‘Think Global Act Local’: a place-based approach to sexual abuse prevention

Abstract

Child sexual abuse is a global concern and its prevention warrants international attention. However the prevalence of child sexual abuse is not evenly distributed amongst the world’s population, with observed rates in some countries, neighbourhoods or local contexts, much higher than in others. Abuse dimensions and dynamics, as well as underlying causal structures and processes, are also likely to differ from location to location within countries. Whilst clinical (individual-level) and epidemiological (whole-population) approaches dominate current research and prevention efforts, given these variations we advocate here for a local place-based approach to sexual abuse prevention that targets specific locations and contexts where these problems become concentrated. Pinpointing key problem contexts (hotspots), opportunity structures and precipitating conditions provides an opportunity to respond at a local neighbourhood or organisational level and target key underlying mechanisms, positioning prevention and intervention resources and efforts where they are most needed. Despite its local focus, this nuanced approach to prevention has the potential to be transferred to a range of locations and contexts around the world, facilitating a more efficient response to sexual abuse.

Background

The incidence and prevalence of crime is not distributed evenly, and opportunities, modus operandi and causal structures differ from crime to crime and from location to location. Ideas in the study of crime have developed over time, from a traditional concentration on criminality, to an environmental perspective emphasising crime patterns and contextual influences. Within environmental criminology, the focus of crime analysis and preventive responses can be arranged along a continuum from global to local, based on the geographic size of the target location.

Brantingham and Brantingham (1991, cited in Wortley and Mazerolle 2008) introduced this continuum, naming the differing levels of analysis (and responses to crime problems) as macro, meso and micro. Macro analysis and responses refer to the study of the distribution of crime on a large aggregate scale, for example between- country or between-city crime distributions, with preventive responses operating at a population level. Meso analysis is situated at an intermediate level. Brantingham and Brantingham explain this analysis as focused on subareas of a city, and trace its origins to the work of the Chicago School which examined systemic influences on crime, and the relationship between neighbourhoods and delinquent behaviour. Micro level responses focus on the smallest unit of analysis, including specific crime sites, building understanding and examining the impact of the immediate environment on behaviour. Hot-spots research in criminology is an example of this analytic approach. Preventive activities at this level target specific parts of the problem, at specific ‘places’.

Table 1 outlines the global–local dimensions of analysis and preventive responses to crime problems. Like many continuums, the boundaries between each level of response are not precise with some overlap acknowledged. Inherent in this model however is the inverse relationship between the area of focus or influence, and the level of detail informing the intervention. In moving from macro to micro levels of analysis and response we see increasing focus on specific detail, within smaller defined spaces.

Table 1 Global–local continuum for analysis and preventive response to crime problems

Analysis of and responses to child sexual abuse can also be arranged along this global–local continuum. The prevalence and presentation of sexual abuse is as nuanced and varied as other forms of crime, and reflects an interaction between an individual and their immediate environment. It stands to reason that efforts to prevent child sexual abuse should be based on the best possible understanding of its precise local causes and context and yet only a detailed and specifically focused approach can achieve this. More attention is therefore required in this field at the meso and micro levels of crime analysis and preventive response.

In this paper, the global–local dimensions of analysis and response to child sexual abuse will be explored. Current approaches to child sexual abuse prevention will be briefly outlined and existing limitations to the prevention of child sexual abuse on a global level will be identified. It will then be argued that more local, place-based approaches to prevention can best address existing limitations in this field. Finally, the feasibility of such a localised approach to such a global concern will be explored, with key global lessons identified.

‘Think Global’: existing approaches to sexual abuse prevention

Child sexual abuse is a serious global public health concern, impacting millions of children and families around the world. Given the widespread nature of this behaviour, efforts to understand and prevent such abuse are vital and warrant international attention and action. Most preventive attention to date has been paid to known offenders, with efforts also made to raise general awareness of child sexual abuse and reduce risks of victimisation at a population level. This work has a large sphere of influence, yet the impact of much of this work is uncertain with respect to what works, for whom and in what conditions (Smallbone and McKillop 2015).

