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PHC6534: A Trauma-Informed, Community-Based Participatory Research (CBPR) Intervention to Increase Child Sexual Abuse Reporting

 

This proposed intervention in Gainesville, FL aims to build upon the lived experience of individuals that have experienced child sexual abuse, community members that have reported child sexual abuse, and professionals within the child welfare field to create a trauma-informed training program for use with individuals in the mesosystem of Bronfenbrenner’s Social Ecological Model (SEM) (Bronfenbrenner, 1977). The intervention design will use trauma-informed principles and community-based participatory research (CBPR) principles to elevate the voices of those with lived experience (SAMHSA, 2014). The training program on how to spot signs of child sexual abuse and the procedures for reporting will be used with community members in the mesosystem, including but not limited to neighbors, teachers, youth pastors, and coaches (Bronfenbrenner, 1977). Training materials created in this intervention will be disseminated into the community and individuals trained will be encouraged to train others within their organizations, ensuring sustainability past the original funding.

Public Health Framework

          This project seeks to reduce the impact of child sexual assault by facilitating reporting, therefore focusing on the secondary level or prevention and helping individuals reach treatment/resources sooner (Kisling & M Das, 2023). This intervention will focus primarily on the secondary level of prevention, but knowledge of the warning signs may allow some children to be protected from the trauma of child sexual abuse at the primary prevention level (Kisling & M Das, 2023). The designed intervention will incorporate training on how community members such as teachers, coaches, and neighbors can screen for risk factors of child sexual assault. This will be done primarily by integrating into the current body of knowledge the unique lived experiences of youth impacted by child sexual assault within Alachua county. Similarly, a sexual health intervention used an iterative process integrating feedback from a board of youth impacted by commercial sexual exploitation (Godoy et al., 2022). Additionally, the intervention will focus on promoting and demystifying the process of reporting child sexual assault to encourage community members to report at higher rates leading to higher detection rates by child protective investigators. This will be done primarily through integrating the lived experience of those who have reported child sexual assault, investigating what risk factors helped them identify it and what knowledge or skills helped them in the reporting process. This intervention aims to become self-sustaining within the community and community organizations and focuses on building upon the public health framework of putting the community in charge of sharing resources so that each member of the community can become a set of eyes looking out for child welfare (Committee on Educating Health Professionals to Address the Social Determinants of Health et al., 2016).

Levels of the Social Ecological Model

          This intervention will address the individual level of Bronfenbrenner's Social Ecological Model (SEM) by addressing individual reasoning for reporting child sexual abuse and individual knowledge of the signs of child sexual abuse and by increasing reporting, so that children in these situations get to treatment and resources sooner (Bronfenbrenner, 1977). However, the primary level of the SEM that this intervention targets is the microsystem of teachers, friends, and friends' parents, coaches, youth leaders, pastors, neighbors, etc. (Bronfenbrenner, 1977). This intervention aims to encourage those in the microsystem that have regular contact with the child to notice signs of childhood sexual abuse and to make a report. This intervention also aims to address the mesosystem by encouraging school systems, youth programs, etc., through those who are a part of this intervention to spread the knowledge of signs of child sexual abuse and potentially change their programs' policies to be more trauma informed (Bronfenbrenner, 1977). For example, individuals from the intervention treatment group might sit on school boards or local government.

Trauma-Informed Principles

          Trauma-informed principles will be built into this intervention. First, emphasis will be placed on ensuring children feel physically and psychologically safe in spaces where these adults interact with them (SAMHSA, 2014). Additionally, the lack of safety that children who are being abused likely feel will be discussed along with appropriate responses and techniques for interacting with youth who are experiencing sexual abuse. Additional discussion will center around safety as defined by youth who have been sexually abused, including their advice on building trust. The distinction between building trust with youth so that they may feel safe to report abuse and the necessity of those conversations being reported (potentially against wishes) will be discussed with examples and role-play so that individuals feel comfortable with potentially tricky situations.        

Additionally, the intervention will implement a discussion of cultural and historical factors that may create areas of intersectionality that may make youth additionally vulnerable to child sexual abuse and ACEs (SAMHSA, 2014). ACEs will also be discussed, and interaction factors with abuse. For example, youth with disabilities are more likely to experience child sexual abuse (Butler, 2013). However, the intervention will also emphasize that risk factors for abuse do not equal abuse and the necessity to be unbiased and resist leaning on stereotypes.

Finally, the trauma-informed principle that the intervention will be based on most extensively is empowerment, voice, and choice (SAMHSA, 2014). This intervention aims to give those within the community who have made reports a voice in sharing their experiences and advice for others to spot the signs of child sexual abuse and feel comfortable reporting. In addition, the intervention aims to empower community members to be more active eyes, improving child safety. Finally, this intervention puts the onus on the people to increase safety and decrease trauma within the community as active participants.

References

Bronfenbrenner, U. (1977). Toward an experimental ecology of human development. American Psychologist, 32(7), 513–531. https://doi.org/10.1037/0003-066x.32.7.513

Committee on Educating Health Professionals to Address the Social Determinants of Health, Board on Global Health, Institute of Medicine, & National Academies of Sciences, Engineering, and Medicine. (2016). A Framework for Educating Health Professionals to Address the Social Determinants of Health. National Academies Press. https://doi.org/10.17226/21923

Godoy, S. M., Thelwell, M., Perris, G. E., Freeman, O., Elander, S., & Bath, E. P. (2022). A roadmap to enhancing community based participatory research strategies and collaborative efforts with populations impacted by commercial sexual exploitation. Children and Youth Services Review, 136, 106427. https://doi.org/10.1016/j.childyouth.2022.106427

Kisling, L. A., & M Das, J. (2023). Prevention Strategies. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/b...dary%20Prevention%3A

Substance Abuse and Mental Health Services Administration. SAMHSA’s Concept of Trauma and Guidance for a Trauma-Informed Approach. HHS Publication No. (SMA) 14-4884. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2014.

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