Data for: Adapting a Selective Parent-Focused Child Sexual Abuse Prevention Curriculum for a Universal Audience: A Pilot Study

Project Overview Parents are an obvious, but underutilized player in the prevention of child sexual abuse (CSA). A handful of universal prevention programs have emerged, however, the evidence for these programs is mixed and the programs suffer ubiquitously from barriers to implementation (e.g., poor engagement, low participation) thereby limiting public health impact. To combat these barriers and improve evidence, researchers previously developed and tested a selective parent-focused CSA prevention program. While promising, the selective approach still leaves a gap in the prevention landscape – parents from the universal audience. However, there appear to be no standardized methods to inform this type of adaptation — interventions designed as universal or selective have primarily been delivered as such. This study sought to adapt the selective curriculum for a universal audience and examined the acceptability and feasibility of the program for evaluation in a future trial. Smart Parents - Safe and Healthy Kids (SPSHK), informed by social cognitive theory, uses role-play scenarios to emphasize skills related to healthy child sexual development, parent-child communication about sex and sexual abuse, and child safety strategies to protect them from victimization (i.e., vetting babysitters, monitoring activities inside and outside of the home, as well as online). SPSHK comprises three segments: (1) healthy child sexual development; (2) parent-child communication; and (3) child safety. Each segment is described in a handbook and is divided into age groups, so parents can easily access the most relevant information for their child’s age and developmental range (i.e., 0-2, 2-5, 6-9, 9-12, 13+). In the “Healthy Sexual Development” segment, parents review typical sexual developmental milestones, behaviors that are atypical and may indicate something abusive or harmful has occurred, and the importance of teaching children anatomical labels for body parts (e.g., vagina, penis, breasts). In the “Parent-Child Communication” segment, parents learn why, when, and where to promote open, accurate, and consistent communication about sexual topics. In the “Child Safety” segment, the parent learns the importance of and how to monitor their child’s activities inside and outside of the home, as well as online. Parents create a safety plan so that their child knows what to do if they are feeling unsafe or if something has happened to them. This segment also reviews the behavioral, emotional, and physical signs of CSA. Parents learn how to react to a disclosure or if they suspect abuse has occurred. SPSHK was uniquely designed to be added to existing parent education (PE) programs (e.g., Parents at Teachers, SafeCare, or Incredible Years) as parents who are enrolled in PE, potentially as a result of involvement in the child protective service system, are at increased risk for subsequent child maltreatment, including CSA. In the adaptation process, it was imperative that we retained qualities of SPSHK that set it apart from other programs: delivery in a single session, use of role play to practice taught skills following principles of social cognitive theory, and provision of materials to the parent that spanned child developmental periods through age 13. The purpose of the current study was to identify any necessary modifications to the content of the curriculum and to ascertain whether parents from the general community (rather than referred through a PE program) would have enough foundational knowledge to be successful in the Smarter Parents. Safer Kids. program. We piloted modifications to the curriculum to foster group rapport and the online delivery system, including online data collection. Using a pre-/post-test design, we examined the preliminary efficacy of Smarter Parents. Safer Kids. delivered in increasing parents’ CSA-related awareness and intention to use protective behaviors. Following an educational workshop, we conducted brief interviews with parents to learn about the acceptability and feasibility of the curriculum delivered in a group setting and online. If acceptable and feasible, the eventual addition of an evidence-based universal parent-focused CSA prevention program to child- and community-based CSA prevention efforts holds promise for affecting rates of CSA prevalence. Overall participants’ mean score on CSA-related awareness and intention to use protective behavioral strategies increased. The participants found the curriculum highly acceptable noting strengths in the content and design. All told, the results of this pilot study suggest the acceptability and feasibility of examining the efficacy of the universal parent focused curriculum in a larger trial. Procedural challenges, such as bots in recruitment, identify areas of caution in design of the larger trial and a roadmap for others seeking to adapt selective programs for universal audiences.
Data and Data Collection Overview Parents...

项目概述：父母在儿童性虐待（CSA）预防中虽显见而未充分运用其作用。然而，若干普遍预防项目的出现，其证据尚存分歧，且这些项目普遍面临实施障碍（例如，参与度低、参与率不高），从而限制了其在公共卫生方面的影响。为克服这些障碍并提升证据质量，研究者先前已开发并测试了一项以父母为焦点的选择性CSA预防项目。尽管该选择性方法颇具前景，但在预防领域仍存在缺口——即普遍受众中的父母。然而，似乎缺乏标准化方法来指导此类调整——旨在普遍或选择性的干预措施，主要仍以原样交付。本研究旨在将选择性课程调整为适用于普遍受众，并评估该方案在未来试验中的可接受性和可行性。‘智慧父母——安全健康儿童’（SPSHK）项目，基于社会认知理论，通过角色扮演情景强调与儿童健康性发展相关的技能，包括父母与子女就性及性虐待进行的沟通，以及保护儿童免受侵害的策略（例如，审查保姆，监控家庭内外活动，以及在线活动）。SPSHK包括三个部分：（1）健康儿童性发展；（2）父母与子女沟通；（3）儿童安全。每个部分均以手册形式描述，并按年龄组划分，以便父母能够轻松获取与其子女年龄和发展阶段最相关的信息（即，0-2岁，2-5岁，6-9岁，9-12岁，13岁以上）。在“健康性发展”部分，父母回顾典型的性发展里程碑，非典型行为以及可能表明发生虐待或有害事件的迹象，以及教授儿童身体部位（如阴道、阴茎、乳房）解剖标签的重要性。在“父母与子女沟通”部分，父母学习为何、何时以及何地进行开放、准确和一致的性话题沟通。在“儿童安全”部分，父母学习如何在家中内外及在线监控子女的活动，以及制定安全计划，以便子女在感到不安全或发生意外时知道如何行动。此外，该部分还回顾了CSA的行为、情绪和生理迹象。父母学习如何对揭发事件作出反应，或当他们怀疑发生虐待时如何应对。SPSHK的独特设计使其能够添加到现有的父母教育（PE）项目中（例如，教师父母、SafeCare或Incredible Years），因为这些项目中的父母，可能由于涉及儿童保护服务系统，面临后续儿童虐待（包括CSA）的风险增加。在调整过程中，保留SPSHK区别于其他项目的特性至关重要：单次会议的交付，使用基于社会认知理论原则的角色扮演来练习所学技能，以及为父母提供涵盖从出生到13岁儿童发展各阶段的材料。当前研究的目的在于确定课程内容中任何必要的修改，以及确定普通社区中的父母（而非通过PE项目推荐）是否具备足够的知识基础以在‘智慧父母，安全儿童’项目中取得成功。我们试点了课程调整以促进小组关系和在线交付系统，包括在线数据收集。采用前/后测试设计，我们考察了‘智慧父母，安全儿童’项目在提高父母CSA相关意识和采用保护行为的意图方面的初步有效性。在教育研讨会之后，我们对父母进行了简短访谈，了解在小组环境和在线环境中交付的课程的可接受性和可行性。如果可接受且可行，最终将基于证据的普遍父母聚焦CSA预防项目添加到基于儿童和社区的CSA预防工作中，有望影响CSA的流行率。总体而言，参与者在CSA相关意识和采用保护行为策略的意图方面的平均得分有所提高。参与者认为课程高度可接受，并指出其内容和设计上的优势。总的来说，该试点研究的结果表明，在更大规模的试验中检验普遍父母聚焦课程的有效性是可接受且可行的。在招募过程中出现的程序挑战，如机器人，在更大规模试验的设计中指出了需要谨慎的领域，并为其他试图将选择性项目调整为普遍受众的项目提供了路线图。