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Table of Contents   
ORIGINAL ARTICLE  
Year : 2017  |  Volume : 10  |  Issue : 6  |  Page : 1720-1723
Comparing the effect of two methods of group education and education by multimedia compact disk on mothers' knowledge and attitude about child sexual abuse


1 Student Research Center, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
2 Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
3 Department of Medical Education, Medical Education Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

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Date of Web Publication11-Jan-2018
 

   Abstract 


Background: Sexual abuse is one of the main health problems of children around the world. Mothers are the most important reliable source for providing information to children. The aim of this study was to compare the effect of two methods of group education and multimedia compact disk(CD) on mothers' knowledge and attitude about child sexual abuse. Materials and Methods: In this clinical trial, 100 mothers of children under 18years of age who had a medical file at health centers of Isfahan, Iran, were selected randomly. Participants were randomly allocated into two groups: group education and education with multimedia CD about child sexual abuse. Data were collected by a researcher-made questionnaire and analyzed using descriptive and inferential statistics. Results: The mean score of knowledge and attitude of mothers about child sexual abuse after the intervention in the group education (92.6 and 84.1) compared to before the intervention(69.7 and 58.4) and also in the multimedia CD group after the intervention(92.3 and 81.4) compared to before the intervention (67.5 and 56) had a statistically significant increase. No significant difference was observed between the mean scores of knowledge and attitude of mothers of both groups about child sexual abuse after the intervention. Conclusions: Two methods have been similarly effective in improving the knowledge and attitude of mothers about child sexual abuse. Therefore, considering the benefits of educating with multimedia CD including its affordability and the possibility of using it at any time, it is recommended to use it for mothers' educational programs.

Keywords: Attitude, child sexual abuse, educating with compact disk, group education, knowledge, mothers, multimedia

How to cite this article:
Lak P, Noroozi M, Ehsanpoor S. Comparing the effect of two methods of group education and education by multimedia compact disk on mothers' knowledge and attitude about child sexual abuse. Ann Trop Med Public Health 2017;10:1720-3

How to cite this URL:
Lak P, Noroozi M, Ehsanpoor S. Comparing the effect of two methods of group education and education by multimedia compact disk on mothers' knowledge and attitude about child sexual abuse. Ann Trop Med Public Health [serial online] 2017 [cited 2018 Nov 17];10:1720-3. Available from: http://www.atmph.org/text.asp?2017/10/6/1720/222704



   Introduction Top


Children are one of the most vulnerable groups of the society and they are always at the risk of being harassed by different people in the family or the society; therefore, they should be supported by their parents and governmental organizations.[1] Child abuse is a global problem and has involved all the countries, developed and developing, through a growing trend.[2] Child sexual abuse might be in the form of touching, fondling, watching the sex organs of the child, masturbation in front of the child, child exploitation such as using them to make sexual films and images(child pornography), and making any sexual contact with the child.[3]

Different statistics about child sexual abuse even in developed countries are all estimated and real cases are always more than the reported statistics. It has been estimated that about 1 in every 5 girls and 1 in every 15 boys would be sexually harassed before the age of 18years.[4] Child abuse of any kind is considered obscene at any society, and in many countries, it is considered a crime and would have legal punishment.[5] According to the statistics in Iran, 66% of the child sexual abuses would be conducted by men and girls are more likely to be harassed than boys.[6]

The consequences of child sexual abuse could appear in the short or long term.[7],[8] Physical consequences include sexually transmitted infections, pregnancy for teenage girls, urinary tract infections, anorexia, overeating, and psychosomatic symptoms(headache, stomachache, and chronic pains). Psychoemotional consequences include anxiety symptoms, fear and panic, insomnia, nightmare, tendency toward suicide, distrust of others, feeling guilty, and anger.[9]

It has been stated that parents' unawareness and disregarding in informing their children has caused children with less sexual knowledge to be at the risk of harassment more.[10] Constant investment for prevention and intervention at the community level is a necessary part for reducing this problem during childhood and preventing its long-term effects during adolescence and adulthood.[1]

