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Published in: BMC Public Health 1/2016

Open Access 01-12-2015 | Study protocol

Cluster randomised-control trial for an Australian child protection education program: Study protocol for the Learn to be safe with Emmy and friends

Authors: Codi White, Dianne C. Shanley, Melanie J. Zimmer-Gembeck, Katrina Lines, Kerryann Walsh, Russell Hawkins

Published in: BMC Public Health | Issue 1/2016

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Abstract

Background

Child maltreatment has severe short-and long-term consequences for children’s health, development, and wellbeing. Despite the provision of child protection education programs in many countries, few have been rigorously evaluated to determine their effectiveness. We describe the design of a multi-site gold standard evaluation of an Australian school-based child protection education program. The intervention has been developed by a not-for-profit agency and comprises 5 1-h sessions delivered to first grade students (aged 5–6 years) in their regular classrooms. It incorporates common attributes of effective programs identified in the literature, and aligns with the Australian education curriculum.

Methods/Design

A three-site cluster randomised controlled trial (RCT) of Learn to be safe with Emmy and friends™ will be conducted with children in approximately 72 first grade classrooms in 24 Queensland primary (elementary) schools from three state regions, over a period of 2 years. Entire schools will be randomised, using a computer generated list of random numbers, to intervention and wait-list control conditions, to prevent contamination effects across students and classes. Data will be collected at baseline (pre-assessment), immediately after the intervention (post-assessment), and at 6-, 12-, and 18-months (follow-up assessments). Outcome assessors will be blinded to group membership. Primary outcomes assessed are children’s knowledge of program concepts; intentions to use program knowledge, skills, and help-seeking strategies; actual use of program material in a simulated situation; and anxiety arising from program participation. Secondary outcomes include a parent discussion monitor, parent observations of their children’s use of program materials, satisfaction with the program, and parental stress. A process evaluation will be conducted concurrently to assess program performance.

Discussion

This RCT addresses shortcomings in previous studies and methodologically extends research in this area by randomising at school-level to prevent cross-learning between conditions; providing longer-term outcome assessment than any previous study; examining the degree to which parents/guardians discuss intervention content with children at home; assessing potential moderating/mediating effects of family and child demographic variables; testing an in-vivo measure to assess children’s ability to discriminate safe/unsafe situations and disclose to trusted adults; and testing enhancements to existing measures to establish greater internal consistency.

