Wood2014 Flag Green Flag Red

554426
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JIVXXX10.1177/0886260514554426Journal of Interpersonal ViolenceWood and Archbold
Article
Journal of Interpersonal Violence
2015, Vol. 30(17) 2999–3021
Bad Touches, Getting © The Author(s) 2014
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DOI: 10.1177/0886260514554426
Keeping Secrets: jiv.sagepub.com
Assessing Student
Knowledge Retention of
the “Red Flag Green Flag
People” Program
McKenzie Wood1 and Carol A. Archbold1
Abstract
School-based prevention programs that target sexual abuse are commonplace
in many elementary schools across the United States. This study examines
the efficacy of the “Red Flag Green Flag People” program presented to
elementary school children in two school districts in the Midwest. A brief,
11-question survey is given to students to assess knowledge retention of
the curriculum from this sexual abuse prevention program. The results of
this study indicate that students are retaining information taught in the Red
Flag Green Flag People program for up to 2 years after the program was
administered.
Keywords
sexual assault prevention, Red Flag Green Flag People program, child abuse,
child sexual abuse
1North Dakota State University, Fargo, ND, USA
Corresponding Author:
McKenzie Wood, Department of Criminal Justice and Political Science, North Dakota State
University, NDSU Dept. 2315, P.O. Box 6050, Fargo, ND 58108-6050, USA.
Email: McKenzie.wood@ndsu.edu
Downloaded from jiv.sagepub.com at Gazi University on January 1, 2016

3000 Journal of Interpersonal Violence 30(17)
Despite receiving increased attention from media outlets, social institutions,

and the criminal justice system, sexual abuse of children continues to be a
problem in the United States. According to the U.S. Department of Health
and Human Services (2012), 62,936 child sexual abuse cases were reported
in the United States in 2012. Due to the nature of this crime, it is likely that
there are many cases of child sexual abuse that go unreported each year. The
National Center for Victims of Crime (2012) asserts that many children do
not report being victims of sexual abuse because they are afraid of repercus-
sions they may face from their abuser, or they feel ashamed, embarrassed, or
blame themselves for the abuse.
Some children may not report being victims of sexual abuse because
they may not understand what sexual abuse is or that sexual abuse is a
crime. Whereas most parents believe that sexual abuse prevention is an
important topic to discuss with their children, one study found that less
than 63% of parents actually talk about it with their children, and even
fewer parents are likely to talk in depth about sexual abuse with their kids
(Tutty, 1993). With many parents reluctant to discuss this topic with their
children, a different environment is needed to ensure that children will be
exposed to this information. Schools, with their regularity and familiarity
with children, emerge as the prime arena to govern these programs
(Wurtele, 1987). Offering sexual abuse prevention training in schools is a
cost-effective way to raise awareness among a large number of children
(Tutty, 2000).
Today, sexual abuse prevention programs can be found in elementary
schools across the United States. The goals of this type of program varies
from helping children have positive feelings about their bodies, to helping
children identify potentially dangerous situations where they are likely to
become victims of sexual abuse (Wurtele, 1987). But how effective are
school-based sexual abuse prevention programs? Do children who participate
in this type of program remember the information presented to them after the
program is over?
This article features an evaluation of student knowledge retention of sex-
ual abuse awareness and prevention skills presented in the “Red Flag Green
Flag People” program (RFGFP hereafter). The RFGFP program teaches chil-
dren to distinguish between good and bad touches, and encourages them to
follow a three-step process if they find themselves in a “red flag” situation:
Say no to the perpetrator, leave the situation, and then report the incident to a
trusted adult. Specifically, this study examines the relationship between stu-
dent characteristics (gender, race, living arrangements, and grade) and knowl-
edge retention of the RFGFP program curriculum in elementary schools in
two school districts in eastern North Dakota.

