Efforts to prevent child sexual abuse focus on education of children to avoid potentially abusive situations. Criticisms of prevention programs point to the fact that many perpetrators are trusted caretakers and therefore have ready access to their victims. In addition, the power differential between perpetrators and their child victims precludes self-defense. However, meta-analyses have shown some benefit in these programs. The most common sexual abuse prevention efforts are school- or classroom-based, with components for children, teachers, and parents. Children learn valuable skills from these programs, but their effect on victimization rates remains unproven.[22]Davis MK, Gidycz CA. Child sexual abuse prevention programs: a meta-analysis. J Clin Child Psychol. 2000 Jun;29(2):257-65.
http://www.ncbi.nlm.nih.gov/pubmed/10802834?tool=bestpractice.com
[23]Bolan RM. Child sexual abuse: prevention or promotion. Social Work. 2003 Apr;48(2):174-85.[24]Mikton C, Butchart A. Child maltreatment prevention: a systematic review of reviews. Bull World Health Organ. 2009 May;87(5):353-61.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2678770
http://www.ncbi.nlm.nih.gov/pubmed/19551253?tool=bestpractice.com
[25]Walsh K, Zwi K, Woolfenden S, et al. School-based education programmes for the prevention of child sexual abuse. Cochrane Database Syst Rev. 2015 Apr 16;(4):CD004380.
https://onlinelibrary.wiley.com/doi/10.1002/14651858.CD004380.pub3/full
http://www.ncbi.nlm.nih.gov/pubmed/25876919?tool=bestpractice.com
[26]Finkelhor D. The prevention of childhood sexual abuse. Future Child. 2009 Fall;19(2):169-94.
http://www.ncbi.nlm.nih.gov/pubmed/19719027?tool=bestpractice.com
Efforts to reduce sexual assault largely focus on education of potential victims, although legislation may also be relevant (e.g., legislation on alcohol, as alcohol is a major risk factor for sexual assault and is often easily and cheaply available; legislation for care facilities requiring criminal checks, criminal prosecution of offenders, and decreased isolation of patients). Other messages relate to minimizing vulnerability, for example increasing awareness of the risks of leaving a drink unguarded in a public place, of mixing drugs and alcohol, and of using unlicensed taxicabs. Further prevention initiatives have focused on vulnerable groups: for example, women with intellectual disabilities and new mothers.[27]Wacker J, Macy R, Barger E, et al. Sexual assault prevention for women with intellectual disabilities: a critical review of the evidence. Intellect Dev Disabil. 2009 Aug;47(4):249-62.
http://www.ncbi.nlm.nih.gov/pubmed/19650680?tool=bestpractice.com
[28]Bair-Merritt MH, Jennings JM, Chen R, et al. Reducing maternal intimate partner violence after the birth of a child: a randomized controlled trial of the Hawaii Healthy Start Home Visitation Program. Arch Pediatr Adolesc Med. 2010 Jan;164(1):16-23.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2825025
http://www.ncbi.nlm.nih.gov/pubmed/20048237?tool=bestpractice.com
Education campaigns to encourage reporting and development of accessible and sensitive services for those who have been sexually assaulted enables early intervention to prevent longer-term morbidity.[27]Wacker J, Macy R, Barger E, et al. Sexual assault prevention for women with intellectual disabilities: a critical review of the evidence. Intellect Dev Disabil. 2009 Aug;47(4):249-62.
http://www.ncbi.nlm.nih.gov/pubmed/19650680?tool=bestpractice.com
The Centers for Disease Control and Prevention has developed an educational program designed to reduce sexual violence by promoting social norms that protect against violence, teaching skills to prevent sexual violence, and fostering the creation of protective environments.[29]Centers for Disease Control and Prevention. STOP SV: a technical package to prevent sexual violence. 2016 [internet publication].
https://www.cdc.gov/violenceprevention/pdf/SV-Prevention-Technical-Package.pdf