Child sexual abuse, including sexual exploitation, is a global issue, affecting 8% to 31% of girls and 3% to 17% of boys worldwide. This systematic review aims to synthesize economic evidence on the cost-effectiveness of community interventions to prevent child sexual abuse/exploitation to inform decision-making. A systematic search was conducted on eight databases for studies published until April 2023. Gray literature was searched using Google. The inclusion criteria were economic evaluation of interventions targeted at children, perpetrators/offenders, or professionals addressing child sexual abuse/exploitation. There was no limitation by country, but an English language abstract was required for non-English articles. Studies without a specific focus on child sexual abuse/exploitation, such as physical, emotional, and domestic violence-related abuse, were excluded. All costs were adjusted to US$ 2023. Reporting quality assessment was conducted using the Consolidated Health Economic Evaluation Reporting Standards 2022 checklist. Of 5,180 screened articles, 17 were included in the final synthesis, with most from the United States and focused on tertiary prevention delivered to offenders. While the intervention components varied across studies, all demonstrated promising and cost-effective results. The findings highlight a small but growing body of economic evidence for child sexual abuse/exploitation interventions. The existing economic evaluation evidence is dominated by tertiary prevention, which focuses on offenders and child victims and highlights the need for more research and action on primary and secondary preventative interventions for general and at-risk populations.
Intimate partner violence (IPV) is a global health problem enacted with varying degrees of severity, leading to mental and physical damage. Despite the acknowledgment that perpetration can be enacted in a subtle or covert way, there is a paucity of literature defining and describing such subtle abuse. Consequently, understanding about the behaviors and impacts of subtle abuse is limited, and there is a potential inability by therapists to recognize it in their clients. This scoping review sought to identify and synthesize the literature around subtle or covert abuse (SCA) in intimate adult relationships to clarify the concept, with the aim to aid professional recognition. PsychINFO (EBSCO), MEDLINE Complete (EBSCO), CINAHL (EBSCO), PsychArticles (EBSCO), Scopus, ProQuest Dissertations and Theses Global, and EThOS were searched using relevant search terms. In total, 19 studies met the inclusion criteria by containing a description or definition of abuse based on primary research with adults in intimate partner relationships. Findings were synthesized using descriptive content analysis under four headings: (a) Descriptions and groupings of SCA behaviors, (b) The impact of SCA on victims, (c) Underlying theories of SCA, and (d) Recognition by professionals. This review suggests that SCA may be the most damaging of all abuses.
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