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REL Midwest Ask A REL Response

May 2019

Question:

What research is available on school-based child abuse and child sexual abuse prevention programs?



Response:

Following an established Regional Educational Laboratory (REL) Midwest protocol, we conducted a search for research reports, literature reviews, and descriptive studies on school-based child abuse and child sexual abuse prevention programs. For details on the databases and sources, keywords, and selection criteria used to create this response, please see the Methods section at the end of this memo.

Below, we share a sampling of the publicly accessible resources on this topic. References are listed in alphabetical order, not necessarily in order of relevance. The search conducted is not comprehensive; other relevant references and resources may exist. For each reference, we provide an abstract, excerpt, or summary written by the study’s author or publisher. We have not evaluated the quality of these references, but provide them for your information only.

Research References

Baker, C. K., Gleason, K., Naai, R., Mitchell, J., & Trecker, C. (2013). Increasing knowledge of sexual abuse: A study with elementary school children in Hawai’i. Research on Social Work Practice, 23(2), 167–178. Retrieved from https://eric.ed.gov/?id=EJ1009457.

From the ERIC abstract: “Objective: Child sexual abuse is a significant health problem with potential long-term consequences for victims. Therefore, prevention and education programs are critical. This preliminary study evaluates changes in children’s knowledge of sexual abuse using a school-based train-the-trainer curriculum. Emphasis was placed on developing a curriculum that considered the unique cultural context in Hawai’i. Method: School staff who had been trained on how to implement the ‘My Body, My Boundaries’ curriculum, which targets the third to fifth grade, were invited to participate in the study. Three schools agreed; students in third grade classrooms in two schools received the curriculum and students in the third school served as the comparison. Result: Children in intervention schools significantly increased their knowledge of appropriate and inappropriate touch and what to do if they experience sexual abuse. Conclusion: Findings suggest the utility of a train-the-trainer model in social work practice to address sensitive topics such as child sexual abuse.”

Barron, I. G., & Topping, K. J. (2013). Exploratory evaluation of a school-based child sexual abuse prevention program. Journal of Child Sexual Abuse, 22(8), 931–948. Retrieved from https://eric.ed.gov/?id=EJ1035092.

From the ERIC abstract: “Internationally, efficacy studies of school-based child sexual abuse prevention programs display a series of methodological shortcomings. Few studies include adolescent participants, recording of disclosures has been inconsistent, and no studies to date have assessed presenter adherence to program protocols or summated the costs of program implementation. A pretest-posttest waitlist control design was used to evaluate the Tweenees program delivered to grade 6 (n=88) and grade 7/8 students (n=117) compared to a control (n=185). Outcome measures included a knowledge/skills questionnaire, systematic coding of disclosures, and video interaction analysis of lessons. Costs were calculated per student, class, and school. Adolescents made small knowledge and skills gains indicating a program ceiling effect. Implementation analysis suggests low levels of adult control facilitated disclosures. Program costs were relatively inexpensive. Recommendations are made for future research.”

Note: Note: REL Midwest was unable to locate a link to the full-text version of this resource. Although REL Midwest tries to provide publicly available resources whenever possible, it was determined that this resource may be of interest to you. It may be found through university or public library systems.

Blakey, J. M., & Thigpen, J. W. (2015). Play it Safe!®: A school-based childhood physical and sexual abuse prevention program. Journal of Adolescent and Family Health, 7(1), 5. Retrieved from https://scholar.utc.edu/cgi/viewcontent.cgi?article=1028&context=jafh

From the abstract: “The purpose of this pilot study was to evaluate the Play it Safe!® program, a school-based childhood physical and sexual abuse prevention program which teaches children to recognize abusive situations, how to respond to potentially abusive situations, and report the abuse to someone who can help stop the abuse.”

Brassard, M. R. & Fiorvanti, C. M. (2015). School-based child abuse prevention programs. Psychology in the Schools, 52(1), 40–60. Retrieved from https://eric.ed.gov/?id=EJ1047728.

