# Changing the Paradigm: CSA as a Preventable Public Health Problem

> **NIH NIH R24** · JOHNS HOPKINS UNIVERSITY · 2021 · $505,782

## Abstract

Child sexual abuse (CSA) ranks 12th in preventable risk factors that contribute to the
U.S. burden of disease, afflicts up to 25% of U.S. girls and 5% of boys, and exacts high
psychological, social, and monetary costs from individuals and society. For over 25
years, experts have called for a public health approach to prevention of CSA to no avail.
Public health prevention strategies have been successfully applied to virtually all types of
child maltreatment with the single exception of CSA, which the public continues to view
as unpreventable. Consequently, policymakers continue to address CSA almost
exclusively with after-the-fact criminal justice policies that do little if anything to prevent
CSA from occurring in the first place. Consistent with PAR-14-324, the proposed project
brings together a multidisciplinary team that is uniquely poised to shift public opinion so
that it aligns with experts' understanding of CSA as a preventable public health problem.
The team includes co-investigators and consultants with extensive expertise in CSA
prevention, policy, and practice as well as experts in public health-focused
communications research. This project aims to create new communication strategies
that effectively overcome gaps to align public with expert understanding of CSA (Aim 1),
to rigorously evaluate those new communication strategies (Aim 2), and to broadly
disseminate effective strategies to the CSA experts and practitioners who interact with
the public and to journalist who report on CSA (Aim 3). To accomplish Aim 1 we will use
qualitative data techniques to identify the expert consensus and public (and practitioner)
opinions about CSA, and comparative analyses to characterize gaps between these
understandings; these findings will inform the development of new CSA messaging
strategies. To accomplish Aim 2 we will evaluate the efficacy of initial communication
reframes via interviews, then conduct a nationally representative survey to test how the
reframes influence public opinion, then conduct follow-up tests to evaluate the durability
of reframes across retellings. To accomplish Aim 3 we will created online workshops,
webinar and in-person trainings, a communications toolkit, and recommendations for
journalists to broadly disseminate study findings and effective communication strategies.
This project will be the first to create a systematic approach for effectively translating
knowledge about CSA prevention and has unique potential to help achieve the critical
goal of including CSA within the nation's violence prevention efforts.

## Key facts

- **NIH application ID:** 10242895
- **Project number:** 5R24HD089955-04
- **Recipient organization:** JOHNS HOPKINS UNIVERSITY
- **Principal Investigator:** Elizabeth J Letourneau
- **Activity code:** R24 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $505,782
- **Award type:** 5
- **Project period:** 2018-09-01 → 2023-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10242895

## Citation

> US National Institutes of Health, RePORTER application 10242895, Changing the Paradigm: CSA as a Preventable Public Health Problem (5R24HD089955-04). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10242895. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*