Abstract
Abstract
Introduction
Child maltreatment (CM) can have significant and long-lasting consequences over the life course. These include long-term physical injuries and an increased risk for mental illness. Preventive applications are critical to reduce maltreatment, promote early detection and initiate early interventions, and prevent further harm. Social marketing (SM) strategies offer a promising approach for the prevention of CM. They use commercial marketing principles to raise awareness and/or influence behaviour of populations for social welfare purposes. To date, there is no comprehensive overview of SM strategies and applications used for prevention, early detection and reduction of harms of physical and emotional child abuse and neglect. This study aims to address this gap by means of a scoping review mapping the national and international literature and to provide an understanding of how SM strategies have been conceptualised and implemented in CM prevention. We chose a scoping review to catalogue and organise the literature, define key constructs and identify gaps, instead of pooling effects.
Methods and analysis
PubMed, Scopus, Web of Science, ERIC and PsycINFO will be searched for relevant existing literature published between 2010 and 2025 using a search string based on the Population, Concept and Context scheme. Empirical studies examining SM strategies for the prevention of physical and emotional abuse and neglect of all designs will be included.
The results will be presented in both narrative and tabular formats. These tables will report on general study characteristics (eg, country, year of publication, study design), key characteristics of SM applications (eg, prevention aims, setting, components, target audiences) and strategies used (eg, media channels, communication formats and theories used). Where reported, we will also summarise evaluations of SM strategies used (eg, study design and outcome measures, main findings).
The reporting of the review follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Extension for Scoping Reviews: Checklist and Explanation and PRISMA Statement for Reporting Literature Searches in Systematic Reviews.
Ethics and dissemination
Literature is used as the only data source, therefore, no ethical approval is required. The findings will be disseminated through peer-reviewed publications and conference presentations. They will identify research gaps and will inform a research agenda on integrating SM strategies in the design of preventive applications regarding child physical/emotional abuse and neglect and future evaluations. Our findings can also inform the design of population-level prevention policies and strategies that use SM strategies to raise public awareness of CM and to promote preventive behaviours in everyday settings.
Study registration
A protocol outlining the scoping review has been preregistered at the Open Science Framework (osf preregistration).
Keywords: PAEDIATRICS, Child protection, Primary Prevention, PUBLIC HEALTH
STRENGTHS AND LIMITATIONS OF THIS STUDY.
Broad mapping and synthesis of social marketing strategies and applications based on multiple characteristics, including study designs, prevention aims, target audiences, communication formats, theories, media channels and outcomes.
Use of four databases with different disciplinary focuses, covering relevant biomedical, public health, social science and education literature, supplemented by citation tracking.
The literature search is limited to published articles since 2010 and to five databases and therefore may not capture all potentially relevant studies.
Background
Child maltreatment (CM) refers to acts of commission or omission by a parent or caregiver that result in actual or potential harm to a child’s health, development or dignity. It includes physical abuse, sexual abuse, emotional abuse and neglect.1–3
According to self-reported lifetime prevalences, sexual abuse was experienced by 13.2% vs 12.2% for physical abuse, 21.7% for emotional abuse and 27.0% for neglect.4 These figures highlight the substantial burden of different forms of CM and the need for prevention approaches that are sensitive to the specific characteristics of each subtype.
The present review focuses on physical abuse, emotional abuse and neglect, hereafter referred to as CM. This focus addresses an important gap in the literature and is aligned with recent efforts to synthesise social marketing (SM) applications in related areas of CM prevention, including the review by Walsh et al5 on child sexual abuse. SM strategies may differ across CM subtypes in terms of behavioural determinants, target audiences and prevention messages, yet no dedicated synthesis has mapped SM approaches for the prevention of physical abuse, emotional abuse and neglect. Mapping the evidence for these forms of CM can therefore provide a more specific understanding of how SM has been conceptualised and implemented beyond the context of sexual abuse.