Educational methods are various and would be applied based on people's needs and the educational content. One of the educational methods is group education. This method would provide face-to-face education and an environment for discussion and question and answer. However, factors such as being busy, tiredness, and spending time and money would challenge the success of this method. Nowadays, traditional educational methods are losing their efficiency by the advancements in technology. Hence, we must be looking for modern methods for transferring the knowledge and increasing the learning.[11] Another educational method is teaching through compact disks(CDs) which would be applied by transferring the concepts using texts, audio, images and video, more simply, extensive, and attractive.[12]

Therefore, to determine, diagnose, and educate the prevention of child sexual abuse, the present study was conducted to compare the effect of two methods of group education and education by multimedia CD on the knowledge and attitude of mothers about child sexual abuse.


   Materials and Methods Top


The present study was a clinical trial (IRCT2016100626756N2) which was conducted on two groups of group education and education using multimedia CD. Study environment for this study was the health centers of Isfahan, Iran. The sample size for both groups was calculated to be 88(with an accuracy of 0.6 and confidence interval of 95%); however, considering the chance of sample loss, sample size was increased to 100. The inclusion criteria were being the mother of a child of under 18years of age, not having college degrees in medical, paramedical, and psychological majors, being literate and able to use CDs and computer, and not having passed any educational courses about sexual education and preventing sexual abuse in the past. The exclusion criteria were not participating in all the conducted educational sessions for the group education, not using the CD or reviewing it incompletely, and unwillingness to continue the study.

After gaining approval from the Ethics Committee of the Research Council of Isfahan University of Medical Sciences(ethics code: 394658), health centers were selected through cluster method, and then nonrandomized quota method. After selecting the health centers, from all the clinics under supervision of health centers 1 and 2 of Isfahan, 6 clinics with appropriate number of clients were selected, nonrandomly. Hence, two clinics were selected from the health center 1 and four clinics were selected from the health center 2. Then, from these 6 clinics, 3 were randomly selected for group education and 3 for education by multimedia CD. Then, using convenience sampling method, eligible mothers were enrolled in the study.

Data gathering tool was a researcher-made questionnaire that was filled by the participants at two stages(before and 1month after the intervention).

The questionnaire had three parts: demographic characteristics, knowledge measurement tool, and attitude measurement tool. Knowledge measurement tool had 364-choice questions and each correct answer had 1 score. Its minimum score was 0 and its maximum score was 36. The attitude measurement tool had 20 questions with 5-point Likert scale(completely agree, agree, no idea, disagree, and completely disagree). In questions for evaluating negative attitude, the score of completely agree was zero, agree was 1, no idea was 2, disagree was 3, and completely disagree was 4. In questions evaluating positive attitude, the scoring was reverse.

To achieve the scientific validity of the data gathering tool content validity and to achieve its reliability, test–retest method was used.

After completing the consent form and conducting the pretest, after prior arrangements, the researcher conducted two 2-h educational sessions during 2 consecutive weeks for the group education using different educational methods(speech, movie and animation, sharing mothers' experiences, and questions and answers) and a computer. After the end of the second group educational session, the researcher distributed the educational CDs(with the same educational content as the ones at the group education sessions) among the mothers of the multimedia CD group.

CDs contained educational texts, audio, images, movies, and animation. The educational content included the definition of child abuse, the prevalence of child abuse in Iran and the world, all types of child abuse with focus on child sexual abuse, consequences and complications of child abuse with focus on child sexual abuse, signs of child sexual abuse, children at the risk of sexual abuse, and preventive methods for child sexual abuse.

The educational content was developed using scientifically validated books, articles, and websites. Then, after 1month, the researcher conducted the posttest. Data were analyzed using descriptive and inferential statistics(t-test, paired t-testn and Chi-square test) andthe statistical package for the social sciences software 19.0 (SPSS version 19.0, Isfahan, Iran).