Wood and Archbold 3001
Effectiveness of School-Based Sexual Abuse

Prevention Programs
School-based sexual abuse prevention programs are designed to teach chil-
dren how to recognize sexual abuse, provide strategies to prevent this type of
abuse, and highlight the importance of reporting the abuse to a trusted adult
(Finkelhor, 2009). There has been some debate regarding the effectiveness of
sexual abuse prevention programs. For example, some studies have found
that school-based education programs can be effective at teaching children
basic concepts related to sexual abuse, how to recognize abusive situations
and actions, and increase awareness of personal safety skills (Finkelhor,
2009; Finkelhor, Asdigian, & Dziuba-Leatherman, 1995; Kenny, Thakkar-
Kolar, Ryan, & Runyon, 2008; Topping & Barron, 2009; Wurtele, 2009);
however, there is little evidence that this type of program actually prevents
sexual abuse. It is difficult to measure whether children apply or use the
information that they learned in school-based sexual abuse prevention train-
ing later on in their lives. Some studies have used a retrospective approach to
explore the effectiveness of school-based sexual abuse prevention programs.
These studies found that people who received sexual abuse prevention educa-
tion in school reported lower rates of sexual abuse later on in their lives, and
were also more likely to report abuse (Finkelhor et al., 1995; Gibson &
Leitenberg, 2000). These findings are positive; however, there is no way to
determine the causal order of these events.
There has also been some concern about possible negative outcomes
resulting from participation in school-based sexual abuse prevention pro-
grams. Some negative outcomes include children becoming more fearful that
they will be victimized, that children will become afraid or confused by posi-
tive physical touches (such as hugs or pats on the back/shoulder), or that it
will negatively influence their sexual development as they grow into adults
(Kenny et al., 2008). Other than a slight increase in anxiety of a few students,
most studies of school-based sexual abuse prevention programs have not
revealed any serious negative outcomes (Finkelhor & Dziuba-Leatherman,
1995; Kenny et al., 2008; Topping & Barron, 2009). Overall, the research that
has been conducted on school-based sexual abuse prevention programs has
found that there are more positive outcomes associated with this type of pro-
gram than there are negative outcomes.
Another vein of research on this topic explores variation in student
response to school-based sexual abuse prevention programs (specifically
looking at student gender, race, and social economic status). There have been
mixed research findings regarding the relationship between school-based
sexual abuse prevention programs and student gender (Baker, Gleason, Naai,

Mitchell, & Trecker, 2013; Briggs & Hawkins, 1994; Finkelhor & Dziuba-
Leatherman, 1995; Hazzard, Kleemeier, & Webb, 1990; Hazzard, Webb,
Kleemeier, Angert, & Pohl, 1991; Kolko, Moser, & Hughes, 1989; MacIntyre
& Carr, 1999). Most studies have found no gender difference in student
response to sexual abuse prevention programs (Baker et al., 2013; Topping &
Barron, 2009). There have been a few studies that found some gender differ-
ences. Specifically, that girls learn and retain more of the information pro-
vided by school-based sexual abuse programs than boys (Finkelhor &
Dziuba-Leatherman, 1995; Hazzard et al., 1991), and that girls who partici-
pated in this type of program are more likely to disclose victimization than
boys (MacIntyre & Carr, 1999). Additional research is needed on this topic to
have a better understanding of gender differences in responding to sexual
abuse prevention programs.
Some researchers have suggested that student race can play a role in how
well children learn the lessons presented to them in education-based sexual
abuse prevention programs (Finkelhor & Dziuba-Leatherman, 1995; Kenny,
2010; Kenny & Wurtele, 2008; Topping & Barron, 2009). Although limited,
there is evidence that children respond differently to sexual abuse prevention
programs based on their race. It is important to point out that the limited
empirical evidence is partially the result of a lack of research using the race
variable when studying this topic. Finkelhor and Dziuba-Leatherman (1995)
found that African American children reported more positive reactions to the
program and more skill utilization than White children. In contrast, Hazzard
et al. (1991) did not find any racial differences in response to this type of
program. Additional research is needed to draw more definitive conclusions
about racial differences in response to sexual abuse prevention programs
offered in schools.
Living arrangement (such as whether a child comes from a one or two
parent/guardian home) is a vital statistic that is often ignored in studies
with children (James & Prout, 1997). Parental marital status needs to be
included in child research to ensure that children are “represented in statis-
tically valid ways” (James & Prout, 1997, p. 90). In general, living arrange-
ment influences educational attainment and knowledge retention, with
students whose parents are divorced having lower grade point averages,
lower academic achievement levels, and lower educational attainment
than students whose parents are not divorced (Amato & Keith, 1991; Call,
Beer, & Beer, 1994; Krein & Bellar, 1988). Other studies have found that
elementary students coming from single-parent families had lower test
scores than those coming from two-parent households; however, these
results appear to be mediated by household income level (Milne, Myers,
Rosenthal, & Ginsburg, 1986).

