Evaluation of a Child Sexual Abuse Prevention Program --- Vermont, 1995--1997

Public health social marketing campaigns have targeted adults to prevent drinking and driving, smoking, and human immunodeficiency virus transmission (1,2); however, adults have not been targeted for prevention of child sexual abuse. In Vermont, STOP IT NOW! addresses child sexual abuse systematically as a public health issue by using social marketing and public education to emphasize the responsibility of adults for prevention. As one component of STOP IT NOW!, Vermont sex offender treatment providers and state attorneys' offices were surveyed in September 1997 to assess self-reported abuse by adults and adolescents. This report summarizes the results of the survey, which indicate that some adults who abuse will turn themselves in voluntarily for treatment despite mandated reporting to the legal system, and some parents will intervene to seek help for their children who have sexual behavior problems even without a victim's report. Continued studies are needed to evaluate this approach to preventing child sexual abuse.

The Vermont Center for the Prevention and Treatment of Sexual Abusers, a public agency jointly funded through Vermont's Department of Correction and Social and Rehabilitative Services, sent a survey to all 18 Vermont treatment providers working with adult and adolescent sex offenders. Sex offender treatment providers were asked to report the number of persons who self-reported before entering the legal system during 1995--September 1997. Fifteen (83%) sex offender treatment providers responded to the survey.

State attorneys' offices in Vermont's 14 counties were contacted by telephone to determine the number of adults and adolescents with sexual behavior problems who voluntarily entered the legal system during 1995--September 1997. These cases were distinguished from those that entered the legal system after a child victim or an adult informed by a child victim reported the situation. Because Vermont does not track self-disclosure, it was not possible to determine the percentage of sex offenders who self-reported.

Vermont sex offender treatment providers reported that 50 persons self-reported sexual abuse before entering the legal system during 1995--September 1997. Of these, 11 were adults who self-reported, and 39 were adolescents who entered treatment as a result of a parent or guardian soliciting help. State attorneys' offices reported that eight adults who had sexually abused a child self-reported to legal authorities in five counties.

Reported by: L Chasan-Taber, ScD, Dept of Biostatistics and Epidemiology, School of Public Health and Health Sciences, Univ of Massachusetts, Amherst; J Tabachnick, MPPM, STOP IT NOW!, Haydenville, Massachusetts. PM McMahon, PhD, Injury Research and Prevention, Louisiana Office of Public Health, Dept of Health and Hospitals and Dept of Pediatrics, School of Medicine, Tulane Univ, New Orleans, Louisiana. Family and Intimate Violence Prevention Team, Div of Violence Prevention, National Center for Injury Prevention and Control, CDC.

Editorial Note:

During 1993, approximately 300,000 children were sexually abused (3). Most child sexual abuse prevention programs focus on teaching children how to lower their risk for becoming a victim of sexual abuse (4). However, the greatest potential for prevention may be with persons who abuse or other adults who can intervene with the abuser. With treatment, those who abuse can modify their behaviors (5).

This report underscores the potential efficacy of targeting persons who abuse and the adults who know them. In Vermont, STOP IT NOW!'s public health intervention uses three strategies: 1) a media campaign targeting all Vermont residents to increase residents' awareness of abuse and its signs; 2) an outreach campaign targeting high-risk families that provides a helpline for adults with questions about or experience of sexual abuse and provides information to agencies working with these families; and 3) a strategy to explore partnerships with Vermont decision-makers and leaders and develop approaches to prevent child sexual abuse.

Community factors may be critical to the success of these programs. Vermont has treatment programs throughout the state and within the prison system. In this setting, STOP IT NOW! can guarantee treatment to anyone who enters the legal system. Vermont also offers accessible media markets for its small population. Finally, Vermont has a coalition of victim and abuser treatment organizations that supported the introduction of this approach to prevention.

The findings in this report probably underestimate the actual number of self-reported cases of child sexual abuse because the state attorneys' offices and sex offender treatment providers do not maintain an official record of self-reports. If information or evidence was insufficient to warrant an investigation, cases might never have reached the state attorneys' offices. In addition, case-patients also may have left the state or met with a therapist not specifically trained in sex offender treatment; these persons would not have been included in the survey.

Evaluation of programs such as STOP IT NOW! will help determine the potential efficacy and need for media and outreach campaigns that focus on persons who abuse and the adults who know them. A collaborative effort between public health officials, sex offender treatment providers, and the criminal justice system in the model of STOP IT NOW! may benefit the well being of children.

References

1. Holtgrave DR, Qualls NL, Curran JW, Valdiserri RO, Guinan ME, Parra WC. An overview of the effectiveness and efficiency of HIV prevention programs. Public Health Rep 1995;110:134--46.
2. Voas RB, Holder HD. The effect of drinking and driving interventions on alcohol-involved traffic crashes within a comprehensive community trial. Addiction 1997;92:221--36.
3. Sedlak AJ, Broadhurst DD. Third National Incidence Study of Child Abuse and Neglect (contract no. 105-91-1800). Washington, DC: National Center on Child Abuse and Neglect, 1996.
4. 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.
5. Hall GC. Sexual offender recidivism revisited: a meta-analysis of recent treatment studies. J Consult Clin Psychol 1995;63:802--9.

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