However, as with all other crime types, evidence suggests that child sexual abuse is geographically unevenly distributed, with concentrations noted in particular “places” (nations, communities, neighbourhoods, social groups, organisations). International epidemiological research has been at the forefront of the macro level or global study of abuse trends. For example, a meta-analysis by Stoltenborgh et al. (2011) reported a higher prevalence of child sexual abuse for boys in Africa and for girls in Australia/New Zealand. Lower prevalence rates were reported in Asia for both boys and girls. Prevalence rates for boys were higher in economically low resource countries. Another recent meta-analysis (Pereda et al. 2009) concluded that the continent on which the study was undertaken was found to have a significant effect on prevalence rates, with the highest rates reported in studies conducted in Africa, whilst those with the lowest rates were conducted in Europe. Differences in prevalence rates were also found based on the area studied. Certain local samples were associated with higher prevalence rates than national samples, highlighting the importance of within-country as well as between-country (or continent differences) research.

In addition to variations in the distribution of abuse, differences in the dimensions of abuse at a more local level are also noted (e.g. gender or age of victims, modus operandi, abuse settings, and available guardianship). Together this presents significant challenges for global level responses to the problem. Existing global resource structures see most prevention funds available in economically developed countries, which may not be associated with the highest prevalence rates. Moreover current practice favours activities which can be rolled out at a population level, rather than reflecting variations in the local manifestation of abuse. This highlights two key limitations in current approaches to prevention. The first is the need to concentrate prevention efforts where they are most needed. The second is the need to address the variability in abuse dynamics and dimensions. Each will be addressed separately.

Concentrating prevention efforts where they are most needed

Given the uneven distribution of child sexual abuse, prevention efforts should be focused where they are most needed. In Australia for example, research has consistently reported higher rates of child sexual abuse in remote Aboriginal communities, locations isolated and far from metropolitan centres where most policy is developed and practice funds are available (e.g. Wild and Anderson 2007; Gordon et al. 2002). Once locations of highest concern are identified, professional responses, resources and research should be concentrated in these places.

Neither individual level approaches (the focus of most clinical, justice and child protection services) nor population level approaches (including large scale public awareness and education campaigns) naturally get to where the main problems are—specific high prevalence and or risky places, neighbourhoods, and organisations. Neither enables us to pinpoint key problem locations (“hot-spots”), which a place-based local level approach could. Whilst global prevalence rates provide an important part of the picture, identifying local ‘hot spots’ (contexts/environments in which prevalence is concentrated) allows a more efficient concentration of intervention efforts and resources. The problem of child sexual abuse is not evenly distributed in Australia, with children in some areas at much higher risk than those in others.

Addressing variability in abuse dimensions and dynamics

Abuse dimensions and dynamics, as well as underlying causal structures and mechanisms, are also likely to differ from location to location, making a response to this variability a second key challenge for the prevention field. It makes sense that very different approaches would be needed to prevent the sexual abuse of children in their family home, in an organisational setting, over the Internet, in a conflict zone, or of a child exploited for sex in the context of extreme poverty or marginalisation.

There are distinct differences between designing prevention interventions based on universal empirical findings about risk and protective factors associated with child sexual abuse, and designing them on the basis of an in-depth knowledge of how this behaviour plays out at a local level. One is general and the other specific. It is acknowledged that the widespread dissemination of programs based on generic risk factors might be argued from an economic viewpoint. However, where generic risk factors fail to reflect local abuse trends, broad-based programs may ultimately fail children. The detail in an understanding of the mechanisms underlying certain patterns of abusive behaviour provides the most valuable information about who, what and how to target prevention strategies (e.g. Tilley 2005; Wikstrom 2007). Crime science approaches provide the unique details needed to best inform child sexual abuse prevention, perhaps better reflecting the diversity in prevalence rates across the globe and the heterogeneity we see (in offenders, victims, abuse behaviours, experiences and settings), than the more traditional approaches.

