key: cord-0939773-qamj44xu
authors: Betül ŞENOL, Fatma; ÜSTÜNDAĞ, Alev
title: The Effect of Child Neglect and Abuse Information Studies on Parents' Awareness Levels during the COVID-19 Pandemic
date: 2021-10-20
journal: Child Youth Serv Rev
DOI: 10.1016/j.childyouth.2021.106271
sha: d3ca21b7f42600e31a77199a20c995a531bcb5cc
doc_id: 939773
cord_uid: qamj44xu

The research was conducted in order to increase the knowledge and awareness of parents with children between the ages of 4-6 during the COVID-19 pandemic process, through social media applications and programs. The research was designed as a quasi-experimental study with pre-testing, post-testing, and control groups using a quantitative research method. There are 67 parents in the study group, 32 of which are experimental, and 35 are of a controlled group. Data was obtained using The Personal Information Form, Child Neglect and Abuse Awareness Scale for Parents, and Parental Abuse Scale. The “Child Neglect and Abuse WhatsApp and Online Education Program” was applied to the participants in the experimental group. Each day, three messages were sent to the participants in the experimental group on the subjects of child neglect, physical abuse, emotional abuse and sexual abuse, respectively. In addition, online training was given on the same subjects and in the same order in four sessions over the Zoom application. The participants in the control group did not receive any intervention. Before and after the implementation of the Child Neglect and Abuse WhatsApp and Online Education Program, data collection tools were given to the participants in the experimental and control groups. Paired samples t Test, Wilcoxon Signed Ranks Test were used to analyze the data. As a result of the study, there was no statistically significant difference between the pre-test scores and the post test scores of the parents in the control group. When the differences between the pre and post test scores of the parents in the experimental group and the pre and post tests scores of the parents in the experimental and control groups were compared, it was observed that there was a significant difference in favor of the experimental group. In line with this result, it can be said that the education applied has had an impact on the parents' knowledge and awareness of child neglect and abuse.

The Coronavirus disease pandemic has emerged suddenly all over the world and has significantly changed the daily lives of both children and families, along with other rapid changes such as school closures, distance learning, flexible working, curfews and staying at home in order to prevent the spread of the disease. The COVID-19 pandemic has brought new challenges to nearly every aspect of parents' and children's lives. The limitations and stress created by these changes in social life due to COVID-19 pose a significant risk to increased domestic violence, including child abuse (Lawson, Piel, & Simon, 2020) . The process of adapting to the changing order, such as economic stress, physical and mental health problems, distant education difficulties, curfew restrictions, and flexible working may contribute to the increase of parenting stress, as well as the possibility of violence and abuse against children (Cuartas, 2020; Griffith, 2020) . In the studies conducted, it is stated that the risk of children being exposed to maltreatment increases with the stress levels of the parents and the situation of the children at home during the COVID-19 epidemic (Abramson, 2020; Brooks et al., 2020) . Child neglect and abuse; refers to the physical or psychological abuse of a child by an adult. In addition, child maltreatment is often synonymous with child abuse and neglect. The World Health Organization (2014) defines child abuse as follows: "All behaviors that adversely affect the child's health, physical and psychosocial development and that are intentionally or unintentionally practiced by an adult, society or state is child maltreatment." Types of abuse include physical, sexual, emotional abuse and neglect. Stress is defined as "stimuli that disrupt the balance of the organism" (Eryılmaz, 2009) . Studies have also revealed that child abuse is more common in families with high stress levels (Gladstone et al., 2004; Stith et al., 2009) .

Family life stresses and lack of social support are important in terms of child abuse (Wilson et al., 1996) .

