Child sexual abuse prevention: A socio-ecological framework for engaging caregivers in institutional action

Child sexual abuse (CSA) remains a widespread and preventable public health problem, yet institutional prevention efforts remain narrowly focused on school-based, child-directed programs. Initiatives in sport, faith-based, healthcare, and other youth-serving settings have expanded but inconsistently meet science-based standards of effectiveness, and few meaningfully engage caregivers. This paper presents a structured narrative review synthesizing multidisciplinary evidence, from public health, psychology, education, and child protection, on caregiver engagement in CSA prevention across institutional settings. Findings are organized within the socio-ecological model (SEM) around three themes: the multi-level barriers to caregiver engagement, the factors that enable it, and implementation strategies that institutions can adopt. The paper then translates these findings into concrete actions for caregivers, institutions, and policymakers, emphasizing scalable, culturally responsive approaches embedded in systems that families already use. Limitations of the review and the proposed framework are discussed, including the difficulty of distinguishing genuine prevention gains from underreporting, and priorities for future research are identified, particularly comparative, sector-specific studies. By organizing fragmented evidence into a single cross-sectoral framework, this manuscript makes both conceptual and practical contributions to CSA prevention research, policy, and practice.