Child sexual abuse (CSA) is a worldwide public health concern. With the widespread dissemination of prevention approaches to end CSA, numerous CSA prevention programs exist in developed countries, but there is little evidence on how these programs are performing in Mainland China. The aim of this study was to review the existing research focusing on CSA prevention programs in Mainland China. Studies of CSA prevention programs were identified by conducting a comprehensive search of major academic databases for Chinese and English research. Articles were retained if they were original empirical studies that conducted programs to prevent CSA in Mainland China and measured related outcomes. Twelve studies met the inclusion criteria. A child-targeted, universally focused, and school-based educational program was the most common (n = 7), followed by specifically focused programs that covered migrant and left-behind children using group-based intervention strategies (n = 2) and ordinary parents with self-learning strategies (n = 2); one study delivered agency-based face-to-face education to parents with disabled children. However, the shortcomings in research design limited its replication to the broader population. CSA prevention program research in Mainland China is in an early stage due to the limited target populations, lack of large-scale government-led initiatives, and low involvement of multicomponent collaboration. We provide suggestions for conducting future research involving more inclusive programs for other populations, comprehensive programs with multiple targets and stakeholders, large-scale evidence-based research, culturally tailored and contextual adaptation programs.
Assini-MeytinL. C.FixR. L.LetourneauE. J. (2020). Child sexual abuse: The need for a perpetration prevention focus. Journal of Child Sexual Abuse, 29(1), 22–40. https://doi.org/10.1080/10538712.2019.1703232
2.
BarthJ.BermetzL.HeimE.TrelleS.ToniaT. (2013). The current prevalence of child sexual abuse worldwide: A systematic review and meta-analysis. International Journal of Public Health, 58(3), 469–483. https://doi.org/10.1007/s00038-012-0426-1
BronfenbrennerU.MorrisP. A. (2006). The bioecological model of human development. In DamonW.LernerR. M. (Eds.), Handbook of child psychology, Vol. 1: Theoretical models of human development (6th ed.). New York, NY: Wiley.
5.
*ChaX.ChenW. (2020). Ertong xing ziwo baohu nengli de huiben xingjiaoyu ganyu yanjiu [Research on picture book sex education intervention of children’s sexual self-protection ability]. Social Construction, 7(2), 3–15.
6.
ChanK.YanE.BrownridgeD.IpP. (2013). Associating child sexual abuse with child victimization in China. Journal of Pediatrics, 162(5), 1028–1034. https://doi.org/10.1016/j.jpeds.2012.10.054.
7.
*ChenJ. (2012). Xiaoxue ernianji xuesheng yufang xingqinfan jiaoyu xiaoguo pingjia [Impact of school child sexual abuse prevention education on grade 2 pupils’ knowledge and skills]. Chinese Journal of School Health, 33(2), 148–150. https://doi.org/10.16835/j.cnki.1000-9817.2012.02.008
8.
*ChenJ.FengY.JinY.ZhaoX.LiJ. (2019). Mounongcun diqu xuexiao yufang xing qinfan jiaoyu dui ertong zhishi jineng de yingxiang [Impact of a school-based sexual abuse prevention education program on knowledge and skills among rural children]. Chinese Journal of School Health, 40(1), 39–44. https://doi.org/10.16835/j.cnki.1000-9817.2019.01.010
9.
*ChenJ.KongY.LiX.LiJ.ZhangW.FengY.ZhaoX.ChenD.YuP. (2015). Xiaoxuesheng jiazhang yufang ertong xingqinfan jiaoyu yingxiang pingjia [Impact of child sexual abuse prevention education on elementary school pupils’ parents]. The Chinese Journal of Human Sexuality, 24(7), 107–111. https://doi.org/10.3969/j.issn.1672-193.2015.07.039
10.
*ChenJ.ZhangW.JinY.LiJ.YuP.ZhaoX.QiuC.KongY. (2015). Zizhu yuedu yufang ertong xingqinfan ziliao dui youer jiazhang de yingxiang [Impact evaluation of self-study child sexual abuse prevention education on knowledge and parent–child communication of preschoolers’ parents]. Chinese Journal of School Health, 36(9), 1313–1318. https://doi.org/10.16835/j.cnki.1000-9817.2015.09.013
11.
*ChenJ.ZhangW.LiJ.LuoX. (2013). Beijingshi sansuo xuexiao chuyi xuesheng yufang xingqinfan jiaoyu yingxiang pingjia [Evaluation of child sexual abuse prevention education in grade 7 students of three schools in Beijing]. Chinese Journal of Children Health Care, 21(1), 23–26.
12.
ChenX.WuY.QuJ. (2021). Parental migration and risk of sexual assault against children in rural China. Crime & Delinquency, 68(4), 613–643. https://doi.org/10.1177/0011128721989072.
