The Current Preventing of Child Sexual Abuse: A Scoping Review

Round 1

Reviewer 1 Report

 

Abstract does not need all the info about sources for systematic review?

I don’t understand why the text is inside a text box: surely this goes into the abstract or introduction?

Refer to the work and findings on impact of csa from the Australian commission into child sexual abuse and the UK Independent Inquiry into Child sexual abuse (iicsa)

Have some critical appraisal of how this article leaves out the grey literature that does not include peer reviewed publications but actually leads much of the policy and price in CSA prevention : look for example at the influence of publications from the end violence alliance (www.end-violence.org) and the commissions (Australia and UK as above) . While I appreciate this cannot be included in a systematic review, it could be recognised that the influence of these ‘grey’ publications is leading the field.

I do not see a description of ethical issues: while it is secondary research, the reviewers and authors could have bene impacted by the material they read and this needs acknowledging in work on this subject area.

Look for more updated definitions of CSA and explore the full range of forms including on line and work being done on preventing online abuse

I think the charts need a little explanation prior to the discussion. I’m not convinced they are needed but will refer to others on that

Line 265: children have a role: this is true but very contentious in the field of work: the responsivity is not on the child to protect themselves; the responsibility is on the perpetrator to stop. Although you mention prevention includes stopping perpetration, the review and the discussion do not develop this. I would want a description of why perpetration is lost in the review and an awareness of the implications for this included in the section that looks at children’s responsibilities. There is a whole body of work on preventative work in schools on male sexually harmful behaviours: why is this not referred to here?

The article is descriptive as opposed to analytical. I would like to see a critical analysis of the material: why do studies not include the relationship between sexual abuse and other forms of abuse, where is the literate about on line harm, what is the difference between csa in the home and extra familial abuse; why is gender not considered here, in terms of female victims and male perpetrators: how are interventions directed to address violence against women; why is the onus on children and parents protecting children? Just some critical debate about these issues to bring the article into contemporary debate about CSA

Author Response

Response to Reviewer 1 Comments

 

Point 1: Abstract does not need all the info about sources for systematic review?

Response 1: This research is a scoping review, which is to map a topic to be studied without a non-systematic review. This is different from a systematic review which aims to analyze something systematically, and usually to see the effect of an intervention.

So that the abstract is adjusted to the information about the scoping review.

 

 

Point 2: I don’t understand why the text is inside a text box: surely this goes into the abstract or introduction?

Response 2: I have deleted it, and I have included it in the introduction and discussion (line 101-105, 106-110, 741-743)

 

 

Point 3: Refer to the work and findings on impact of csa from the Australian commission into child sexual abuse and the UK Independent Inquiry into Child sexual abuse (iicsa)

Response 3: I have added it.

“The impact of CSA is adverse outcomes in all areas of survivors and victims’ lives, include adverse of physical health, emotional wellbeing, mental health and internalizing behaviors, externalizing behaviors, Interpersonal relationships, Socioeconomic outcomes, religious and spiritual belief, and vulnerability to revictimization. These adverse outcomes are not just experienced over the short or medium term following sexual abuse, but even  can suffer over a survivors and  victims’s lifetime (Independent Inquiry into Child Sexual Abuse)”. (line 57-63)

 

 

Point 4: Have some critical appraisal of how this article leaves out the grey literature that does not include peer reviewed publications but actually leads much of the policy and price in CSA prevention : look for example at the influence of publications from the end violence alliance (www.end-violence.org) and the commissions (Australia and UK as above) . While I appreciate this cannot be included in a systematic review, it could be recognised that the influence of these ‘grey’ publications is leading the field

Response 4: We put it into the limitation as follows:

“another limitation is does not include publications from the gray literature that are not peer reviewed, although may leads much of the policy in CSA prevention.” (line 733-734)

Gray publications were not included in the study because we used pre-determined inclusion criteria, in order to focus on the theme raised.

 

 

Point 5: I do not see a description of ethical issues: while it is secondary research, the reviewers and authors could have bene impacted by the material they read and this needs acknowledging in work on this subject area.

Response 5: Ethics: No ethical approval was required for the study, because it is a review of existing published studies. (line 172-173).

But ethically researchers try to take official sources used in this study.

 

 

Point 6: Look for more updated definitions of CSA and explore the full range of forms including on line and work being done on preventing online abuse

Response 6: Child sexual abuse (CSA) is sexual activity that violates the laws or social taboos of society with a child (person less than 18 years old) by an adult, adolescent or older child, or more powerful person, where the child does not fully comprehend,  does not consent to or is unable to give informed consent to, or is not developmentally prepared for give consent (CDC, 2022; Greijer & Doek, 2016; Prevent Child Abuse North Carolina, 2022). (line 48-52)

 

 

Point 7: I think the charts need a little explanation prior to the discussion. I’m not convinced they are needed but will refer to others on that

Response 7: I have added it.

“Figure 1 summarizes a flowchart of the scoping review and article selection process in this study, which follow to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines (Moher, Liberati, Tetzlaff, & Altman, 2009)” (line 174-175).

 

 

Point 8: Line 265: children have a role: this is true but very contentious in the field of work: the responsivity is not on the child to protect themselves; the responsibility is on the perpetrator to stop.

Although you mention prevention includes stopping perpetration, the review and the discussion do not develop this. I would want a description of why perpetration is lost in the review and an awareness of the implications for this, included in the section that looks at children’s responsibilities.

Response 8: I have revised it (line 466-494)

Adequate CSA prevention knowledge in children is essential in other to children do not become victims (Solehati, Pramukti, Kosasih, Hermayanti, & Mediani, 2022).. This can be done by increasing their knowledge, attitudes, behavior, self-efficacy, and skills practice through prevention intervention of CSA.  Child safety must be supported by parents, teachers, professionals, and caregivers who play a role in protecting children from CSA by increasing knowledge, skills practice, awareness, self-efficacy, attitudes, motivation, empathy, behavior, perceptions, communication practices, reporting responsibilities and responses to allegations of CSA. Parents and  teachers significantly contributed to CSA prevention information (Solehati et al., 2022).

The literature study of perpetration has investigated other researchers. The relationship between gender, age, perpetration, and sexual abuse(Choudhry et al., 2018; Solehati, Pramukti, Hermayanti, Kosasih, & Mediani, 2021). (line 100-102).

I have revised it (line  , 329-333)

 

 

 

 

Point 9: There is a whole body of work on preventative work in schools on male sexually harmful behaviours: why is this not referred to here?

