BH TIG Week: When Promising and Best Practices are All We Have: Child Abuse Prevention in Schools by Marian Bussey

Hello, I’m Marian Bussey, LCSW, PhD., Associate Professor Emerita in the Graduate School of Social Work, University of Denver, and a mostly-retired evaluator for a small foundation that supports school-based child sexual abuse prevention. Technically, my title is Academic Consultant, and each of the three agencies we’ve funded over the past several years does its own evaluation, which I monitor.

Being retired, I have time to observe the programs live, watching presenters and children tackle the tough subject of child abuse. Even child advocates may at first think: Are we scaring the children, destroying their innocence? Shouldn’t the adults protect them? Five years and 15 presentations later, I can say that the children, grades K-8, take the information in stride. They know bad things happen; they are hungry to know how to resist it and how to help others as a helpful bystander. Further, the programs are not ad hoc; they are designed by children’s advocacy centers or sexual assault experts. Yet none of the programs are evidence-based in the sense of randomized controlled trials (RCTs) for two primary reasons: 1) evaluation overload for school districts; and, more crucially, 2) the difficulty of obtaining outcome on abuse rates.

Lesson Learned: It is much easier to do RCTs for a social problem whose outcomes can be measured – like bullying and substance abuse. But the only (old!) RCTs involving child abuse prevention confine themselves to measuring children’s change in knowledge, and sometimes in protective skills, pre and post intervention. The three programs we fund do that kind of evaluation, and while no one has systematically surveyed school administrators, principals keep asking the programs back each year; but the programs I’ve observed – Bringing in the Bystander, Safe from the Start (modified from the Committee for Children’s Second Step), and Child Assault Prevention – are listed only as Promising or Best Practice (by Colorado’s School Safety Resource Center).

I’ve tried to interest my state legislators in funding these programs, and they want a quick assurance that these programs are evidence-based. There is evidence that they work to increase knowledge and that they have resulted in substantiated cases of child abuse revealed just after the program. There is also evidence from one retrospective study of female college students that the programs may reduce rates of sexual assault; Laura Gibson and Harold Leitenberg (2000) in Child Abuse & Neglect found that students who reported learning this kind of prevention were half as likely to report a history of sexual assault. While everyone agrees child sexual and physical abuse are terrible, the funding to carry out RCTs looking at the ultimate outcome of reducing child abuse is not there. It would take a federal or state project, with cooperation by both school districts and departments of child welfare, but this is unlikely. From what I have seen and read, in this case, Promising and Best Practices will suffice until we fund more rigorous inquiries. One legislator asked if I would benefit from increased funding – no, but I believe children would.

The American Evaluation Association is celebrating Behavioral Health (BH) TIG Week with our colleagues in Behavioral Health Topical Interest Group. The contributions all this week to aea365 come from our BH TIG members. Do you have questions, concerns, kudos, or content to extend this aea365 contribution? Please add them in the comments section for this post on the aea365 webpage so that we may enrich our community of practice. Would you like to submit an aea365 Tip? Please send a note of interest to aea365@eval.org. aea365 is sponsored by the American Evaluation Association and provides a Tip-a-Day by and for evaluators.