Living arrangement and its association with socioeconomic status impact

academic success (Lee & Burkam, 2002). Research looking at educational
achievement levels of African American and Hispanic children found that liv-
ing arrangement and socioeconomic status are highly correlated (Battle, 1997,
1998). There is some evidence that parental socioeconomic status influences
their child’s level of academic success (Sirin, 2005). This suggests that students
who come from a single-parent, one-income household may be at a disadvan-
tage when it comes to retaining knowledge presented in a school setting.
Studies evaluating child sexual abuse prevention programs have also
found that socioeconomic status influences knowledge retention. A study
evaluating the THINK FIRST for KIDS injury prevention program found that
students coming from low socioeconomic status schools were more likely to
retain program information than students who came from higher socioeco-
nomic status schools (Greene et al., 2002). While investigating another sex-
ual abuse prevention program, researchers found that children from low
socioeconomic status backgrounds had less positive program outcomes both
during initial testing and at follow-up testing 12 months later (Briggs &
Hawkins, 1994). The difference in student response to sexual abuse preven-
tion programs was largely influenced by parental involvement, as well as the
child’s life experiences (Briggs & Hawkins, 1994). Single-parent families
may be at increased risk of poverty, which, in turn, can limit focus on aca-
demic fulfillment (Gassama, 2012). Difficulties retaining knowledge might
stem from less parental reinforcement in single-parent homes. Currently,
there are no published studies that consider student living arrangement and
knowledge retention of sexual abuse prevention programs.
Another issue related to the effectiveness of school-based sexual abuse
prevention programs is the length of time that students retain the information
they learn from such programs. Some studies have found that children are
able to retain information learned from this type of prevention program for
several months after the program has ended (MacIntyre & Carr, 1999;
Oldfield, Hays, & Megal, 1996; Rispens, Aleman, & Goudena, 1997; Tutty,
1992). Other studies have found that students are able to retain sexual abuse
prevention knowledge for up to 1 year after participating in this type of pro-
gram (Briggs & Hawkins, 1994; Hazzard et al., 1991; Ko & Cosden, 2001).
Most of the research that has been conducted on student retention of knowl-
edge acquired during school-based sexual abuse prevention programs does
not extend beyond the scope of 1 year.
After reviewing the existing literature on school-based sexual abuse pre-
vention programs, it is clear that there is still a lot to learn about the effective-
ness of this type of prevention program. This is surprising, given that this
type of program has been utilized in elementary schools across the United

States for more than three decades (Wurtele, 2009). The study presented in
this article contributes to this body of literature by examining student knowl-
edge retention of the RFGFP program for up to 2 years after students partici-
pated in the program.
The RFGFP Program

