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Discussion

It was the finding of this study that a seminar based child abuse prevention strategy was influential in changing knowledge and behaviour within organisations that provide extra-curricula activities for young people. It was noted that the distribution strategy for a prevention pack intervention that required two-way communication (e.g. seminar) was more influential on increasing knowledge and encouraging behaviour in organisations than a one-way strategy (e.g. receipt by post). Downie et al (1996) stresses the importance of two-way communication in health education alluding to a need for educators and clients to converse so that an, ‘...inappropriate, professionally defined model of rationality [is] not imposed’ (Downie et al, 1996:p45). From this study it can be seen that mode of intervention is influential in achieving the desired result. One possible explanation for the results observed in this study can be drawn from the models of behaviour change reported in the introduction. The Health Belief Model (Rosenstock, Becker & Strecher, 1988), the Theory of Reasoned Action (Ajzen&Fishbein,1988) and Prochaska and DiClemente’s model of change (1984) all contain references to the individual’s cognitive state as being important in influencing change. Factors such as motivation, intention, perceived susceptibility etc. are all considered influential in deciding whether an individual will choose to undertake change. In a two-way communication strategy it is possible for both educator and client to explore and influence these factors. This exploration and discussion is not possible when information content, type and expression is under the control of the educator and passively passed from educator to client.

Differing levels of motivation have been used to explain differences between individuals in the uptake of positive behaviours (Miller & Rollnik, 1991). In this study, however, those that received the prevention pack via the seminar and those that received the prevention pack by other means could arguably be perceived as equally motivated. Individual organisations chose for themselves the method by which they received the pack. Those that received the pack by post or other means needed to be motivated enough to find out about the project (without the help of the interventionists) and to write off or phone in and pay a fee for the intervention. On the other hand, organisations that attended the seminar also needed to motivated. They needed to be motivated enough to respond to an invitation and to give up an evening to attend an hour long seminar. The self-selection of the group as to whether and how they received the intervention is a major limitation of the study in terms of exploring the true impact of distribution method. Differences in the learning styles, personality characteristics and subtle differences in motivation of the individual’s are all possible explanations for finding that the seminar approach appeared more influential in improving knowledge and behaviour when compared with a one-way strategy.

The present study found that the majority of organisers of extra-curricula activities for young people already held many attitudes about child abuse that were conducive to the protection of young people, prior to the instigation of a child abuse prevention intervention. This finding has several potential implications when reflecting on the issue of effective child abuse prevention and child abuse prevention strategies. In a large-scale survey of public attitudes towards child sexual abuse, Finkelhor (1984) observed that in typical child sexual buse articles, writers comment on the existence of widespread ‘myths’ (i.e. misinformation) about child abuse and proceeded to explain why it is important to challenge these myths within the general public. Whilst it has been empirically proven that holding ‘false’ beliefs about child abuse affects individuals’ responses to allegations of child abuse (Finkelhor, 1983), ‘..no one has ever established empirically that these child abuse myths are prevalent or just how prevalent they are.’ (Finkelhor, 1984:p87) In the present study, 24 statements about child abuse and related issues were presented to the organisers’ of extra-curricula activities for young people. The average number of statements that were answered ‘correctly’ prior to the intervention was 17. The fact that so many of the organisations in the study correctly answered the statements before the intervention may reflect some insensitivity in the questionnaire (which will be discussed in the limitations section), or it may reflect a limitation of the contents of the intervention. Some of the contents of the child abuse prevention pack used in this study attempted to address some of the very ‘myths’ that Finkelhor was questioning in 1984. Although the phrasing of the statements were adapted for use in this study, the underlying ‘myths’ that were challenged were the same. In particular, the information in the prevention pack targeted the following beliefs: 1) that children are molested by strangers 2) that girls are the exclusive targets of abusers, and 3) that sexual abusers are violent, aggressive, senile or mentally ill (Finkelhor, 1984). The prevention pack attempted to challenge these beliefs by providing the ‘correct’ information. However, the data collected prior to the release of the intervention suggests that most of the respondents knew these statements to be untrue and held appropriate knowledge about the issues prior to the intervention. This finding suggests that knowledge and levels of awareness about child abuse issues within the general populace may be higher than interventionists think.

Given the extent of media coverage that can occur when cases of abuse are reported, together with easier public access to information via the Internet and other sources, it is entirely possible that many individuals may not require specific intervention to raise awareness of issues. This view is supported by this study in that knowledge change was seen to occur within organisations that did not receive the targeted intervention but were merely exposed to a general environment for 1 year. Given the levels of child abuse knowledge reported in this study, one might question the cost-effectiveness of a purely knowledge based, area wide, primary prevention approach to child abuse prevention. However, it is clear from the comments of those that received the prevention pack (either at seminar or by other means) that additional help and reminders about the importance of the issues in general is helpful.

With respect to the present study sample, the demographic data collected indicated that the organisers of extra-curricula activities were extremely diverse in nature (ranging from the qualified, trained individual to the altruistic parent or other self-funding member of the public). In addition to the range of people involved, at least 19% of the organisations that took part in the initial phases of the study were no longer in existence 1 year later and it is unknown how many organisations might have ‘sprung up’ to take their place. As such, the findings indicate that the group identified by the ‘Childsafe’ team represent an extremely fluid population structured on an often ‘ad hoc’ basis. If the aim of the intervention is to raise knowledge and encourage specific behaviours within a targeted population this appears to be achievable in the short term (as evidenced by the findings relating to the impact of the seminar on knowledge and behaviour). However, the fluidity of the population and the fact that some organisation’s level of knowledge declined over time suggests than any impact that might be made by a one off intervention may be short lived. Under these circumstances, it is difficult to see how any strategy other than an annual, community directed, primary prevention approach targeted at all members of a specific population (regardless of prior knowledge) could reach those most in need.

Having questioned the effectiveness of purely knowledge based intervention strategies, it should be noted that there were organisations within the study group that were comparatively lower in knowledge than their peers. These organisations were also associated with lower levels of child protection behaviours and the belief that child protection training was not required. At first glance, this finding could be considered quite worrying. One explanation for the finding could be that individuals low in knowledge are unaware of the risks and therefore are less likely to be aware that a need for education exists. If this were the case then knowledge raising would be an appropriate aim in the hope that it would influence help seeking and protection behaviour. In this study, levels of knowledge and expressed need for training were found to differ according to type of organisation, membership composition and number of trained staff. The full extent of these relationships was not explored in the context of this evaluation. However, one finding might be that organisations that low in knowledge and express low need may do so because they have only a minimal number of young people as members. Fewer young people within an organisation may mean that the organisations have less chance to gain knowledge of the issues or perceive there to be little risk due to the low young person membership. This was evidenced in some of the comments regarding the appropriateness of the interventions. It was the belief of the ‘Childsafe’ team that if even one young person attended an organisation then that young person should be as protected as if everyone that attended was a young person. The organisers of extra-curricula activities, however, may not have held this belief. Without further exploration of the relationships, it is not possible to draw any solid conclusions. However, a suggestion is made that the content of the prevention pack may do better to focus more on supplying information relating to specific behaviours that would protect young people rather than on simply raising awareness.

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