Adding a parent-focused child sexual abuse prevention module to home visiting: a provider cohort study protocol

Home visiting programs are an effective resource for parents to learn how to best support and protect their children as they grow and develop; however, there is a gap in home visiting content for equipping parents with the knowledge and skills needed to protect their children from child sexual abuse (CSA). Delivering CSA prevention content may be unfamiliar or uncomfortable, even for seasoned home visiting providers (i.e., parent educators). As provider acceptability and self-efficacy are critical predictors of implementation fidelity and the effectiveness of any added module, it is essential to evaluate these factors accordingly. This study is nested within an ongoing national clinical trial (NCT05976867) assessing the effectiveness of adding a CSA prevention module to Parents as Teachers, an evidence-based home visiting model. Leadership at participating sites (N = 25) will complete a baseline survey to aid in understanding providers' environmental contexts.

Providers who agree to participate in research (target N = 100) will complete longitudinal assessments evaluating changes in attitudes and self-efficacy from baseline (pre-training) to immediately following training in the CSA module, and annually thereafter (up to 3 years). The primary modeling approach will use linear mixed-effects regression to fit the outcomes attitudes and self-efficacy. Annual semi-structured interviews will be analyzed qualitatively both deductively and inductively with a codebook centered on study aims and the REAIM framework.

This work will contribute to understanding implementation practicalities, provider acceptability, and key areas in which to strengthen provider training to bolster implementation fidelity and ultimately promote the effectiveness of the CSA prevention module.

The procedures described herein were approved by the New York University Institutional Review Board (FWA00006386). Informed consent will be collected from all participants who wish to participate in the study.

Upon study completion, the research team anticipates that findings will be disseminated to academic peers through publication and shared with the Home Visiting Applied Research Collaborative (HARC).