Following its formation in 1980, the RFGFP program has been used in all 50
states in the United States and more than 70 foreign countries). The program is
designed to inform elementary school students about personal safety and sex-
ual abuse prevention. The RFGFP program teaches children to “recognize
appropriate and inappropriate kinds of touches from family, friends, and strang-
ers . . . and how to recognize potentially harmful situations, assertive responses,
and examples of trusted adult helpers” (RFGFP workbook, 2008, p. 2).
There are two main strategies used in the presentation of the RFGFP cur-
riculum: First, instructors present and discuss the RFGFP material in a class-
room setting for 45 min over the course of 2 days. RFGFP instructors are
trained to administer the RFGFP program by the program coordinator at the
local Rape and Abuse Crisis Center. Second, each child is given a 28-page
RFGFP workbook to use as a visual guide while the instructor presents the
RFGFP material. The students are asked to follow along in the workbook
(completing short activities and coloring pictures) as the instructor is present-
ing the material to the class. The workbook is designed to stimulate discus-
sion and generate questions from students. The workbook provides basic
instructions on identifying good and bad touches, what to do if students find
themselves in risky situations (say no, leave the situation, tell a helper), and
provides illustrations of scenarios of both red and green flag situations. The
purpose of using both visual aids and verbal presentation of the material is to
increase the likelihood that students will learn and retain the information
beyond classroom instruction. In addition, the use of picture-based informa-
tion in the workbook is helpful, given the age and varying reading capabili-
ties of the children who participate in the program (second grade).
Few evaluations have been conducted on the RFGFP program since its
inception in 1980. In a study conducted by Miltenberger and Thiesse-Duffy
(1988), parents were given the RFGFP workbook and asked to use it to teach
the material to their children (ranging in age from 4 to 7 years). Although spe-
cifically designed as a primary component of the RFGFP program, the work-
book has also been sold commercially to the public. Children were given a
baseline assessment prior to the workbook distribution and another assessment
following the workbook distribution. Assessments were executed by showing
pictures and giving explanations to the children depicting “good” and “bad”

touches. Children were then asked to respond whether the scene was good or
bad. Role-playing scenarios were also used in the assessment, where a research
assistant played the role of a potential perpetrator, and the child was asked to
demonstrate how they would react in each situation. Results from this portion
of the study revealed that only a few valuable skills were learned by the chil-
dren as a result of only reviewing the RFGFP workbook.
The next phase of the study consisted of children participating in a behav-
ioral skills training component, specifically, one-on-one sessions with evalua-
tors and research assistants involving role-playing, modeling, and feedback.
The children were assessed again following the behavioral skills training,
which resulted in all children displaying newly developed personal safety
expertise. This suggests that the RFGFP program workbook alone has limited
effects on child sexual abuse prevention knowledge unless it is partnered with
a behavioral skills training component (Miltenberger & Thiesse-Duffy, 1988).
A follow-up study conducted 2 years later by Miltenberger, Thiesse-Duffy,
Suda, Kozak, and Bruellman (1990) found that there was no effect on sexual
abuse prevention skills among children whose parents used the RFGFP work-
book as a teaching tool, even when parents used an instruction manual pro-
viding them with teaching instructions for optimal use. No negative effects of
the program (such as nightmares, behavioral problems) were reported, but
positive outcomes such as increased awareness of one’s body and decreased
fear of strangers were reported by children who participated in the program.
While this study demonstrates that parental use of this program is chiefly
ineffective, this finding should be interpreted with caution as it was based on
an analysis of a very small sample (n = 9).
An evaluation of the RFGFP program conducted in an educational setting
with third and fourth graders yielded more positive results than the previ-
ously described home studies. An experimental design was used by Kolko,
Moser, Litz, and Hughes (1987) that compared two experimental schools
(schools that administered the RFGFP program in conjunction with the film
“Better Safe Than Sorry II”) to a control school. Students in the experimental
group were better able to discern between good touches and bad touches and
were more willing to approach adults when confronted with threatening situ-
ations compared to those in the control group. Children in the experimental
group also were more likely to follow prevention steps (say no, get away, and
tell a trusted adult) than children from the control group. While these results
are encouraging, it is important to note that the researchers did not separate
the effects of the RFGFP program from the effects of the film, “Better Safe
than Sorry II” (which is not a part of the RFGFP program).
A follow-up to Kolko et al.’s (1987) study was conducted in 1989 with
third graders. This study focused on knowledge retention rates of students 6

