Date of Award

8-2026

Degree Name

Doctor of Philosophy

Department

Psychology

First Advisor

Amy Damashek, Ph.D.

Second Advisor

Amy Naugle, Ph.D.

Third Advisor

Scott Gaynor, Ph.D.

Fourth Advisor

Maureen Kenny, Ph.D.

Abstract

Child sexual abuse (CSA) affects 1 in 4 girls and 1 in 13 boys before the age of 18, resulting in significant long-term physical, emotional, and social consequences. Caregivers play a crucial role in preventing CSA by engaging in preventative behaviors with their children. Primary care settings may be an avenue through which to educate caregivers on their role in prevention of CSA. The present study used a randomized controlled trial (RCT) design to investigate the efficacy of a caregiver-focused educational program to prevent CSA, provided via integrated behavioral health (IBH) in a pediatric primary care setting. Participants (n=56) were parents and caregivers of children ages 3-11 attending well-child visits at a Midwestern pediatric primary care clinic. They were randomized to either receive anticipatory guidance focusing on CSA prevention or to an educational discussion about general child safety. Outcomes, based on self-report and measured at pretest, posttest, and one month follow up, consisted of measures of knowledge, beliefs, and engagement in behaviors related to CSA prevention. Results demonstrated that, at pretest, caregivers had adequate knowledge of CSA, and many were engaging in CSA-related preventative behaviors with their children, including discussing CSA. Results also found that receipt of anticipatory guidance resulted in an increase in caregivers’ intention to discuss CSA with their children, as well as an increase in the number of preventative behaviors believed to be important in preventing CSA. Additional follow-up within-group analyses also demonstrated an increase in comfort discussing CSA and perceived risk of CSA in the treatment group from pretest to posttest. However, there was no effect of the anticipatory guidance on reports of behavior change (i.e., engaging in conversations or other preventative behaviors following education). Additional research is needed to further demonstrate feasibility and efficacy of caregiver-focused CSA prevention in primary care settings, as well as to address barriers to behavior change. However, these results suggest that there may be some benefit to caregiver-focused prevention education provided via IBH to reduce children’s risk of CSA.

Comments

Fifth Advisor: Maureen Kenny, Ph.D.

Access Setting

Dissertation-Open Access

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