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School-based education programmes for the prevention of child sexual abuse.
Cochrane Database Syst Rev. 2015;4:CD004380
Authors: Walsh K, Zwi K, Woolfenden S, Shlonsky A
Abstract
BACKGROUND: Child sexual abuse is a significant global problem in both
magnitude and sequelae. The most widely used primary prevention strategy has
been the provision of school-based education programmes. Although programmes
have been taught in schools since the 1980s, their effectiveness requires
ongoing scrutiny.
OBJECTIVES: To systematically assess evidence of the effectiveness of
school-based education programmes for the prevention of child sexual abuse.
Specifically, to assess whether: programmes are effective in improving
students' protective behaviours and knowledge about sexual abuse prevention;
behaviours and skills are retained over time; and participation results in
disclosures of sexual abuse, produces harms, or both.
SEARCH METHODS: In September 2014, we searched CENTRAL, Ovid MEDLINE, EMBASE
and 11 other databases. We also searched two trials registers and screened the
reference lists of previous reviews for additional trials.
SELECTION CRITERIA: We selected randomised controlled trials (RCTs),
cluster-RCTs, and quasi-RCTs of school-based education interventions for the
prevention of child sexual abuse compared with another intervention or no
intervention.
DATA COLLECTION AND ANALYSIS: Two review authors independently assessed the
eligibility of trials for inclusion, extracted data, and assessed risk of bias.
We summarised data for six outcomes: protective behaviours; knowledge of sexual
abuse or sexual abuse prevention concepts; retention of protective behaviours
over time; retention of knowledge over time; harm; and disclosures of sexual
abuse.
MAIN RESULTS: This is an update of a Cochrane Review that included 15 trials
(up to August 2006). We identified 10 additional trials for the period to
September 2014. We excluded one trial from the original review. Therefore, this
update includes a total of 24 trials (5802 participants). We conducted several
meta-analyses. More than half of the trials in each meta-analysis contained
unit of analysis errors.1. Meta-analysis of two trials (n = 102) evaluating
protective behaviours favoured intervention (odds ratio (OR) 5.71, 95%
confidence interval (CI) 1.98 to 16.51), with borderline low to moderate
heterogeneity (Chi² = 1.37, df = 1, P value = 0.24, I² = 27%, Tau² = 0.16). The
results did not change when we made adjustments using intraclass correlation
coefficients (ICCs) to correct errors made in studies where data were analysed
without accounting for the clustering of students in classes or schools.2.
Meta-analysis of 18 trials (n = 4657) evaluating questionnaire-based k
nowledge favoured intervention (standardised mean difference (SMD) 0.61, 95%
CI 0.45 to 0.78), but there was substantial heterogeneity (Chi² = 104.76, df =
17, P value PMID: 25876919 [PubMed - indexed for MEDLINE]
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Dette abstract er hentet via PubMed fra National Library of Medicine, USA
(http://www.ncbi.nlm.nih.gov/About/disclaimer.html).
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Se abstractet i PubMed: http://evidens.link/1SkZMxp
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