Changing the Paradigm: CSA as a Preventable Public Health Problem

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Child sexual abuse (CSA) ranks 12th in preventable risk factors that contribute to the U.S. burden of disease, afflicts up to 25% of U.S. girls and 5% of boys, and exacts high psychological, social, and monetary costs from individuals and society. For over 25 years, experts have called for a public health approach to prevention of CSA to no avail. Public health prevention strategies have been successfully applied to virtually all types of child maltreatment with the single exception of CSA, which the public continues to view as unpreventable. Consequently, policymakers continue to address CSA almost exclusively with after-the-fact criminal justice policies that do little if anything to prevent CSA from occurring in the first place. Consistent with PAR-14-324, the proposed project brings together a multidisciplinary team that is uniquely poised to shift public opinion so that it aligns with experts' understanding of CSA as a preventable public health problem. The team includes co-investigators and consultants with extensive expertise in CSA prevention, policy, and practice as well as experts in public health-focused communications research. This project aims to create new communication strategies that effectively overcome gaps to align public with expert understanding of CSA (Aim 1), to rigorously evaluate those new communication strategies (Aim 2), and to broadly disseminate effective strategies to the CSA experts and practitioners who interact with the public and to journalist who report on CSA (Aim 3). To accomplish Aim 1 we will use qualitative data techniques to identify the expert consensus and public (and practitioner) opinions about CSA, and comparative analyses to characterize gaps between these understandings; these findings will inform the development of new CSA messaging strategies. To accomplish Aim 2 we will evaluate the efficacy of initial communication reframes via interviews, then conduct a nationally representative survey to test how the reframes influence public opinion, then conduct follow-up tests to evaluate the durability of reframes across retellings. To accomplish Aim 3 we will created online workshops, webinar and in-person trainings, a communications toolkit, and recommendations for journalists to broadly disseminate study findings and effective communication strategies. This project will be the first to create a systematic approach for effectively translating knowledge about CSA prevention and has unique potential to help achieve the critical goal of including CSA within the nation's violence prevention efforts.