months after they participated in the RFGFP program and viewed the film
“Better Safe than Sorry II.” Students in the experimental group were more
likely to report incidents of inappropriate touching than those in the control
group. This evaluation also found that students who participated in the
RFGFP program displayed greater knowledge retention of the program mate-
rial than students in the control group. This evaluation of the RFGFP program
revealed that, in general, the program, when administered in a school setting,
can be effective in increasing children’s knowledge about sexual abuse and
providing them with operational prevention strategies. These findings appear
to be evident in both short- and long-term situations (Kolko et al., 1989).
The RFGFP program continues to be offered in elementary schools today;
however, the RFGFP program has not been evaluated since 1990. The study
presented in this article provides a contemporary look at student knowledge
retention of the RFGFP program. This study is different from previous stud-
ies because it examines both long-term knowledge retention (1 and 2 years
after participating in the RFGFP program) and short-term knowledge (stu-
dents who participated in the RFGFP program within 3 months of completing
the survey). Previous studies of student knowledge retention of school-based
sexual prevention programs have not examined knowledge retention beyond
1 year after participating in this type of program. The current study also
includes a new variable of interest—student living arrangements as it relates
to knowledge retention of the RFGFP curriculum. To our knowledge, this
variable has not been used in any of the previously published studies on
school-based sexual abuse prevention programs. Specifically, the current
study responds to the following research questions:
Research Question 1: Is student knowledge retention of the RFGFP pro-

gram influenced by the amount of time that has passed since participation
in the program?
Research Question 2: Do student characteristics (including gender, race,
and living arrangement) influence knowledge retention of the RFGFP pro-
gram curriculum?
Method
Participants
The current study is based on survey data collected from eight elementary
schools in two school districts in Eastern North Dakota (cross-sectional). The
RFGFP program has been offered to all second graders in all of the elemen-
tary schools in both school districts each year for the last 10 years. The

community within the first district consists of 2,329 residents (U.S. Census
Bureau, 2010). Most of the residents in this city are White (97.3%), and the
median household income is US$51,250 (U.S. Census Bureau, 2010). The
elementary school in the first district houses kindergarten through fifth grade.
There are 339 students in this school and nearly all (98%) of the students are
White (National Enrollment Statistics for Elementary Schools, 2011).
In the second school district, the community consists of 25,830 residents
(U.S. Census Bureau, 2010). Most (93.5%) of the residents in this city are
White, 2% are African American, 1.4% are Asian, 1% are American Indian
and Alaska Native, and the remaining percentage is a combination of all other
races. The median household income is approximately US$61,000. The
seven elementary schools within the second district consist of 2,540 students
(National Enrollment Statistics for Elementary Schools, 2011). Most (91.9%)
of the students in this district are White, with 2.9% Hispanic, 2.2% African
American, 1.9% American Indian or Alaskan Native, and the remaining 1% a
combination of other races.
Approval to conduct this study was granted in August 2011 by the
Institutional Review Board of the university campus that employs the authors
of this article. Several weeks before the surveys were administered, letters
containing information about the study were sent home with every student in
the classrooms included in this study. The letter had a section at the end where
parents could request that their child/children not be included in the study.
The classroom teachers instructed the nonparticipating children to read or
work on other activities while the survey was administered to participating
students. In addition, informed consent sheets were read aloud to the students
before surveys were distributed to them. The children had the option not to be
part of the study even if their parents had consented to their participation.
Survey distribution began on November 15, 2011 and concluded on April
27, 2012. The principals at each of the elementary schools randomly selected
the classrooms for each grade level that participated in the study. A research
team comprised of at least three people was present during the administration
of the surveys to answer questions about the survey or to help students who
had difficulty writing their responses to the questions.
Surveys were distributed to one section of second, third, and fourth grades
in all eight of the elementary schools (a total of 24 classrooms). Out of 546
students, 180 students did not participate in the study because they were new
to the district, absent on the day of survey administration, their parents would
not allow them to participate in the study, or the students chose not to partici-
pate. The response rate was 67% (366/546).
The racial composition of the student sample includes 334 (91%) students
who are White, and 32 (9%) students of all other races. There are slightly

