A Cochrane review [Abstract] 1 included 24 studies with a total of 5 802 subjects to assess effectiveness of school-based education programmes for the prevention of child sexual abuse compared with no intervention or the standard school curriculum. 23 studies were conducted in primary (elementary) schools and one in a special school for adolescents with intellectual disabilities. Study participants' mean ages at baseline ranged from 5.8 years to 13.4 years.
School-based programme increased protective behaviour (OR 5.71, 95% CI 1.98 to 16.51; 2 studies, n=102), questionnaire-based knowledge (SMD 0.61, 95% CI 0.45 to 0.78, statistical heterogeneity I² = 84%; 18 studies, n=4 657), vignette-based knowledge (SMD 0.45, 95% CI 0.24 to 0.65, statistical heterogeneity I² = 71%; 11 studies, n=1 688). The effect of intervention seemed to persist beyond the immediate assessment (SMD 0.78, 95% CI 0.38 to 1.17; I² = 84%; 4 studies, n = 956) to 6 months (SMD 0.69, 95% CI 0.51 to 0.87; 4 studies, n = 929). No increase or decrease in adverse effects (harm) manifesting as child anxiety or fear in intervention participants (SMD -0.08, 95% CI -0.22 to 0.07; 3 studies, n = 795) was observed. Three studies were included in the meta-analysis for disclosure of previous or current sexual abuse, and the results favoured intervention (OR 3.56, 95% CI 1.13 to 11.24; n=1 788). However, adjusting for the effect of clustering widened the confidence intervals and produced a non-significant OR.
Comment: The quality of evidence is downgraded by imprecise results (wide confidence intervals).
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