Prevention Is Possible! Exploring the Public Health Approach

Using the tools of public health to prevent child sexual abuse

Posted Oct 13, 2016

Image by iStock
Source: Image by iStock

Did you know that approximately one third to one half of child sexual abuse is committed by other youth? While concern about our children becoming victims of child sexual abuse is vital, we should also be concerned with preventing our children from engaging in sexually abusive behavior towards others. But how do we do that? A public health approach to preventing child sexual abuse offers the best solution.

Developing effective interventions designed to reduce child sexual abuse requires the following steps:

  • Surveillance: Measuring the scope of child sexual abuse and the burden it places on individuals, families and communities.
  • Risk and protective factors: Identifying what increases or decreases a child’s risk of committing or experiencing sexual abuse.
  • Program development and evolution: Developing programs that target the risk factors or enhance the protective factors identified through previous research. In this step, we also test these programs to make sure they are effective, and if not effective, to figure out how they can be improved.
  • Adaptation and dissemination: Distributing effective programs to schools, communities and other organizations interested in preventing child sexual abuse victimization and perpetration.

A public health approach has worked to address a variety of social problems: Traffic collisions, hospital infections, falls and physical abuse are all areas in which public health strategies have been used to prevent injury for millions of people throughout the world. How do we know a public health approach to preventing child sexual abuse can work?

The good news is that there are already effective programs in use that reduce problem sexual behaviors. Programs like Safe Dates, Shifting Boundaries and the Oklahoma University Treatment for Child Sexual Behavior Problems Oklahoma University Treatment for Child Sexual Behavior Problems are effective universal and selective interventions that effectively prevent the onset of harmful sexual behaviors. For adolescents who have previously engaged in harmful or illegal sexual behaviors, Multisystemic Therapy for Problem Sexual Behaviors is an example of a well-validated indicated intervention that reduces sexual recidivism and sexual risk behaviors. 

Our work at the Moore Center for the Prevention of Child Sexual Abuse aims to expand the current research by developing prevention interventions that specifically target the sexual behavior by older children and teens against younger children. In one project, we’re developing a selective prevention program for adolescents with a sexual interest in younger children. In another project we are designing a universal prevention program to reduce the likelihood that 6th and 7th graders will experiment sexually with younger children. Projects like these are examples of the ways that we can put the public health approach in action to prevent child sexual abuse. 

We know that experiencing child sexual abuse victimization increases the risk of a host of physical, mental and behavioral health problems that can last throughout a lifetime. Preventing victimization would save many children from experiencing these effects. With other related social problems like bullying and sexual violence, the public health approach offers real, evidence-based solutions that work. It’s time to start putting the same effort towards preventing child sexual abuse.

So what do we need to do? We need to talk more about child sexual abuse prevention within our families and communities. We need to understand that child sexual abuse prevention rests on all of our shoulders. We need to demand funding that can help us build the science of child sexual abuse prevention. And most importantly, we need to believe that we can stop children from experiencing this preventable violence.

Ryan T. Shields, PhD, is the associate director at the Moore Center for the Prevention of Child Sexual Abuse at the Johns Hopkins Bloomberg School of Public Health.