Maximizing the reach of universal child sexual abuse prevention: An equivalence trial

儿童性虐待(CSA)是一个公共卫生问题，18岁前每5个女孩中就有1个受到影响，每12个男孩中就有1个受到影响。 国家估计表明，7至13岁的儿童患CsA的风险最高，CsA与 终身的负面后遗症。以学校为基础的预防方案提供具有成本效益的全民方案 教授学生个人安全技能，识别违反边界和有害形式的知识 接触或接触，如何有效地拒绝接洽或邀请，增加代理和获得资源的机会。 几个方案证明了在增加儿童自我保护和保护知识方面的有效性 其中一些与便利披露有关，包括安全接触。尽管效率很高， 普遍的校本课程的计划范围受到对学校的固有依赖的限制 基础设施和现有替代交付方式的匮乏，如虚拟交付。这是最多的 最近突显的是史无前例的学校停课以缓解新冠肺炎的传播，其中 预防方案编制的基础设施，因此学校工作人员有可能查明潜在的虐待行为 和披露，都被取消了。这些情况虽然不同寻常，但突显了在 即使在大流行之外，有效的校本预防教育方案的实施方式 泰晤士报。尽管一些以证据为基础的学校项目可能已经过渡到虚拟交付，但没有一个 都经过了经验评估，也没有与面对面的版本进行经验比较。建议数 R21旨在解决CSA预防研究领域的这一空白，独特地利用现有的 基于大学的研究人员(NYU)、SAFE Touch模型开发商(NYSPCC)和 在两个州积极实施安全接触的社区组织，代表 城市/农村、低收入/高收入和种族多元化的环境。这项研究将使用严格的随机分组 设计以确定两种安全触摸交付方式之间的等效性：在- 人与虚拟。我们将确定概念学习习得(目标1)和保持(目标1)的等价性 2)在教室(N=180)中接受面对面(n=90)或虚拟(n=90)安全触摸的学生中 研修班。要得出等价性结论，重要的是要检查可能影响未来传播的因素。 和实施，特别是学校人员的计划采用率和实施忠诚度(AIM 3)。研究结果将为正在制定有效的CSA预防计划和政策提供信息 关于在学校系统内可持续地整合这类项目的决定。考虑到范围和 CSA的负担，特别是在小学生中，有效地提高CSA的负担是公共卫生的优先事项 广泛传播有效的校本预防计划。

Child sexual abuse (CSA) is a public health problem affecting 1 in 5 girls and 1 in 12 boys before age 18. National estimates indicate children ages 7 to 13 are at highest risk for CSA and CSA is associated with lifelong negative sequelae. School-based prevention programs offer cost-effective universal programming teaching students personal safety skills, knowledge to identify boundary violations and unwanted forms of touch or contact, how to refuse approaches or invitations effectively, increase agency and access to resources. Several programs have demonstrated effectiveness in increasing children’s knowledge of self-protection and some have been linked with facilitating disclosures, including Safe Touches. Effectiveness notwithstanding, the programmatic reach of universal school-based programs is limited by the inherent reliance on school infrastructure and a dearth of available alternative delivery modalities, such as virtual delivery. This was most recently highlighted by the unprecedented school closures to mitigate the spread of COVID-19 wherein the infrastructure for prevention programming, and therefore the potential for school staff to identify potential abuse and disclosures, was eliminated. These circumstances, though unusual, highlighted the need for flexibility in the mode of delivery for effective school based preventive education programs even outside of pandemic times. Though some evidence-based school-based programs may have transitioned to virtual delivery, none have been empirically evaluated nor were they empirically compared against in-person versions. The proposed R21 is designed to address this gap in the CSA prevention research field, uniquely leveraging an existing partnership between university-based researchers (NYU), the Safe Touches model developer (NYSPCC), and community-based organizations with active implementations of Safe Touches in two states representing urban/rural, low/high income, and racially diverse settings. The study will use a rigorous cluster randomized design to determine the equivalence of effectiveness between two delivery modalities of Safe Touches: in- person vs. virtual. We will determine the equivalence of concept learning acquisition (Aim 1) and retention (Aim 2) among students in classrooms (N=180) that receive the in-person (n = 90) or virtual (n=90) Safe Touches workshop. To conclude equivalence, it is important to examine factors that may impact future dissemination and implementation, specifically program adoption among school personnel and implementation fidelity (Aim 3). Study findings will inform the ongoing development of effective CSA prevention programs and policy decisions regarding the sustainable integration of such programs within school systems. Given the scope and burden of CSA, especially among elementary aged students, it is a public health priority to efficiently disseminate effective school-based prevention programs on a wide scale.