Effectiveness of Video Tutorial Coaching in Improving the Knowledge of School Teachers on Child Abuse and Neglect in Puducherry

Abstract

Aim

Child abuse and neglect (CAN) is a major threat to the health and well-being of children throughout the world. Apart from healthcare professionals, teachers also play an important role in recognizing and reporting child abuse as they are in a better position to observe the behavioral changes in children as they spend substantially more time at school. The aim of this study was to evaluate the effectiveness of a video tutorial program in improving the knowledge of school teachers on CAN.

Materials and results

A cross-sectional questionnaire-based study was conducted among the 79 school teachers of Puducherry. At baseline, a prevalidated questionnaire was used to assess the knowledge of the school teachers on CAN. After the intervention, the same prevalidated questionnaire was repeated. The mean knowledge score of teachers before intervention was 9.13. After video intervention knowledge score was improved to 14.46 (p < 0.05).

Conclusion

The study showed that a knowledge deficit exists among teachers regarding CAN, and the video tutorial program was found to be effective in improving the knowledge of school teachers. The government, as well as the schools should take the initiative to create awareness among teachers.

How to cite this article

Shivashankarappa PG, Pitchiah PA, Adimoulame S. Effectiveness of Video Tutorial Coaching in Improving the Knowledge of School Teachers on Child Abuse and Neglect in Puducherry. Int J Clin Pediatr Dent 2022;15(5):575-578.

Introduction

Child abuse and neglect (CAN) is a major threat to the health and well-being of children throughout the world. This may occur at homes, in neighborhoods, schools, public places, residential care institutions, and workplaces but primarily in the family setting and is a problem firmly rooted in societies.¹

The concept of child abuse came into importance soon after World War II when pediatric radiologists discovered the problem of physical abuse of children by their parents.¹ This led to a large number of public exposures of CAN, which was published as an article “battered child syndrome” in 1962 by Kempe et al.²

Children from all parts of society, irrespective of age, gender, race, or socioeconomic conditions, may be victims of CAN. Globally, it is estimated that up to 1 billion children aged 2–17 years have experienced physical, sexual, or emotional violence or neglect in the year 2019.³ The coronavirus disease 2019 pandemic and society's response to it have had a significant impact on the prevalence of child abuse and are expected to have long-term detrimental consequences.⁴

Around 19% of the world's children live in India, and 42% of the Indian population is below the age of 18 years. Although India is an active participant in various international declarations concerning the rights of children, the prevalence of all forms of child abuse is exceedingly high—physical abuse (66%), emotional abuse (50%), and sexual abuse (50%).⁵ According to India's ministry of women and child development, more than half (53%) of children were physically and/or sexually abused.⁶

According to the American Academy of Pediatric Dentistry, “It is important for all healthcare providers, including dental providers, to be alert to and knowledgeable about signs and symptoms of CAN and to know how to respond.” ⁶

Teachers, in addition to health care professionals, play a crucial role in recognizing and reporting child abuse because they are in a better position to observe behavioral changes in children, and children spend substantially more time in school.⁶ However, these teachers lack the adequate knowledge, expertise, and mental preparation to deal with the issue.^1,7

Of the various available means of training a teacher, audiovisual aids are one of the most valuable tools as these have a long-lasting impression on the target population and can be repeated according to the viewers’ needs. Packer et al. reported that videotaped instructions were more effective than traditional lectures.⁸

According to the literature search, no study has used educational videos to exclusively train teachers in creating awareness and improving knowledge in recognizing, reporting, and preventing CAN. Therefore, the aim of the study was to evaluate the effectiveness of a video tutorial program in improving the knowledge of school teachers on CAN.

Materials and Methods

A cross-sectional questionnaire-based study was conducted among the school teachers of Puducherry. The methodology for the present study was approved by the Institutional Ethical committee IGIDSIEC2020NRP54PGPRPPD.

A structured questionnaire with two domains such as demographic data with age, experience, educational qualification, marital status, children, and family type (nuclear and joint) and a 15-item questionnaire to assess the knowledge of the school teachers on CAN was designed by the investigators and translation of the same was done in the native language. The questionnaire was validated by experts, and according to their opinion, relevant necessary changes were incorporated. The Cronbach's α value was 0.81, which implies good internal consistency.

Permission was obtained from the Directorate of School Education, the Government of Puducherry, and the authority of the respective schools. The study included randomly selected government schools in Puducherry, from which teachers were selected. Finally, 79 teachers from nine schools were included.

In each randomly selected school, the purpose of the study was explained to the participating teachers through an information sheet, and informed consent was taken.

At baseline, the prevalidated questionnaire was distributed in both languages, English and Tamil, depending on the preferred language of the participating teachers in a group setting in a common place (classroom). Sufficient time was given to fill in the details and mark the correct options.

