INTRODUCTION:

“So kyo Manda Akhiye Jit Jamme Rajaan”

Shri Guru Nanak Dev Ji

Adolescence from Latin: adolescence meaning "to grow up" is a transitional stage of physical and mental human development generally occurring between puberty and legal adulthood (age of majority). According to Erik Erikson's stages of human development, adolescent is a person between the ages of 13 - 19 year.¹

It is often stated that girls are the world’s most valuable resources and assets, but their rights throughout the world are largely ignored often resulting into tragic outcomes. This is because of the vulnerability of girls. From infancy to adolescence, girls are dependent on parents for safety and ongoing nurturing and this puts them at risk of maltreatment in many forms.²

Adolescence age is a critical time to inspire and empower girls in the pivotal years. But when conflicts or crises displace adolescent girls from their homes, families and schools, they face heightened risks of exploitation, sexual and gender-based violence and early pregnancy. Their education is often disrupted, and many are forced into early marriage. Yet with the right skills and resources, adolescent girls can transform themselves, their families, their communities and their societies.³

Sexual abuse also referred to as molestation, is the forcing of undesired sexual behavior by one person upon another. When that force is immediate, of short duration, or infrequent, it is called sexual assault.

The offender is referred to as sexual abuser or molester. When the victim is younger than the age of consent, it is referred to as child sexual abuse.⁴

The global prevalence of sexual abuse has been estimated at 19.7% for females and 7.9% for males, according to a 2009 study published in Clinical Psychology Review that examined 65 studies from 22 countries. Using the available data, the highest prevalence rate of sexual abuse geographically was found in Africa (34.4%), primarily because of high rates in South Africa; Europe showed the lowest prevalence rate (9.2%); America and Asia had prevalence rates between 10.1% and 23.9% respectively. Most sexual abuse offenders are known their victims; approximately 30% are relatives of the girl, most often brothers, fathers, uncles or cousins; around 60% are other acquaintances such as 'friends' of the family, babysitters, or neighbors; strangers are the offenders in approximately 10% of sexual abuse cases.⁵

In the world, India has the largest number of children 375 million, covering 40% of its population, out of which 69% of Indian girls are victims of physical, emotional and sexual abuse. New Delhi, the nation’s capital, has an abuse rate over 83%. More than 70% of cases are unreported or unshared even with family members Global Prevalence of Sexual Abuse study conducted by The Centers for Disease Control and the U.S. 19.7% of women globally experienced sexual abuse prior to the age of 18. The highest prevalence rate of sexual abuse geographically was found in Africa (34.4 %) Europe showed the lowest prevalence rate (9.2%). America and Asia had prevalence rates between 10.1% and 23.9%.⁶

Adolescent girl is sexually abused when they are forced or persuaded to take part in sexual activities. This doesn't have to be physical contact, and it can happen online. Sometimes the child won't understand that what's happening to them is abuse. They may not even understand that it's wrong. Sexual abuse or violence against adolescents is defined as a situation in which children or adolescents are used for the sexual pleasure of an adult or older adolescent which ranges from petting, fondling of genitalia, breasts or anus, sexual exploitation, voyeurism, pornography, exhibitionism, pressuring a child to engage in sexual activities, indecent exposure of the genitals, nipples etc. with intent to gratify their own sexual desires or to intimidate or groom the child. Sexual abuse is an especially complicated form of abuse because of its layers of guilt and shame.⁷

Sexual abuse has gained public attention in the past few decades and has become one of the most high-profile crimes. Since the 1970s the sexual abuse of girls and child molestation has increasingly been recognized as deeply damaging to children and thus unacceptable for society as a whole. While sexual abuse has been present throughout history, it has also become the object of significant public attention in recent times.⁸

Even though the economic, political and social conditions in India are changing swiftly, still for women the circumstances are rare to be able to feel safe within their bodies with the startling increase in the number of rape cases in recent years. This is of concern to everybody including the government hence a solution is sought in many different forms. Departments such as Justice, Social Welfare, and Health are taking steps to fight this crime.⁹

Study conducted by ministry of women and child development government of India in 2007 regarding Sexual Abuse find out that 53.22% girls reported having faced one or more forms of sexual abuse. Andhra Pradesh, Assam, Bihar and Delhi reported the highest percentage of sexual abuse among both boys and girls. 21.90% girls respondents reported facing severe forms of sexual abuse and 50.76% other forms of sexual abuse. Out of the child respondents, 5.69% reported being sexually assaulted. Children on street, children at work and children in institutional care reported the highest incidence of sexual assault. 50% abuses are persons known to the girl or in a position of trust and responsibility. Most girls did not report the matter to anyone.¹⁰

