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

基本信息

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
项目类别：
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

项目摘要

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.

抽象的儿童性虐待 (CSA) 是一个全球性公共卫生问题，影响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 方面具有独特的地位，但在儿童遭受 CSA 侵害时，父母在很大程度上被忽视了。 CSA 一级预防工作和少数确实存在的工作尚未证明对家长教育 (PE) 计划为家长提供与孩子相关的基本技能。这些基本技能可以逻辑地延伸到发展、亲子沟通和安全等方面。与 CSA 预防相关的教学法：健康的性发育、与父母沟通的策略他们的孩子和其他人谈论性话题和性行为，并创造身体和在线我们的团队开发了 Smart，以防止潜在的剥削和识别梳理行为。家长 – 安全健康的孩子（聪明的家长）作为单一课程、基于技能、以家长为中心的 CSA 预防模块将这些关键的 CSA 特定预防概念添加到体育项目课程中。体育基础技能，智慧家长为家长提供CSA预防知识，提高他们的体育基础技能 CSA 相关态度和认知规范以及练习保护行为技能的机会 A。最近的整群随机临床试验初步证明可有效提高家长的认识当添加到家长作为教师 (PAT) 中时，增加他们使用 CSA 保护行为的意愿，一项由大多数州儿童福利系统支持的基于证据的体育项目拟议的研究旨在扩大智能父母有效性的经验证据并探索实施可能促进或阻碍采用、保真度和可扩展性的因素，拟议的研究使用类型 2 混合我们将进行阶梯式楔形集群随机试验（N = 400）。确定智能父母添加到 CSA 相关 PAT（PAT+智能父母）后的有效性（目标 1）与接受 PAT 治疗的父母相比，使用 CSA 保护行为的意识和意愿通常（PAT-TAU）。我们将在 12 个月和 24 个月时对参与这两种情况的家长进行随访，以确定保持意识（即知识和态度）和实际使用保护行为（目标 2）。描述对未来传播和实施工作有希望的因素（目标 3），我们将：评估家长、提供者和组织层面的智能父母有效性调节者；进行成本分析；与 Smart Parents 提供者（N = 100）和关键 PE 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。利用国家支持的家庭服务提供商在现有 PE 中教授的基本技能美国——并通过《家庭优先预防服务法》等联邦政策的支持—— 将聪明父母融入体育项目不仅高效且具有成本效益，而且构成了在全系统范围内、现实世界、以社区为基础实施 CSA 初级预防的可持续模式。