After the collection of the preintervention questionnaire, the teachers were shown the video for its full duration. The video covered the following topics: (1) how to recognize CAN; (2) how to respond to and report CAN; (3) the importance of reporting and the current campaign for the prevention of CAN. The seating arrangement was made such that the content of the video was audible to all the participants. Immediately after the intervention, the same prevalidated questionnaire was distributed and collected after the teachers completed filling out the questionnaire. An immediate posttest is done to deepen the understanding of CAN in the participants and thereby ensure active learning. It reinforces knowledge by correcting mistakes, debunking misconceptions, and modifying the behavior at the moment.

A score of 1 was assigned to every correct answer. Thereby, the maximum score possible was 15. Data entry was carried out in a Microsoft Excel sheet and subjected to statistical analysis by Statistical Package for the Social Sciences 17 version software.

Result

Among the 79 participants, 57 were females, and 22 were males from nine randomly selected government schools, of which six were primary schools and three were higher secondary schools.

Of the participants, 79 teachers, 72% were females, and 28% were males. The majority of the teachers (91.9%) were married and had children (86.07%). Around 50% of teachers had bachelor's degrees, and 50% had master's degrees.

An independent t-test was used to determine the differences in knowledge among demographic variables like gender, educational qualification, familial type, and marital status. However, there was no statistically significant difference in knowledge among demographic variables like gender (p = 0.37), education (p = 0.09), familial type (p = 0.29), and marital status (p = 0.16).

The mean knowledge score before the intervention was 9.13, which improved to 14.46 after the intervention. Postintervention, there was a statistically significant increase in the knowledge level (p < 0.05) (Table 1).

Table 1.

Mean knowledge of the teachers pre and postintervention

Paired samples statistics					t	df	p-value
		Mean	N	Standard deviation
Pair 1	Pretest score	9.13	79	2.13	21.7	78	0.001
	Posttest	14.46	79	0.83

df, degree of freedom

In the questionnaire, a suggestion for alternative ways to prevent CAN was given by all the participating teachers (Fig. 1).

Fig. 1.

Alternative ways suggested by teachers to prevent CAN

Discussion

Child abuse and neglect (CAN) is a global problem with serious life-long consequences. According to World Health Organization (WHO), child abuse is defined as “all types of dynamic and/or emotional ill-treatment, sexual abuse, negligence, and commercial or other exploitation, which results in actual or potential harm to the child's well-being, survival, development or dignity in the context of a relationship like responsibility, trust, or power.” ⁹

World Health Organization (WHO) has reported that one in five women and one in 13 men have been abused during their childhood between the age of 0 and 17 years.¹⁰ On the contrary, in the present study before the intervention, 56.96% of teachers answered that CAN is common only in the female gender because some teachers thought that girls are more vulnerable, while the rest were not aware of abuse against the male gender. After video intervention, 89.87% of teachers answered that both boys and girls are prone to CAN (p < 0.05). A small proportion (10.13%) of teachers still answered that girls are victims of CAN, and this could be attributed to their social and cultural beliefs.

An abused child is more likely to abuse others as an adult, resulting in violence being passed down from generation to generation. Breaking the cycle of violence and having a good multigenerational impact is therefore critical.¹⁰ In the present study, before the intervention, 86.08% of teachers were aware of the importance of reporting CAN. However, 13.92% of teachers answered that child abuse wouldn't be a problem for the abused child as they grow. This reluctant nature of teachers shows the need for regular school programs for training and explaining the sensitivity of CAN. However, after the intervention, 97.46% of teachers agreed upon and understood how CAN would affect the child if left unreported (p < 0.05).

The study results showed no statistical difference in knowledge among demographic variables like gender, family type, and marital status. The awareness about CAN was higher in teachers with a postgraduate degree but was not statistically significant (p = 0.09) when compared to teachers with an undergraduate degree. Similar results were reported by Tessy et al.¹¹ and Shah,⁷ who reported that knowledge of teachers had no significant association with demographic variables.

Child abuse and neglect (CAN) are often unreported or reported less compared to other crimes. This is mainly because even if the child confides, the facts are often covered under the fear of family reputation and social stigma.¹² Important personality feature of a person develops during their childhood, and it has been considered as the critical phase of human life. Each individual who is involved with a child has the moral obligation to understand the fundamentals of child protection.⁶

About 60–75% of child abuse victims present with head, face, and mouth injuries, wherein it is inevitable for a dentist to identify any case of CAN, bring it to the notice of the parents, or even report it to the concerned authorities.¹³ Pediatric dentistry being an age-defined specialty, mainly aims at providing primary and comprehensive preventive oral care for infants and children through adolescence, including those with specific healthcare needs.¹⁴ Pediatric dentist's education program includes a mandatory child abuse curriculum. It is also the social responsibility of a dentist to provide valuable information and assistance to other health care providers, teachers, and childcare providers about the various aspects of CAN.¹⁵

The protection of a child is not only an individual issue but also a community concern. Teachers, being an integral part of the community, play a significant role in the welfare of the child, including protection from any forms of abuse or neglect. Also, children spend considerably more time in school, giving teachers greater access to students than most other professionals.⁶ In this study, before the intervention, 50.63 % of teachers answered that only relatives (43.03%) and peer groups of children (7.60%) played a significant role in recognizing and preventing CAN. After the video intervention, all the participants understood their significant role in recognizing and preventing CAN (p < 0.05).