13.
ChuiC. H.-K.JordanL. (2018). Child protection in China: Threats and opportunities. Asia Pacific Journal of Social Work and Development, 28(2), 84–96. https://doi.org/10.1080/02185385.2018.1432411.
14.
CluverL.MeinckF.YakubovichA.DoubtJ.RedfernA.WardC.SalahN.StoneS.D.PetersonD.MpimpilasheP.RomeroR.H.NcoboL.LachmanJ.TsoanyanoS.ShenderovichY.LoeningH.ByrneJ.SherrL.KaplanL.GardnerF. (2016). Reducing child abuse amongst adolescents in low-and middle-income countries: A pre-post trial in South Africa. BMC Public Health, 16(1), 1–11. https://doi.org/10.1186/s12889-016-3262-z.
15.
Collin-VézinaD.DaigneaultI.HebertM. (2013). Lessons learned from child sexual abuse research: Prevalence, outcomes, and preventive strategies. Child and Adolescent Psychiatry and Mental Health, 7, 22. https://doi.org/10.1186/1753-2000-7-22
16.
DaignaultI. V.HébertM. (2009). Profiles of school adaptation: Social, behavioral and academic functioning in sexually abused girls. Child Abuse & Neglect, 33(2), 102–115. https://doi.org/10.1016/j.chiabu.2008.06.001
17.
De BellisM. D.SprattE. G.HooperS. R. (2011). Neurodevelopmental biology associated with childhood sexual abuse. Journal of Child Sexual Abuse, 20(5), 548–587. https://doi.org/10.1080/10538712.2011.607753
18.
DebS.MukherjeeA.MathewsB. (2011). Aggression in sexually abused trafficked girls and efficacy of intervention. Journal of Interpersonal Violence, 26(4), 745–768. https://doi.org/10.1177/0886260510365875
GirardetR. G.LemmeS.BiasonT. A.BoltonK.LahotiS. (2009). HIV post-exposure prophylaxis in children and adolescents presenting for reported sexual assault. Child Abuse & Neglect, 33(3), 173–178. https://doi.org/10.1016/j.chiabu.2008.05.010
21.
*GuoS.ChenJ. (2019). Yufang ertong xingqinfan jiaoyu dui tingzhang ertong muqin zhishi he qinzi jiaoliu de yingxiang [Impact of child sexual abuse prevention education on the knowledge and parent–child communication of mothers of children with hearing loss]. The Chinese Journal of Human Sexuality, 28(9), 139–142. https://doi.org/10.3969/j.issn.1672-1993.2019.09.040
22.
HerbertJ.BromfieldL. (2021). A quasi-experimental study of the Multi-Agency Investigation & Support Team (MIST): A collaborative response to child sexual abuse. Child Abuse & Neglect, 111, 104827. https://doi.org/10.1016/j.chiabu.2020.104827
23.
*HuangS.CuiC. (2020). Preventing child sexual abuse using picture books: The effect of book character and message framing. Journal of Child Sexual Abuse, 29(4), 448–467. https://doi.org/10.1080/10538712.2020.1719449
24.
*HuangX.ZhangF. (2019). Xiaozu gongzuo jieru liudong ertong ziwo baohu nengli yanjiu [Research on improving migrant children’s self-protection ability with group work intervention]. Social Welfare, 7, 42–52.
25.
HudsonK. (2018). Preventing child sexual abuse through education: The work of Stop it Now! Wales. Journal of Sexual Aggression, 24(1), 99–113. https://doi.org/10.1080/13552600.2017.1383088
26.
HughesK.BellisM. A.JonesL.WoodS.BatesG.EckleyL.McCoyE.MiktonC.ShakespeareT.OfficerA. (2012). Prevalence and risk of violence against children with disabilities: A systematic review and meta-analysis of observational studies. The Lancet, 380(9845), 899–907. https://doi.org/10.1016/S0140-6736(11)61851-5.
*JinY.ChenJ.JiangY.YuB. (2017). Evaluation of a sexual abuse prevention education program for school-age children in China: A comparison of teachers and parents as instructors. Injury Prevention, 24, A41–A41. https://doi.org/10.1136/injuryprevention-2018-safety.109
29.
KennyM.C.WurteleS.K. (2012). Preventing childhood sexual abuse: An ecological approach. Journal of Child Sexual Abuse, 21(4), 361–367. https://doi.org/10.1080/10538712.2012.675567
30.
KızıltepeR.EslekD.IrmakT. Y.GüngörD. (2021). “I am learning to protect myself with Mika”: A teacher-based child sexual abuse prevention program in Turkey. Journal of Interpersonal Violence, 37(11–12), NP10220–NP10244. https://doi.org/10.1177/0886260520986272
31.