Response : This study followed the inclusion criteria that had been determined in accordance with the scoping review research protocol that we had previously made. This is a research limitation

 

 

Point 9: The article is descriptive as opposed to analytical. I would like to see a critical analysis of the material: why do studies not include the relationship between sexual abuse and other forms of abuse, where is the literate about on line harm, what is the difference between csa in the home and extra familial abuse; why is gender not considered here, in terms of female victims and male perpetrators:

Response : Then there are other studies of  the relationship between sexual abuse and other forms of abuse (Choudhry et al., 2018; Solehati et al., 2021), the literate about online Sexual Activity (OSA) involving webcams was conducted (Koops, Dekker, & Briken, 2018), the difference between csa in the home and extra familial abuse (Choudhry et al., 2018; Solehati et al., 2021), and the relationship between gender, age, and sexual abuse (Babatsikos, 2010; Choudhry et al., 2018; Solehati et al., 2021).  (2021). (line 95-102).

Many research teams are conducting CSA prevention interventions to address CSA problems with school-based child populations, rarely in the community. Various methods of CSA prevention interventions are being developed especially for children, but are still rare for adults or people who care for children.

 

 

Point 10: how are interventions directed to address violence against women;

Response 10: This research is limited to only examining sexual crimes in children aged 0-18 years, not women (ages 19 years and over), maybe it will be investigated in the next literature review research.

 

 

Point 11: why is the onus on children and parents protecting children? Just some critical debate about these issues to bring the article into contemporary debate about CSA

Response 11: I have revised it (line 466-494)

Adequate CSA prevention knowledge in children is essential in other to children do not become victims (Solehati, Pramukti, Kosasih, Hermayanti, & Mediani, 2022).. This can be done by increasing their knowledge, attitudes, behavior, self-efficacy, and skills practice through prevention intervention of CSA.  Child safety must be supported by parents, teachers, professionals, and caregivers who play a role in protecting children from CSA by increasing knowledge, skills practice, awareness, self-efficacy, attitudes, motivation, empathy, behavior, perceptions, communication practices, reporting responsibilities and responses to allegations of CSA. Parents and  teachers significantly contributed to CSA prevention information (Solehati et al., 2022)

Reviewer 2 Report

Overall comments: This scoping review aimed to identify literature on child sexual abuse (CSA) prevention interventions. While it has potential as a valuable contribution to the field, I would recommend significant revisions for clarity and comprehensiveness prior to publication. 

Abstract

• Pg 1, line 19-20: Unclear what is meant by “2) the preventive effect of CSA.” Does it mean effectiveness for preventing CSA? Recommend clarifying.

Introduction

• Pg 2, line 37: Add space after victims before parentheses

• Pg 2, line 39-40: Incomplete sentence (ends with “academic failure victims.”

• Pg 2, line 45-46: “Children are a group at risk of experiencing CSA.” Children are the only group at risk of experiencing CSA. Recommend removing this sentence.

• Pg 2, line 52-53: Recommend explaining benefits of primary prevention approach

• Pg 2, line 53-58: Author already defined CSA. Recommend incorporating this information into earlier definition or removing it.

• Pg 2, line 60-64: Recommended revision: “While most studies evaluating CSA prevention literature have focused on prevalence rates in developed countries (Barth et al., 2013; Mathews et al., 2016), there are also studies that review the nature of CSA interventions and their effectiveness in developing countries (Russell, Higgins, Posso, & neglect, 2020).”

• Pg 2, line 70-71: What limitations were identified? Recommend more clearly explaining the gap.

• Pg 3, line 80-82: Summarized research question is unclear. More specific research questions provided in lines 77-80 don’t seem to align with themes identified in the abstract

Materials and methods

• Pg 3, line 95: Inclusion criteria was publication in English. How did this impact desired focus on developed and developing countries? Note here to make sure this is included in limitations 

• Pg 3, line 112-113: Unclear what is meant by “We also took articles related to CSA prevention from expert researcher of 112 CSA via email.” Recommend clarifying 

• Pg 3, line 115: “All researchers provided the study selection process.” Recommend changing “provided” to “contributed to” or “participated in” 

• Pg 3, line 116: Change “trough” to “through”

• Pg 3-4, line 118-123: Revise for grammar

• Pg 4, figure 1: Order is not sequential. Check for spelling errors

Results

• Pg 5, line 150: Change “was” to “were”

• Pg 5, line 155: Add period at end of sentence 

• Major revision suggested: Themes not clearly or comprehensively described– recommend revising to provide additional detail. (Examples: The effectiveness of the program 197 Judging from the research output, almost all CSA prevention programs had a sig- 198 nificant effect (n = 25), although there were studies showing the program had a partial 199 effect (n = 11).”)

Discussion

• Major revision suggested: Too much detail in discussion- much of this info should have been covered in results. Recommend restructuring/revising after revising results

Author Response

Response to Reviewer 2 Comments

 

Point 1: Abstract : Pg 1, line 19-20: Unclear what is meant by “2) the preventive effect of CSA.” Does it mean effectiveness for preventing CSA? Recommend clarifying.

Response 1: Yes, it means effectiveness for preventing CSA. I have revised it (line 302, 318)

 

 

Point 2: Introduction: Pg 2, line 37: Add space after victims before parentheses

Response 2: I have revised it (line 53)

 

 

Point 3: Pg 2, line 39-40: Incomplete sentence (ends with “academic failure victims.”

Response 3: I have revised it to be “and academic failure in the victim” (line 56)

 

 

Point 4: Pg 2, line 45-46: “Children are a group at risk of experiencing CSA.” Children are the only group at risk of experiencing CSA. Recommend removing this sentence.

Response 4: I have revised it (line 466-494)

Adequate CSA prevention knowledge in children is essential in other to children do not become victims (Solehati, Pramukti, Kosasih, Hermayanti, & Mediani, 2022).. This can be done by increasing their knowledge, attitudes, behavior, self-efficacy, and skills practice through prevention intervention of CSA.  Child safety must be supported by parents, teachers, professionals, and caregivers who play a role in protecting children from CSA by increasing knowledge, skills practice, awareness, self-efficacy, attitudes, motivation, empathy, behavior, perceptions, communication practices, reporting responsibilities and responses to allegations of CSA. Parents and  teachers significantly contributed to CSA prevention information (Solehati et al., 2022).

The literature study of perpetration has investigated other researchers. The relationship between gender, age, perpetration, and sexual abuse(Choudhry et al., 2018; Solehati, Pramukti, Hermayanti, Kosasih, & Mediani, 2021). (line 100-102).