Child maltreatment is an important public health problem associated with life-long impairments in psychological, behavioral and physiological functions (Cicchetti, 2016) . It has been suggested that the economic difficulties experienced by parents may be a risk factor for emotional and physical abuse (Conrad-Hiebner & Byram, 2020) . The family stress model emphasizes that economic instability, which includes situations such as unemployment, debt, income and inability to balance, puts a significant pressure on family relations (Conger & Elder, 1994) . As stress increases, the risk of child abuse increases significantly (Conger & Elder, 1994) . There are concerns that the child abuse situation may have increased during the COVID-19 pandemic. Studies also support the increase in child abuse cases during epidemics or major events affecting the general population (Schneider, Waldfogel, & Brooks-Gunn, 2017; Schenck-Fontaine & Gassman-Pines, 2020) . There are many factors in the family that can lead to child abuse, not just economic difficulties. Parents can also use physical and emotional violence as a means of discipline (Devries et al., 2018) . According to UNICEF (2014; 2017) , half of children under the age of 15 are subjected to physical abuse worldwide, and three out of every four children between the ages of 2-4 are regularly exposed to emotional and physical abuse. In this case, COVID-19, which requires children to spend much more time together at home, can cause parents to have problems coping with their children. Presumably, the fact that children are prohibited from going out may also be correlated with increasing coping problems, due to the lack of outdoor activities where they can drain their increased energy. Parents use methods such as restraint, blame, humiliation, isolation, or emotional manipulation to control their children (UNICEF, 2010) . It is thought that increasing parent-child coexistence during the pandemic process may increase the frequency of using these methods. Studies show that parents' maltreatment of their children depends on their ability to cope with stress (Hillson & Kuiper, 1994) .

Parental stress is an important factor affecting parenting behaviors towards children and the overall quality of parent-child relationship. Parental stress develops when parents are unable to cope with stress, feel inadequate, unable to parent their children well, and think that parentchild relationships are negative (Cappa et al., 2011) . The effects of positive helpful studies can be evaluated within the scope of alleviating the negative emotions caused by the stress experienced by parents during the COVID-19 pandemic, and also raising their awareness with the proper support. It is thought that informing the parents can contribute to increasing their awareness and making their behavior more manageable. Such supportive and awareness-raising work can reduce the threat of risk factors for child maltreatment, both pre-existing and newly developing threats due to COVID-19.

Due to COVID-19, the use of digital technology tools used for distance learning and also working remotely has increased, in addition to the use of social media applications. WhatsApp is a social media tool where individuals with smartphones send messages, pictures, videos, and audio recordings to each other without any charge (except internet package). More than one billion users around the world use the WhatsApp application (Wikipedia, 2009; Yazıcı, 2015; Yiğittürk, 2020) . Especially because of COVID-19, people cannot meet each other face to face, so the WhatsApp application has begun to be used more often than usual. The WhatsApp application can also be used to share information with one another, or even for an educator to teach via WhatsApp. In particular, during COVID-19, the inability to conduct face-to-face training has brought the use of such social media applications to the agenda. Due to the increase in the frequency of people using WhatsApp during the pandemic process, it is thought that posts for educational purposes through this application will have a positive effect. However, in addition to the specified positive effects, it is thought that preschool children, who spend more time at home with their families during the pandemic process, are exposed to child neglect and abuse. All things considered, it is believed that the education that had been given to families about child neglect and abuse will enable families to increase their knowledge and awareness and to show positive behavior towards their children.

In this study, it was aimed to increase the knowledge and awareness of parents who had children between the ages of 4-6 through social media applications and programs during COVID-19.

WhatsApp was preferred as a social media application and Zoom was preferred as its video conferencing program. In line with the purpose of the research, the following questions were sought:

1. Is there a significant difference between the pre-test and post-test of the knowledge and awareness levels of the parents in the experimental group regarding child neglect and abuse of the informative studies conducted through social media applications and programs? 2. Is there a significant difference between the pre-test and post-test levels of knowledge and awareness of parents in the control group about child neglect and abuse?

The research was designed as an experimental study in which a quantitative research method was used, including pre-test, post-test and control groups. This model was preferred because experimental studies are the most appropriate studies that enable a cause and effect relationship to be established (Erkuş, 2017) .

The research was carried out in Afyonkarahisar which is a province in the inner Aegean region of Turkey. Criterion sampling, one of the most purposeful sampling methods, was used in the selection of the study group of the study. Parents' inclusion criteria has been determined as having a child between the ages of 4-6, using a smartphone, using the WhatsApp application, having no communication barriers and being able to use the Zoom program. Parents' exclusion criteria has been determined as they did not fill in the data collection tool and wanted to leave at any stage of the study. The level of knowledge of the parents about child neglect and abuse before and during the pandemic was not measured.