   Results Top


Results of the study showed that the mean age, number of children, number of children under 18years of age, duration of marriage, job, and educational level of the participants had no significant difference between both groups(P>0.05).

The mean score of knowledge and attitude of mothers about child sexual abuse before the intervention had no significant difference between the group education and multimedia CD groups[Table1].
Table 1: Comparison of the mean scores of mother's knowledge and attitude about child sexual abuse before and after the intervention in two groups

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Results of the study showed that the mean score of knowledge in the group education was significantly improved after the intervention compared to before the intervention(P<0.001). Furthermore, the mean score of knowledge was significantly improved after the intervention in the multimedia CD group (P<0.001)[Table1].

Regarding mothers' attitude toward child sexual abuse, results showed a significant increase in the score of mothers' attitude after the intervention compared to before the intervention in the group education(P<0.001). In addition, the mean score of attitude toward child sexual abuse was significantly improved in the multimedia CD group after the intervention compared to before the intervention(P<0.001)[Table1].

Results showed no significant difference between both groups after the intervention regarding their mean scores of knowledge and attitude about child sexual abuse (P>0.05).


   Discussion Top


The present study was conducted to compare the effect of two educational methods of group education and multimedia CD on the knowledge and attitude of mothers about child sexual abuse. According to the results, the mean scores of knowledge and attitude of mothers about child sexual abuse was significantly improved in both the group education and multimedia CD groups after the intervention. Astudy that was conducted byMostofi etal.in Tehran also showed a significant improvement in the scores of knowledge and attitude of teenage girls' mothers after receiving sexual education using group education method.[9] Another study that was conducted by Rheingold et al. in the USA revealed that web-based e-learning would improve the knowledge, attitude, and practice of childcare personnel in preventing child sexual abuse.[13] The study byWhite et al. in Australia demonstrated that e-learning through three different educational websites would increase the mean scores of knowledge and attitude about preventing child sexual abuse.[14]

Results of the present study showed no significant difference between both groups of group education and multimedia CD group regarding their mean scores of knowledge and attitude after the intervention.

However,Hugenholtz et al. evaluated the effect of education by e-learning for physicians and revealed a significant increase in the mean scores of knowledge and attitude of people who received e-learning compared to those who were trained by lecture-based method.[15]

Furthermore, results of a study byHashemiparast et al. in Tehran showed that, although the mean score of knowledge about controlling hospital infections was improved in both groups of e-learning and lecture-based education, the mean scores of learners in the lecture-based group was higher than the e-learning group.[16]

It seems that the similar effect of educating by multimedia CD and group education method on changing the mothers' knowledge and attitude about child sexual abuse might be due to the appropriate content of the multimedia CDs and its diversity and attractiveness; despite it was the same as the content of the group educational sessions. In addition, it is possible that easy access to the content of the multimedia CD repeatedly and at any time has made mothers to use its content efficiently.


   Conclusions Top


Educating mothers for taking care of and preventing child sexual abuse is of great importance. But there is a lack of specialized force for education. Also conducting group educational programs is facing challenges due to financial and time constraints. Multimedia CD has various features including learning based on the interests and its pervasiveness, affordability, being self-teaching, efficiency, accessibility, the possibility of reviewing it repeatedly and at any time, flexibility, being learner-oriented, possibility of learning without concerns about time and tiredness. So considering its features and broad educational capability, educating through multimedia CD is recommended as an educational method for mothers.

Acknowledgments

This article was derived from a master thesis of Peymaneh Lak with project number 394658, Isfahan University of Medical Sciences, Isfahan, Iran. We should thank the Vice-chancellor for Research of Isfahan University of Medical Sciences for their support.

Financial support and sponsorship

Isfahan University of Medical sciences.

Conflicts of interest

There are no conflicts of interest.



