Background: Existing efforts to understand school-based child sexual abuse (CSA) prevention programs mainly focus on the effectiveness of these programs in increasing participants’ CSA knowledge and self-protective skills. There are currently no reviews addressing the underpinning pathways leading to these outcomes. In order to increase our understanding about the underpinning causal and contextual factors and inform the further development of school-based CSA prevention programs, a realist review was conducted to synthesize existing evidence from a broad range of data. Methods: An iterative search of electronic databases and grey literature was conducted, supplemented with citation tracking to locate relevant literature. For quantitative evidence, we considered evaluation studies that focused on students aged 5–18 years, who were enrolled in primary or secondary schools; for other types/formats of studies/documents, no population restrictions were applied. We included school-based CSA prevention programs that focused on improving knowledge of CSA or self-protective skills. Outcomes of interest included knowledge of CSA or self-protective skills. We did not apply methodological filters in terms of the types of studies to be included. Thematic content analysis was conducted to synthesize data. Results: Sixty-two studies were included. Five themes and five overarching Context-Strategy-Mechanism-Outcome configurations (CSMOs) that contributed to the success of school-based CSA interventions were identified, including tailoring programs to participants’ cognitive developmental levels, repeated exposure of key concepts and skills, utilization of interactive delivery methods and positive feedback, delivery of positive information and application of the ‘train-the-trainer’ model. Implications: Findings from this realist review provide insights into the underlying program theory of school-based CSA prevention programs, which can aid in the development and implementation of these programs in the future.

中文翻译：

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拆开以学校为基础的儿童性虐待预防计划：现实主义评论

背景：了解以学校为基础的儿童性虐待 (CSA) 预防计划的现有努力主要集中在这些计划在增加参与者的 CSA 知识和自我保护技能方面的有效性。目前没有针对导致这些结果的基础途径的审查。为了增加我们对基础因果和背景因素的理解，并为进一步发展以学校为基础的 CSA 预防计划提供信息，我们进行了现实主义审查，以综合来自广泛数据的现有证据。方法：对电子数据库和灰色文献进行了迭代搜索，并辅以引文跟踪以定位相关文献。对于定量证据，我们考虑了针对 5-18 岁在小学或中学就读的学生的评估研究；对于其他类型/格式的研究/文件，没有应用人口限制。我们纳入了以学校为基础的 CSA 预防计划，这些计划侧重于提高 CSA 知识或自我保护技能。感兴趣的结果包括 CSA 知识或自我保护技能。我们没有根据要纳入的研究类型应用方法学过滤器。进行主题内容分析以综合数据。结果：纳入了 62 项研究。确定了有助于以学校为基础的 CSA 干预成功的五个主题和五个总体背景-战略-机制-结果配置 (CSMO)，包括根据参与者的认知发展水平量身定制计划、重复接触关键概念和技能、利用交互式交付方法和积极反馈、积极信息的交付和“培训培训师”模型的应用。启示：这次现实主义审查的结果提供了对以学校为基础的 CSA 预防计划的基本计划理论的见解，这有助于未来这些计划的开发和实施。