India has a history of many incidents of violence against women which was well publicized but it was the recent 2012 Delhi gang-rape case that galvanized a large scale of public response that pressurizes the government to take positive measures India’s Economy Outlook in January 2013 The police system in India plays a significant role in protecting the women and preventing gender based violence. However, there have also been reports in India on violation and discrimination by authorities tasked with protecting victim of sexual crime blocking investigation of the rape or dissuading the victim from registering a case based on the gender, class or caste. In India, both the state authorities and the society play a significant role in relation to women’s situation in the populous nation. ¹¹

The prevalence of Child Sexual Abuse in girls is consistently higher than in boys. Prevalence rates range from 5.8% to 33.8% in 1996 adolescent girls and 6% in 1997 to 15.1% in 2000 boys. Differences in prevalence rates may be attributed to different operational definitions of Child Sexual Abuse, as well as differences in occurrence of Child Sexual Abuse among varied populations across geographical regions. Gender specific factors involved in data collection and male definitions of abuse also affect prevalence rates.¹²

Under the law, sexual abuse is an umbrella term describing criminal and civil offenses in which an adult engages in sexual activity with a minor or exploits a minor for the purpose of sexual gratification. The American Psychiatric Association states that "children cannot consent to sexual activity with adults", and condemns any such action by an adult: "An adult who engages in sexual activity with a child is performing a criminal and immoral act which never can be considered normal or socially acceptable behavior because sexual abuse often occurs alongside other possibly confounding variables, such as poor family environment and physical abuse. Some scholars argue it is important to control for those variables in studies which measure the effects of sexual abuse.¹³

Adolescent girls sexual abuse can have immediate and long-term effects that span across an individual’s physical, cognitive, interpersonal, and emotional functioning. Thus, it is important for parents and educators to familiarize themselves with the signs and symptoms of sexual abuse know what to do if faced with a child who has been molested, and take appropriate steps toward the prevention of sexual abuse. Abused girls may experience delays in physical and psychosocial development, resulting in psychopathology and impaired neuropsychological functions including executive function, attention, processing speed, language, memory and social skills. For some girls, sexual harassment reduced their desire to continue their schooling, for others it increased their fear of being withdrawn if parents come to hear of any incident. ¹⁴

The experiences of abuse can therefore have a negative impact on the positive resolution of the crisis of this developmental stage. Erikson points out that the developmental needs of preadolescents and adolescents focus on individual competence, socialization, and identity. The age at which a child experiences abuse has developmental consequences affecting the child’s ability to complete developmental milestones, for example, the forming of an identity during adolescence.¹⁵

NEED FOR THE STUDY:

During adolescence, individuals face a time of uncertainty and questioning of who they are and who they are becoming. Erik Erickson’s psychosocial theory defines this stage as identity versus role confusion. In a normally developing teen, the questions about where they fit into society can be quite overwhelming. When negative life experiences such as child sexual abuse become part of an adolescent’s history, increased stress adds to the complexity of one’s life trajectory during this stage of development. Since adolescents with Child Sexual Abuse histories vary in the symptoms and squeal exhibited, it is difficult to create one symptom profile that applies to all adolescents. Understanding the multifarious nature of Child Sexual Abuse allows for the selection of appropriate assessment tools and treatment plans tailored to the individual adolescent.¹⁶

According to the latest census of India conducted in 2011 shows that India is the second most famous country in the world with total population of over 1.21 billion. Adolescents (13-19 years) form a large section of population – about 22.5 percent, that is, about 225 million. Adolescents aged between 10-19 years account for more than one-fifth of the world’s population. Characterized by distinct physical and social changes, the separate health, education, economic and employment needs of adolescents cannot be ignored. Adolescents are also entitled to enjoy all basic human rights – economic, social, political and cultural. ¹⁷

Many children are prone to be sexually abused. It is known that such children grow up and initiate sexual activity at an early age. Since early age of initiation of sexual activity puts adolescents at risk of pregnancy and a myriad of social and health consequences, it is essential that they need to be educated on these aspects. In a study from Kolkata of adolescent girls found that many of them had poor knowledge on matters related to sexuality, sexually transmitted diseases. They also suggested that regular surveys on sexual attitudes, knowledge, and behaviors are essential in understanding the epidemic of sexually transmitted diseases.¹⁸