Lack of familiarity with the signs and symptoms of CAN and hesitation of teachers makes it extremely difficult for an individual to report the suspected abuse.⁶ In this present study, 65.81% and 83.54% of teachers were not aware of signs and how an abused child will react, respectively. This is mainly due to the lack of awareness of teachers on signs of CAN and the social stigma of teachers even talking about it. After the video tutorial program, all the teachers got aware and were receptive toward recognizing the signs of CAN (p < 0.05).

The present study findings reveal that school teachers have insufficient knowledge in recognizing and reporting CAN. The results are in agreement with studies conducted by Rani¹ and Saadoon and Salih,¹⁶ who reported that 43 and 50% of teachers had low knowledge of child abuse, respectively. The present study also supports the results of a study conducted by Naregal et al., which showed that 60% had poor knowledge regarding CAN.¹⁷

This lack of knowledge, cultural beliefs, and social stigma increase the need for training of teachers related to CAN, as teacher training programs being a part of school oral health programs have produced affirmative results in improving the overall health of children.¹⁸ Training for educators is vital, and it should include ways to support the victims and their families.¹⁹ Of the various training methods, audiovisual aids are a valuable tool that clarifies any point, better for both individuals or a group. The major advantage of videos is that they can be used for training effectively, and the recipient retains the concepts better and for a longer duration.⁸

In the present study, an educational video, “Guardians of Angels,” was composed by the authors and used to train teachers to create awareness and thereby improve knowledge in recognizing, reporting, and preventing CAN. This video intervention has significantly increased the knowledge of teachers in CAN in the present study from a mean knowledge score of 9.13 (preintervention)–14.46 (postintervention) with p = 0.0001, that is, p < 0.05. The main advantage of video tutorial interventions is the ability to pause, rewind, and play, which enables the audience to view the video repeatedly, thereby enabling higher retention of the knowledge. Also, in this pandemic situation, education has moved online, and this video tutorial intervention could be made accessible to all teachers. In the literature, self-instruction guidelines used by Rani¹ also reported statistically significant improvement in the knowledge of teachers and parents on child abuse.

In the present study, 41.8% suggested awareness about CAN could be increased among teachers, children, and parents to prevent CAN, either by conducting awareness programs in school or by the Ministry of Women and Child Development. A total of 22.8% of teachers emphasized the need for counseling and supervision for children. However, 30% had no suggestions.

Based on the results of this study, we would like to emphasize that one of the primary strategies that are most effective in the prevention of CAN is school-based educational programs. Government must conduct training programs for teachers like the Protection of Children from Sexual Offences (POCSO) Act workshop, and also take steps to create awareness about the child helpline.²⁰ Even before the video intervention, the majority of the teachers had awareness regarding the child helpline (65.83%) and POCSO (62.03%) act, respectively which is a good sign. However, 79.74% of teachers were not aware that the law would protect them, teachers when they reported CAN. Even after video intervention, 53% of teachers lacked a complete understanding of the laws related to CAN, and this increased the need for insisting on POCSO among teachers.

Government must inspect whether all the schools have rehabilitation programs for abused children, Grievance Redressal Committee. Also, schools should conduct regular parent awareness programs, individual guidance for children, special lectures, drama, and stage show on CAN for both parents and children.²⁰

In the present study, 79.74% of teachers were only aware of the “good touch and bad touch” campaign and were not updated about the current campaign “no touch” against CAN. After video intervention, the majority of teachers (98.46%) were aware of the current “no touch” campaign (p < 0.05).

Awareness regarding CAN is essential in the contemporary era for teachers. Training of teachers on child safety and child development should be made mandatory. Also, training of selected teachers for conducting child safety sessions for students.²¹

The limitation of this study is the small sample size. The video tutorial coaching must be reinforced on a larger population of teachers of both government and private schools.

Conclusion

• From the present study, it's clear that a knowledge deficit exists among teachers regarding CAN, and the video tutorial program was found to be effective in improving the knowledge of school teachers on CAN.

• The government, as well as the schools, should take the initiative to create awareness among teachers, and the concept of CAN, its identification, reporting, and prevention could be included in a teacher education program.

Orcid

Prathima G Shivashankarappa https://orcid.org/0000-0001-6379-9567

Pragadeesh A Pitchiah https://orcid.org/0000-0001-5366-1767