Physical abuse, emotional abuse and neglect are considered adverse childhood experiences, which have been associated with multiple negative health consequences, specifically an increased risk of mental health problems later in life.6 In addition, economic consequences to society are profound. They include increased healthcare needs and reduced workforce productivity.3 Therefore, prevention and early intervention are critical to reducing these impacts and promoting children’s optimal health and development.2 SM strategies represent a potential approach for prevention.5 7 Building on early conceptual work in the field, SM is now widely understood as a systematic, research-based approach to promoting social ideas, with core elements often summarised as the ‘4 Ps’: product, price, place and promotion.8 Unlike traditional advertising or propaganda, SM seeks to achieve behavioural change in the public interest. It emphasises strategic planning and audience insight, while clearly distinguishing itself from persuasion driven by ideology or commercial profit motives.9 In the context of CM prevention, SM strategies can serve several complementary functions. They may raise public awareness of maltreatment and its consequences, educate individuals about recognising and responding to signs of abuse and neglect, and promote behavioural or attitudinal change, for example, by encouraging early reporting of suspected cases or reducing behaviours that constitute maltreatment.7 SM applications can also contribute to strengthening public engagement to promote stable, nurturing environments and violence-free environments for children.10
The relevance of SM in child protection is also reflected in increasing political and institutional commitment. Governments and public institutions have funded universal, media-based campaigns that aim to prevent child abuse, promote positive parenting, inform families about available support services and foster a broader community culture of protection and vigilance.11 12 Such approaches assume that population-level communication can complement individual or family based prevention by shaping awareness, norms and help-seeking behaviours.
The increasing use of digital and social media may further enhance the reach and accessibility of SM strategies.13 Therefore, SM represents a promising strategy in the prevention of CM.
SM campaigns have the potential to be effective in raising public awareness, increasing knowledge about maltreatment and promoting prosocial family behaviours.7
Some existing evidence syntheses have addressed related but distinct areas of CM prevention. For example, the Campbell Collaboration evidence gap map on institutional CM systematically maps available research on applications aimed at preventing, identifying, responding to and treating abuse, neglect and exploitation in institutional settings such as foster care, residential facilities, schools and juvenile justice systems.14 van Dijken et al reviewed studies focusing on the role of social networks, support systems, cross-sectoral collaboration and community-based approaches.12 However, these syntheses do not specifically map how SM approaches have been applied to the prevention of physical abuse, emotional abuse and neglect.
Evidence on the effectiveness of SM campaigns for the prevention of physical abuse, emotional abuse and neglect remains limited, particularly regarding measurable behaviour change and sustained awareness. Existing reviews have reported a range of evaluation outcomes, including awareness, knowledge, attitudes, help-seeking, self-reported parenting behaviours, parental anger, parental self-efficacy and reported actions in response to violence or suspected maltreatment.7 15 However, only a few studies have examined more distal outcomes, such as actual maltreatment incidence or sustained behavioural change. For example, Poole et al15 identified only three studies assessing child physical abuse incidence, with significant reductions reported in two studies, while Horsfall et al7 emphasised that many evaluations relied on indirect or self-reported indicators of behaviour change. Evidence from universal media-based campaigns for child physical abuse prevention suggests that rigorous evaluations remain limited, particularly for outcomes beyond short-term changes in knowledge or attitudes, and findings on effectiveness are inconclusive.15
However, no recent review has systematically examined and synthesised current evidence on evaluation studies and the characteristics of SM applications for preventing physical abuse, emotional abuse and neglect. While one recent review has focused on SM applications in the context of sexual abuse, previous reviews addressing CM prevention more broadly, including other forms of CM, were conducted more than 15 years ago. This represents a gap in the literature, particularly as evidence beyond the context of sexual abuse has not yet been systematically mapped. Other reviews have addressed community-based interventions and interventions addressing institutional CM,12 14 but they do not specifically map how SM approaches have been applied to the prevention of CM.
Advancements in research on CM prevention over the past 15 years, for example, due to increasing usage of digital and social media platforms have to our knowledge not been captured. Although digital and social media approaches may expand the reach of SM strategies15 and enable more targeted engagement with relevant audiences, their application in CM prevention has not yet been systematically mapped.