Sexual abuse is the biggest kept secret in India due to societal denial, ignorance, and silence owing to the discomfort generated out of acknowledgement. It is a universal problem that occurs across gender, caste, religious, ethnic, occupational and socio-economic groups, threatening a girl's right to protection. While great awareness has been raised about sexual violence against women in India, much less is known about the problem of sexual abuse of adolescent girls.¹⁹

Adolescence is the period from the onset of puberty in preteen years until adulthood. It is a period of intense development with profound physical changes as well as transition between childhood and adulthood. Adolescents are less able than adults to manage their emotions, use good judgment, and engage in thoughtful decision-making. These developmental factors place adolescents in danger for participating in risky behavior. Early marriage, early pregnancy being a cultural norm, poor access to reproductive and sexual health services and information, increasing trend in violence and sexual abuse pose a tremendous challenge for addressing their development.

India has the dubious distinction of having the world's largest number of sexually abused girls; with a girl child below 16 years raped every 155th minute, a child below 10 every 13th hour and one in every 10 children sexually abused at any point of time. The prevalence of sexual abuse in upper and middle class was found to be proportionately higher than in lower or in lower middle class, it found in both joint and nuclear families. Majority of the abusers were people known to the child and strangers were a minority. Sexual harassment in public places and exhibitionism was higher by strangers. Sexual abuse of girls was very often a pre-planned insidious abuse of a relationship by an abuser over the girl.²¹

The World health organization estimates that 150 million girls under 18 have experienced forced sexual intercourse or other forms of sexual violence involving physical contact, though this is certainly an underestimate. Much of this sexual violence is inflicted by family members or other people residing in or visiting a child's family home- people normally trusted by children and often responsible for their care.²²

Due to sexual abuse, most of the children used to go in a wrong way. So it affects the health of the new generations. Child sexual abuses are dark realities in Indian society like in any other nation. 53 % of our adolescent girls are sexually abused, according to a statistic from a survey done by the Government of India. Numbers of cases of sexual abuse in the home are hard to attain because most of these crimes go unreported. Societal abuses that are a result of poverty such as malnutrition, lack of education, poor health, neglect are recognized in various forms by the Indian legal system²³

A study conducted by united nation children’s fund find out that 50% of the girls said that they had been abused when less than 12 years of age, 35% had been abused between the ages of 12-16 years of age. The average sex offender has 76 victims. There are at least 18 million children living on the streets in. One million children are trafficked into prostitution, in Asia every year.²⁴

Sexual violence against girls is a global human rights violation of vast proportions with severe health and social consequences. Sexual violence has serious and long-lasting consequences for the physical and mental health of individuals and their social an occupational functioning, as well as for their families and communities, and can impede social and economic development.²⁵

There are a number of factors that make children, in particular girls, vulnerable to sexual violence. A key factor is social tolerance of sexual violence against girls at different levels of society and abuse/exploitation is perceived as something normal and outside the control of communities. The factor include girl who has experienced sexual violence is often blamed for the violence and poverty, social disparities; limited educational and employment opportunities for girls; family disintegration; and weak legal and policy frameworks and enforcement.²⁶

The consequences of sexual abuse are both short term and long term. Short term include impact on core aspects of emotional, behavioral, and physical health and social development throughout life. Long-term effects include: Aggression, conduct disorder, delinquency, anti-social behavior, substance abuse, anxiety, depression and suicide. Sexual transmitted infections.²⁷

Three siblings were subjected to sexual abuse for eight months by their van driver in New Delhi in September 2010. Three minor girls were raped and murdered in Mumbai in February 2011. Most people read about these incidents and move on to the next news item; believing that 'such incidents' happen to other children. The incidents listed above are not random occurrences, but represent the shocking reality of our country. Most of the cases of child sexual abuse by close relatives the accused has taken advantage of a helpless and defense less of a girl who did not even understand the gravity of the offence.²⁸

Based on Review of Literature and the Personal Experience of Investigator during community posting found many cases of sexual abuse among adolescent girls. Lack of awareness was found to be one of the causes of sexual abuse. From the above information and thinking about present scenario of sexual abuse in society particular among adolescent girls and their consequences on girls the researcher felt that there is a need to assess their awareness regarding sexual abuse. Sexual abuse has a profound impact on core aspects of emotional, behavioral, and physical health and social development throughout life. So it is essential for girls to be aware regarding sexual abuse during their adolescent age. So they can prepare themselves to cope with this problem in future and present time.

REVIEW OF LITERATURE:

It refers to an extensive, exhaustive and systemic examination of publications relevant to research project. ²⁹

I. Review related to prevalence of sexual abuse.

II. Review related to awareness regarding sexual abuse.

III. Review related to effectiveness of structured teaching program regarding sexual abuse.

i. Review related to prevalence of sexual abuse.

