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Principal Investigator: Katelyn Guastaferro
Organization: NEW YORK UNIVERSITY
Fiscal Year: 2024
Award: $603,181
Funding agency: Eunice Kennedy Shriver National Institute of Child Health and Human Development
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.
Terms: <0-11 years old><21+ years old><Active Follow-up><Address><Adoption><Adult><Adult Human><Affect><Age><Approaches to prevention><Attitude><Awareness><Behavior><Behavior Conditioning Therapy><Behavior Modification><Behavior Therapy><Behavior Treatment><Behavioral><Behavioral Conditioning Therapy><Behavioral Modification><Behavioral Therapy><Behavioral Treatment><Biologic Models><Biological Models><Child><Child Abuse and Neglect><Child Behavior><Child Development><Child Rearing><Child Sexual Abuse><Child Sexual Molestation><Child Welfare><Child Youth><Childhood maltreatment><Children (0-21)><Clinical Trials><Cluster randomization trial><Cluster randomized trial><Communication><Communities><Conditioning Therapy><Cost Analyses><Cost Analysis><Cues><Curriculum><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><General Public><Grooming><Health><Individual><Infant and Child Development><Infrastructure><Intention><Intervention><Intervention Strategies><Interview><Knowledge><Learning Skill><Model System><Monitor><Parenting><Parenting Education><Parenting behavior><Parents><Position><Positioning Attribute><Prevalence><Preventative strategy><Prevention><Prevention approach><Prevention strategy><Preventive strategy><Primary Prevention><Provider><Public Health><Research><Risk Factors><Safety><Sampling><School-Age Population><Schools><Science><Scientist><Services><Sex Behavior><Sexual Activity><Sexual Behavior><Sexual Development><Structure><Supervision><System><Teaching><Testing><active followup><adolescent welfare><adulthood><ages><assess cost><assess effectiveness><behavior intervention><behavioral intervention><biopsychosocial><boys><care as usual><career><child maltreatment><child well being><child wellbeing><childhood sexual abuse><childrearing><community intervention><community level intervention><community-based intervention><context for implementation><cost assessment><cost effective><cost evaluation><design><designing><determine effectiveness><developmental><effectiveness and implementation trial><effectiveness assessment><effectiveness evaluation><effectiveness testing><effectiveness/implementation design><effectiveness/implementation hybrid design><effectiveness/implementation hybrid trial><effectiveness/implementation trial><enroll><evaluate cost><evaluate effectiveness><evidence base><examine cost><examine effectiveness><experience><family support><federal policy><follow up><follow-up><followed up><followup><foster child><girls><hybrid type 2 design><hybrid type II design><implementation context><implementation determinants><implementation efforts><implementation factors><implementation science><innovate><innovation><innovative><interventional strategy><juvenile sex abuse><kids><lesson plans><male><parent><parent-child communication><parenting education intervention><parenting education programs><parenting intervention><parenting program><parenting skill training><parenting training><physical abuse><physical maltreatment><post intervention><prevention service><programs><protective behavior><randomized, clinical trials><scale up><school age><service providers><sex activity><sex development><sexual activities><skills><skills training><teacher><treatment as usual><usual care><youngster>