Download the full-sized PDF of Adult Education to Help Reduce Child Sexual Abuse: Developing Novel Classroom and Online Approaches Designed to Change Knowledge, Attitudes, and BehavioursDownload the full-sized PDF



Permanent link (DOI):


Export to: EndNote  |  Zotero  |  Mendeley


This file is in the following communities:

Graduate Studies and Research, Faculty of


This file is in the following collections:

Theses and Dissertations

Adult Education to Help Reduce Child Sexual Abuse: Developing Novel Classroom and Online Approaches Designed to Change Knowledge, Attitudes, and Behaviours Open Access


Other title
Type of item
Degree grantor
University of Alberta
Author or creator
Martin, Erin K
Supervisor and department
Silverstone, Peter (Department of Psychiatry)
Joyce, Anthony (Department of Psychiatry)
Examining committee member and department
Andrew Greenshaw, (Department of Psychiatry)
Ian Winship, (Department of Psychiatry)
Kathy Hegadoren, (Department of Psychiatry)
Delphine Collin-Vézina, (Department of Pediatrics)
Department of Psychiatry

Date accepted
Graduation date
2016-06:Fall 2016
Doctor of Philosophy
Degree level
Child sexual abuse (CSA) is common and individuals who experience CSA have higher rates of psychopathology and higher risk of medical, psychological, behavioural, and sexual disorders than those who have not been sexually abused. Adults who interact with children are in ideal positions to reduce children’s vulnerability to CSA and their vulnerability to negative impacts associated with CSA. Few CSA prevention programs targeting adults are developed using a research informed approach, and even fewer have been evaluated to determine effectiveness. Evaluations have focused on knowledge gain, attitude change, and behavioural intentions. Little is known about participant’s actual behaviour change in regards to CSA preventative behaviours. This doctoral study involved developing and evaluating a novel research-informed CSA education program for adults, designed from a Canadian perspective. After extensive literature review and consultation with topic experts, a classroom format and then an online format was developed. The evaluation aimed to answer three questions. (1) How effective is the classroom version of the program? (2) How effective is the online version of the program? (3) How does the effectiveness of the online version compare to the effectiveness of the classroom version? The hypotheses were that participants taking part in the program would have an increase in their knowledge regarding CSA, decrease their adherence to myths (negative attitudes) about CSA, and increase their use of preventative behaviours meant to reduce children’s vulnerability to CSA. For the online version, it was predicted that behavioural change scores would be statistically significant, but smaller in magnitude, than the in-person classroom version. Behaviour change was the primary outcome goal, and attitude and knowledge change were secondary outcome goals. Using a pre-test post-test within-subject design, participants completed questionnaires before taking the program (baseline) and then again 3 months after the program. A total of 23 classroom format workshops were completed with a large number of participants (n=366), of whom 312 completed baseline ratings prior to taking the program. Of these individuals, 195 (63% of total baseline sample = 53% of total possible sample) completed follow-up assessments at 3 months. Next baseline data was collected for the evaluation of the online version, which was completed by 165 individuals, of which 101 completed follow-up assessments at 3 months (61% of total sample). In both groups the samples were similar, comprising primarily females aged between ages 18 and 49, predominantly reporting high levels of education. Most had no prior child sexual abuse training. The sample for the online format included signficantly more people who identified as having experienced child sexual abuse themselves (50%) than the sample for the classroom version (32%). The Wilcoxon signed-rank test was used to determine statistically significant change from baseline to post-test for the classroom and online groups. There were statistically significant improvements in the classroom group and the online group for the amount of time participants’ spent talking about sexual abuse and healthy sexual development, and also significant increases in the use of individual action strategies. There were statistically significant improvements in the classroom group, but not the online group, for the use of organizational action strategies. A Mann-Whitney U test was performed to compare participants’ individual change scores and organizational change scores between the classroom group and the online group, and results indicated there was no statistically significant difference between them. Thus, both appeared equally effective in terms of the primary outcome goals. A CSA prevention program can change adults’ behaviours, in both a classroom format and on online format, and these changes are sustained for at least 3 months following the program. Both versions of the program increased adults’ knowledge and decreased adherence to myths about CSA. The degree of change that occurred after taking the online version of the program was similar to the change after taking the in-person classroom version of the program, suggesting that an online approach may be a useful option for educating the general public adults about CSA. These results have the potential to lead to meaningful improvements in preventing child sexual abuse. The results suggest both the classroom and the online formats of the program are effective and support the program’s more widespread use.
This thesis is made available by the University of Alberta Libraries with permission of the copyright owner solely for the purpose of private, scholarly or scientific research. This thesis, or any portion thereof, may not otherwise be copied or reproduced without the written consent of the copyright owner, except to the extent permitted by Canadian copyright law.
Citation for previous publication
Martin, E. K., & Silverstone, P. H. (2016). An evidence-based education program for adults about child sexual abuse (“Prevent It!”) that significantly improves attitudes, knowledge, and behaviour”. Frontiers in Psychology, 7(1177), 1-13.Martin, E. K., & Silverstone, P. H. (2013). How much child sexual abuse if “below the surface” and how can we help adults identify it early? Frontiers in Psychiatry, 4(58), 1-10 doi: 10.3389/fpsyt.2013.00058.

File Details

Date Uploaded
Date Modified
Audit Status
Audits have not yet been run on this file.
File format: pdf (PDF/A)
Mime type: application/pdf
File size: 1820601
Last modified: 2017:11:08 17:51:53-07:00
Filename: martin_erin_k_201609_PhD.pdf
Original checksum: 2d70e0541dd194e2c3a49bb8d1c8ed5d
Activity of users you follow
User Activity Date