Evelin, M. Euser et al. (2013)³⁰ conducted a Meta analysis study on current prevalence rate of sexual abuse among girls. They collected a data since 1992 and reviewed among adolescent girls age between 13 to 19.These six studies suggest that overall prevalence rate of sexual abuse is 7.5% -11.7%. Prevalence rate among girls are 10.7% -17.4% and for boys are 3.8% - 4.6%. An estimated 7.9% of men and 19.7% of women globally experienced sexual abuse prior to the age of 18.U.S. rates were 7.5% for males and 25.3% for females. The highest prevalence rate of child sexual abuse geographically was found in Africa (34.4 %). Europe showed the lowest prevalence rate (9.2%). America and Asia had prevalence rates between 10.1% and 23.9%.

Arun B Nair, Devika J (2013)³¹ had done a study in schools of Kerala on sexual abuse among a group of adolescent girls attending life skills education workshops in Kerala. The samples of the study were 1000 participants, 382 (38.2%) reported that they were abused at some point of their life.26.02% reported about contact abuse and 11.68% reported about non contact abuse.73% girls known their abusers and 37.5% reported that perpetrator was a family member or close relative. 26.6% girls report abuse to their parents or teachers.

David Finkelhor (2010)³² done descriptive study on child maltreatment in united states department of health and human services found that 1 out of 5 girls is a victim of sexual abuse. Study shows that 20% adult female recall sexual abuse incident. 28% had been sexually abused over the course of their lifetime ages between 14 to 17. Girls are more vulnerable between the ages of 7 and 13. During a one year period in U.S 16% of youth ages 14 to 17 had been sexually victimized.

Saranavan Sheela (2009)³³conducted study on prevalence of sexual abuse among girls in Bangalore and Karnataka among 348 girls revealed that 83% of the respondents had experienced some form of child sexual abuse, about 60% of the girls had experienced some form of abuse till the age of 15 years. Out of these 60% girls 40% were suffered in public places and 20% had suffered abuse by close relatives.

Marian J.bakerman Kranburg et al. (2009)³⁴ performed a meta–analysis study on 65 research studies across 22 countries to analyze the overall international figure for sexual abuse. Study findings shows that highest prevalence rate of sexual abuse geographically was found in Africa 34.4%. Europe shows the lowest 9.2%. America and Asia had prevalence rate between 10.1% to 23 %.

Marijie Stolen Burg (2009)³⁵ performed a descriptive study on prevalence of child hood sexual abuse on 9, 911, 788 participants out of which 38920 are independent samples. The result shows that overall prevalence rate was 47%. 20% had experienced severe type of sexual abuse and 15% had experienced sexual abuse in public places.18% had self report the sexual abuse to police or parents.

Sobti P, Biswas G et al. (2008)³⁶ conducted study to determine the prevalence of sexual abuse among adolescent medical and nursing students at Punjab, India. 532 subjects were taken age 17-26 years. The overall prevalence rate of any form of sexual abuse was 32.1%.A severe form of sexual abuse was reported by 30 subjects. The most common type of abuse reported was in the form of showing pornographic material among male students 23% and touching of breasts 33.9% among females. The minimum age of victims at the time of the first incident was >16 years in 48.5 Forty-one subjects 23% currently experienced abuse memories in the form of unwanted scenes flashing in dreams, difficulty in maintaining relationships, feeling of guilt, fear or nausea when touched, and disturbing sexual thoughts, alone or in combination.

Tulir (2006)³⁷ conducted an exploratory study among 2211 school going children in Chennai. Study indicated that overall prevalence rate of sexual abuse is 42%.Girls of all socio economic class are equally vulnerable. Out of these 39% girls are suffered by known people. 40% girls experienced sexual abuse before they complete their 18.the most vulnerable age between 13-19.

Paulo Sergio (2006)³⁸ conducted study on Sexual harassment of girls in school occurs around the world. A study results found that 83% of girls in grades 8 through 11 (aged around 12 to 16) in public schools experienced some form of sexual harassment. 50% of the girls said they had been touched in a sexual manner “without permission, by either their teachers or fellow schoolboys”. In Latin America, sexual harassment in schools has been found to be widespread in the Dominican Republic, Honduras, Guatemala, Mexico, Nicaragua, and Panama, among other countries.