 

I have revised it (line 329-333)

This study followed the inclusion criteria that had been determined in accordance with the scoping review research protocol that we had previously made. This is a research limitation

 

 

Point 5 : Pg 2, line 52-53: Recommend explaining benefits of primary prevention approach

Response 5: I have added it with statement “The benefit of primary prevention approach is to prevent children from becoming victims of CSA, because primary prevention is implemented before the initial incident of CSA occurs (Knack, Winder, Murphy, & Fedoroff, 2019).  “  (line 76-78)

 

 

Point 6: Pg 2, line 53-58: Author already defined CSA. Recommend incorporating this information into earlier definition or removing it.

Response 6 : I have removed it

 

 

Point 7: Pg 2, line 60-64: Recommended revision: “While most studies evaluating CSA prevention literature have focused on prevalence rates in developed countries (Barth et al., 2013; Mathews et al., 2016), there are also studies that review the nature of CSA interventions and their effectiveness in developing countries (Russell, Higgins, Posso, & neglect, 2020).”

Response 7: I have revised it to be “Previous studies of the CSA prevention review literature have done on developed countries alone investigating prevalence rates (Barth et al., 2013; Mathews et al., 2016) , other studies in developing countries alone that review the nature of CSA interventions and identify the types of CSA prevention initiatives implemented and their effectiveness (Russell, Higgins, Posso, & neglect, 2020)”  (line 85-89)

 

 

 

Point 8: Pg 2, line 70-71: What limitations were identified? Recommend more clearly explaining the gap.

Response 8: This is limitations were identified :Previous studies of the CSA prevention review literature have done on developed countries alone investigating prevalence rates (Barth, Bermetz, Heim, Trelle, & Tonia, 2013; Mathews et al., 2016) , other studies in developing countries alone that review the nature of CSA interventions and identify the types of CSA prevention initiatives implemented and their effectiveness (Russell, Higgins, Posso, & neglect, 2020) , studies review school-based CSA prevention alone (Fryda & Hulme, 2015; Topping & Barron, 2009; Walsh, Zwi, Woolfenden, & Shlonsky, 2015), focusing on knowledge about sexual harassment and the concept of sexual harassment prevention, as well as skills in protective behavior (Walsh et al., 2015), state of science on school-based CSA prevention programs (Fryda & Hulme, 2015), primary, tertiary, and secondary prevention related to harmful sexual behavior (McKibbin, 2017). (McKibbin, 2017). Then there are other studies of  the relationship between sexual abuse and other forms of abuse (Choudhry et al., 2018; Solehati, Pramukti, Hermayanti, Kosasih, & Mediani, 2021), the literate about online Sexual Activity (OSA) involving webcams was conducted (Koops, Dekker, & Briken, 2018), the difference between CSA in the home and extra familial abuse (Choudhry et al., 2018; Solehati et al., 2021), and the relationship between gender, age, perpetration, and sexual abuse (G Babatsikos, 2010; Choudhry et al., 2018; Solehati et al., 2021). Many research teams are conducting CSA prevention interventions to address CSA problems with school-based child populations, rarely in the community. Various methods of CSA prevention interventions are being developed especially for children, but are still rare for adults or people who care for children. Previous studies found some limitations, are still fragmentary or have not been fully reviewed. Preliminary feasibility studies are promising but need identification of certain intervention to preventive CSA, including the type of intervention, the length of time required for the intervention, the place of implementation of the intervention, and real evidence of the effect of successful intervention in reducing the prevalence of CSA (line 83-110)

 

The gap is: Many research teams are conducting CSA prevention interventions to address CSA problems with school-based child populations, rarely in the community. Various methods of CSA prevention interventions are being developed especially for children, but are still rare for adults or people who care for children. Previous studies found some limitations, are still fragmentary or have not been fully reviewed. Preliminary feasibility studies are promising but need identification of certain intervention to preventive CSA, including the type of intervention, the length of time required for the intervention, the place of implementation of the intervention, and real evidence of the effect of successful intervention in reducing the prevalence of CSA. Based on the gap above, a literature review is needed to map out the overall prevention of CSA comprehensively. So, in the current study we will include CSA prevention interventions in all countries (developed and developing countries), school and community-based, and focus not only on gaining knowledge and skills in protective behavior, but also in all aspects. This scoping review aimed to identify the literature on CSA prevention interventions as a method for preventing child sexual abuse, specifically to determine the types of studies that have been conducted, the purposes of the program, the types of methods used, the duration of intervention, place of intervention implementation, the effectiveness of the program, and the study improvement recommendations. (line 102-119)

 

 

 

Point 9: Pg 3, line 80-82: Summarized research question is unclear. More specific research questions provided in lines 77-80 don’t seem to align with themes identified in the abstract

Response 9: The study aimed to identify the literature on CSA prevention interventions as a method for preventing child sexual abuse, specifically to determine the types of studies that have been conducted, the purposes of the program, the types of methods used, the duration of intervention, place of intervention implementation, the effectiveness of the program, and the study improvement recommendations. (Line 19-22)

 

 

 

Point 10: Materials and methods

 Pg 3, line 95: Inclusion criteria was publication in English. How did this impact desired focus on developed and developing countries? Note here to make sure this is included in limitations 

Response 10 : I have added it to “Limitations: This study has limitations. All the articles included in study were written in English.  It is may not be able to generalize the actual results, because it is possible that there are articles on the theme of preventing CSA but using non-English ​​are not filtered in this study. (line 730-732)

 

 

Point 11: Pg 3, line 112-113: Unclear what is meant by “We also took articles related to CSA prevention from expert researcher of 112 CSA via email.” Recommend clarifying 

Response 11: The point is that the CSA articles are recommended by the research gate that goes to the author's email, then the author searches for the article articles manually on the web (search engines manual searching) and is filtered according to the inclusion criteriaI have revised it (line 25-26, 151, 188-192)

 

 

 

Point 12: Pg 3, line 115: “All researchers provided the study selection process.” Recommend changing “provided” to “contributed to” or “participated in” 

Response 12: I have revised it (line 154)

 

 

 

Point 13 : Pg 3, line 116: Change “trough” to “through”

Response 13: I have revised it (line 155)

 

 

 

Point 14: Pg 3-4, line 118-123: Revise for grammar

Response 14: I have revised it to be “Data were extracted manually from the study using the tabulation method. TS designed the study and provided the concept, selection study, screening, methods, original draft, data extraction, data analysis, review, editing, and manuscript writing. CEK, and ARF did data extraction and manuscript writing. YH and HSM did collection and analysis of data. TS, HSM, IP, and YH revising of the manuscript for important intellectual contents. (line 157-163)