more female students (195 or 53.3%) in the sample than there are male stu-
dents (171 or 46.7%). Most (292 or 83%) students live with both of their
parents in the same household, while 59 students (17%) live in single-parent
homes, with guardians, or in foster homes. There was equal representation for
all grades, with 116 (31.7%) second graders, 130 (35.5%) third graders, and
120 (32.8%) fourth graders.
The survey instrument contained questions that inquired about student
demographic information (name of school, gender, race, and living arrange-
ment). The survey also contained questions inquiring about specific informa-
tion from the RFGFP curriculum that was presented to students in the
classroom and that is also found in the RFGFP workbook given to each stu-
dent at the beginning of the program. Wording for each question was derived
directly from the RFGFP curriculum material in an effort to generate age-
appropriate questions. Curriculum-based questions on the survey included
the following: “Do you remember the Red Flag Green Flag People program
from second grade?”; “What is a red flag touch?”; “What should you do if
someone tries to give you a red flag touch?”; and “What should you do if
someone tells you to keep a red flag touch a secret?”
Before the survey instrument was administered to the students, it was
reviewed by a local elementary schoolteacher to ensure that the questions
were cognitively appropriate for children in second, third, and fourth grade.
In addition, the survey was also reviewed by an instructor of the RFGFP pro-
gram and the director of the local Rape and Abuse Crisis Center to ensure that
the questions reflected the curriculum that is presented to children who par-
ticipate in the RFGFP program.
Dependent Variables
The goal of this study is to examine the short- and long-term knowledge
retention of elementary students who have participated in the RFGFP pro-
gram. As a result, the dependent variables in this study are drawn from survey
questions that are based on the core components of the RFGFP program
curriculum.
The survey contains the question, “Do you remember the Red Flag Green
Flag People program from second grade?” This question measures whether
or not students (in general) remember the RFGFP program (0 = no, 1 = yes).
A fundamental lesson from the RFGFP program is to teach children the
distinction between good (green flag) and bad (red flag) touches. To deter-
mine student knowledge of red flag/green flag touches, the survey included
the question, “What is a red flag touch?” Responses were coded 0 = physical
touch or other responses that did not mention that it was a sexual touch (hit,

slap, pulling hair, etc.) and 1 = sexual touch (touch in a private spot, etc.).
According to the RFGFP curriculum, the correct answer is sexual touch.
The RFGFP program teaches children to follow a three-step process when
responding to a red flag touch: (1) say no, (2) run/get away, and (3) tell a
helper/trusted adult. To measure student knowledge of these three steps, the
survey includes the question, “What should you do if someone tries to give
you a red flag touch?” Responses were coded as 0 = none of the three steps
were identified in the response or 1 = one or more of the steps were men-
tioned in the response.
The RFGFP program stresses the importance of not keeping secrets about
red flag touches. Specifically, the program teaches children that under no
circumstances should children keep secrets about red flag touches. The sur-
vey includes the question, “What should you do if someone tells you to keep
a red flag touch a secret?” The responses for this question were coded 0 =
keep the secret, or do not tell anyone, or some other response, and 1 = do not
keep it a secret, tell someone.
Independent Variables
The current study includes several student characteristics that have been used
in previous studies (including gender, race, and grade), but also adds to the
existing literature by including a new variable of interest: student living
arrangement.
Gender. To examine gender differences in knowledge retention of the RFGFP

program, girls were coded as “0” and boys were coded as “1.”
Race. The race variable in the current study is coded as 0 = all races other
than White, and 1 = White. Collapsing all races other than White into one
group is a limitation, because effects of individual races will not be captured
in the analyses.
Grade. To measure both short- and long-term knowledge retention of the

RFGFP program, we surveyed second graders (0 = 2nd) who had participated
in the program within 3 months of survey distribution, third graders (1 = 3rd)
who had participated in the program a year before completing the survey, and
fourth graders (2 = 4th) who had participated in the program 2 years prior to
completing the survey.
Living arrangement. The current study examines the extent to which living