Jaswal S. (2005)³⁹done exploratory study to find out the prevalent patterns of cases of adolescent sexual abuse reporting to different health facilities. Checklists were distributed in the concerned OPDs at the health facilities for strategic screening of cases. A total number of four male children and adolescents in the age group 6-16 years and 16 female children and adolescents in the age group of 13 months to 15 years were identified as having been sexually abused or reporting with sexual abuse during the period of the study.

ii. Reviews related to awareness regarding sexual abuse.

R. Umadevi, R. Rama et al. (2013)⁴⁰ conducted a study on Adolescent Health Present Status and Its Related Programmes in India. Study shows that 2.7% boys and 8% girls reported sexual debut before the age of 15 and most of the sexual activity happens in the context of marriage, this leads to early pregnancy due to social pressure. Even though contraceptive awareness is 94% among girls aged 15–19, only 23% of the married and 18% of the sexually active unmarried girls in this group, used a contraceptive once at least. All the three shows almost equal prevalence (59.1%, 59.8% and 58.2%) of pregnant and mothered adolescent and there is a steady increase in percentage of first pregnancy among adolescents (11.7%, 12.4% and 14.4%). Early marriage and low contraceptive usage are the reasons behind this trend.

R. Shashikumar, R C Das (2012)⁴¹conducted a cross sectional study on factors associated with adolescent sexuality. Study conducted in two co-educational schools of Goa. Total study sample was 642. It comprised 357 (61.93%) girls and 229 (39.07%) boys. 30.08% girls had reported having sexual experience. Average age of first sexual contact for girl was 14.09 years. 41.09% girls and 53.04% boys have the knowledge regarding sex education.

Jeffrey K. Clark, Rebbeca (2009)⁴² had done preliminary study on delivery of sexuality related education to adolescent girls. Pre and post test results were collected from 21 physicians. As part of the pre- and post-tests, the physicians responded to items that measured their opinions concerning patient education, level of sex comfort, sexual attitudes, and knowledge. To analyze the scores for each of the measures, a MANOVA was used. There was a statistically significant difference found between the pre-test and post-test regarding the percent of time physicians plan to spend educating their patients about sexual health concerns. At the pre-test, physicians indicated a mean percent of time of 4.2% and at the post-test the mean time was 9.7%.

K. Srivatava, P.S. Bhatt et al (2008)⁴³done descriptive study for understanding a sexuality among Indian urban school adolescent. Students were selected from class 8^th to 12^th. Self-reporting questionnaires were administered matters related to sexuality. Requisite ethical clearances were taken as also the consent of the parents and students before administration of the questionnaire. The authors clarified doubts to adolescents. The incidence of having sexual contact was 30.08% for boys and 17.18% for girls. 6.31% boys and 1.31% girls reported having had experienced sexual intercourse. Friends constituted the main sexual partners for both boys and girls. Sexual abuse had been reported by both girls and boys.

Jayant Ramchandra Kalkute (2007)⁴⁴ performed study to assess the knowledge about sexual health among female students of schools of an urban area. All 245 female students of 8^th to 11^th standard of all three educational streams of two schools were included in the study. Most of the students in age group of 15-16 years (56%). Science students had “adequate” knowledge compared to arts and commerce students (P=0.004). Students whose parents 34% were unskilled and semiskilled by occupation had “inadequate” knowledge about sexual health when compared with students whose parents were skilled by occupation (P<0.05). Education of parents 40% had positive effect on the knowledge about sexual health of students (P=0.062). In posttest, the knowledge about sexual health of students was found to have increased significantly when compared to pretest. The mean posttest score was 12.61 which was significantly higher than the mean pretest score of 6.34 (SD 3.23) (P<0.001). Students from nuclear families had “adequate” knowledge about sexual health when compared to students from joint families.

Dzimadzi R. (2009)⁴⁵ had undertaken a study on knowledge of sexual abuse among female students in Malawi. The sample size was 219 selected through systematic random sampling. The overall prevalence rate of sexual abuse was 41%. Only 55.6% reported their sexual victimization to others Sexual abuse experiences were reported by 55.6% (n=50) while 44.4% (n=40) remained silent about their experiences. 27.8%, told their friends, 16.7% told their mothers only, 7.8% told family members including sisters, aunts and grandparents. Respondents who did not report sexual abuse provided several reasons. These are the victims’ fear of consequences and lack of knowledge that they were being abused. Respondents indicated they would like to know more about the prevention and control of sexual abuse.