 

 

 

Point 15: Pg 4, figure 1: Order is not sequential. Check for spelling errors

Response 15: Spelling error has been revised. For pictures, the order is appropriate because the middle column is the final result of numbers from subtracting numbers in the left column. (according to the PRISMA-ScR), Moher D, Liberati A, Tetzlaff J, Altman DG, The PRISMA Group (2009). Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement. PLoS Med 6(7): e1000097. doi:10.1371/journal.pmed1000097

 

 

 

Point 16 : Results

Pg 5, line 150: Change “was” to “were”

Response 16: I have revised it (line 196)

 

 

 

Point 17: Pg 5, line 155: Add period at end of sentence 

Response 17: I have revised it (line 201)

 

 

 

Point 18: Major revision suggested: Themes not clearly or comprehensively described– recommend revising to provide additional detail. (Examples: The effectiveness of the program 197 Judging from the research output, almost all CSA prevention programs had a sig- 198 nificant effect (n = 25), although there were studies showing the program had a partial 199 effect (n = 11).”)

Response 18 : I have revised it.

“Thirty-six studies on the prevention of CSA have been identified. The research objectives varied. The results of the review found that the research objectives varied, the majority (n=25) increasing knowledge (Brown, 2017; Bustamante et al., 2019; Citak Tunc et al., 2018; Czerwinski, Finne, Alfes, & Kolip, 2018; Daigneault, Hébert, McDuff, & Frappier, 2012; Dale et al., 2016; Gushwa, Bernier, & Robinson, 2019; Hudson, 2018; Morris et al., 2017; Müller, Röder, & Fingerle, 2014; Navaei, Akbari-Kamrani, Esmaelzadeh-Saeieh, Farid, & Tehranizadeh, 2018; Neherta, Machmud, Damayanti, & Afrizal, 2015, 2017; Ogunfowokan & Fajemilehin, 2012; Rheingold et al., 2015; Weatherley et al., 2012; Yi-Chuen, Fortson, & Kai-Wen, 2012), skills (n = 13) (Barron & Topping, 2013a; Citak Tunc et al., 2018; Czerwinski et al., 2018; Dale et al., 2016; Kim, 2016; Moon, Park, & Sung, 2017; Ogunfowokan & Fajemilehin, 2012; Rowe, Jouriles, & McDonald, 2015; Yi-Chuen et al., 2012), attitude (n = 7) (Baker, Naai, Mitchell, & Trecker, 2014; Boduszek et al., 2019; Czerwinski et al., 2018; Müller et al., 2014; Navaei et al., 2018; Rheingold et al., 2015; E. Yıldız & Tanrıverdi, 2018)”

(Line 216-229)

 

“Interventions in children aged 12-18 years can be carried out using several methods such as lecture, role models, stimulation discussion, debate, dice roll game, role-playing scenarios, curriculum, written materials, newspaper materials that reported sexual abuse experiences, Q&A with media tools such as PowerPoint, website, Helpline, and other tools (Baker et al., 2014; Barron & Topping, 2013a; Horn et al., 2015; Kim, 2016; Ogunfowokan & Fajemilehin, 2012). School-age children (6-12 years) can use the lectures, discuss/group discussion, game lessons, workshop, role play, video demonstrations, visual auditory kinesthetic, presentation, illustration, role play book, Q&A, online training videos method, Application Mob_APP, textbook based, picture, video, doll, sketch, theatre, website, curriculum, Interactive,  culturally appropriate puppets,  web-based training, film clips, stories, tasks, and Helpline (Bustamante et al., 2019; Czerwinski et al., 2018; Espelage, Low, Polanin, & Brown, 2013; Horn et al., 2015; Moon et al., 2017; Morris et al., 2017; Neherta et al., 2017; Nickerson et al., 2019; Pulido et al., 2015; Shin-Jeong & Kyung-Ah, 2017; Yi-Chuen et al., 2012). In pre-school age children (4-6 years)  method used can be narration, Q&A, discuss, with media tools such as application web, picture book, reading of book stories, video/ showing of movie, doll, sketch, website, scenarios, drawings, structured, learning, class exercises, parent newsletters, class materials, handouts, skill-based scenarios, homework for the children, DVD, flash drive, curriculum, workbook psychoeducation, role-playing, and Helpline (Citak Tunc et al., 2018; Dale et al., 2016; Horn et al., 2015; Nickerson et al., 2019).

 

Prevention Intervention of CSA for parents can be provided using counseling with the GATHER method consulting steps, Q&A with media tools such as internet, video, audio visual, printed books applications, PowerPoint, social story writing, phantom model, website, and Helpline (Horn et al., 2015; Hudson, 2018; Navaei et al., 2018; Nickerson, Livingston, & Kamper-DeMarco, 2018; G. Yıldız, Cavkaytar, & Disability, 2017). Prevention Intervention of CSA for teachers can be done using interactive online training course, online (web), lectures, Q&A, role play, song with media tools such as local language song, pictorial, sketch stories, leaflets, or film (Goldman & Grimbeek, 2014; Gushwa et al., 2019; Horn et al., 2015; Neherta et al., 2015; Nurse, 2017). Prevention Intervention of CSA for professionals and caregivers can be done using e-learning, Q&A, media tools such as web videos online, curriculum modules, website, and Helpline (Horn et al., 2015; Man-Ging, Böhm, Fuchs, Witte, & Frick, 2015; Rheingold et al., 2015)”

(Line 240-271)

 

“The duration of intervention varied, ranging from one-hour sessions-96 weeks, the majority were 24 weeks (n = 6) (Baker et al., 2014; Bustamante et al., 2019; Dale et al., 2016; Man-Ging et al., 2015; Nurse, 2017), but seven studies did not mention the duration. To evaluate the output of the study, the researchers carried out follow-up with a period that varied from 12 day-2 years, majority one-month post-intervention (n=7), and a few were after the intervention (n=1), two months post-intervention (n=1), three months post-intervention (n=3) , and six months post-intervention (n=3), 12 months post-intervention (n=2), 24 months post-intervention (n=1), but most of studies did not mention when the effect of the in-tervention occurred (n=18).”