arrangement influences student knowledge retention of the RFGFP program

(0 = living arrangements include single-parent families, foster care, or some

other arrangement and 1 = both parents living at home).
Data Analysis Plan

Pearson chi-square test is used to assess the relationship between categorical
variables (Somekh & Lewin, 2005). Pearson chi-square tests will be used to
determine whether there is a relationship between RFGFP program knowl-
edge retention and student grade (Research Question 1), and also if there is a
relationship between each of the student characteristics (including gender,
race, and living arrangement) and knowledge retention of the RFGFP pro-
gram curriculum (Research Question 2). Binary logistic regression measures
the relationship between a categorical (dichotomous) dependent variable and
one or more independent variables (Hosmer & Lemeshow, 2004). Binary
logistic regression will be used to determine whether student characteristics
(gender, race, living arrangement, and grade) influence student knowledge
retention of the RFGFP program (Research Questions 1 and 2).
Results
The first research question asked, “Is student knowledge retention of the
RFGFP program influenced by the amount of time that has passed since par-
ticipation in the program?” Overall, 69.4% of all students surveyed reported
that they remember the program. As expected, the second graders who had
participated in the program within 3 months of completing the survey had the
highest percentage of students reporting that they remember the RFGFP pro-
gram (90.4%), with fewer third graders remembering the program (63%), and
just over half (55.9%) of the fourth graders remembering the program from 2
years prior. A Pearson chi-square test determined that there is a significant
relationship between program knowledge retention and grade of student (χ2 =
36.070, p < .01). This was also the case with the binary logistic regression
model (see Table 1).
The program manual teaches students that a red flag touch is “a touch that
makes us feel scared, mixed up, or unhappy” (p. 11). Overall, 54.9% of all
students surveyed identified a red flag touch as a sexual touch. It appears that
as students get older (and advance in grade level), their understanding of a
red flag touch increases. Nearly half (48.7%) of second graders associated a
red flag touch with a sexual touch, but this number rises with 54.6% of third
graders and 61.2% of fourth graders identifying a red flag touch as a sexual
touch. A Pearson chi-square test did not find statistical significance between
understanding of a red flag touch and grade; however, the statistical model

Table 1. Logistic Regression Statistics: Do You Remember the RFGFP Program?
(n = 346).
Predictor Variable B Wald p r Exp(B)

Grade 4 −2.024* 28.624 .000 .378 0.132
Grade 3 −1.770* 22.327 .000 .375 0.170
Gender −0.264 1.093 .296 .253 0.768
Race 0.925* 4.816 .028 .422 2.523
Living arrangement −0.735* 4.191 .041 .359 0.480
Constant 2.207 14.170 .000 .586 9.091
Reference category for grade (2nd grade)
Reference category for gender (female)
Reference category for race (White)
Reference category for living arrangement (live with both parents)
Model χ2 47.665 .000
df 5
*p < .05.
Table 2. Logistic Regression Statistics: What Is a Red Flag Touch? (n = 351).

Grade 4 0.598* 4.772 .029 .274 1.819
Grade 3 0.323 1.487 .223 .265 1.382
Gender −0.592* 7.258 .007 .220 0.553
Race 0.566 2.092 .148 .391 1.761
Living arrangement 0.002 0.000 .994 .293 1.002
Constant −0.310 0.409 .522 .485 0.409
Model χ2 13.984 .016
df 5
*p < .05.
revealed that fourth graders were more likely than second or third graders to
identify a red flag touch as a sexual touch (see Table 2).
Throughout the RFGFP program, students are informed of three steps that
can be used to prevent a red flag touch: (1) say no, (2) get away from the situ-
ation, and (3) tell a helper. Overall, 83.3% of the students surveyed could

Table 3. Logistic Regression Statistics: What Should You Do If Someone Tries to
Give You a Red Flag Touch? (n = 351).