As already outlined, responses to sexual abuse and violence have typically been dominated by individual psychopathology frameworks, with perpetrators of abuse seen as a distinct sub-group of sexually disordered offenders who require intensive, individually based therapeutic interventions, and the general public seen to be in need of education and protection from these individuals (e.g. Finkelhor 2009). This primarily ‘individual’ focus sits in contrast with earlier work in the child abuse field advocating the need to consider the contribution of ecological factors to child maltreatment generally and their importance to prevention (e.g. Belsky 1993; Jack 1997). In locations where concentrations of sexual violence and abuse have been identified, explanations are rarely based on concentrations of disordered individuals. Instead, explanations provided for these concentrations tend to rely more on systemic and environmental factors. A recent review of endemic sexual violence and abuse identified a breakdown in usual social and behavioural controls and in surveillance and guardianship as some common factors across otherwise disparate case examples (Rayment-McHugh et al. 2015). The contribution of ecological and environmental factors to endemic sexual violence and abuse therefore suggests that a radically different approach to prevention is indicated, particularly where higher concentrations of abuse are identified.

To address the limitations outlined above, ‘acting local’ makes sense. A more local place-based approach to prevention of child sexual abuse is therefore advocated. In the next section we will explore this approach in more detail, outlining the steps to implementing this approach using a current place-based project as an example, and highlighting ways this alternative approach can address these limitations.

‘Act Local’: a place-based approach to prevention

Hot-spots and problem-oriented policing, shaped by a detailed understanding of specific local manifestations of a problem, have proven very effective for a wide range of offence types. Crime analysis and mapping is used to identify “places” with higher crime rates and understand crime trends at this local level, and police activity is subsequently focused on these specific sites (Weisburd 2008). There is a strong evidence base to support the effectiveness of this approach, with demonstrated reductions in crime, some diffusion of benefits to neighbouring locations, and little displacement (e.g. Braga et al. 2012; Weisburd et al. 2008).

There has been much less attention to place-based approaches to sexual abuse prevention. The authors currently work on an Australian project doing just that. The Griffith Youth Forensic Service—Neighbourhoods Project (known as the Neighbourhoods Project) aims to reduce the extent and impact of youth sexual violence and abuse in two locations, one a small remote Aboriginal community, and the other a culturally diverse suburban precinct within a regional city. These locations were initially identified by clinical practitioners, with subsequent systematic analysis indicating endemic problems with youth sexual violence and abuse (Smallbone and Rayment-McHugh 2013; Smallbone et al. 2013). This analysis also identified abuse trends and patterns at both locations, which have informed the development of localised prevention plans, the implementation of targeted prevention activities, and planned evaluation strategies.

Local place-based prevention aims to make places safer, reducing the extent and impacts of the target problem and thus making people in these environments safer. Immediate situations are understood to present opportunities for crime (including sexual abuse) to occur, with already motivated offenders exploiting or manipulating such opportunities. Situations may also precipitate criminal (or abusive) behaviours even amongst those not previously motivated to engage in such activity (Wortley 1997). The interaction between people and their immediate environment is reflected in the ‘crime triangle’ (Eck 2003) which outlines the convergence in both space and time of a potential offender and suitable target (vulnerable victim), in the absence of a suitable crime controller (guardians, handlers and place managers). Child sexual abuse may therefore occur when a potential offender is in the same place as a vulnerable child, without an effective guardian present or able to exert influence over the offender’s actions. Making places safer may therefore involve activities to reduce factors in the immediate environment that may precipitate abuse motivations in potential offenders, reduce opportunities for contact between potential offenders and potential victims, and/or increase guardianship and place management.

The definition of “place” is obviously important in place-based prevention. The criminological literature describes “place” as a very small area (e.g. a building or street), quite distinct from a larger neighbourhood or community (e.g. Eck and Guerette 2012) and thus reflects crime analysis and response at a micro level. In addressing sexual violence and abuse, “place” has been defined more broadly within the Neighbourhoods Project as a specific location of interest, that is, a place or location with a concentration of child sexual abuse. In sexual abuse prevention it is therefore suggested that “places” refer to a specific and defined localised context which could include an organisational setting, defined geographic location (e.g. a park), a specific neighbourhood or even a small remote community—perhaps more commonly associated with meso and micro levels of focus. There is a pragmatic element to this approach, with “place” being defined on a case-by-case basis, based on the range of the identified “hot-spot”. What distinguishes this “place-based” approach from whole population based approaches is in part the focus on local variations in the way the problem presents, as well as a focus on “place” rather than "individuals". Indeed “place” rather than “individuals” is the common feature where concentrations of abuse are identified. By identifying locations with endemic problems, place-based strategies can be applied where they are most needed, addressing one of the key limitations of other current prevention efforts.

