Suchergebnisse

While existing studies have examined the effectiveness of school-based child sexual abuse (CSA) prevention programs in China, there is currently little qualitative evidence on how stakeholders view these programs and research on CSA in China more generally. To address this research gap, the aims of this study were to explore stakeholders' perspectives on: (a) school-based CSA prevention programs in China; (b) the components of these programs; (c) CSA research in China. Qualitative semi-structured interviews were conducted with 21 participants in Beijing and a county under Lanzhou City, China. Interview transcripts were systematically coded and emerging themes were developed from the codes. An inductive thematic analysis approach was utilized to analyze the interview data. Participants' perspectives on school-based CSA prevention programs included: (a) recognition of the importance of school-based CSA prevention programs; (b) fear about a possible negative impact on children participating in such programs; (c) assessment that school-based CSA prevention programs alone are not enough to prevent CSA. Components that participants thought needed to be part of Chinese school-based CSA prevention programs were: (a) content regarding online-facilitated CSA; (b) the use of a rights-based approach; and (c) greater parental and community involvement. Participants also identified factors that have both fostered the implementation of CSA research (e.g., the growing awareness of CSA in the central government) and prevented researchers from effectively conducting CSA research: (a) lack of national data; (b) inadequate government support; and (c) barriers to research collaboration among organizations. The findings indicate that while CSA prevention programs are on the whole regarded positively by key stakeholders in China, a number of important concerns were identified. Our study highlighted a number of ways in which future CSA prevention programs and research on CSA could be strengthened in the Chinese context.

The impact of violence on children's health and development has had growing attention in global and national politics. Research on children's experiences of violence has increased in recent years and this paper aims to add to this literature by highlighting key messages and learning points from the experiences of researchers who have worked with children and violence across the different contexts of the UK and South Africa. As qualitative and quantitative researchers, our concepts, aims, methods, resources and approaches were very different but we all faced similar challenges in working with children and violence in contexts were adults' views about what violence counted predominated. We argue that children's participation in research and highlighting children's own understandings, agency and negotiations in relation to violence are crucial for challenging sometimes unhelpful taken for granted views about the impact of violence on children's lives.

Low ART-adherence amongst adolescents is associated with morbidity, mortality and onwards HIV-transmission. Reviews find no effective adherence-promoting interventions for adolescents. Social protection (cash + care) has shown benefits in other adolescent HIV-outcomes such as prevention, and has potential to support ART-adherence. This study examines associations of ten potential social protection provisions with adherence in a large community-based sample of HIV-positive adolescents. All 10-19 year olds ever ART-initiated in 53 government healthcare facilities in a health district of South Africa's Eastern Cape were traced and interviewed in 2014-15 (n=1175 eligible). 90.1% of the eligible sample was included (n=1059). Potential social protection predictors were 'cash/cash in kind': government cash transfers, food security, school fees/materials, school feeding, clothing; and 'care': HIV support group, sports groups, choir/art groups, positive parenting and high parental supervision/monitoring. Analyses used multivariate regression, checks for interaction and calculation of marginal effects models in SPSS and STATA. Analyses controlled for sociodemographic, HIV and healthcare-related covariates. Findings showed that self-reported past-week ART non-adherence (75 copies/ml) (aOR 1.98, CI 1.1-3.45). Independent of covariates, three social protection provisions were associated with reduced non-adherence: food provision (aOR.57, CI.42-.76, p<.001); attending an HIV support group (aOR.60, CI.40-.91, p<.02), and high parental/caregiver supervision (aOR.56, CI.43-.73, p<.001). Combination social protection showed additive benefits. With no social protection, non-adherence was 54%, with any one protection it was 39-41%, with any two social protections, 27-28%, and with all ...

Child maltreatment is a major public health problem, affecting at least 55 million children in the WHO European Region. The impact of abuse and/or neglect in childhood is detrimental to physical, psychological and reproductive health throughout the life-course, yet the high costs to society are avoidable. There are clear risk factors for maltreatment at the level of the individual, family, community and society. This status report documents the progress that has been made by Member States in implementing the WHO European child maltreatment prevention action plan 2015–2020 at its midpoint. The plan has a target of a 20% reduction in child maltreatment and homicides by 2020. Data were collected through a survey of government-appointed national data coordinators of 49 participating countries in the Region. Results show that good progress is being made overall towards achieving the objectives. Development of national policy for the prevention of child maltreatment has increased across the Region, with three quarters of countries reporting an action plan, but these must be informed by robust national data. Surveillance of child maltreatment remains inadequate in many countries, with information systems in low- and middle-income countries most in need of strengthening. Legislation to prevent maltreatment is widespread, but better enforcement is warranted. The implementation of child maltreatment prevention programmes, including home-visiting, parenting education, school and hospital-based initiatives, has accelerated, but evaluation of impact is needed. Child maltreatment is a societal issue that crosses sectoral boundaries, meaning a sustained, systematic, multidisciplinary and evidence-informed approach to prevention must remain a priority for governments.