From the ERIC abstract: “Child abuse is a leading cause of emotional, behavioral, and health problems across the lifespan. It is also preventable. School-based abuse prevention programs for early childhood and elementary school children have been found to be effective in increasing student knowledge and protective behaviors. The purpose of this article is to help school psychologists understand the potential positive impact of abuse prevention programs in their school, choose a high-quality program for their population, and be aware of the practical considerations of implementation.”

Note: REL Midwest was unable to locate a link to the full-text version of this resource. Although REL Midwest tries to provide publicly available resources whenever possible, it was determined that this resource may be of interest to you. It may be found through university or public library systems.

Fryda, C. M., & Hulme, P. A. (2015). School-based childhood sexual abuse prevention programs: An integrative review. The Journal of School Nursing, 31(3), 167–182. Retrieved from https://eric.ed.gov/?id=EJ1060277.

From the ERIC abstract: “One prevention strategy for childhood sexual abuse (CSA) involves educational programs delivered to children in the school environment. The purpose of this integrative literature review was to determine the state of the science on school-based CSA prevention programs. The authors extracted data from 26 articles that fit inclusion criteria to answer research questions on types of programs, methods used to evaluate programs, and program success. Analysis of the extracted data led to the identification of seven categories of teaching learning content. Delivery methods included films, plays, discussion, and role play. Most authors used an untreated or placebo control group pretest/posttest design for evaluation. According to the child outcome measures chosen, the majority of programs were successful. The review also found school nurses rarely involved in these programs. Although not a traditional aspect of their responsibilities, information from this review can help school nurses implement a school-based CSA prevention program.”

Morris, M. C., Kouros, C. D., Janecek, K., Freeman, R., Mielock, A., & Garber, J. (2017). Community-level moderators of a school-based childhood sexual assault prevention program. Child Abuse & Neglect, 63, 295–306. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5191955/.

From the abstract: “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@Last program compared to a waitlist control condition. 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 1,177 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.”

Pulido, M. L., Dauber, S., Tully, B. A., Hamilton, P., Smith, M. J., & Freeman, K. (2015). Knowledge gains following a child sexual abuse prevention program among urban students: A cluster-randomized evaluation. American Journal of Public Health, 105(7), 1344–1350. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4463397/.

From the abstract:Objectives. We evaluated a school-based child sexual abuse (CSA) prevention program, Safe Touches, in a low–socioeconomic status, racially diverse sample. Methods. Participants were 492 second- and third-grade students at 6 public elementary schools in New York City. The study period spanned fall 2012 through summer 2014. We cluster-randomized classrooms to the Safe Touches intervention or control groups and assessed outcomes with the Children’s Knowledge of Abuse Questionnaire. Hierarchical models tested change in children’s knowledge of inappropriate and appropriate touch. Results. The intervention group showed significantly greater improvement than the control group on knowledge of inappropriate touch. Children in second grade and children in schools with a greater proportion of students in general (vs special) education showed greater gains than other participants in knowledge of inappropriate touch. We observed no significant change in knowledge of appropriate touch among control or intervention groups. Conclusions. Young children benefited from a school-based, 1-time CSA prevention program. Future research should explore the efficacy of CSA prevention programs with children before the second grade to determine optimal age for participation.”

Smothers, M. K., & Smothers, D. B. (2011). A sexual assault primary prevention model with diverse urban youth. Journal of Child Sexual Abuse, 20(6), 708–727. Retrieved from https://eric.ed.gov/?id=EJ952700.

From the ERIC abstract: “In this study, a nonprofit community mental health clinic developed a socioecological model of sexual abuse prevention that was implemented in a public school. The goal of the program was to promote and create community change within individuals and the school community by reducing tolerance of sexual violence and sexual harassment. Participants were 5th-12th graders at a school from a Midwest city. Completed measures were obtained from 202 students, and a quasiexperimental time series research design was developed to evaluate the effectiveness of the prevention program. The program was found to be effective at increasing participant’s knowledge of sexual abuse, awareness of school and community sexual assault support resources, and identification of components of healthy and unhealthy relationships.”