LetourneauE. J.SchaefferC. M.BradshawC. P.FederK. A. (2017). Preventing the onset of child sexual abuse by targeting young adolescents with universal prevention programming. Child Maltreatment, 22(2), 100–111. https://doi.org/10.1177/1077559517692439.
32.
LiaoM.LeeA. S.Roberts-LewisA. C.HongJ. S.JiaoK. (2011). Child maltreatment in China: An ecological review of the literature. Children and Youth Services Review, 33(9), 1709–1719. https://doi.org/10.1016/j.childyouth.2011.04.031.
33.
LuoY.ParishW. L.LaumannE. O. (2008). A population-based study of childhood sexual contact in China: Prevalence and long-term consequences. Child Abuse & Neglect, 32(7), 721–731. https://doi.org/10.1016/j.chiabu.2007.10.005
McKibbinG.HumphreysC. (2020). Future directions in child sexual abuse prevention: An Australian perspective. Child Abuse & Neglect, 105, 104422. https://doi.org/10.1016/j.chiabu.2020.104422.
36.
MeinckF. (2014). Physical, emotional and sexual child abuse victimization in South Africa [PhD Dissertation, University of Oxford].
37.
MeinckF.CluverL. D.BoyesM. E.MhlongoE. L. (2015). Risk and protective factors for physical and sexual abuse of children and adolescents in Africa: A review and implications for practice. Trauma, Violence, & Abuse, 16(1), 81–107.
PengJ.ZhuH.ShaoJ.YaoW.YuC.YaoH.ShiJ.XiangH. (2015). A systems approach to addressing child maltreatment in China. Child Abuse & Neglect, 50, 33–41. https://doi.org/10.1016/j.chiabu.2015.08.008
41.
Pérez-FuentesG.OlfsonM.VillegasL.MorcilloC.WangS.BlancoC. (2013). Prevalence and correlates of child sexual abuse: A national study. Comprehensive Psychiatry, 54(1), 16–27. https://doi.org/10.1016/j.comppsych.2012.05.010
42.
PhamM.RajicA.GreigJ.SargeantJ.PapadopoulosA.McEwenS. (2014). A scoping review of scoping reviews: Advancing the approach and enhancing the consistency. Research Synthesis Methods, 5(4), 371–385. https://doi.org/10.1002/jrsm.1123
43.
PlummerC. A.NjugunaW. (2009). Cultural protective and risk factors: Professional perspectives about child sexual abuse in Kenya. Child Abuse & Neglect, 33(8), 524–532. https://doi.org/10.1016/j.chiabu.2009.02.005
44.
QiD.WangY. J.WanG. W. (2018). The severity, consequences, and risk factors of child abuse in China. Children and Youth Services Review, 95, 290–299. https://doi.org/10.1016/j.childyouth.2018.10.039
45.
QianL. (2017). “Dangerous adolescence”: Sexuality and disability of institutionalized children in a Chinese orphanage. Sexually and Disability, 35(4), 445–459. https://doi.org/10.1007/s11195-017-9511-y.
46.
RudolphJ.Zimmer-GembeckM. (2018). Reviewing the focus: A summary and critique of child-focused sexual abuse prevention. Trauma, Violence, & Abuse, 19(5), 543–554. https://doi.org/10.1177/1524838016675478.
47.
RudolphJ.Zimmer-GembeckM. J.ShanleyD. C.HawkinsR. (2018). Child sexual abuse prevention opportunities: Parenting, programs, and the reduction of risk. Child Maltreatment, 23(1), 96–106. https://doi.org/10.1177/1077559517729479
48.
RumbleL.FebriantoR. F.LarasatiM. N.HamiltonC.MathewsB.DunneM. P. (2020). Childhood sexual violence in Indonesia: A systematic review. Trauma, Violence, & Abuse, 21(2), 284–299. https://doi.org/10.1177/1524838018767932
49.
RussellD.HigginsD.PossoA. (2020). Preventing child sexual abuse: A systematic review of interventions and their efficacy in developing countries. Child Abuse & Neglect, 102, 104395. https://doi.org/10.1016/j.chiabu.2020.104395
50.
SawrikarP.KatzI. (2018). Preventing child sexual abuse (CSA) in ethnic minority communities: A literature review and suggestions for practice in Australia. Children and Youth Services Review, 85, 174–186. https://doi.org/10.1016/j.childyouth.2017.12.028
51.
SkarbekD.HahnK.ParrishP. (2009). Stop sexual abuse in special education: An ecological model of prevention and intervention strategies for sexual abuse in special education. Sexually and Disability, 27(3), 155–164. https://doi.org/10.1007/s11195-009-9127-y
StoltenborghM.Van IjzendoornM. H.EuserE. M.Bakermans-KranenburgM. J. (2011). A global perspective on child sexual abuse: Meta-analysis of prevalence around the world. Child Maltreatment, 16(2), 79–101. https://doi.org/10.1177/1077559511403920.