(Line 275-282)

 

School-based CSA prevention programs were carried out starting from the Play Group-high school level, such as: Pre-school school-age children (Brown, 2017; Citak Tunc et al., 2018; Dale et al., 2016; Maureen C Kenny, Wurtele, & Alonso, 2012; White et al., 2018; Zhang et al., 2014), Play Group and elementary school-age children (Dale et al., 2016; Nickerson et al., 2019), school-age children (Boduszek et al., 2019; Bustamante et al., 2019; Czerwinski et al., 2018; Daigneault et al., 2012; Espelage et al., 2013; Holloway & Pulido, 2018; Moon et al., 2017; Morris et al., 2017; Müller et al., 2014; Neherta et al., 2017; Pulido et al., 2015; Shin-Jeong & Kyung-Ah, 2017; Weatherley et al., 2012; Yi-Chuen et al., 2012), children of junior high school age (Barron & Topping, 2013b; Rowe et al., 2015),  and children of high school age (Baker et al., 2014; Ogunfowokan & Fajemilehin, 2012), teachers of all school levels (Goldman & Grimbeek, 2014; Gushwa et al., 2019), teachers and elementary school children (Neherta et al., 2015), and parents (Navaei et al., 2018).

(Line 288-300)

 

The majority of studies used the control group and the intervention group where the control group was used as a comparison for the intervention group on the results of the interventions carried out, while the remaining studies only used the intervention group where there was no comparison of research results.

(Line 308-312)

 

 

Point 19:    Discussion

Major revision suggested: Too much detail in discussion- much of this info should have been covered in results. Recommend restructuring/revising after revising results

Response 19:

I have revised it

The results of the review found that the majority of the sample were children. The target of CSA prevention research is more focused on children, rarely on adults such as parents and adults who work with children in a professional capacity. However it is very important to educate parents, professionals, and the public about CSA (M. C. Kenny & Wurtele, 2012). Involving parents in educating children about CSA prevention is effective in supportive children to apply self-protection skills (G Babatsikos, 2010; Nickerson et al., 2018). This can be the basis for further research to prevent CSA by involving adults such as parents and adults who work with children in a professional capacity. If the research is viewed from the country of origin, research on the prevention of CSA is still rarely carried out by developing countries, even though the incidence of CSA is high not only in developed countries but also in developing countries. Nowadays, research of CSA prevention interventions has continued to focus on western and developed countries, whereas CSA levels are consistently higher in developing and non-western countries (Russell et al., 2020). Research on CSA is needed in developing countries as an evidence base to create a targeted CSA prevention program. This research is the first step toward developing health policies to be more research-oriented and focused (Russell et al., 2020)

(line 398-414)

 

The majority  of the research  increasing knowledge , and several other to increasing skills and attitude

(line 416-417)

The awareness is important because it is a key success factor in avoiding harmful situations, recognizing signs of CSA, and listening to a child's problems without skepticism (G Babatsikos, 2010). Perception is also important to study because it will affect a person's actions. Mothers’ perceptions of CSA are very important because may affect their understandings of CSA and their actions to protect the children (Alzoubi et al., 2018). Parents and adults who are responsible for children also need to have high self-efficacy to increase confidence in preventing CSA, one of which is counseling. Counseling is an effective device in increasing the self-efficacy of parents on CSA (Navaei et al., 2018). Next is communication practices. Children often have curiosity about something new, including sexual problems. The refusal of parents to correctly answer questions from the child can reduce their interest in the future (Navaei et al., 2018), so that children do not get adequate information. To protect children from CSA, it is essential for parents need to convey the message that their genitals should not be seen or touched by others. However, many parents do not give such a notice but tell their children to stay away from strangers to avoid kidnapping (Navaei et al., 2018). One attempt of the measures to counteract the possibility of CSA are the development of self-protection skills and other strategies, such as children ability to resist touch (Wulandari, Hanurawan, Chusniyah, & Sudjiono, 2020), so that children can distinguish between appropriate and inappropriate touch.

 (line 429-447 )

 

Adequate CSA prevention knowledge in children is essential in other to children do not become victims (Solehati, Pramukti, Kosasih, Hermayanti, & Mediani, 2022).. This can be done by increasing their knowledge, attitudes, behavior, self-efficacy, and skills practice through prevention intervention of CSA.  Child safety must be supported by parents, teachers, professionals, and caregivers who play a role in protecting children from CSA by increasing knowledge, skills practice, awareness, self-efficacy, attitudes, motivation, empathy, behavior, perceptions, communication practices, reporting responsibilities and responses to allegations of CSA. Parents and  teachers significantly contributed to CSA prevention information (Solehati et al., 2022).

(line 466- 508)

 

Various CSA prevention intervention methods, single and multi-method, can be carried out according to the age of children and adults. This is so that the material provided is right on target.

(line 511-513)

 

It is necessary to carry out further studies on the effective duration of implementation for an intervention.

(line 528-529)

 

Quasi-experimental research is widely used in intervention research. Intervention research would be better if it used an RCT design. RCTs are considered the “gold standard” in evidence-based research (S Hamer & G Collinson, 2014). (Susan Hamer & Gill Collinson, 2014) to produce reliable evidence of cause and effect (Polit & Beck, 2012). Experimenters (RCTs) can be relatively confident in the authenticity of causal relationships because they are observed under controlled conditions and usually meet the criteria for establishing causality, true experimental research will offer the most convincing evidence of the effect of one variable on another (Polit & Beck, 2012). T

(line576-584 )

 

However, this study also found that several studies did not impact the achievement of research objectives. This is possible because there are several things, such as the lack of time duration needed for an intervention to achieve its goals, intervention materials are only given in one place, the lack of involvement of adults in research, the topic of sexual violence that is considered sensitive by parents, difficulty accepting information related to sexual abuse, and the topic is considered unimportant because there is no incident of CSA in the surrounding environment. There needs to be a study of the duration and frequency of time necessary to carry out an intervention to be right on target. The children need repeated exposure to maintain self-protection knowledge and skills (Weatherley et al., 2012). In addition, it is also necessary to think about involving adults in carrying out CSA prevention interventions. Prevention programs will be more effective and provide great potential if they involve adults such as parents and adults who work with children in a professional capacity (Rheingold, Zajac, & Patton, 2012).. Prevention programs will be more effective and provide great potential if they involve adults such as parents and adults who work with children in a professional capacity (Rheingold et al., 2012). The children need repeated exposure to maintain self-protection knowledge and skills (Weatherley et al., 2012).

(line 605-671)

 

Evaluation of the efficacy of government-led or broader community-wide CSA prevention interventions is needed to reduce the actual prevalence of CSA (Russell et al., 2020).