Das Palas et al. (2010)⁴⁶ had done study on improvement in the knowledge and attitude on health among adolescent girl students of Kolkata. 20% percent of the students answered all the questions about reproductive health correctly before the course and 70–100% of them at the end of four months. 95% percent of the sample thought that the school should provide information about sexuality and 74% of the students suggested that it should be introduced in the lower grades of secondary schools. 87% percent of the subjects knew that the condom also offered protection against sexually abuse.

Dube S.R et al. (2005)⁴⁷conduced studies on sexual abuse in Chinese society have shown that the problem is not uncommon, It is very important to understand and improve public awareness of Sexual abuse prevention. All of the 385 respondents were pupils' parents—115 fathers (29.9%) and 270 mothers (70.1%). More than 80% of the respondents knew that the problems of sexual abuse exist around the world (83.9%) and that a person who has sexually abused a child will likely repeat the offense (83.6%). Nearly 80% of respondents knew that the sexually abused child was not to blame (79.0%) and that boys can also be sexually abused (78.7%). More than 70% of respondents believed that men sexually abuse girls in most cases (75.7%).

iii. Review related to effectiveness of structured teaching program related sexual abuse.

B.Muneeswari (2013)⁴⁸ performed a study to assess the effectiveness of planned health teaching programme using child-to –child approach on knowledge of selected first aid measures among school children in selected schools at Dharapuram in Tamil Nadu, India. Quasi experimental design was adopted. The present study was conducted at Dharapuram in Erode district, Tamil Nadu India. The samples were 200 selected by simple random sampling method. The results showed that (‘Z’ value =1.96) mean pre and post-tests value were 10.26 and 21.55. The study concluded that about 68.5percent of students gained adequate knowledge after teaching programme using child-to-child approach.

Patil, B. Sushma (2013)⁴⁹ conducted study on effectiveness of structured teaching program on knowledge regarding child abuse and its prevention among primary teachers in Karnataka 60 samples were selected by convenient sampling technique. The study results shows that mean post test knowledge score is 32.51% is higher than pre test knowledge score with median 33, mode 33.98 and range 9. This shows that structured teaching is effective.

Kaur Daljit, Shukla Bhavnesh (2011)⁵⁰ did a quasi-experimental study to assess the effectiveness of structured teaching programme on knowledge regarding prevention of STDs among women in the selected rural areas, Hoshiarpur, Punjab – India Total sample consists of 60 subjects – 30 experimental and 30 in control group. Purposive sampling was done for selection of samples. To prevent contamination, experimental group was taken from village Sataur and control group from the village Baghpur, Hoshiarpur. The difference between pre and post test knowledge score of control group was statistically non significant at p<0.05 level. In experiment group, the mean pre test knowledge score was 11.53, mean percentage was 57.65 and mean post test knowledge score was 17.03, mean percentage was 85.15. The difference between mean pre and post test knowledge score of experimental group was statistically significant at p<0.001 level. Thus structured teaching is an effective tool in improving the knowledge of women regarding prevention of STDs among women.

Baker. A, Danunc (2009)⁵¹ conducted study related Effectiveness of Psycho-Educational School-Based Child Sexual Abuse Prevention Training Program on Turkish Students, . The subjects consisted of 36 students. During this period, the control group did not receive any treatment. ANCOVA analysis showed the students who attended the sexual abuse prevention program scored significantly higher than the control group (p.05). The effect size of the study was calculated by Cohen's d, and it was.80 which is satisfactory. As a result, the prevention child sexual abuse program was effective students and this effect was lasting eight weeks later.

Vikas Choudhary, Parul Saini (2010)⁵² done a study to assess the Effectiveness of Structural Teaching Programme on Knowledge Regarding the Contraceptive Method among the Eligible Couples Data was collected by Administering structured knowledge questionnaire prior and after the administration of structural teaching programme. The study Findings revealed that knowledge gained through STP was good, as it was evident with pre-test and post-test mean knowledge score of eligible couples in control and experimental group, the pre-test and post-test mean knowledge score of control group (25.42, 24.02) was not statistically significant, whereas the pre-test and post-test mean knowledge score of experimental group (23.18, 36.54) was highly significant at p<0.001concluded that there is significant difference in the understanding of eligible couples regarding contraceptive method by using a structured teaching programme.

David J. Miller(2009)⁵³ did study to assess the awareness of previous campaign in both rural and urban Kenya. A total number of 1195 respondents were interviewed; previous study was conducted in 1999.The findings show levels of awareness and knowledge about sexual abuse increased in adults. Thus, 96% of adults and 80% of children interviewed had heard about child abuse and neglect. A large number of the respondents were able to identify' forms of child abuse without any guidance as it was in the previous study i.e. reading a list of pre coded concepts. The respondents were also able to mention other forms of child' abuse such as verbal abuse, early marriage, and female circumcision, and abortion and sex discrimination. These were some of the concepts used in the campaign. This is a clear demonstration that the campaign had yielded some results.