Background: The INSPIRE framework was developed by 10 global agencies as the first global package for preventing and responding to violence against children. The framework includes seven complementary strategies. Delivering all seven strategies is a challenge in resource limited contexts. Consequently, governments are requesting additional evidence to inform which 'accelerator' provisions can simultaneously reduce multiple types of violence against children. Methods and Findings: We pooled data from two prospective South African adolescent cohorts including Young Carers (2010-2012), and Mzantsi Wakho (2014-2017). The combined sample size was 5034 adolescents. Each cohort measured six self-reported violence outcomes: sexual abuse, transactional sexual exploitation, physical abuse, emotional abuse, community violence victimisation, and youth lawbreaking; and seven self-reported INSPIRE-aligned protective factors: positive parenting, parental monitoring and supervision, food security at home, basic economic security at home, free schooling, free school meals, and abuse response services. Associations between hypothesised protective factors and violence outcomes were estimated jointly in a sex-stratified multivariate path model, controlling for baseline outcomes and socio-demographics, and correcting for multiple hypothesis testing using the Benjamini-Hochberg procedure. We calculated adjusted probability estimates conditional on the presence of no, one, or all protective factors significantly associated with reduced odds of at least three forms of violence in the path model. Adjusted risk differences (ARD) and risk ratios (ARR) with 95% confidence intervals (CI) were also calculated. The sample mean age was 13.54 years and 56.62% were female. There was 4% loss to follow up. Positive parenting, parental monitoring and supervision, and food security at home, were each associated with lower odds of three or more violence outcomes (p<0.05). For girls, the adjusted probability of violence outcomes was estimated to be ...

Purpose: Violence against children increases in adolescence, but there is a research and practice gap in research-supported child abuse prevention for the adolescent years. A pilot programme for low-resource settings was developed in collaboration with NGOs, government and academics in South Africa, using research-supported principles. Methods: This study used a pre-post design to test initial effects of a 10-session parenting programme with 60 participants (30 caregiver-adolescent dyads) in high-poverty rural South Africa. Areas requiring further testing and adaptation were also identified. Results: Pre-post findings show medium to large programme effects in reducing child abuse and adolescent problem behaviour, as well as large effects in improvements of positive parenting, and perceived parent and adolescent social support. Discussion: There is potential to reduce child abuse, improve parenting, and reduce adolescent problem behaviour in rural South Africa through parenting programmes. Further development, testing and longer-term follow-up are required to ascertain potential for scale-up.

Background: Violence against children increases in adolescence, but there is a research and practice gap in evidence-based child abuse prevention for the adolescent years. A pilot programme for low-resource settings was developed in collaboration with NGOs, government and academics in South Africa, using evidence-based principles. Methods: This study used a pre-post design to test initial effects of a 10-session parenting programme with 60 participants (30 caregiver-adolescent dyads) in high-poverty rural South Africa. Areas requiring further testing and adaptation were also identified. Results: Pre-post findings show significant reductions in child abuse, violent discipline, adolescent problem behaviour, poor supervision and acceptance of violence. Improvements were seen in positive and involved parenting, and parent and adolescent social support. Conclusions: There is potential to reduce child abuse, improve parenting, and reduce adolescent problem behaviour in rural South Africa through parenting programmes. Further development is required to improve skills such as non-violent and consistent discipline.

