Student Knowledge Gain Following the Second Step Child Protection Unit: the Influence of Treatment Integrity.

Treatment integrity is an important yet understudied component of school-based prevention programming, particularly for sensitive topics such as child sexual abuse prevention (CSA). This study examined student- and teacher-level characteristics, including components of treatment integrity, that contributed to greater knowledge gain among students participating in the Second Step Child Protection Unit (CPU). The study was conducted with 1132 students and 57 teachers from four elementary schools enrolled in a randomized controlled trial of the CPU. Students were administered assessments at pre-test, post-test, 6-month follow-up, and 12-month follow-up. Teachers were observed and rated on Content Integrity (CI; adherence to content), Process Integrity (PI; teacher enthusiasm, encouragement, behavior management), and Dose Received (DR; student behavior and interest) when delivering the lessons. Hierarchical linear growth modeling indicated that students who received the CPU made gains in the knowledge of CSA concepts and skills over a 12-month follow-up period. Girls had significantly greater CSA knowledge than boys immediately after the intervention, with gender remaining significant even when accounting for level-3 variables. Older children had better knowledge scores at post-test, but growth over time results revealed that younger students made greater gains. For students in 2nd through 4th grade, CI was more important for post-test outcomes, while for all students, CI and grade taught were important to post-test scores. Teachers of lower grades had students with a faster growth rate on correct responses to vignettes. Implications for CSA prevention programming and future research are discussed.