STATEMENT OF PROBLEM:

A pre - experimental study to assess the effectiveness of structured teaching programme on knowledge regarding awareness about sexual abuse among the adolescents studying in selected school of district Gurdaspur, Punjab.”

OBJECTIVES:

1. To assess the pre-test knowledge regarding awareness about sexual abuse among adolescents studying in selected school.

2. To assess the post-test knowledge regarding awareness about sexual abuse among adolescents studying in selected school.

3. To compare the pre-test post-test knowledge regarding awareness about sexual abuse among adolescents studying in selected school.

4. To determine the association of pre-test and post-test knowledge score regarding awareness about sexual abuse among adolescents studying in selected school with selected socio-demographic variables.

MATERIALS AND METHODS:

The Pre- Experimental, quantitative approach was used to assess the effectiveness of structured teaching programme regarding awareness about sexual abuse among adolescents studying in selected school. The aim of the study was to assess the effectiveness of structured teaching programme on the level of knowledge regarding awareness about sexual abuse among adolescents studying in selected school. Purposive Sampling technique was adopted to draw the sample, with sample size of 60 adolescents. The study was delimited to adolescents; between the age group of 13-19years.

The adolescents who are present at time of data collection in school. The tool consist of self structured questionnaire to assess the knowledge of adolescents studying in selected schools regarding awareness about sexual abuse. The permission for study was obtained from principal of Marigold Academy Aliwal road Batala, Gurdaspur. Hypothesis for present studies were given below which were statistically analyzed at p<0.05:

H₁- There will be a significant difference between pretest and post-test knowledge of adolescents regarding awareness about sexual abuse.

H₂- There will be a significant association between post-test knowledge of adolescent girls and selected socio-demographic variables.

H₀ - There will be a no significant difference between pretest and post- test knowledge of adolescent girls regarding awareness of sexual abuse.

The data was collected from the adolescents present at that time of data collection and willing to be part of study by means of the self structured questionnaire. Unpaired T-test was used to do comparison between the group and within the group. Chi square Test was used to find out association with demographic variables.

ETHICAL CLEARANCE:

Permission for conducting study was taken from respective school principal. Informed Consent was obtained from each adolescents who were willing to participate in study after discussing with each of them the purpose of the study and all related matters for the research purpose. All the adolescents were informed that obtained data is confidential and only used for research purposes. They were informed about their right to refuse from participating in the study. Anonymity of study subject and confidential of information was maintained throughout the data collection procedure. Keeping in mind the legal rights of the subject only those subjects who were willing to participate were included in the study.

RESULT:

1. Regarding the age group of adolescents, the majority of them belongs to 15-16 years (51%), 17-18 (33%), 13-14 (10%) and 19(5%).There is no significant association found between the level of knowledge related to adolescents with their age in pre and post test.

2. Regarding gender of adolescents, 50% were females and 50% were males. There is no significant association found between the level of knowledge related to adolescents with their gender in pre and post test.

3. Regarding class 25(42%) Of them are of 10^th class, 22(37%) Of them are of 11^th, 13 (22%) Of them are of 12 and 0(0%) of 9^th class. There is no significant association found between the level of knowledge related to adolescents with class in pre interventional and post interventional have no significant association with class.

4. Regarding education of father, 10^th 31(51%), 12^th 22(37%), primary educated 4(7%), and graduated are 3(5%). There is significant association found between the levels of knowledge related to adolescents with father’s education.

5. Regarding education of mother, 10^th 27(45%), 12^th 25(42%), primary educated are 5(8%), graduated are 3(5%). There is no significant association found between the levels of knowledge related to adolescents with mother’s education.

6. Regarding type of family, nuclear 39(65%), joint families 21(35%), extended are 0(0%).there is no significant association found between the levels of knowledge related to adolescents with type of family.

7. Regarding source of income, 5000-10, 000Rs. 33(55%), Less then 5000Rs. 12(20%), Above 20, 000Rs. 11(18%), 10001-20, 000Rs. 4(7%). There is significant association between the knowledge related to adolescents with source of income.

8. Regarding source of information, parents 21(35%), school 20(34%), mass media 11(18%), Others 8(13%). There is significant association found between the levels of knowledge related to adolescents with source of information.