Place-based prevention therefore refers to prevention initiatives which target small, clearly defined locations or contexts, in contrast to larger, population based approaches. In narrowing the focus for prevention, this approach facilitates a more in-depth exploration of the problem, and nuanced tailoring of the response. This ensures that local dimensions of the problem are defined and understood, given that abuse dynamics, underlying causal mechanisms, and opportunity structures (i.e. how, when or where an offence occurs, and who offends against whom) will differ from location to location. This addresses another key limitation of other current prevention efforts.

The key steps undertaken by the Neighbourhoods Project in implementing a local place-based prevention model are outlined in Fig. 1. Note this is not a linear sequence with interactions and feedback loops inherent in the process.

Fig. 1

Six key steps to implementing a place-based prevention model for child sexual abuse

Identify locations of concern

First, locations of concern were identified. With respect to this project, clinical work brought to attention two disparate locations where youth sexual violence and abuse was a problem, and unlikely to be impacted even by the most successful tertiary offender based interventions. Subsequent systematic investigation confirmed these clinical impressions, verifying and quantifying the extent of the problem (Smallbone et al. 2013).

Other approaches could also be adopted to identify locations of concern. The analysis of crime data at a very local level may provide an alternative first step to identifying such locations of interest (e.g. Allard et al. 2012). However limits to this are acknowledged, given so much sexual abuse is not officially reported. Epidemiological research may also help to identify these concentrations, with subsequent systematic analysis providing the much needed local detail critical to a place-based response.

Understand the problem at a local level

Defining the presenting problem and analysing causal structures is key to tailoring responses in a meso or micro level response. Who does it involve? What is the primary presentation (e.g. a high concentration of intrafamilial child sexual abuse will require a different approach to prevention, than a concentration of abuse cases in a particular organisational setting)? Where does this typically occur (e.g. within homes, in organisational settings, or in public locations)? When does this typically occur (e.g. during the day, at night, weekdays, weekends)? How do potential victims and potential offenders come into contact with one another (e.g. familial relationship, peers, organisational role)? What are the conditions that precipitate these behaviours (e.g. prompts, provocations, perceived permissibility)? What are the barriers to active guardianship that might otherwise have protected children at this location from abuse (e.g. poor child protection policies in an organisation, poor supervision)? Does the physical environment at this location impact the behaviour (e.g. preventing barriers to surveillance or guardianship)? In conceptualising “place” more broadly, this would also involve an assessment of broader systemic influences (e.g. available services and resources, broader systemic problems which co-exist in this location).

Develop locally informed prevention plans

A problem-solving approach is at the core of developing locally informed prevention plans from this localised knowledge base. This process involves breaking larger problems down into smaller ones, clearly defining each problem, analysing the causes or contributing factors, critically examining current responses to the issue, and working out new strategies to deal with them, based on the analyses. This is consistent with the ‘SARA’ problem solving model (Eck and Spelman 1987). This acronym denotes four steps. ‘Scanning’ involves the collation of information on the nature and extent of the problem. ‘Analysis’ involves developing and testing hypotheses about the conditions contributing to the problem. ‘Response’ includes strategies being applied to the problem based on this analysis. Finally, ‘Assessment’ equates to an evaluation of these strategies.

Place based approaches can involve numerous interventions, informed by various prevention disciplines. Indeed a broader definition of “place” perhaps goes hand in hand with the use of a broader range of prevention strategies to address the behaviour. Whilst place-based approaches are usually associated with situational and community crime prevention initiatives, we advocate utilising a broader range of theoretically and empirically informed prevention approaches including (but not limited to) developmental prevention, offender and victim focused initiatives, as well as situational and community crime prevention. This is consistent with the 12-Point Model for preventing child sexual abuse developed by Smallbone et al. (2008), which integrates public health and broader crime prevention models, identifying four prevention targets (offenders, victims, situations and communities) across different levels of prevention (primary, secondary and tertiary).

