Maximizing the reach of universal child sexual abuse prevention: Protocol for an equivalence trial

Background: Child sexual abuse (CSA) affects 1 in 5 girls and 1 in 12 boys before age 18. Universal school-based prevention programs are an effective and cost-efficient method of teaching students an array of personal safety skills. However, the programmatic reach of universal school-based programs is limited by the inherent reliance on the school infrastructure and a dearth of available alternative delivery modalities. Methods: The design for this study will use a rigorous cluster randomized design (N N = 180 classrooms) to determine the equivalence of two delivery modalities of Safe Touches: : as usual vs. modified. The as usual workshop will be delivered by two facilitators with live puppet skits (n n = 90). Whereas, the modified workshop will be delivered by one facilitator using prerecorded skit videos (n n = 90). We will determine the equivalence by measuring concept learning acquisition preworkshop to immediate postworkshop (Aim 1) and retention at 3months postworkshop (Aim 2) among students in classrooms that receive the as usual or modified workshops. To conclude equivalence, it is imperative to also examine factors that may impact future dissemination and implementation, specifically program adoption among school personnel and implementation fidelity between the two modalities (Aim 3). Conclusion: Study findings will inform the ongoing development of effective CSA prevention programs and policy decisions regarding the sustainable integration of such programs within schools. Clinical trial registration: NCT06195852.