54.
TettehP. M.MarkweiU. (2018). Situating the notion of “gbɛkɛfɔŋs” in the discourse of child sexual abuse among the Ga in Accra, Ghana. Journal of Child Sexual Abuse, 27(5), 510–522. https://doi.org/10.1080/10538712.2018.1477225.
55.
ThielenF. W.Ten HaveM.de GraafR.CuijpersP.BeekmanA.EversS.SmitF. (2016). Long-term economic consequences of child maltreatment: A population-based study. European Child & Adolescent Psychiatry, 25(12), 1297–1305. https://doi.org/10.1007/s00787-016-0850-5.
56.
TriccoA. C.LillieE.ZarinW.O'BrienK. K.ColquhounH.LevacD.MoherD.PetersM.HorsleyT.WeeksL.HempelS.AklE.ChangC.McgowanJ.StewartL. A.HartlingL.AldcroftA.WilsonM. G.GarrittyC.LewinS.GodfreyC.M.McdonaldM. T.LangloisE. V.Soares-WeiserK.MoriartyJ.CliffordT.TuncalpO.StrausS. E. (2018). PRISMA extension for scoping reviews (PRISMA-ScR): Checklist and explanation. Annals of Internal Medicine, 169(7), 467–473.
WalshK.BerthelsenD.HandK.BrandonL.NicholsonJ. (2019). Sexual abuse prevention education in Australian primary schools: A national survey of programs. Journal of Interpersonal Violence, 34(20), 4328–4351. https://doi.org/10.1177/0886260519869246
59.
WanG.TangS.XuY. (2020). The prevalence, posttraumatic depression and risk factors of domestic child maltreatment in rural China: A gender analysis. Children and Youth Services Review, 116, 105266. https://doi.org/10.1016/j.childyouth.2020.105266
60.
WangC.TangJ.LiuT. (2020). The sexual abuse and neglect of “left-behind” children in rural China. Journal of Child and Sexual Abuse, 29(5), 586–605. https://doi.org/10.1080/10538712.2020.1733159.
61.
WangM.VictorB. G.HongJ. S.WuS.HuangJ.LuanH.PerronB. E. (2020). A scoping review of interventions to promote health and well-being of left-behind children in Mainland China. The British Journal of Social Work, 50(5), 1419–1439. https://doi.org/10.1093/bjsw/bcz116
62.
WHO. (2006). Preventing child maltreatment: A guide to taking action and generating evidence. World Health Organization.
XuY.BrightC. L.AhnH. (2018). Responding to child maltreatment: Comparison between the USA and China. International Journal of Social Welfare, 27(2), 107–120. https://doi.org/10.1111/ijsw.12287
65.
XuY.HeN.LuW.FlukeJ. (2021). Understanding factors associated with barefoot social workers' decision making in assessing and reporting child physical abuse in China. Child Abuse & Neglect, 120, 105–177. https://doi.org/10.1016/j.chiabu.2021.105177.
66.
YanL.ZhuQ.TuX.ZuoX.YuC.LouC.LianQ. (2018). Bullying victimization and child sexual abuse among left-behind and non-left-behind children in China. Peer J, 6, e4865. https://doi.org/10.7717/peerj.4865.
67.
*YangX.WenH.WangD.WangX.YaoF. (2019). Mianyangshi liushou nvtong xinganquan zhishi zhixiaolv diaocha ji tuantixing xinli fudao xiaoguo [Investigation on awareness rate of sexual safety knowledge of left-behind girls in Mianyang city and the efficacy of group psychological counseling]. Sichuan Mental Health, 32(4), 346–349. https://doi.org/10.186/j.isn.1073256.2019.04.012
68.
*ZhangW.ChenJ.FengY.LiJ.LiuC.ZhaoX. (2014). Evaluation of a sexual abuse prevention education for Chinese preschoolers. Research on Social Work Practice, 24(4), 428–436. https://doi.org/10.1177/1049731513510409
69.
ZhaoF.HamalainenJ.ChenH. (2017). Child protection in China: Changing policies and reactions from the field of social work. International Journal of Social Welfare, 26(4), 329–339. https://doi.org/10.1111/ijsw.12268
70.
ZollnerS.FuchsK.FegertJ. (2014). Prevention of sexual abuse: Improved information is crucial. Child and Adolescent Psychiatry and Mental Health, 8, 5. https://doi.org/10.1186/1753-2000-8-5
Supplementary Material
Please find the following supplemental material available below.
For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.
For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.
