Methods to increase reporting of childhood sexual abuse in surveys: the sensitivity and specificity of face-to-face interviews versus a sealed envelope method in Ugandan primary school children.
Methods to increase reporting of childhood sexual abuse in surveys: the sensitivity and specificity of face-to-face interviews versus a sealed envelope method in Ugandan primary school children.
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DOI：
10.1186/s12914-016-0110-2
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发表时间：
2017-02-23
影响因子：
3
通讯作者：
Devries KM
中科院分区：
文献类型：
--
作者：
Barr AL;Knight L;Franҫa-Junior I;Allen E;Naker D;Devries KM
儿童性虐待的漏报是获得可靠的流行率估计数的主要障碍。我们通过比较强迫性行为的披露数量与更保密的数据收集模式——密封信封法（SEM）——来测试面对面访谈（FTFI）方法的敏感性和特异性。我们还报告了ftfi中与不披露相关的个人特征。对2014年进行的横断面调查数据进行二次分析，调查对象为乌干达Luwero区3843名小学生。计算敏感性和特异性，并使用混合效应逻辑回归模型检验一种或两种模式下与信息披露相关的因素。在FTFI中，1.1% （n = 42）的儿童报告曾经历过强迫性行为，而扫描电镜中为7.0% （n = 268）。与扫描电镜相比，FTFI方法在检测强迫性行为方面表现出低灵敏度（13.1%,95%CI 9.3-17.7%）和高特异性（99.8%,95%CI 99.6-99.9%）。男孩比女孩更不可能在FTFI中透露，但是使用扫描电镜，性别患病率没有差异（aOR = 0.91, 95%CI 0.7-1.2; P = 0.532）。在两种披露模式中，披露其他形式性暴力的经历都与强迫性行为的经历有关。扫描电镜方法在识别小学儿童，特别是男孩的强迫性行为方面优于ftfi。报告外来移民中其他形式的性暴力可能表明有被迫进行性行为的经历。今后的调查研究和估计性暴力普遍程度的努力应利用更加保密的披露方法来发现儿童性虐待。
Underreporting of childhood sexual abuse is a major barrier to obtaining reliable prevalence estimates. We tested the sensitivity and specificity of the face-to-face-interview (FTFI) method by comparing the number of disclosures of forced sex against a more confidential mode of data collection, the sealed-envelope method (SEM). We also report on characteristics of individuals associated with non-disclosure in FTFIs. Secondary analysis of data from a cross-sectional survey conducted in 2014, with n = 3843 children attending primary school in Luwero District, Uganda. Sensitivity and specificity were calculated, and mixed effects logistic regression models tested factors associated with disclosure in one or both modes. In the FTFI, 1.1% (n = 42) of children reported ever experiencing forced sex, compared to 7.0% (n = 268) in the SEM. The FTFI method demonstrated low sensitivity (13.1%, 95%CI 9.3–17.7%) and high specificity (99.8%, 95%CI 99.6–99.9%) in detecting cases of forced sex, when compared to the SEM. Boys were less likely than girls to disclose in the FTFI, however there was no difference in prevalence by sex using the SEM (aOR = 0.91, 95%CI 0.7–1.2; P = 0.532). Disclosing experience of other forms of sexual violence was associated with experience of forced sex for both modes of disclosure. The SEM method was superior to FTFIs in identifying cases of forced sex amongst primary school children, particularly for boys. Reporting of other forms of sexual violence in FTFIs may indicate experience of forced sex. Future survey research, and efforts to estimate prevalence of sexual violence, should make use of more confidential disclosure methods to detect childhood sexual abuse.