Parent-focused primary prevention of child sexual abuse: An Effectiveness-Implementation Hybrid Trial

以家长为中心的儿童性虐待一级预防：有效性-实施混合试验

• 批准号: 10583612
• 负责人: Katelyn Guastaferro
• 金额: $ 65.93万
• 依托单位: NEW YORK UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-08-14 至 2028-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10583612
• 关键词: Address; Adoption; Adult; Affect; Age; Attitude; Awareness; Behavior; Behavior Therapy; Behavioral; Biological Models; Child; Child Abuse and Neglect; Child Behavior; Child Development; Child Rearing; Child Sexual Abuse; Child Welfare; Clinical Trials; Cluster randomized trial; Communication; Communities; Cost Analysis; Cues; Development; Dissemination and Implementation; Economic Burden; Educational Curriculum; Educational process of instructing; Effectiveness; Enrollment; Environment; Experimental Designs; Family; Female; Focus Groups; Foundational Skills; Funding; Future; General Population; Grooming; Health; Individual; Infrastructure; Intention; Intervention; Interview; Knowledge; Learning Skill; Monitor; Parenting Education; Parents; Positioning Attribute; Prevalence; Prevention; Prevention approach; Prevention strategy; Primary Prevention; Provider; Public Health; Research; Risk Factors; Safety; Sampling; School-Age Population; Schools; Science; Scientist; Services; Sex Behavior; Sexual Development; Structure; Supervision; System; Testing; biopsychosocial; boys; career; cost effective; design; effectiveness evaluation; effectiveness testing; effectiveness/implementation design; effectiveness/implementation trial; evidence base; experience; family support; federal policy; follow-up; foster child; girls; hybrid type 2 design; implementation context; implementation determinants; implementation efforts; implementation science; innovation; male; parent-child communication; physical abuse; post intervention; prevention service; programs; protective behavior; randomized, clinical trials; scale up; service providers; skills; skills training; teacher; treatment as usual

ABSTRACT Child sexual abuse (CSA) is a global public health problem affecting 1 in 5 girls and 1 in 12 boys before age 18. Parents are uniquely positioned to protect children from CSA, yet parents have largely been ignored in CSA primary prevention efforts and the few that do exist have not demonstrated a significant effect on protective behaviors. Parent education (PE) programs provide parents with foundational skills related to child development, parent-child communication, and safety. These foundational skills can be logically extended into didactics relevant to CSA prevention: healthy sexual development, strategies for parents to communicate with their children and others about sexual topics and sexual behaviors, and creating physical and online environments safe from potential exploitation and recognizing grooming behaviors. Our team developed Smart Parents – Safe and Healthy Kids (Smart Parents) as a single session, skills-based, parent-focused CSA prevention module that adds these key CSA-specific prevention concepts to PE program curricula. Leveraging the PE foundational skills, Smart Parents provides parents with CSA-prevention knowledge to increase their CSA-related attitudes and perceived norms as well as the opportunity to practice protective behavioral skills. A recent cluster randomized clinical trial demonstrated preliminary to be effective in raising parents' awareness and increasing their intention to use of CSA protective behaviors when added to Parents as Teachers (PAT), an evidence-based PE program supported by most state child welfare systems. The proposed study seeks to expand the empirical evidence for the effectiveness of Smart Parents and to explore the implementation factors that might promote or hinder adoption, fidelity, and scalability, the proposed study uses a type 2 hybrid effectiveness-implementation design. We will conduct a stepped wedge-cluster randomized trial (N = 400) To determine effectiveness (Aim1) of Smart Parents when added to PAT (PAT+Smart Parents) on CSA-related awareness and intention to use CSA protective behaviors compared to parents receiving PAT treatment as usual (PAT-TAU. We will follow-up participating parents in both conditions at 12- and 24-months to determine retention of awareness (i.e., knowledge and attitudes) and actual use of protective behaviors (Aim 2). To describe factors that hold promise for future dissemination and implementation efforts (Aim 3), we will: assess parent, provider, and organizational-level moderators of Smart Parents effectiveness; conduct a cost analysis; and conduct structured interviews with Smart Parents providers (N = 100) and focus groups with key PE stakeholders (N = 25) to identify factors that may impact future dissemination and implementation. By leveraging the foundational skills taught in existing PE used by state-supported family service providers across the US—and supported through federal policy such as the Family First Prevention Services Act—the integration of Smart Parents into PE programs is not only efficient and cost-effective, but constitutes a sustainable model of system-wide, real-world, community-based implementation of primary CSA prevention.

摘要 儿童性虐待（CSA）是一个全球性的公共卫生问题，影响到五分之一的女孩和十二分之一的男孩。 18.父母在保护儿童免受CSA侵害方面具有独特的地位，但在很大程度上， 加空局的初级预防努力和少数确实存在的努力没有显示出对 保护行为。家长教育（PE）计划为家长提供与孩子相关的基本技能 发展、亲子沟通和安全。这些基本技能可以逻辑地扩展到 与预防CSA有关的教学法：健康的性发展，父母沟通的策略 他们的孩子和其他人关于性话题和性行为，并创造物理和在线 环境安全，免受潜在的剥削和识别梳理行为。我们的团队开发了Smart 家长-安全和健康的孩子（聪明的父母）作为一个单一的会议，技能为基础，家长为重点的CSA 预防模块，将这些关键的CSA特定预防概念添加到体育课程中。利用 在体育基础技能方面，Smart Parents为家长提供预防CSA的知识，以提高他们的 CSA相关的态度和认知规范以及练习保护性行为技能的机会。一 最近的一项随机临床试验初步证明， 并增加他们使用CSA保护行为的意图，当添加到家长作为教师（PAT）， 这是一个以证据为基础的体育项目，得到了大多数州儿童福利系统的支持。拟议的研究旨在 扩大智慧型父母有效性的实证证据，并探讨其实施 可能促进或阻碍采用，保真度和可扩展性的因素，拟议的研究使用了2型混合 有效实施设计。我们将进行一项阶梯式楔形群随机试验（N = 400）， 确定智能父母在添加到PAT（PAT+智能父母）时对CSA相关的有效性（目标1） 与接受PAT治疗的父母相比， 通常（PAT-TAU.我们将在12个月和24个月时对这两种情况下的参与父母进行随访， 保持意识（即，知识和态度）和实际使用的保护行为（目标2）。到 描述对未来传播和实施工作有希望的因素（目标3），我们将：评估 父母，供应商和组织级的智能父母有效性的主持人;进行成本分析; 并与Smart Parents提供者（N = 100）和具有关键PE的焦点小组进行结构化访谈 利益相关者（N = 25），以确定可能影响未来传播和实施的因素。通过 利用国家支持的家庭服务提供者使用的现有体育课程中教授的基础技能 在美国，并通过联邦政策，如家庭第一预防服务法， 将聪明的父母融入体育项目不仅效率高，成本效益好，而且构成了一个 在全系统、现实世界、以社区为基础实施CSA初级预防的可持续模式。