Initially, 70 parents were included in the study, 35 of which were experimental and 35 were in the control groups. However, some of the parents in the experimental group quit the study because they did not want to continue their education and some did not want to complete the final test. In this case, 32 parents remained in the experimental group. The demographic characteristics of the parents in the experimental and control groups are presented in Table 1 . 

Personal information form, Child Neglect and Abuse Awareness Scale for Parents, Parental

Abuse Scale and Interview Form were used as data collection tools.

The form was prepared by the researchers in order to obtain demographic information of the parents participating in the study, and the form includes questions about the gender, age, occupation, education level and number of children.

and Boz (2020) to determine parents' awareness of child neglect and abuse. The scale is a fivepoint Likert type (1-strongly disagree, 2-disagree, 3-indecisive, 4-agree, 5-strongly agree) and

consists of 45 items and 5 sub-dimensions. The sub-dimensions are as follows: General Information Sub-Dimension (12 items), Physical Abuse Sub-Dimension (6 items), Emotional

Abuse Sub-Dimension (15 items), Sexual Abuse Sub-Dimension (8 items), Child Neglect Sub-Dimension (4 items). The total score, determined by adding all the sub-dimensions, is high, which indicates that the awareness of child neglect and abuse is high. The Cronbach's alpha reliability coefficient of the scale was calculated as 0.81. (Ünal & Boz, 2020) . In this study, the reliability coefficient was found to be 0.885.

Parental Abuse Scale: The scale was developed by Adalı (2007) (Adalı, 2007) . In this study, the reliability coefficient was found to be 0.717.

The scales were sent to the participants via Google Forms. The data of the study was collected between December 2020 and January 2021. Pre-tests were applied to the experimental and control groups between the 1st-5th of December 2020. WhatsApp messages were sent to the experimental group between December 7, 2020 and January 20, 2021, and online information training was provided on Zoom between January 21st and January 25th of 2021. Post tests were applied to the participants in the experimental and control groups between the 26th-31st of January, 2021. Social support includes advice, childcare help, and emotional support. Having social support will increase the likelihood that parents will approach their children with more knowledge and awareness, and therefore with an attitude that supports their social and emotional development.

It is thought that the education given in this study will cause an increase in the levels of awareness for parents. It is thought that this positive result, which occurs at the level of knowledge and awareness, may also have an effect on the behavior of parents.

Participants in the experimental group were included in the WhatsApp group. WhatsApp messages were sent between December 7, 2020 and January 20, 2021, and online training was provided via Zoom between January 21st and January 25th.

The contents of the messages sent were of child neglect, physical abuse, emotional abuse and sexual abuse, respectively. Messages were sent every day at 13:00, 15:00 and 18:00.

There The trainings lasted about 30 minutes. 

In the analysis of the data, it was first determined whether the data showed normal distribution or not. As a result of the Kolmogorov-Smirnov Test applied to the pre test and post test, normally distributed or non-distributed results were obtained. Paired samples t Test was used for values showing normal distribution, and Wilcoxon Signed Ranks Test was used for values that did not show normal distribution in the comparison of differences between two partners in dependent groups. For the significant p values, the "Cohen d" effect size was calculated.

In this section, the comparison of the scores of the experimental and control groups in the pre and post tests are included. When the pre-test and post-test results of the experimental group obtained from the Parental Abuse Scale are compared, it is seen that the post test scores are significantly lower than the pre-test scores.

When the pre-test and post-test results of the experiment group obtained from Child Neglect and Abuse Awareness Scale for Parents are compared, it is seen that the post-test scores are significantly higher than the pre-test scores.

At the same time, when the effect sizes of the comparisons with a significance level below the p value are evaluated, it is seen that their effect sizes are large. When the pre-test and post-test scores of the control group are compared, it is seen that there is no statistically significant difference.

In this study, whether the level of knowledge and awareness of parents with children between the ages of 4-6 during the COVID-19 pandemic has increased with the information studies conducted through social media applications and programs were examined. In general, the findings obtained have shown that information studies conducted via WhatsApp and Zoom positively affected the awareness levels of the parents.

First, the study group was determined, and the experimental and control groups were formed from the parents who volunteered to participate in the study. The knowledge levels of parents about child neglect and abuse were revealed within the applied scales. While there was no intervention in the control group, a four-session training program was applied to the experimental group. As a result of the study, it was determined that there is a significant difference between the pre-test and the post-test of the knowledge and awareness levels of the parents in the experimental group regarding child neglect and abuse in the informative studies conducted through social media applications and programs.

