chance de relatar insônia frequente por motivo de preocupação. Foram constatadas ainda diferenças significativas dos efeitos em mulheres e homens, sendo os impactos sobre solidão e insônia maiores para o primeiro grupo e sobre número de amigos maiores para o segundo.

An Evidence-Based Education Program for Adults about Child Sexual Abuse ("Prevent It!") That Significantly Improves Attitudes, Knowledge, and Behavior

Here we describe the development of an evidence-based education program for adults about childhood sexual abuse (CSA), called Prevent It! Uniquely, the primary goal of this program was to change the behavior of participants, as well as to increase knowledge about CSA and positive attitudes toward it. A comprehensive review shows no previous similar approach. The program includes a detailed manual to allow standardized administration by trained facilitators, as well as multiple video segments from CSA survivors and professionals. A total of 23 program workshops were run, with 366 adults participating. Of these, 312 (85%) agreed to take part in the study. All completed baseline ratings prior to the program and 195 (63% of study sample) completed follow-up assessments at 3-months. There were no significant differences between the demographic make-up of the baseline group and the follow-up group. Assessments included demographic data, knowledge, attitudes, and several measures of behavior (our primary outcome variable). Behavioral questions asked individuals to select behaviors used in the previous 3-months from a list of options. Questions also included asking "how many times in the previous 3-months" have you "talked about healthy sexual development or Child sexual abuse (CSA) with a child you know"; "suspected a child was sexually abused"; "taken steps to protect a child"; or "reported suspected sexual abuse to police or child welfare"? The majority of attendees were women, with the commonest age group being between 30 and 39 years old. Approximately 33% had experienced CSA themselves. At 3-month follow-up there were highly statistically significant improvements in several aspects of behavior and knowledge, and attitudes regarding CSA. For example, the number of subjects actively looking for evidence of CSA increased from 46% at baseline to 81% at follow-up, while the number of subjects who actively took steps to protect children increased from 25% at baseline to 48% at follow-up. For general public adults, this is the first program designed using the current evidence base for effective training in CSA examining longer-term outcomes and the first to focus on actual behavioral outcomes. The results suggest it is highly effective and support its widespread use.

How Much Child Sexual Abuse is "Below the Surface," and Can We Help Adults Identify it Early?

Child sexual abuse (CSA) occurs frequently in society to children aged between 2 and 17. It is significantly more common in girls than boys, with the peak age for CSA occurring when girls are aged 13-17. Many children experience multiple episodes of CSA, as well as having high rates of other victimizations (such as physical assaults). One of the problems for current research in CSA is different definitions of what this means, and no recent review has clearly differentiated more severe forms of CSA, and how commonly this is disclosed. In general we suggest there are four types of behavior that should be included as CSA, namely (1) non-contact, (2) genital touching, (3) attempted vaginal and anal penetrative acts, and (4) vaginal and anal penetrative acts. Evidence suggests that CSA involving types (2), (3), and (4) is more likely to have significant long-term outcomes, and thus can be considered has having higher-impact. From the research to date approximately 15% of girls aged 2-17 experience higher-impact CSA (with most studies suggesting that between 12 and 18% of girls experience higher-impact CSA). Approximately 6% of boys experience higher-impact CSA (with most studies suggesting that between 5 and 8% experience higher-impact CSA). The data also suggests that in over 95% of cases the CSA is never disclosed to authorities. Thus, CSA is frequent but often not identified, and occurs "below the surface" in the vast majority of higher-impact cases. Helping adults to understand "below the surface" CSA might help them to recognize it early, but there are very few indicators specific to CSA, making this a challenging goal to achieve. Nonetheless, given that CSA frequently occurs with other types of abuse, a training program that focuses on both CSA and other abuse may offer a method to allow both early recognition and prevention by adults in the general population.

Evaluation of an innovative tool for child sexual abuse education

Child sexual abuse poses a serious threat to public health and is often unreported, unrecognized, and untreated. Prevention, early recognition, and treatment are critically important to reduce long-term effects. Little data are available on effective methods of preventing child sexual abuse. The current research demonstrates a unique approach to promoting awareness and stimulating discussion about child sexual abuse. Qualitative methods have rarely been used to study child sexual abuse prevention. Qualitative inductive analyses of interviews from 20 key informants identified both positive and negative assessments with six emergent themes. The themes revealed inherent tensions in using narrative accounts to represent the complex cultural context within which child sexual abuse occurs. More research is needed, but the program shows potential as a methodology to raise awareness of child sexual abuse.