Topping, K. J., & Barron, I. G. (2009). School-based child sexual abuse prevention programs: A review of effectiveness. Review of Educational Research, 79(1), 431–463. Retrieved from https://eric.ed.gov/?id=EJ879157.

From the ERIC abstract: “In this systematic and critical review of purely school based child sexual abuse prevention program efficacy studies, 22 studies meeting the inclusion criteria differed by target population, program implementation, and evaluation methodology. Measured outcomes for children included knowledge, skills, emotion, risk perception, touch discrimination, reported response to actual threat or abuse, disclosure, maintenance of gains, and negative effects. Many studies had methodological limitations (e.g., sampling problems, lack of adequate control groups, lack of reliable and valid measures). However, most investigators claimed that their results showed significant impact in primary prevention (increasing all children’s knowledge or awareness and/or abuse prevention skills). There was little evidence of change in disclosure. There was limited follow-up evidence of actual use and effectiveness of prevention skills, and the evidence for maintenance of gains was mixed. Several programs reported some negative effects. Very few studies reported implementation fidelity data, and no study reported cost-effectiveness. Implications for future research, policy, and practice are outlined.”

Note: REL Midwest was unable to locate a link to the full-text version of this resource. Although REL Midwest tries to provide publicly available resources whenever possible, it was determined that this resource may be of interest to you. It may be found through university or public library systems.

Walsh, K., Zwi, K., Woolfenden, S., & Shlonsky, A. (2018). School-based education programs for the prevention of child sexual abuse: A Cochrane systematic review and meta-analysis. Research on Social Work Practice, 28(1), 33–55. Retrieved from https://eric.ed.gov/?id=EJ1163574.

From the ERIC abstract: “Objective: To assess evidence of the effectiveness of school-based education programs for the prevention of child sexual abuse (CSA). The programs deliver information about CSA and strategies to help children avoid it and encourage help seeking. Methods: Systematic review including meta-analysis of randomized controlled trials (RCTs), cluster RCTs, and quasi-RCTs. Results: Twenty-four studies with 5,802 participants were included. Child self-protective skills, odds ratio - 5.71, confidence interval - [1.98, 16.51]; factual, standardized mean difference (SMD) - 0.61 [0.45, 0.78]; and applied knowledge, SMD - 0.45 [0.24, 0.65], increased in the intervention group, and knowledge gains were retained at 6 months, SMD - 0.69 [0.51, 0.87]. There were no differences in anxiety or fear, SMD - -0.08 [0.22, 0.07], and findings regarding disclosure of abuse were inconclusive. Conclusion: Children’s self-protective skills and knowledge can be increased by participation in school-based sexual abuse prevention programs. However, it is unknown whether gains in skills and knowledge actually decrease the likelihood of CSA.”

Wood, M., & Archbold, C. A. (2015). Bad touches, getting away, and never keeping secrets: Assessing student knowledge retention of the ‘Red Flag Green Flag People’ program. Journal of Interpersonal Violence, 30(17), 2999–3021. Retrieved from https://journals.sagepub.com/doi/full/10.1177/0886260514554426.

From the abstract: “School-based prevention programs that target sexual abuse are commonplace in many elementary schools across the United States. This study examines the efficacy of the ‘Red Flag Green Flag People’ program presented to elementary school children in two school districts in the Midwest. A brief, 11-question survey is given to students to assess knowledge retention of the curriculum from this sexual abuse prevention program. The results of this study indicate that students are retaining information taught in the Red Flag Green Flag People program for up to 2 years after the program was administered.”