(line 676-678)

 

Various sexual crimes threaten children, both from the internal and external environment. External factors such as online crime need to be considered, considering that all people of various ages today use online to find the necessary information. Online sexual activity  could implicate for violations of sexual boundaries, ranging from minor issues to serious forms of sexual harassment (Koops et al., 2018). There are several ways to consider preventing CSA. First, with Adequate CSA prevention knowledge for the children. Adequate CSA prevention knowledge in children is essential in other to children do not become victims (Solehati, Pramukti, Kosasih, Hermayanti, & Mediani, 2022). This can be done by increasing their knowledge, attitudes, behavior, self-efficacy, and skills practice through prevention intervention of CSA. Child safety must be supported by parents, teachers, professionals, and caregivers who play a role in protecting children from CSA by increasing knowledge, skills practice, awareness, self-efficacy, attitudes, motivation, empathy, behavior, perceptions, communication practices, reporting responsibilities and responses to allegations of CSA. CSA prevention is primarily the task of the parents and those responsible for children (Navaei et al., 2018). Parents and  teachers significantly contributed to CSA prevention information(Solehati et al., 2022). Second, by stopping the perpetrator's actions. Namely by 1) more severe punishment and increased monitoring of sex offenders; 2) the design and implement evidence-informed policy, such as how to motivate the CSA prevention; 3) develop community policies to expand the notion of what constitutes abuser accountability, encourage community responsibility and healing, provide safety, restitution, healing, and avenues for input for victims; 4) integrate what is known about perpetration into prevention programs, public education, and victim services (Tabachnick & Klein, 2011). Third, selecting sexual information contained online. Modern information-communication technology such as the Internet plays a vital part in everyday life (Koops et al., 2018). The government has the right to block information related to sexual harassment online. There are some to improve systematically the prevention and responses to online CSAE in LMICs (UNICEF, 2021) :move towards a comprehensive and integrated approach to tackling CSA and child sexual exploitation, move from project-based to system-strengthening through legal bodies, invest in evidence-based policy making-advocacy, strengthen multisectoral and national collaboration, facilities cross-border-regional-international collaboration, strengthen children’s  digital skills including online safety, promote children’s participation and agency (Unicef, 2021). Fourth, involve parents and professionals, community services, the general public, and policymakers in creating and implementing CSA prevention programs. Efforts in CSA prevention are need improve surveillance systems and data collection for monitoring CSA, increase understanding of risk and protective factors for CSA perpetration and victimization, reinforce existing and develop new evidence-based policies-programs-practices for the primary prevention of CSA, increase spread and implementation of evidence-based strategies of CSA prevention (CDC, 2022). The importance of starting early on school-based (Nickerson et al., 2019) and community-based CSA prevention efforts

 (line 679-719)

 

 

 

 

Round 2

Reviewer 1 Report

I would still like the view of other reviewers or the editor on the validity of inserting the tables in the text

In more detail

Page 2,

line 44: the sentence is not completed: the insert has been added on top of the old sentence  so it does not make sense

Similarly line 48

Line 55 : IICSA needs a full reference to the publication they had that talks about impact of CSA

Line 57: is 2013 recent?

Page 2 and 3 need a thorough proof read to ensure sentence construction is complete, commas and full stops used appropriately.

Page 4 : Line 106: ethical approval not needed I agree, but the impact of reading about sexual abuse should be addressed for researchers

Unless I have missed it I still don’t see coverage of the fact that much of the literature there is on this topic is ‘grey’ literature. It might not be included in the review but it does need to be noted that there is a lot more , up to date literature in grey literature

Page 6: line 202 and 203 repeat each other

Lines 202 to 241 : It is difficult to keep the thread with all the references. Can these be put into a box, or some delineation so that the sentence can flow ?

Line 272: write out question and answer  not give Q&A

Should the start of the description to the reference be ‘in …’ Is it not that the authors of the study found that..

Under ‘discussion’ there needs to be a check on all text to see that the additions are flowing in the sentence.

Author Response

Response to Reviewer 1 Comments

 

Point 1: I would still like the view of other reviewers or the editor on the validity of inserting the tables in the text

Response 1: herewith I attached the validity of article inserting the tables in the text (line 1300)

.

Point 2: Page 2, line 44: the sentence is not completed: the insert has been added on top of the old sentence  so it does not make sense

Response 2: I have revised it

Line 45-48, sexual activity that violates the laws or social taboos of society with a child (person less than 18 years old) by an adult, adolescent or older child, or more powerful person, where the child does not fully comprehend, does not consent to or is unable to give informed consent to, or is not developmentally prepared for giving consent (CDC, 2022; Greijer & Doek, 2016; Prevent Child Abuse North Carolina, 2022)

 

Point 3: Page 2, Similarly line 48

Response 3: I have revised it.

Line 50-54, CSA has short and long-term adverse effects on its victims (World Health Organization, 2017), such as biopsychosocial health problems (Alzoubi, Ali, Flah, & Alnatour, 2018; Padmanabhanunni & Gqomfa, 2022), bad behavior and personality problems, cognitive impairment, and academic failure in the victim  (Al-rasheed, 2017; Fergusson, McLeod, & Horwood, 2013).

 

Point 4: Page 2, Line 55 : IICSA needs a full reference to the publication they had that talks about impact of CSA

Response 4: I have revised it.

Line 54-64, According to Independent Inquiry into Child Sexual Abuse (2017), the impact of CSA is adverse outcomes in all areas of survivors' and victims' lives, including adverse physical health, emotional well-being, mental health and internalizing behaviors, externalizing behaviors, Interpersonal relationships, socioeconomic outcomes, religious and spiritual belief, and vulnerability to revictimization. These adverse outcomes are not just experienced over the short or medium term following sexual abuse but even can suffer over a survivor and victim's lifetime  (Fisher, Goldsmith, Hurcombe, & Soares, 2017). CSA can also adversely affect their families, such as personal relationships, employment and financial stability, over the medium to long term (Fisher et al., 2017).

 

Point 5: Page 2, Line 57: is 2013 recent?

Response 5: I have revised it.

Line 64-66, Global meta-analyses suggest that estimates of the prevalence of CSA nearly 24 % for female children (Qu et al., 2022) and 3-17% for boys (Barth, Bermetz, Heim, Trelle, & Tonia, 2013). (but for the current prevalence of csa for boys from Barth, Bermetz, Heim, Trelle, & Tonia (2013)

 

Point 6: Page 2 and 3 need a thorough proof read to ensure sentence construction is complete, commas and full stops used appropriately.

Response 6: I have revised it.