Evaluation of a personal safety program with Latino preschoolers

This study evaluated a personal safety educational program designed for Latino families attending preschools in a large metropolis. Seventy-eight children who participated in the Kids Learning About Safety program were compared to 45 control children. Compared with controls, participating children demonstrated enhanced ability to recognize inappropriate touches, learned correct genital terminology, were able to recognize the inappropriateness of touch requests made by "good" people, demonstrated higher levels of personal safety skills, and learned general safety rules. Gains in knowledge were maintained at three-month follow-up testing for all content areas except genital terminology. Although feedback provided by participating families was positive, recruiting participants and maintaining attendance at sessions was difficult. Discussion includes recommendations for future research and engagement of this population.

Evaluation of a sexual abuse prevention workshop in a multicultural, impoverished urban area

Participants in the ESPACE sexual abuse prevention workshop were in grades 1 through 4 and attended three Montreal, Canada, public schools in low socioeconomic areas. The sample was culturally diverse, with half born outside of Canada. An evaluation was conducted to explore the effects associated with participating in the workshop and the effects of booster sessions conducted two years later. Outcomes included knowledge gained, the ability to offer behavioral responses to abusive situations, peer victimization, sense of safety, empathy, self-efficacy, and support. Results revealed that participants in this sample obtained low scores on measures of sexual abuse knowledge and that short booster sessions that elicit children's recall of the learned material might produce greater improvements.

Assessing parent education programs for families involved with child welfare services: evidence and implications

Parent education programs may be offered or mandated at various stages of the child welfare services continuum. However, little is known regarding their efficacy in addressing the parenting problems that bring families to the attention of child welfare services. This article synthesizes outcome data generated from 58 parenting programs with families determined to be at-risk of child maltreatment and/or abusive or neglectful. It places parent education programs within the broader context of research on effective parenting as well as the leading etiological models of child maltreatment to assess the evaluations of these programs with regard to methodological rigor as well as theoretical salience. Practical and theoretical implications are presented along with recommendations for future research.

Prevention of child sexual abuse: evaluation of a community media campaign

Given that mass media techniques have been an effective tool within the public health field for affecting behavioral change, these strategies may prove successful for the primary prevention of child sexual abuse (CSA). This study was an independent evaluation of a CSA media campaign. Two hundred parents were recruited from eight sites across the United States. Results indicated that the combined mass media campaign affected knowledge about CSA at the time of intervention compared to no intervention. No significant differences were found in regards to CSA attitudes. A significant positive impact on primary prevention response behaviors assessed using hypothetical vignettes was found; however, no significant findings were noted for several other behavioral responses. Knowledge and behavioral gains were not maintained at the one-month follow-up. Small sample size at follow-up may have affected findings. Results of this study imply that media campaigns alone may not significantly affect primary prevention of CSA.

Parental knowledge of child sexual abuse symptoms

The purpose of this study was to investigate parental knowledge of symptoms of child sexual abuse (CSA), and to determine the factors associated with that knowledge. A total of 150 parents listed symptoms of CSA in the following areas: physical/medical, emotional, sexual behavior, and behavior towards others. Results suggest that, although most parents are familiar with some of the symptoms of CSA, they are more likely to know emotional or behavioral reactions which could be suggestive of many other life stressors. Parents with higher socioeconomic status listed more symptoms, but race and parenting experience were not significant factors. Results suggest the need to inform parents of more indicative physical or sexual symptoms, and to target parents of lower SES background in awareness efforts. doi:10.1300/ J070v15n04_01.

Child sexual abuse

Child sexual abuse is a worldwide concern. It is an insidious, persistent, and serious problem that, depending on the population studied and definition used, affects 2-62% of women and 3-16% of men as victims. Pain and tissue injury from child sexual abuse can completely heal in time, but psychological and medical consequences can persist through adulthood. Associated sexually transmitted diseases (such as HIV) and suicide attempts can be fatal. All physicians who treat children should be aware of the manifestations and consequences of child sexual abuse, and should be familiar with normal and abnormal genital and anal anatomy of children. This aim is best accomplished through training and routine examination of the anus and genitalia of children. Because as many as 96% of children assessed for suspected sexual abuse will have normal genital and anal examinations, a forensic interview by a trained professional must be relied on to document suspicion of abuse.