 
   References Top

1.
HagrasAM, MoustafaSM, BarakatHN, El-ElemiAH. Medico-legal evaluation of child sexual abuse over a six-year period from 2004 to 2009 in the Suez Canal area, Egypt. Egypt J Forensic Sci 2011;1:58-66.  Back to cited text no. 1
    
2.
BechtelK, BennettBL. Evaluation of Sexual Abuse in Children and Adolescents. Available from: http://www.uptodate.com/contents/evaluation-of-sexual-abuse-in-children-and-adolescents.[Last accessed on 2017Jun09].  Back to cited text no. 2
    
3.
Frías SM, ErvitiJ. Gendered experiences of sexual abuse of teenagers and children in Mexico. Child Abuse Negl 2014;38:776-87.  Back to cited text no. 3
    
4.
ShattuckA, FinkelhorD, TurnerH, HambyS. Children exposed to abuse in youth-serving organizations: Results from national sample surveys. JAMA Pediatr 2016;170:e154493.  Back to cited text no. 4
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5.
BarilK, TourignyM, Paillé P, Pauzé R. Characteristics of sexually abused children and their nonoffending mothers followed by child welfare services: The role of a maternal history of child sexual abuse. JChild Sex Abus 2016;25:504-23.  Back to cited text no. 5
    
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ShariatS, MonsheiGH. Aprediction model based on personality traits and domestic violence against women and child abuse history spouses in Isfahan. Community Health 2017;4:90-8.  Back to cited text no. 6
    
7.
CelikCB, OdaciH. The effect of experience of childhood abuse among university students on self-perception and submissive behavior. Child Youth Serv Rev 2012;34:200-4.  Back to cited text no. 7
    
8.
SadockBJ, SadockVA, RuizP. Kaplan and Sadock's Synopsis of Psychiatry: Behavioral Sciences/Clinical Psychiatry. 11thed. Netherlands: Wolters Kluwer; 2015.  Back to cited text no. 8
    
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MostofiN, GarmaroudiG, ShamshiriA, ShakibazadehE. Effect of group education on knowledge, attitude and practice of mothers of adolescent girls about sex education. JSch Public Health Inst Public Health Res 2016;14:45-59.  Back to cited text no. 9
    
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AbolghasemiN, Merghati KhoeiE, TaghdissiH. Teachers' perceptions of sex education of primary school children. JSch Public Health Inst Public Health Res 2010;8:27-39.  Back to cited text no. 10
    
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Khorami RadA, HeidariA, Ahmari TehranH. Comparison of two self-learning methods(CD-Rom or booklet) for physician education about reporting diseases cases. Iran J Med Educ 2011;11:149-58.  Back to cited text no. 11
    
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JayatillekeAC, YoshikawaK, YasuokaJ, PoudelKC, FernandoN, JayatillekeAU, etal. Training Sri Lankan Public Health midwives on intimate partner violence: Apre-and post-intervention study. BMC Public Health 2015;15:331.  Back to cited text no. 12
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13.
RheingoldAA, ZajacK, ChapmanJE, PattonM, de ArellanoM, SaundersB, etal. Child sexual abuse prevention training for childcare professionals: An independent multi-site randomized controlled trial of stewards of children. Prev Sci 2015;16:374-85.  Back to cited text no. 13
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14.
WhiteC, ShanleyDC, Zimmer-GembeckMJ, LinesK, WalshK, HawkinsR, etal. Cluster randomised-control trial for an Australian child protection education program: Study protocol for the learn to be safe with Emmy and friends™. BMC Public Health 2016;16:72.  Back to cited text no. 14
    
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HugenholtzNI, de CroonEM, SmitsPB, van DijkFJ, NieuwenhuijsenK. Effectiveness of e-learning in continuing medical education for occupational physicians. Occup Med(Lond) 2008;58:370-2.  Back to cited text no. 15
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HashemiparastMS, SadeghiR, GhaneapurM, AzamK, TolA. Comparing E-learning and lecture-based education in control of nosocomial infections. Payavard Salamat 2016;10:230-8.  Back to cited text no. 16
    

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Correspondence Address:
Mahnaz Noroozi
Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan
Iran
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ATMPH.ATMPH_610_17

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