Trial registration

Australian and New Zealand Clinical Trials Register (ACTRN12615000917​538). Registered (02/09/2015). 
Literature
1.
go back to reference Krug EG, Mercy JA, Dahlberg LL, Zwi AB. The world report on violence and health. Lancet. 2002;360:1083–8.CrossRefPubMed Krug EG, Mercy JA, Dahlberg LL, Zwi AB. The world report on violence and health. Lancet. 2002;360:1083–8.CrossRefPubMed
2.
go back to reference Pinheiro PS. World report on violence against children. Geneva: United Nations Publishing Service; 2006. Pinheiro PS. World report on violence against children. Geneva: United Nations Publishing Service; 2006.
3.
go back to reference Petersen A, Joseph J, Feit M, editors. New directions in child abuse and neglect research. Washington, DC: National Academies Press; 2014. Petersen A, Joseph J, Feit M, editors. New directions in child abuse and neglect research. Washington, DC: National Academies Press; 2014.
4.
go back to reference World Health Organization [WHO], & International Society for Prevention of Child Abuse and Neglect [ISPCAN]. Preventing child maltreatment: A guide to taking action and generating evidence. Geneva: World Health Organization; 2006. World Health Organization [WHO], & International Society for Prevention of Child Abuse and Neglect [ISPCAN]. Preventing child maltreatment: A guide to taking action and generating evidence. Geneva: World Health Organization; 2006.
6.
go back to reference Felitti VJ, Anda RF, Nordenberg D, Williamson DF, Spitz AM, Edwards V, et al. Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults: The Adverse Childhood Experiences (ACE) Study. Am J Prev Med. 1998;14:245–58.CrossRefPubMed Felitti VJ, Anda RF, Nordenberg D, Williamson DF, Spitz AM, Edwards V, et al. Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults: The Adverse Childhood Experiences (ACE) Study. Am J Prev Med. 1998;14:245–58.CrossRefPubMed
7.
go back to reference Fergusson DM, Boden JM, Horwood LJ. Exposure to childhood sexual and physical abuse and adjustment in early adulthood. Child Abuse Negl. 2008;32:607–19.CrossRefPubMed Fergusson DM, Boden JM, Horwood LJ. Exposure to childhood sexual and physical abuse and adjustment in early adulthood. Child Abuse Negl. 2008;32:607–19.CrossRefPubMed
8.
go back to reference Stouthamer-Loeber M, Loeber R, Homish D, Wei E. Maltreatment of boys and the development of disruptive and delinquent behavior. Dev Psychopathol. 2001;13:941–55.PubMed Stouthamer-Loeber M, Loeber R, Homish D, Wei E. Maltreatment of boys and the development of disruptive and delinquent behavior. Dev Psychopathol. 2001;13:941–55.PubMed
9.
go back to reference Daro DA, McCurdy KP. Interventions to prevent child maltreatment. In: Doll LS, Bonzo DA, Mercy JA, Sleet, editors. Handbook of injury and violence prevention. Atlanta, GA: Springer; 2007. p. 137–55.CrossRef Daro DA, McCurdy KP. Interventions to prevent child maltreatment. In: Doll LS, Bonzo DA, Mercy JA, Sleet, editors. Handbook of injury and violence prevention. Atlanta, GA: Springer; 2007. p. 137–55.CrossRef
11.
go back to reference Flandreau-West P. The basic essentials: Protective behaviours anti-victimization and empowerment process. Adelaide: Essence Publications; 1989. Flandreau-West P. The basic essentials: Protective behaviours anti-victimization and empowerment process. Adelaide: Essence Publications; 1989.
12.
go back to reference Miller-Perrin CL, Wurtele SK. Children’s conceptions of personal body safety: A comparison across ages. J Clin Child Psychol. 1989;18:25–35.CrossRef Miller-Perrin CL, Wurtele SK. Children’s conceptions of personal body safety: A comparison across ages. J Clin Child Psychol. 1989;18:25–35.CrossRef
13.
go back to reference Wurtele SK. The body safety training workbook: A personal safety program for parents to teach their children. Wurtele: Colorado Springs, CO; 2007. Wurtele SK. The body safety training workbook: A personal safety program for parents to teach their children. Wurtele: Colorado Springs, CO; 2007.
14.
go back to reference Finkelhor D. Prevention of sexual abuse through educational programs directed toward children. Pediatrics. 2007;120:640–5.CrossRefPubMed Finkelhor D. Prevention of sexual abuse through educational programs directed toward children. Pediatrics. 2007;120:640–5.CrossRefPubMed
16.
go back to reference Davis MK, Gidycz CA. Child sexual abuse prevention programs: A meta-analysis. J Clin Child Psychol. 2000;29:257–65.CrossRefPubMed Davis MK, Gidycz CA. Child sexual abuse prevention programs: A meta-analysis. J Clin Child Psychol. 2000;29:257–65.CrossRefPubMed
17.
go back to reference Fryda CM, Hulme PA. School-based childhood sexual abuse prevention programs: An integrative review. J Sch Nurs. 2015;31:167–82.CrossRefPubMed Fryda CM, Hulme PA. School-based childhood sexual abuse prevention programs: An integrative review. J Sch Nurs. 2015;31:167–82.CrossRefPubMed
18.
go back to reference Hawkins RMF. Family inclusive protection practice: The need for rigorous evaluation. Child Aust. 2014;39:81–6.CrossRef Hawkins RMF. Family inclusive protection practice: The need for rigorous evaluation. Child Aust. 2014;39:81–6.CrossRef
19.
go back to reference Rispens J, Aleman A, Goudena PP. Prevention of child sexual abuse victimization: A meta-analysis of school programs. Child Abuse Negl. 1997;21:975–87.CrossRefPubMed Rispens J, Aleman A, Goudena PP. Prevention of child sexual abuse victimization: A meta-analysis of school programs. Child Abuse Negl. 1997;21:975–87.CrossRefPubMed
20.
go back to reference Dale R, Shanley DC, Zimmer-Gembeck MJ, Lines K, Pickering K, White C. Empowering and protecting children by enhancing knowledge, skills and well-being: A randomized trial of Learn to BE SAFE with Emmy™. Child Abuse Negl. 2015. doi:10.1016/j.chiabu.2015.07.016.PubMed Dale R, Shanley DC, Zimmer-Gembeck MJ, Lines K, Pickering K, White C. Empowering and protecting children by enhancing knowledge, skills and well-being: A randomized trial of Learn to BE SAFE with Emmy™. Child Abuse Negl. 2015. doi:10.​1016/​j.​chiabu.​2015.​07.​016.PubMed