Line 104-112, The gap in this research are: 1) Many research teams are conducting CSA prevention interventions to address CSA problems with school-based child populations, rarely in the community; 2) Various methods of CSA prevention interventions are being developed especially for children, but are still rare for adults or people who care for children; 3) Previous studies found some limitations, are still fragmentary or have not been fully reviewed, 4)Preliminary feasibility studies are promising but need identification of particular interventions to prevent CSA, including the type of intervention, the length of time required for the intervention, the place of implementation, and real evidence of the effect of successful intervention in reducing the prevalence of CSA.

 

Point 7: Page 4, Line 106: ethical approval not needed I agree, but the impact of reading about sexual abuse should be addressed for researchers.

Response 7: All information related to sexual violence in this study needs to be understood comprehensively, do not misunderstand because the sexual violence disclosed is to be prevented, not to be imitated (line 793-795)

 

Point 8: Unless I have missed it I still don’t see coverage of the fact that much of the literature there is on this topic is ‘grey’ literature. It might not be included in the review but it does need to be noted that there is a lot more , up to date literature in grey literature

Response 8: All articles used in this study go through a process of checking the credibility of the

   RCT or quasi-research using the format issued by JBI (Appraisal check results are

   attached)

 

Point 9: Page 6: line 202 and 203 repeat each other

Response 9: I have deleted the word repeat “quasi-experimental (n = 15)” (line 325)

 

Point 10 Lines 202 to 241 : It is difficult to keep the thread with all the references. Can these be put into a box, or some delineation so that the sentence can flow

Response 10:   I have revised by using pointer to make it more clear (Lines 220 to 391).

 

Point 11: Line 272: write out question and answer  not give Q&A

Response 11: I Have revised it to be “question and answer “

• line 252, … question and answer with media tools such as PowerPoint, website…..
• line 257, … question and answer , online training videos…..
• line 264-265, … question and answer , discuss…..
• line 272, ,… question and answer  with media tools such as internet,….
• line 278…question and answer , role play….
• line 284, ,… question and answer , media tools….
• line 418,….. Q7A= question and answer

 

Point 11: Should the start of the description to the reference be ‘in …’ Is it not that the authors of the study found that.

Response 11: I have revised it to be “the study found that” (line 207)

 

Point 12: Under ‘discussion’ there needs to be a check on all text to see that the additions are flowing in the sentence.

Response 12: I have revised it.

• line 427-428, Even though it is essential to educate parents, professionals, and the public about CSA
• line 430-433, Prevention programs will be more effective and provide great potential if they involve adults such as parents and adults who work with children professionally (Rheingold, Zajac, & Patton, 2012).
• line 435-438, Most of the countries that studied CSA were developed countries. In that case, research on the prevention of CSA is still rarely carried out by developing countries, even though the incidence of CSA is high not only in developed countries but also in developing countries
• line 440-443, Research on CSA is needed in developing countries as an evidence base to create a targeted CSA prevention program. This research is needed because it is the first step toward developing health policies to be more research-oriented and focused (Russell et al., 2020)
• line 445-447, Most of the research increases knowledge, skills and attitude. Other to increase communication practices are motivation, self-efficacy, ability to resist touch, perception, and self-awareness.
• line 478-490, Adequate CSA prevention knowledge in children is essential for children not to become victims (Solehati, Pramukti, Kosasih, Hermayanti, & Mediani, 2022). This can be done by increasing their knowledge, attitudes, behavior, self-efficacy, and skills practice through the prevention intervention of CSA. Child safety must be supported by parents, teachers, professionals, and caregivers who play a role in protecting children from CSA by increasing knowledge, skills practice, awareness, self-efficacy, attitudes, motivation, empathy, behavior, perceptions, communication practices, reporting responsibilities and responses to allegations of CSA. Parents and teachers significantly contributed to CSA prevention information (Solehati et al., 2022). Various CSA prevention intervention methods, single and multimethod, can be carried out according to the age of children and adults. This is so that the material provided is right on target. Various CSA prevention intervention methods, single and multimethod, can be carried out according to the age of children and adults. This is so that the material provided is right on target.
• line 511-524, Various sexual crimes threaten children, one of which is an online crime, which needs to be considered, considering that all people of various ages today use online to find the necessary information. Online sexual activity could implicate violations of sexual boundaries, ranging from minor issues to severe forms of sexual abuse (Koops et al., 2018). Therefore, the prevention of CSA through the internet approach is very appropriate. Unfortunately, the Internet and applications have not been widely used in the results of this review. Internet-based methods have several advantages, such as easy access to information during education (Paranal, Washington Thomas, & Derrick, 2012), and can be done anywhere and by anyone. Social media applications were interesting for someone today who is Internet literate. Social media was described as a great personal and promotional tool (Okazaki & Taylor, 2013), has a significanteffect on communication and is a new revolution in communication (Patino, Pitta, & Quinones, 2012). This method would be better if packaged in a mobile application where messages are conveyed through an interesting multimethod method.
• line 580-581, There needs to be a study of the duration and frequency of time necessary to carry out an intervention to be right on target.
• line 630-631, The review results showed that most of the study designs were quasi-experimental.
• line 631-634 , Quasi-experimental research is widely used in intervention research, but it would be better to use an RCT design. RCTs are considered the "gold standard" in evidence-based research (Hamer & Collinson, 2014), to produce reliable evidence of cause and effect (Polit & Beck, 2012)
• line 638-641, In this review, it was also found that the majority of studies used the control group and the intervention group, where the control group was used as a comparison for the intervention group on the results of the interventions carried out
• line 661-662, In addition, the contribution of parents in providing support to the program (Kim, 2016)
• line 662-667, …and the convenience of watching online can help parents overcome the obstacles associated with attending the CSA prevention program in person(Love, Sanders, Metzler, Prinz, & Kast, 2013), and distributing CSA materials widely…
• line 732-740, This review also resulted in six themes of recommendations for CSA prevention interventions from the researchers. The primary purpose of the recommendation was to identify gaps and inform research priorities that will drive theory about planning and implementation intentions intervention in the health context going forward (Hagger et al., 2016). A helpful recommendation for researchers, funders, and policymakers to consider in future research starts with broadening the meaning of intervention, reviewing aspects relevant to formative work, intervention planning, recruitment, retention, implementation, evaluation, and analysis(Stevens et al., 2017) in order to solve problems effectively and on target.
• line 786-792, In addition, for further research, it is necessary to look at the effect of the intervention on reducing the incidence of CSA so that more tangible benefits can be found in solving the CSA problem. This takes quite a bit of time. Therefore, it is important to cooperate with policymakers in conducting research and evaluation related to the prevention of CSA in the future. Evaluation of the efficacy of government-led or broader community-wide CSA prevention interventions is needed to reduce the actual prevalence of CSA (Russell et al., 2020).