The COVID-19 pandemic has brought both economic and social challenges. Parents' perspectives and attitudes are very important in difficult and stressful processes, such as COVID-19. Because of these stressful events, children's adaptation to the new order is largely dependent on their parents' emotional state (Shorer & Leibovich, 2020) . If parents cannot cope effectively with this process, they may be less helpful in coping with their own stress (Cohen & Shulman, 2019) , due to the fact that the increase in parents' stress levels is associated with their use of harsh discipline methods (Beckerman et al., 2017) . Parents' application of harsh discipline methods is known to increase the risk of children being exposed to abuse (Gershoff, 2002) . For this reason, it is important to increase the awareness of parents. As a result of the research conducted by Aznar (2021) , it was determined that during the COVID-19 process, parents had problems coping with their children and parents discipline their children more harshly compared to the past. The need to protect children from maltreatment is among the fundamentals of children's rights.

This is important, not only during COVID-19, but also in pre and post pandemic contexts.

Maintaining the health of children and ensuring their safety are among the primary duties of parents. Research findings by Fabbri et al. (2020) also showed that children of the COVID-19

generation are more likely to be exposed to violent disciplinary methods at home. While we cannot generalize the results, increases in the number of children subjected to violent methods of discipline at home can be expressed as a result of the COVID-19 pandemic.

By informing parents about raising awareness of child neglect and abuse, it will probably protect children from maltreatment as a protective intervention, and this may reduce the risk of child neglect and abuse. Similarly, as a result of the research conducted by Jin, Chen, and Yu (2019), it was determined that the educational practices given to parents on preventing child neglect and abuse directly affect children's self-protection skills. UNICEF recommends that everyone who is in direct or indirect contact with children should increase their knowledge and awareness through child protection education programs (Jackson & Wernharm, 2005) .

Protection of children includes protection from child negligence, abuse and maltreatment.

According to Finkelhor and Jones (2006) , prevention activities related to child neglect and abuse are effective in reducing the rates of child neglect and abuse. The success of child neglect and abuse prevention programs depends on how parents define child neglect and abuse. (2019) show in their study that child sexual abuse prevention programs can be effective for preschool children. The conclusion that parents have a protective priority regarding child neglect and abuse and that informing education for parents is effective in increasing their awareness is consistent with the literature (Jin, Chen, & Yu, 2019; Finkelhor & Jones, 2006; Rudolph & Zimmer-Gembeck, 2018) . The use of technology in health and education services is not new and has a successful history. However, the COVID-19 pandemic has largely revealed the difficulties and positive aspects of technology in providing access to healthcare and education services (Tener et al., 2020) . Research findings also revealed that social media applications and programs are effective in education and information activities.

It is primarily the responsibility of their parents to protect their children from all forms of maltreatment. The COVID-19 pandemic process has brought many social and economic challenges worldwide. Children who spend their entire time at homes due to curfews and distance learning are likely to be exposed to different practices involving negligence and abuse at home. For this reason, in the study, it was aimed to increase the knowledge and awareness of parents with children between the ages of 4-6 during the COVID-19 pandemic process through social media applications and programs. The findings revealed that informative studies increased the awareness level of the parents.

Since it has been determined that informative studies conducted through social media applications and programs increase the awareness of parents, in future studies, similar education programs can be organized for the parents of children of different age groups. The effect of awareness training given to parents on children can be evaluated. Intervention programs that ensure school-family cooperation can be established by carrying out similar education programs through schools.

Before the data collection process, approval was obtained from Afyon Kocatepe University Social and Human Sciences Scientific Research and Publication Ethics Committee (Document numbered 2020/239).

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964

Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.

Author 1: Conceptualization, Methodology, Formal analysis, Investigation, Writing -original draft, writing-review & editing.

Author 2: Conceptualization, Formal analysis, Investigation, Writing -original draft

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Author 1: Conceptualization, Methodology, Formal analysis, Investigation, Writing -original draft, writing-review & editing

Author 2: Conceptualization, Formal analysis, Investigation, Writing -original draft

We gratefully acknowledge the contribution of participating mothers and fathers.

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

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