In addition to evidence on effectiveness, an overview is lacking on how SM approaches in CM prevention have been conceptualised and implemented in existing studies. Little is known about their target groups, the types of media used, the strategies for application development and the content that is communicated.
The present review addresses this gap by mapping existing SM strategies for the prevention of CM, specifically physical and emotional abuse, and physical and emotional neglect in children. By focusing on these forms of CM, this scoping review aims to provide a more specific understanding of how SM strategies for CM prevention have been conceptualised, implemented and evaluated beyond applications in the context of sexual abuse. It addresses a broad range of SM strategies targeting populations, communities or the public.
Methods and analysis
The study is designed as a scoping review to map the existing evidence on SM strategies for the prevention of CM. The methodological approach is guided by the Joanna Briggs Institute’s updated guidance for the conduct of scoping reviews.16 A scoping review was chosen because we aim to provide a comprehensive overview of the available evidence across multiple study designs and identify research gaps rather than conducting a quantitative synthesis of study findings. The development of the initial search strategy began in 2024, and the review is expected to be completed by March 2027.
A protocol outlining the scoping review has been preregistered at the Open Science Framework (osf preregistration).
The reporting follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Extension for Scoping Reviews (PRISMA-ScR): Checklist and Explanation17 the PRISMA-S: an extension of the PRISMA Statement for Reporting Literature Searches in Systematic Reviews,18 and the PRISMA-P 2015 statement.19 The completed PRISMA-ScR, PRISMA-S and PRISMA-P checklists are provided in online supplemental appendices 2–4, respectively.
Eligibility criteria
Studies will be eligible for inclusion if they meet the criteria presented in table 1. Following the PCC (Population, Context, and Concept) framework,16 the population of this review comprises children affected by or at risk of CM. The concept of interest is the application of SM strategies, including their conceptualisation, implementation and evaluation. The context is CM prevention across all settings in which SM strategies are used, including community, healthcare, educational, digital and public health contexts. Target groups addressed by SM strategies, such as parents, caregivers, professionals, communities or the public, will be extracted as application characteristics. Such applications may include campaigns delivered through webpages, posters, brochures, social media, television or radio. Applications restricted to individual teaching, person-centred education or other exclusively individual-level approaches will be excluded. The full reporting of all SM benchmark criteria, such as the ‘4Ps’, audience segmentation or a stated theoretical framework, is not required for inclusion; where reported, these elements will be extracted in greater detail during data charting.
Table 1. Criteria for inclusion and exclusion.
| Inclusion criteria | Exclusion criteria | |
|---|---|---|
| Population | Studies targeting:
|
Studies targeting individuals or persons |
| Concept | Studies using SM for prevention:
|
Studies using other prevention approaches, for example:
|
| Context | Studies focusing on SM for prevention of the following forms of CM:
|
Studies focusing on other forms of CM, violence and crimes against children:
|
| Additional information |
|
|
CM, child maltreatment; SM, social marketing.
This review focuses on SM strategies for preventing physical abuse, emotional abuse and neglect in routine caregiving and social contexts, including family, educational, institutional and community settings. Forms of violence primarily occurring in extraordinary, organised or conflict-related contexts were excluded because they are shaped by different structural, legal and situational determinants and require distinct prevention approaches.20
Empirical studies of any design published in scientific journals will be eligible for inclusion, whereas grey literature, unpublished studies, doctoral theses, commentaries and opinion papers will be excluded.