21.
go back to reference Torgerson DJ, Torgerson CJ. Designing randomised trials in health, education and the social sciences: An introduction. New York: Palgrave Macmillan; 2008.CrossRef Torgerson DJ, Torgerson CJ. Designing randomised trials in health, education and the social sciences: An introduction. New York: Palgrave Macmillan; 2008.CrossRef
22.
go back to reference Midford R, Cahill H, Foxcroft D, Lester L, Venning L, Ramsden R, et al. Drug education in victorian schools (DEVS): The study protocol for a harm reduction focused school drug education trial. BMC Public Health. 2012;12:112.PubMedCentralCrossRefPubMed Midford R, Cahill H, Foxcroft D, Lester L, Venning L, Ramsden R, et al. Drug education in victorian schools (DEVS): The study protocol for a harm reduction focused school drug education trial. BMC Public Health. 2012;12:112.PubMedCentralCrossRefPubMed
24.
go back to reference Duane Y, Carr A. Prevention of child sexual abuse. In: Carr A, editor. Prevention: What works with children and adolescents? East Sussex: Brunner-Routledge; 2002. p. 181–204. Duane Y, Carr A. Prevention of child sexual abuse. In: Carr A, editor. Prevention: What works with children and adolescents? East Sussex: Brunner-Routledge; 2002. p. 181–204.
25.
26.
go back to reference Wurtele SK. School-based child sexual abuse prevention. In: Schewe PA, editor. Preventing violence in relationships: Interventions across the life span. Washington DC: American Psychological Association; 2002. p. 9–25.CrossRef Wurtele SK. School-based child sexual abuse prevention. In: Schewe PA, editor. Preventing violence in relationships: Interventions across the life span. Washington DC: American Psychological Association; 2002. p. 9–25.CrossRef
27.
go back to reference Wurtele SK. Preventing sexual abuse of children in the twenty-first century: Preparing for challenges and opportunities. J Child Sex Abus. 2009;18:1–18.CrossRefPubMed Wurtele SK. Preventing sexual abuse of children in the twenty-first century: Preparing for challenges and opportunities. J Child Sex Abus. 2009;18:1–18.CrossRefPubMed
28.
go back to reference Kenny MC. Child sexual abuse prevention: Psychoeducational groups for preschoolers and their parents. J Spec Group Work. 2009;34:24–42.CrossRef Kenny MC. Child sexual abuse prevention: Psychoeducational groups for preschoolers and their parents. J Spec Group Work. 2009;34:24–42.CrossRef
30.
go back to reference Dunkerley GK, Dalenberg CJ. Secret-keeping behaviors in black and white children as a function of interviewer race, racial identity, and risk for abuse. J Aggress Maltreat Trauma. 2000;2(2):13–35.CrossRef Dunkerley GK, Dalenberg CJ. Secret-keeping behaviors in black and white children as a function of interviewer race, racial identity, and risk for abuse. J Aggress Maltreat Trauma. 2000;2(2):13–35.CrossRef
31.
go back to reference Johnson BM, Miltenberger RG, Egemo-Helm K, Jostad C, Flessner C, Gatheridge B. Evaluation of behavioral skills training for teaching abduction-prevention skills to young children. J Appl Behav Anal. 2005;38:67–78.PubMedCentralCrossRefPubMed Johnson BM, Miltenberger RG, Egemo-Helm K, Jostad C, Flessner C, Gatheridge B. Evaluation of behavioral skills training for teaching abduction-prevention skills to young children. J Appl Behav Anal. 2005;38:67–78.PubMedCentralCrossRefPubMed
32.
go back to reference Johnson BM, Miltenberger RG, Knudson P, Egemo-Helm K, Kelso P, Jostad C, et al. A preliminary evaluation of two behavioral skills training procedures for teaching abduction-prevention skills to schoolchildren. J Appl Behav Anal. 2006;39:25–34.PubMedCentralCrossRefPubMed Johnson BM, Miltenberger RG, Knudson P, Egemo-Helm K, Kelso P, Jostad C, et al. A preliminary evaluation of two behavioral skills training procedures for teaching abduction-prevention skills to schoolchildren. J Appl Behav Anal. 2006;39:25–34.PubMedCentralCrossRefPubMed
34.
go back to reference Reynolds CR, Richmond BO. Revised Children’s Manifest Anxiety Scale-Second edition manual. Torrance, CA: Western Psychological Services; 2008. Reynolds CR, Richmond BO. Revised Children’s Manifest Anxiety Scale-Second edition manual. Torrance, CA: Western Psychological Services; 2008.
35.
go back to reference Ang RP, Lowe PA, Yusof N. An examination of the RCMAS-2 scores across gender, ethnic background, and age in a large Asian school sample. Psychol Assess. 2011;23:899–910.CrossRefPubMed Ang RP, Lowe PA, Yusof N. An examination of the RCMAS-2 scores across gender, ethnic background, and age in a large Asian school sample. Psychol Assess. 2011;23:899–910.CrossRefPubMed
36.
go back to reference Abidin R. Parenting Stress Index Manual. Charlottesville: Pediatric Psychology Press; 1995. Abidin R. Parenting Stress Index Manual. Charlottesville: Pediatric Psychology Press; 1995.
37.
go back to reference Raudenbush SW, Bryk AS. Hierarchical linear models: Applications and data analysis methods. Thousand Oaks, CA: Sage; 2002. Raudenbush SW, Bryk AS. Hierarchical linear models: Applications and data analysis methods. Thousand Oaks, CA: Sage; 2002.
Metadata
Title
Cluster randomised-control trial for an Australian child protection education program: Study protocol for the Learn to be safe with Emmy and friends™
Authors
Codi White
Dianne C. Shanley
Melanie J. Zimmer-Gembeck
Katrina Lines
Kerryann Walsh
Russell Hawkins
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2016
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-016-2721-x

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