"I have the right to feel safe": Evaluation of a school-based child sexual abuse prevention program in Ecuador.

BACKGROUND

Child sexual abuse (CSA) is a complex public health problem that has lifelong implications for children's wellbeing. Interventions may provide children strategies to protect themselves against CSA, but few have been studied in Latin America.

OBJECTIVE

Evaluate the immediate and medium-term impact of a 10-week educational program on children's knowledge of CSA self-protection strategies in Ecuador.

PARTICIPANTS AND SETTINGS: Children aged 7-12 years from six public elementary schools in Ecuador were cluster-randomized to either receive the intervention between October and November 2016 (Group 1, k = 4) or between March and April 2017 (Group 2, k = 2).

METHODS

To assess CSA knowledge, a random sample of students completed a questionnaire at three time points: 1) initial: before any group received the intervention, 2) intermediate: immediately after Group 1 completed the program but before Group 2 started it, and 3) final: after Group 2 completed the program. We evaluated changes in scores using mixed linear regression models with school as a clustering variable and adjusted degrees of freedom (df = 4).

RESULTS

Pre-post effect estimates at program completion adjusted for age, sex and clustering by school were 6.5% (95% CI: 2.9, 10.0) and 6.8% (95% CI 3.0, 10.7) for Groups 1 and 2, respectively. Scores did not change among children who had not yet received the intervention at intermediate evaluation (0.94%, 95%CI: -6.0, 7.9). Children in Group 1 maintained the scores six months after the program ended.

CONCLUSIONS

The self-protection program increased and maintained CSA knowledge six months after the intervention finished.