Databases and search strategy
The search strategy was first developed and piloted in PubMed (National Institutes of Health [NIH], National Library of Medicine) and subsequently adapted to the other selected databases: Scopus (Elsevier), Web of Science (Clarivate), ERIC (National Library of Education, Institute of Education Sciences) and PsycINFO (American Psychological Association). Its development was informed by discussion within the review team and by exchange with authors of related reviews, including the review by Horsfall et al7 and Walsh et al.5 The strategy relies primarily on free-text terms, supplemented by selected database-specific controlled vocabulary terms where appropriate. For the population component of the PubMed search, a validated PubMed filter for identifying paediatric studies was used to support sensitivity for child-related and adolescent-related records.21 The full search strategy can be found in online supplemental appendix 1. Articles will only be included if published within 2010–2025. Articles published before 2010 were not considered, as they had already been included in the review by Horsfall et al.7 To complement the database search, citation tracking will be conducted to identify additional potentially eligible publications.
Data management
The search strategy has been developed, and the database searches have been completed, while citation tracking is ongoing. Search results were exported and uploaded to Covidence.22 Duplicates will be identified automatically and additionally checked manually before title-abstract screening. Title-abstract screening, full-text screening and data extraction will be conducted within the same platform.
Selection process
Two reviewers independently screen titles and abstracts based on the eligibility criteria. The methodological steps leading up to and including screening were piloted and discussed within the review team, including the search strategy, the screening criteria and the screening process. A subset of records was used to pilot the application of the screening criteria during title/abstract screening and, subsequently, during full-text screening. Discrepancies were discussed within the review team, and the shared understanding of the eligibility criteria was refined if necessary. Disagreements between the two reviewers will first be resolved through joint re-evaluation and discussion until consensus is reached. If consensus cannot be reached, a senior member of the research team will be consulted. In cases where the abstract does not contain enough information to decide, the article will be forwarded to full-text screening. The same procedure will be applied during full-text screening. Reasons for exclusion of articles in full-text-screening will be documented.
Data extraction process
A structured data extraction template will be developed and piloted prior to commencing the extraction process. The results will be reported both narratively and in tabular form. The data extraction form will include predefined items on general study information, application characteristics, prevention type, type of CM addressed, media and communication-related information, target group access, study design, evaluation approach and key findings. The draft data extraction form is provided in online supplemental appendix 5. More specific items will include, for example, the application aims and components, the type and setting of the medium, professional media support, intended outcomes and classification details where relevant, such as the rationale for classifying prevention type or socioecological level. Additional categories will be developed inductively based on the information provided in the included studies to account for heterogeneity in the reporting and implementation of SM applications. We will test our data extraction template regarding missing or insufficient criteria using a sample of included studies and two reviewers. Results of the pilot phase will be discussed, and the data extraction template will be revised, finalised and applied to all studies. As needed, the template will be deductively expanded by new data extraction items to cover relevant novel aspects in the data not yet included.
Summarising and reporting data
A descriptive narrative synthesis will be used to summarise the included studies across the predefined dimensions of the data extraction template. Findings will be grouped and categorised according to study characteristics, prevention aims, target audiences, communication formats, media channels, theoretical underpinnings and SM-specific elements. This approach will be used to identify recurring patterns, differences in the application of SM strategies and gaps in the evidence base. In parallel, numerical data will be presented in tabular form to provide an overview of the frequency and distribution of study characteristics. The study selection process will be reported using a PRISMA flow chart.
Any important deviations from the published protocol will be documented and justified and will be reported transparently in the final scoping review.
Patient and public involvement
No patients or members of the public were involved in the development of this protocol.
Ethics and dissemination
Because our work involves synthesising information from publicly accessible publications and does not involve the collection of personal, sensitive or confidential data from participants, ethical approval is not required. The findings of this review will be disseminated through publication in a peer-reviewed journal and presentations at relevant national and international conferences, academic meetings and professional forums.
Supplementary material
Footnotes
Funding: This study is supported by grants from the Jürgen Manchot Foundation. The funder was not involved in the conceptualisation, methodology, data collection, analysis or writing of the manuscript.
Prepublication history and additional supplemental material for this paper are available online. To view these files, please visit the journal online (https://doi.org/10.1136/bmjopen-2026-118255).
Provenance and peer review: Not commissioned; externally peer reviewed.
Patient consent for publication: Not applicable.
Patient and public involvement: Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.
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