Let us take as an example, an education program for parents, to enhance safety for children in their care. Traditional prevention approaches may involve the development of a generic parenting program that can be implemented on a large scale. The content of the program is likely to be based on recognised risk factors and empirically validated parenting strategies. However, despite the evidence base, on a local level it may completely miss the mark, in terms of the specific assistance that parents may require. Whilst limitations in parental supervision may be identified as a broad family risk factor, different mechanisms may underlie such limitations. For example in one community substance use or domestic violence may limit parental capacity to provide active supervision for children and youth, yet in another location the contributing mechanisms may instead simply reflect poor awareness of the risks in the local area. Patterns in these underlying mechanisms can therefore inform prevention responses, with different strategies required to address different mechanisms. A local focus is therefore informed by a local understanding of how the problem plays out and by local knowledge of the context and both the drivers and barriers for change. Addressing the “right” issue should increase the effectiveness of the intervention.

There is also a pragmatic element to developing locally informed prevention plans. Problems and interventions are prioritised according to likely impact and other practicalities (“do-ability”). The choice of interventions should be informed where possible on established crime prevention concepts and methods as well as evidence informed therapeutic interventions.

Both locations being targeted in the Neighbourhoods Project have recorded sexual abuse problems, however features of this behaviour vary between locations, from serious pervasive peer-to-peer sexual assaults in one community, perpetuated by sub-group norms associated with male entitlement and an acceptance of this behaviour, to chronic sexualised behaviour amongst both children and younger teens in the other. Limits to parental and community guardianship have also been noted in both communities, though the factors underlying this differ quite significantly. Similarly different resources are available at each site. Because of the different nature of the two communities, different prevention approaches and activities have therefore been developed. Thus in one community, bystander interventions are indicated along with parenting education focused on the specific risks faced by adolescents in that location, whilst in the other community prevention activities are more broadly focused on mobilising community engagement with this issue, and building safety focused parenting skills amongst families of much younger children. Whilst higher abuse concentrations triggered the need for attention to prevention in these locations, it is the features of the abuse in each context that informs the prevention approach to be undertaken.

Notwithstanding the need for strategies to be tailored to the situation, global knowledge about child sexual abuse may also inform the development of specific activities within these localised prevention plans. This might include adapting evidence-based practice developed in a different context, identifying evidence-based programs that have addressed similar mechanisms and manifestations to those observed locally, or even learning from what has ‘not worked’ in other places.

Establish and consult with local advisory groups and partners

Developing local advisory groups and partnerships with place managers and other local stakeholders has been core to the Neighbourhoods Project, with these advisors and stakeholder partners critical to implementing prevention plans (and to the initial development of these plans). Advisory groups help to ensure the ecological validity of planned strategies and that implementation reflects local community context, strengths and interests. They help shape specific culturally sensitive approaches and measures. They also help to ascertain and secure community engagement and acceptance. Place managers and other local stakeholders can provide both important insight and practical assistance to the implementation of prevention activities. Higher level government partnerships are also imperative, given the importance of policy and resourcing in an overall response. Government level partnerships also aid important coordination among various agencies and interventions.

Implement and monitor prevention activities

In accordance with the locally tailored prevention plans, key prevention activities are subsequently implemented. These locally tailored plans provide the framework and direction for prevention activities but remain flexible and are reviewed regularly so they can be adjusted as necessary to ensure their effectiveness and sensitivity to changing community contexts, community responses, practice reflections and initial evaluation data, as well as pragmatic issues.

Within the Neighbourhoods Project key stakeholders have played an important implementation role, often delivering key prevention activities in partnership with project staff. The involvement of other stakeholders also serves to enhance the knowledge and capacity of local service agencies to respond to sexual abuse issues, in turn contributing to the long-term sustainability of these prevention activities.

Evaluate outcomes and disseminate new knowledge

Finally, evaluating outcomes and disseminating new knowledge are critical to the transfer of this knowledge to other locations and the scaling up of a place-based response. Narrowing down the problem to a local context also provides a better opportunity for evaluation efforts to assess what works best for whom, in what conditions, and how. This is an iterative process, with a cycle of review and monitoring inbuilt to facilitate improvements in both program design and evaluation clarity (Pawson and Tilley 1997; Tilley et al. 2014).

