Child Sexual Abuse Prevention Programs: What Makes Them Effective in Protecting Children?

Child sexual abuse prevention programs have proliferated over the past several years. Many of these program approaches, which include plays, games and videos, are visually appealing and highly entertaining, and parents and teachers have widely embraced them. However, despite the popularity of such programs, little effort has been made to evaluate their effectiveness in changing children's behavior. As a result of participation in a sexual abuse prevention program, has a child's vulnerability to abuse been reduced, for example, or has his or her sense of personal safety been enhanced

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

Background: Child sexual abuse is a significant problem that requires an effective means of prevention. Objectives: To assess: if school-based programmes are effective in improving knowledge about sexual abuse and self-protective behaviours; whether participation results in an increase in disclosure of sexual abuse and/or produces any harm; knowledge retention and the effect of programme type or setting. Search strategy: Electronic searches of Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, PsycINFO, CINAHL, Sociological Abstracts, Dissertation Abstracts and other databases using MESH headings and text words specific for child sexual assault and randomised controlled trials (RCTs) were conducted in August 2006. Selection criteria: RCTs or quasi-RCTs of school-based interventions to prevent child sexual abuse compared with another intervention or no intervention. Data collection and analysis Meta-analyses and sensitivity analysis, using two imputed intraclass correlation coefficients (ICC) (0.1, 0.2), were used for four outcomes: protective behaviours, questionnaire-based knowledge, vignette-based knowledge and disclosure of abuse. Meta-analysis was not possible for retention of knowledge, likelihood of harm, or effect of programme type and setting. Main results Fifteen trials measuring knowledge and behaviour change as a result of school-based child sexual abuse intervention programmes were included. Over half the studies in each initial meta-analysis contained unit of analysis errors. For behaviour change, two studies had data suitable for meta-analysis; results favoured intervention (OR 6.76, 95% Cl 1.44, 31.84) with moderate heterogeneity (I-2=56.0%) and did not change significantly when adjustments using intraclass coefficients were made. Nine studies were included in a meta-analysis evaluating questionnaire-based knowledge. An increase in knowledge was found (SMD 0.59; 0.44, 0.74, heterogeneity (12=66.4%). When adjusted for an ICC of 0.1 and 0.2 the results were SMD 0.6 (0.45, 0.75) and 0.57 (0.44, 0.71) respectively. Heterogeneity decreased with increasing ICC. A meta-analysis of four studies evaluating vignette-based knowledge favoured intervention (SMD 0.37 (0.18, 0.55)) with low heterogeneity (I2=0.0%) and no significant change when ICC adjustments were made. Meta-analysis of between-group differences of reported disclosures did not show a statistically significant difference.Authors' conclusions: Studies evaluated in this review report significant improvements in knowledge measures and protective behaviours. Results might have differed had the true ICCs from studies been available or cluster-adjusted results been available. Several studies reported harms, suggesting a need to monitor the impact of similar interventions. Retention of knowledge should be measured beyond 3-12 months. Further investigation of the best forms of presentation and optimal age of programme delivery is required

Interventions that address institutional child maltreatment: an evidence and gap map.

Purpose: This evidence and gap map collates evidence reporting on the effectiveness of interventions aimed to prevent, disclose, respond to, or treat child maltreatment occurring in institutional settings. Methods: A comprehensive and systematic literature search identified primary studies and systematic reviews meeting the review’s eligibility criteria. Literature screening, data extraction and critical appraisals were undertaken independently by multiple reviewers. Data extracted and reported from the included studies included information about the institutional setting, target population, type of maltreatment, intervention type and outcomes. Results: Seventy-three studies were identified, including 11 systematic reviews and 62 primary studies. Overall, the methodological quality of the studies was low to moderate. Most evaluated curriculum-based interventions delivered in educational settings, primarily aimed at preventing sexual abuse. Fewer studies examined other institutional settings or intervention types. Conclusions: This review highlights a need for high-quality studies evaluating a more diverse range of interventions across more varied institutional contexts