 

 

Reviewer 2 Report

The authors did directly address my specific comments and suggestions.

Authors need to check for clarity of writing.

Author Response

Response to Reviewer 2 Comments

 

Point 1:.

• The authors did directly address my specific comments and suggestions.
• Authors need to check for clarity of writing.

 

Response 1: I've revised the clarity of writing of my manuscript. Thank you very much

• Line 45-48, sexual activity that violates the laws or social taboos of society with a child (person less than 18 years old) by an adult, adolescent or older child, or more powerful person, where the child does not fully comprehend, does not consent to or is unable to give informed consent to, or is not developmentally prepared for giving consent (CDC, 2022; Greijer & Doek, 2016; Prevent Child Abuse North Carolina, 2022)
• Line 50-54, CSA has short and long-term adverse effects on its victims (World Health Organization, 2017), such as biopsychosocial health problems (Alzoubi, Ali, Flah, & Alnatour, 2018; Padmanabhanunni & Gqomfa, 2022), bad behavior and personality problems, cognitive impairment, and academic failure in the victim  (Al-rasheed, 2017; Fergusson, McLeod, & Horwood, 2013).
• Line 104-112, The gap in this research are: 1) Many research teams are conducting CSA prevention interventions to address CSA problems with school-based child populations, rarely in the community; 2) Various methods of CSA prevention interventions are being developed especially for children, but are still rare for adults or people who care for children; 3) Previous studies found some limitations, are still fragmentary or have not been fully reviewed, 4)Preliminary feasibility studies are promising but need identification of particular interventions to prevent CSA, including the type of intervention, the length of time required for the intervention, the place of implementation, and real evidence of the effect of successful intervention in reducing the prevalence of CSA.
• I have revised the results by using pointer to make it more clear (Lines 220 to 391).
• I have deleted the word repeat “quasi-experimental (n = 15)” (line 316) I have deleted the word repeat “quasi-experimental (n = 15)” (line 325)
• line 427-428, Even though it is essential to educate parents, professionals, and the public about CSA
• line 430-433, Prevention programs will be more effective and provide great potential if they involve adults such as parents and adults who work with children professionally (Rheingold, Zajac, & Patton, 2012).
• line 435-438, Most of the countries that studied CSA were developed countries. In that case, research on the prevention of CSA is still rarely carried out by developing countries, even though the incidence of CSA is high not only in developed countries but also in developing countries
• line 440-443, Research on CSA is needed in developing countries as an evidence base to create a targeted CSA prevention program. This research is needed because it is the first step toward developing health policies to be more research-oriented and focused (Russell et al., 2020)
• line 445-447, Most of the research increases knowledge, skills and attitude. Other to increase communication practices are motivation, self-efficacy, ability to resist touch, perception, and self-awareness.
• line 478-490, Adequate CSA prevention knowledge in children is essential for children not to become victims (Solehati, Pramukti, Kosasih, Hermayanti, & Mediani, 2022). This can be done by increasing their knowledge, attitudes, behavior, self-efficacy, and skills practice through the prevention intervention of CSA.  Child safety must be supported by parents, teachers, professionals, and caregivers who play a role in protecting children from CSA by increasing knowledge, skills practice, awareness, self-efficacy, attitudes, motivation, empathy, behavior, perceptions, communication practices, reporting responsibilities and responses to allegations of CSA. Parents and teachers significantly contributed to CSA prevention information (Solehati et al., 2022). Various CSA prevention intervention methods, single and multimethod, can be carried out according to the age of children and adults. This is so that the material provided is right on target. Various CSA prevention intervention methods, single and multimethod, can be carried out according to the age of children and adults. This is so that the material provided is right on target.
• line 511-524, Various sexual crimes threaten children, one of which is an online crime, which needs to be considered, considering that all people of various ages today use online to find the necessary information. Online sexual activity could implicate violations of sexual boundaries, ranging from minor issues to severe forms of sexual abuse (Koops et al., 2018). Therefore, the prevention of CSA through the internet approach is very appropriate. Unfortunately, the Internet and applications have not been widely used in the results of this review. Internet-based methods have several advantages, such as easy access to information during education (Paranal, Washington Thomas, & Derrick, 2012), and can be done anywhere and by anyone. Social media applications were interesting for someone today who is Internet literate. Social media was described as a great personal and promotional tool (Okazaki & Taylor, 2013), has a significant effect on communication and is a new revolution in communication (Patino, Pitta, & Quinones, 2012). This method would be better if packaged in a mobile application where messages are conveyed through an interesting multimethod method.
• line 580-581, There needs to be a study of the duration and frequency of time necessary to carry out an intervention to be right on target.
• line 630-631, The review results showed that most of the study designs were quasi-experimental.
• line 631-634 , Quasi-experimental research is widely used in intervention research, but it would be better to use an RCT design. RCTs are considered the "gold standard" in evidence-based research (Hamer & Collinson, 2014), to produce reliable evidence of cause and effect (Polit & Beck, 2012)
• line 638-641, In this review, it was also found that the majority of studies used the control group and the intervention group, where the control group was used as a comparison for the intervention group on the results of the interventions carried out
• line 661-662, In addition, the contribution of parents in providing support to the  program (Kim, 2016)
• line 662-667, …and the convenience of watching online can help parents overcome the obstacles associated with attending the CSA prevention program in person(Love, Sanders, Metzler, Prinz, & Kast, 2013), and distributing CSA materials widely…
• line 732-740, This review also resulted in six themes of recommendations for CSA prevention interventions from the researchers. The primary purpose of the recommendation was to identify gaps and inform research priorities that will drive theory about planning and implementation intentions intervention in the health context going forward (Hagger et al., 2016). A helpful recommendation for researchers, funders, and policymakers to consider in future research starts with broadening the meaning of intervention, reviewing aspects relevant to formative work, intervention planning, recruitment, retention, implementation, evaluation, and analysis(Stevens et al., 2017)  in order to solve problems effectively and on target.
• line 786-792, In addition, for further research, it is necessary to look at the effect of the intervention on reducing the incidence of CSA so that more tangible benefits can be found in solving the CSA problem. This takes quite a bit of time. Therefore, it is important to cooperate with policymakers in conducting research and evaluation related to the prevention of CSA in the future. Evaluation of the efficacy of government-led or broader community-wide CSA prevention interventions is needed to reduce the actual prevalence of CSA (Russell et al., 2020).

Round 3

Reviewer 1 Report

This has improved