Introduction: Child maltreatment (physical abuse, sexual abuse, emotional abuse, neglect and exposure to domestic violence) is widely understood to be associated with multiple mental health disorders, physical health problems and health risk behaviours throughout life. However, Australia lacks fundamental evidence about the prevalence and characteristics of child maltreatment, its associations with mental disorders and physical health, and the associated burden of disease. These evidence gaps impede the development of public health strategies to better prevent and respond to child maltreatment. The aims of this research are to generate the first comprehensive population-based national data on the prevalence of child maltreatment in Australia, identify associations with mental disorders and physical health conditions and other adverse consequences, estimate attributable burden of disease and indicate targeted areas for future optimal public health prevention strategies. Methods and analysis: The Australian Child Maltreatment Study (ACMS) is a nationwide, cross-sectional study of Australia's population aged 16 years and over. A survey of approximately 10 000 Australians will capture retrospective self-reported data on the experience in childhood of all five types of maltreatment (physical abuse, sexual abuse, emotional abuse, neglect and exposure to domestic violence). A customised, multimodule survey instrument has been designed to obtain information including: the prevalence and characteristics of these experiences; diagnostic screening of common mental health disorders; physical health; health risk behaviours and health service utilisation. The survey will be administered in March-November 2021 to a random sample of the nationwide population, recruited through mobile phone numbers. Participants will be surveyed using computer-assisted telephone interviews, conducted by trained interviewers from the Social Research Centre, an agency with extensive experience in studies of health and adversity. Rigorous protocols protect the safety of both participants and interviewers, and comply with all ethical and legal requirements. Analysis will include descriptive statistics reporting the prevalence of individual and multitype child maltreatment, multiple logistic and linear regression analyses to determine associations with mental disorders and physical health problems. We will calculate the population attributable fractions of these putative outcomes to enable an estimation of the disease burden attributable to child maltreatment. Ethics and dissemination: The study has been approved by the Queensland University of Technology Human Research Ethics Committee (#1900000477, 16 August 2019). Results will be published to the scientific community in peer-reviewed journals, scientific meetings and through targeted networks. Findings and recommendations will be shared with government policymakers and community and organisational stakeholders through diverse engagement activities, a dedicated Advisory Board and a systematic knowledge translation strategy. Results will be communicated to the public through an organised media strategy and the ACMS website.

Background An estimated one billion children experience child abuse each year, with highest rates in low and middle income countries. The Sinovuyo Teen programme is part of Parenting for Lifelong Health, a WHO/UNICEF initiative to develop and test violence prevention programmes for implementation in low-resource contexts. The objectives of this parenting support programme are to prevent the abuse of adolescents, improve parenting, and reduce adolescent behavior problems. This trial aims to evaluate the effectiveness of Sinovuyo Teen compared to an attention-control group of a water hygiene programme. Methods This is a pragmatic cluster randomized controlled trial, with stratified randomization of 37 settlements (rural and peri-urban) with 40 study clusters in the Eastern Cape of South Africa. Settlements receive either a 14-session parenting support programme or a 1-day water hygiene programme. The primary outcomes are child abuse and parenting practices, and secondary outcomes include adolescent behavior problems, mental health and social support. Concurrent process evaluation and qualitative research are conducted. Outcomes are reported by both primary caregivers and adolescents. Brief follow-up measures are collected immediately after the intervention, and full follow-up measures collected at 3-8 months post-intervention. A 15-24 month follow-up is planned, but this will depend on financial and practical feasibility given delays related to high levels of ongoing civil and political violence in research sites. Discussion This is the first known trial of a parenting programme to prevent abuse of adolescents in a low or middle income country. The study will also examine potential mediating pathways and moderating factors.

An estimated one billion children experience child abuse each year, with the highest rates in low- and middle-income countries. The Sinovuyo Teen programme is part of Parenting for Lifelong Health, a WHO/UNICEF initiative to develop and test violence-prevention programmes for implementation in low-resource contexts. The objectives of this parenting support programme are to prevent the abuse of adolescents, improve parenting and reduce adolescent behavioural problems. This trial aims to evaluate the effectiveness of Sinovuyo Teen compared to an attention-control group of a water hygiene programme.This is a pragmatic cluster randomised controlled trial, with stratified randomisation of 37 settlements (rural and peri-urban) with 40 study clusters in the Eastern Cape of South Africa. Settlements receive either a 14-session parenting support programme or a 1-day water hygiene programme. The primary outcomes are child abuse and parenting practices, and secondary outcomes include adolescent behavioural problems, mental health and social support. Concurrent process evaluation and qualitative research are conducted. Outcomes are reported by both primary caregivers and adolescents. Brief follow-up measures are collected immediately after the intervention, and full follow-up measures collected at 3-8 months post-intervention. A 15-24-month follow-up is planned, but this will depend on the financial and practical feasibility given delays related to high levels of ongoing civil and political violence in the research sites.This is the first known trial of a parenting programme to prevent abuse of adolescents in a low- or middle-income country. The study will also examine potential mediating pathways and moderating factors. Pan-African Clinical Trials Registry PACTR201507001119966.