Whilst the benefits of this local place-based approach have been outlined, limitations must also be acknowledged. Most importantly is the smaller sphere of influence. Indeed it is reasonable to question the feasibility of such a localised approach to such a global concern. Looking at global lessons from this local approach, as well as strategies to scale-up this approach for global impact go some way to addressing these limitations. Both will be addressed in the next section.

‘Think Global’: global lessons for sexual abuse prevention

The global–local dimensions of the prevention of child sexual abuse are illustrated in Fig. 2. Whilst the local place-based approach advocated in this paper sits towards the micro and meso ends of this continuum, action taken at a local level is also informed by global (macro) knowledge. Global research may provide a critical first step to identifying places with higher prevalence rates. More importantly, evidence regarding preventive interventions developed in other ‘places’ may be applicable at a new site, or may be adapted to take into account local place based considerations.

Fig. 2

Situating place-based prevention on the global-local continuum

It is also true that global lessons may be learned from local placed based prevention approaches. Such lessons might include: (a) that a more detailed understanding of problems improves the targeting of interventions; (b) that no single strategy is likely to be effective in all circumstances given variability in the manifestation of abuse in different contexts; and (c) that reducing situational risks, including reducing opportunities, will be useful for preventive purposes.

Scaling-up prevention efforts to address child sexual abuse on an international level is also important given the global nature of this problem, and reflects another way in which local approaches can have a global influence. So how can you scale-up such a localised nuanced approach to prevention? Is this even possible?

In other fields, scaling up prevention activities has typically involved taking promising interventions to a larger population. This is consistent with a standard develop, test, and expand model. However scaling up a place-based prevention approach to address child sexual abuse on a global level requires a somewhat different approach: (a) the identification of locations of concentrated endemic sexual abuse, (b) crime analysis to identify trends and patterns in problem manifestation at the local level, (c) matching prevention strategies to new locations (this may include the development of new prevention strategies or the adoption and modification of existing approaches), and (d) building an evidence base with respect to this approach.

Transfer and replication of proven prevention activities is obviously one goal in scaling up a prevention approach. However even this is more complex than it first sounds. What aspects of the new context/location are similar to the context in which the intervention was tested? Are there reasons to believe that a proven activity will be well suited and effective in a new location? Are there potential unintended negative consequences in the new location that weren’t relevant at the site in which the prevention activity was originally evaluated? Does the new local context dictate the need for adaptations to the program delivery? A thorough understanding of the mechanisms underlying the prevention activity, may aid more successful replication. This is the reason a realist evaluation framework has been adopted in the Neighbourhoods Project (Tilley et al. 2014).

Another key aspect to scaling up place-based prevention is an evidence base supporting the effectiveness of the approach. Whilst there is clear evidence to support the effectiveness of placed-based approaches to crime prevention for other crime types (e.g. Eck and Guerette 2012), the evidence for the application of this approach to child sexual abuse is still in its infancy. Despite this, there are sound theoretical, economic and social reasons for supporting this approach. The extent to which our own place-based prevention work is effective and transferable is still to be determined, but we hope it will actively contribute to this emerging field.

Summary

There are clear benefits to a global response to child sexual abuse. Given the extent of the problem, it makes perfect sense to optimise the sphere of influence of any intervention that might be funded. The challenges inherent in this global response relate to the need to target both resources and interventions to areas in which they are most needed, and to ensure that interventions target the precise problem. In light of these challenges, this paper advocates for a local place-based approach to sexual abuse prevention.

A place based approach focuses efforts on places and contexts with the most serious problems. Such a focused approach enables resources to be concentrated where they are most needed, getting the largest impact for the investment. A place-based approach also relies on a detailed local analysis of the problem at the target location and the adoption of informed pragmatic strategies to make these places safer. Changing behaviour by focusing on changing places (environments) rather than individuals offers a non-stigmatising, do-able approach to prevention.

This is a “bottom up” approach, focused on understanding and working with the problem on a very local level, and scaling up to promote a more global sphere of influence by learning from this approach, and identifying and documenting implications for either policy or practice transfer to other locations. This therefore sits in significant contrast to “top down” whole population approaches imposed on communities, regardless of “fit”.