Zeuthen, K., & Hagelskj√¶r, M. (2013). Prevention of child sexual abuse: Analysis and discussion of the field. Journal of Child Sexual Abuse, 22(6), 742–760. Retrieved from

From the ERIC abstract: “Prevention of child sexual abuse is complicated, challenging, and highly necessary as sexual abuse of children and youth represents an extensive problem across the world. This article reviews the existing preventive interventions targeting children, parents, and professionals. An alternative way of organizing the child sexual abuse prevention research literature is offered and applied with emphasis on three areas: (a) child sexual abuse prevention interventions, (b) meta-analyses of child sexual abuse prevention interventions, and (c) general theoretical models about prevention and the child. Based on an analysis of these areas, it was found that there was a lack of connection between theoretical models and concrete preventive interventions. An overview of current challenges and future possibilities in this area is provided.”

Note:REL Midwest was unable to locate a link to the full-text version of this resource. Although REL Midwest tries to provide publicly available resources whenever possible, it was determined that this resource may be of interest to you. It may be found through university or public library systems.

Additional Organizations to Consult

Child Welfare Information Gateway: School-Based Prevention Programs – https://www.childwelfare.gov/topics/preventing/prevention-programs/schoolbased/

From the website: “Teachers and other school staff are in an optimal position to prevent, identify, and assist victims of child abuse and neglect because of their frequent contact with students.”

California Evidence-Based Clearinghouse for Child Welfare: Selecting and Implementing – https://www.cebc4cw.org/implementing-programs/

From the website: “The goal of the CEBC Selecting and Implementing Programs section is to provide guidance and resources about the implementation of Evidence-Based Practices (EBPs). Research on implementation, both in child welfare and in related fields, is still in its early stages. The limited amount of existing implementation research in child welfare focuses on factors (e.g., research-practice partnerships, provider attitudes, technical assistance teams, organizational culture and climate) that facilitate or impede the implementation of EBPs.

Over the coming years, data from completed studies and studies currently under way will help to inform policy makers, agency directors, providers, and consumers about the best ways to facilitate implementation of evidence-based practice in real-world practice settings. Additional resources and information will continuously be added to this section of the CEBC website that will keep the consumer up-to-date on the emerging field of implementation.”

Methods

Keywords and Search Strings

The following keywords and search strings were used to search the reference databases and other sources:

  • “child abuse” prevention

  • “child abuse” “program evaluation”

  • “child protection training”

  • “evidence based program” child abuse

Databases and Search Engines

We searched ERIC for relevant resources. ERIC is a free online library of more than 1.6 million citations of education research sponsored by the Institute of Education Sciences (IES). Additionally, we searched IES and Google Scholar.

Reference Search and Selection Criteria

When we were searching and reviewing resources, we considered the following criteria:

  • Date of the publication: References and resources published over the last 15 years, from 2004 to present, were included in the search and review.

  • Search priorities of reference sources: Search priority is given to study reports, briefs, and other documents that are published or reviewed by IES and other federal or federally funded organizations.

  • Methodology: We used the following methodological priorities/considerations in the review and selection of the references: (a) study types—randomized control trials, quasi-experiments, surveys, descriptive data analyses, literature reviews, policy briefs, and so forth, generally in this order, (b) target population, samples (e.g., representativeness of the target population, sample size, volunteered or randomly selected), study duration, and so forth, and (c) limitations, generalizability of the findings and conclusions, and so forth.
This memorandum is one in a series of quick-turnaround responses to specific questions posed by educational stakeholders in the Midwest Region (Illinois, Indiana, Iowa, Michigan, Minnesota, Ohio, Wisconsin), which is served by the Regional Educational Laboratory (REL Midwest) at American Institutes for Research. This memorandum was prepared by REL Midwest under a contract with the U.S. Department of Education’s Institute of Education Sciences (IES), Contract ED-IES-17-C-0007, administered by American Institutes for Research. Its content does not necessarily reflect the views or policies of IES or the U.S. Department of Education nor does mention of trade names, commercial products, or organizations imply endorsement by the U.S. Government.