Evaluation of the school-based Healthy Relationships Project for primary prevention of child sexual abuse among children pre-K through 5th grade

项目摘要 儿童性行为一级预防校本健康关系项目效果评价 学龄前至五年级儿童中的虐待行为 儿童性虐待(CSA)是一个世界性的重大问题，有严格的证据表明其规模和对 社交、情感和身体健康。虽然存在对环孢素A的一级预防干预措施，但很少有干预措施 经过严格评估。预防CSA的校本教育项目回顾(Walsh等人，2015) 结果发现，共有24项试验，代表7个国家的小学和高中的5802名参与者。 发现包括保护行为和知识改善的证据，但证据有限 披露的几率增加了。没有人发现CSA的发病率/患病率随着时间的推移而发生变化。健康的人 由佛蒙特州防止虐待儿童组织创建、修改和运行的关系项目(HRP)具有 自1990年以来一直提供CSA初级预防课程，在美国30个州实施， 包括佛蒙特州的全州范围内。在这几十年里，佛蒙特州每年确诊的病例都有所下降 61%，儿童犯罪者的数量每年下降69%。解决研究优先事项1， HRP在学前班到五年级的实施将分混合方法进行严格的评估 楔形随机试验设计，在华盛顿特区的三个高需要病房的16所公立特许学校中进行。 颁布了2018年《学校安全总括修正案》，规定特区学校有义务预防和 解决学生性虐待问题。我们的合作伙伴Safe Shores，DC儿童倡导中心(CAC)， 在公立特许学校成功实施了HRP；仍有机会在学校进行这一试验 在没有交付的地方，通过与地区和学校建立信任来增加其可行性。我们的 关于其有效性的发现可能会将HRP置于循证计划的梯队中，许多 学校寻求使用，特别是那些被授权提供CSA预防计划的学校。来自外管局的数据 从华盛顿特区所有公立学校收到涉嫌虐待儿童报告的CAC Shares将 作为主要成果使用，包括CSA调查和其他服务的数量和类型 由CAC提供，参与学校包括法医服务、家庭辩护、案件 管理以及更多内容。更常用的保护行为改善措施，自我保护 疗效、知识和披露将从照顾者(n=3500)和教师(n=266)那里收集。定性的 将包括评估干预推广、保真度监测、经验教训的优势和劣势的研究 学习和可持续发展。这项创新和新颖的混合方法评价研究将推动 以社区为基础的参与性研究伙伴关系推进儿童性虐待预防研究 在家庭暴力预防研究的科学家、社区组织的专业人员和 参与需求高的城市地区的公立小学。总而言之，一项严格的实验 将对现有的具有30多年历史的普遍初级预防方案进行评估 在30个州实施了多年，并有强大的试点数据。

Project Abstract Evaluation of the school-based Healthy Relationships Project for primary prevention of child sexual abuse among children pre-K through 5th grade Child sexual abuse (CSA) is a major issue worldwide, with rigorous evidence of its magnitude and impacts on social, emotional and physical health. While interventions for the primary prevention of CSA exist, few have been rigorously evaluated. A review of school-based education programs for CSA prevention (Walsh et al., 2015) found a total of 24 trials representing 5,802 participants in both elementary and high schools across 7 countries. Findings included evidence of improvements in protective behaviors and knowledge, with limited evidence of increased odds of disclosure. None found changes in incidence/prevalence of CSA over time. The Healthy Relationships Project (HRP) created, modified and run by the organization Prevent Child Abuse Vermont, has been delivering CSA primary prevention curricula since 1990 with implementation across 30 U.S. States, including statewide in Vermont. During those decades, substantiated cases per year in Vermont dropped 61% and the number of child perpetrators per year dropped 69%. Addressing Research Priority 1, implementation of the HRP in Pre-K through 5th grade will be rigorously evaluated in a mixed-methods stepped wedge randomized trial design with 16 public charter schools in three high-need wards in Washington, DC. The School Safety Omnibus Amendment Act of 2018 was enacted to obligate DC schools to prevent and address student sexual abuse. Our partner Safe Shores, the Child Advocacy Center (CAC) for DC, has implemented HRP in public charter schools with success; the opportunity remains to conduct this trial in schools where it has not been delivered and increase its feasibility via established trust with the district and schools. Our findings about its efficacy will potentially place the HRP into the echelon of evidence-based programs that many schools seek to use, especially those mandated to deliver CSA prevention programming. Data from Safe Shores, the CAC that receives reports of suspected child abuse from all Washington, DC public schools, will be utilized as the primary outcome including the numbers and types of CSA investigations and other services provided by the CAC involving the participating schools which include forensic services, family advocacy, case management and more. More commonly utilized measures of improvements in protective behaviors, self- efficacy, knowledge and disclosure will be collected from caregivers (n=3,500) and teachers (n= 266). Qualitative research will be included to assess strengths and weaknesses of intervention rollout, fidelity monitoring, lessons learned and sustainability. This innovative and novel mixed methods evaluation study will move the science of child sexual abuse prevention research forward with a community-based participatory research partnership between scientists in family violence prevention research, professionals at community-based organizations and participating public elementary schools in high need urban areas. In summary, a rigorous experimental evaluation will be conducted of an existing universal primary prevention program with a history of 30+ years of implementation across 30 states and robust pilot data.