Preliminary validation of a structured interview to assess parents' practical implementation of behavioral strategies for child sexual abuse prevention

Child sexual abuse (CSA) is a pervasive public health problem requiring parental action. While evidence supporting the effectiveness of parent-focused CSA prevention programs is growing, current measures focus on parent knowledge, awareness, and intentions to use preventive behaviors. This challenges the establishment of a robust evidence-base. The current study presents preliminary validation of a new tool to address this gap.

Original constructs and items were generated in alignment with principles of CSA prevention to form the Parental Use of Behavioral Strategies Interview (PUBSI). A modified Delphi panel was conducted with (N = 12) experts to identify salient CSA-related preventive strategy domains. A modified content validation index assessed agreement. Then, a convenience sample of parents (N = 18) with children under 13 were recruited to participate in concurrent verbal probing (n = 12) and think aloud (n = 6) cognitive interviews to assess face validity and acceptability by evaluating comprehension and consistency of item interpretation. Interview data were coded thematically, merged, and quantified.

Universal agreement of relevance was reached among experts for 5/6 constructs. Item-level changes to the measure informed by parent cognitive interviews were categorized into five dimensions: reading level (4th grade); item specificity (recall periods); scale revision (response options; terminology); acceptability/relevance (item reduction) and intervention-specific item reduction. Overall, parent feedback indicated high acceptability and face validity.

Knowledge, awareness, and intentions are important to CSA prevention; these attributes are not sufficient in assessing parents' actual behavior change. Findings from the current study indicate promise for filling this gap and advancing parent-focused CSA prevention interventions.