9. The pre test knowledge score regarding awareness about sexual abuse represented that, 20% were having good knowledge score followed by 50% were having average knowledge and remaining (30%) who were having poor knowledge score.

10. The post test knowledge score regarding awareness about sexual abuse represented that, in post-test 88.4% adolescent had good knowledge followed by 11.6% adolescent had average knowledge and 0% had poor knowledge.

11. The present study revealed the effectiveness of STP in relation to the knowledge of adolescents regarding awareness about sexual abuse, reveals that the knowledge of adolescents was higher in the post test as compare to pretest. In which (20% ) adolescents were having good knowledge followed by(50%) adolescents were having average knowledge and remaining (30%) who were having poor knowledge before providing STP. Whereas after providing STP 88.4.% adolescents were having good knowledge followed by 11.6% average knowledge and none had poor knowledge.

CONCLUSION:

Significant association was found between the level of knowledge related to education of father, family income, source of information at p<0.05and there was no significant association found between level of knowledge related to adolescents with their age, gender, class, education of mother and types of family.

DISCUSSION:

OBJECTIVE 1:

To assess the pretest level of knowledge regarding awareness about sexual abuse among adolescent s in selected schools.

The pre test knowledge score regarding awareness about sexual abuse represented that, 20% were having good knowledge score followed by 50% were having average knowledge and remaining (30%) who were having poor knowledge score. A cross sectional study was conducted ion Goa, sexual abuse and risk behavior in adolescent. The aim of study was to assess the sexual abuse and risk behavior among adolescent girls. The sample for study belong to the age group 12-17 Year. A significant number of these experience involved more severe abuse, and 92% of those abused were subjected to sexual intercourse and stranger abuse accounted for 5% of all abuse experience. The study concluded that there is poor access of awareness of sexual abuse.⁴¹

OBJECTIVE 2:

To assess the post test level of s knowledge regarding awareness about sexual abuse among adolescents.

The post test knowledge score regarding awareness about sexual abuse represented that, in post-test 88.4% adolescent had good knowledge followed by 11.6% adolescent had average knowledge and 0% had poor knowledge. After the administration of structured teaching programme. Post test knowledge of adolescents regarding awareness about sexual abuse show increase in level of knowledge. A cross sectional study was conducted in south Africa on risk indicators and psychopathology in traumatized children and adolescents with a history of sexual abuse, Multinomial logistic regression analysis revealed female gender and single parent families to the significantly higher physical and emotional abuse sub scale scores and total childhood trauma questionnaire scores than non abused children depression was 33% and post trauma stress disorder 63.8% were the most psychologically consequent traumas and both were significant associated with child sexual abuse.th e study concluded that high rates of child sexual abuse predicted high rates of post –traumatic stress disorder in this traumatized sample.³⁴

Objective 3:

To compare the pre-test and post test knowledge regarding awareness about sexual abuse among adolescents.

Knowledge of adolescents regarding awareness about sexual abuse compared pretest and posttest conclude that knowledge was increased in post test. The present study revealed the effectiveness of STP in relation to the knowledge of adolescents regarding awareness about sexual abuse, reveals that the knowledge of adolescents was higher in the post test as compare to pretest. In which (20%) adolescents were having good knowledge followed by (50%) adolescents were having average knowledge and remaining (30%) who were having poor knowledge before providing STP. Whereas after providing STP 88.4.% adolescents were having good knowledge followed by 11.6% average knowledge and none had poor knowledge. A study was conducted in USA on prevention efforts is more effective if (a) behavioral practice. (b) medical and counseling services routinely assessed for prior victimization and other risk factors, (d) education programme.²²

OBJECTIVE 4:

To find out the association of pre-test and post-test knowledge score of adolescents with their selected socio demographic variables.

Knowledge association between pretest and post test shows that Significant association was found between the level of knowledge related to education of father, family income, source of information at p<0.05and there was no significant association found between level of knowledge related to adolescents with their age, gender, class, education of mother and types of family. An exploratory study to find out the prevalent patterns of cases of adolescent sexual abuse reporting to different health facilities. Checklists were distributed in the concerned OPDs at the health facilities for strategic screening of cases. A total number of four male children and adolescents in the age group 6-16 years and 16 female children and adolescents in the age group of 13 months to 15 years were identified as having been sexually abused or reporting with sexual abuse during the period of the study. Find associated with type of family and parents education and area of residence at p<0.001³⁹

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Received on 18.08.2016 Modified on 20.08.2016

Int. J. Nur. Edu. and Research. 2017; 5(1): 33-43.

DOI: 10.5958/2454-2660.2017.00008.4