Grade 4 −1.663* 11.871 .001 .483 0.190
Grade 3 −1.541* 10.323 .001 .480 0.214
Gender −0.745* 5.844 .016 .308 0.475
Race 0.923* 4.152 .042 .453 2.517
Living arrangement 0.018 0.002 .964 .389 1.018
Constant 2.457 12.880 .000 .685 11.666
Model χ2 27.876 .000
df 5
*p < .05.
identify at least one of the three steps, with “tell a helper” being the most
reported step. Second graders were most likely to report that they remember
at least one of the three steps (94.8%), followed by third graders (78.5%), and
then fourth graders (77.7%). A Pearson chi-square test determined that there
is a significant relationship between children knowing the preventive steps in
red flag situations and student grade (χ2 = 15.854, p < .01). The binary logis-
tic regression revealed that students were less likely to remember one or more
steps as their grade level increased (see Table 3).
When asked whether or not they should keep secrets about red flag touches,
many students (79.8%) reported that they should tell someone and not keep it
a secret. The majority of second graders (93.9%) reported that they would not
keep the secret, along with over half (68.5%) of third graders and more than
three quarters (78.5%) of fourth graders. A Pearson chi-square test revealed a
statistically significant relationship between students reporting whether or not
they should keep secrets about red flag touches and student grade (χ2 = 24.685,
p < .01). The binary logistic model also revealed that grade was significant,
with third and fourth graders being less likely to tell someone (or keep the red
flag touch a secret) compared with second graders (see Table 4).
After considering all of the results of the statistical analyses, it appears
that the passage of time does influence student knowledge retention of the
RFGFP program (both in general and with regard to specific material found
in the RFGFP curriculum). Whereas second graders were most likely to
remember the program and its core lessons, there is also evidence of long-

Table 4. Logistic Regression Statistics: What Should You Do If Someone Tells
You to Keep a Red Flag Touch a Secret? (n = 351).

Grade 4 −1.389* 9.242 .002 .457 0.249
Grade 3 −1.884* 18.417 .000 .439 0.152
Gender −0.404 2.026 .155 .284 0.668
Race 0.469 1.048 .306 .458 1.599
Living arrangement −0.205 0.289 .591 .381 0.815
Constant 2.693 16.366 .000 .666 14.775
Model χ2 28.042 .000
df 5
*p < .05.
term knowledge retention of the RFGFP program for up to 2 years after par-
ticipation in the program.
The second research question asks, “Do student characteristics (including
gender, race, and living arrangement) influence knowledge retention of the
RFGFP program curriculum?” When measuring knowledge retention, 70.6%
of White students reported that they remember the RFGFP program, compared
with 56.3% of student from all other races. Fewer male students (67.1%)
remembered the RFGFP program when compared with female students
(71.4%), and fewer students who live in a two-parent household (68.6%)
remembered the RFGFP program compared with students who were raised in
households with one parent or foster families (78%). The chi-square tests for all
three of these variables were not statistically significant. When all three of
these variables were included in the regression model with the grade variable,
student race and living arrangements were statistically significant (see Table 1).
When asked to identify a red flag touch, over half (61%) of the female
students identified it as a sexual touch (vs. a physical touch) when compared
with male students (48%). More White students (55.7%) identified it as a
sexual touch when compared with students of all other races (46.9%). There
was only a slight difference when comparing student living arrangements.
Over half (55%) of the students who live with both parents identified a red
flag touch as a sexual touch compared with students living with single-parent
or foster families (55.9%). Pearson chi-square test revealed that student

gender is significant at the .05 level (χ2 = 6.288, p = .012), while race and
living arrangement were not statistically significant. When all three of the
demographic variables were included in a statistical model with the grade
variable, males were less likely than females to identify a red flag touch as a
sexual touch (see Table 2). Student race and living arrangements were not
statistically significant in the regression model.
When asked “What should you do if someone tries to give you a red flag
touch?” fewer male students (43.9%) were able to recall one or more of the
three preventative steps taught by the RFGFP program compared with female
students (56.1%). More White students (84.4%) were able to identify one or
more of the RFGFP program steps compared with 71.9% of students from all
other races. Students who live with both parents were slightly more likely to
recall one or more steps (84.2%) compared with students who lived with
single-parent or foster families (81.4%). A chi-square test found student gen-
der to be statistically significant (χ2 = 5.710, p = <.017). Student race was
close to reaching significance (χ2 = 3.315, p = .06), while student living
arrangement showed no statistical significance. When these three variables
were included in a regression model with the grade variable, males were less
likely to identify one or more steps, and White students were more likely to
identify one or more steps (see Table 3). Living arrangement was not statisti-
cally significant in the full model.
When students were asked whether or not they should keep secrets about
red flag touches, most (82.6%) female students reported they would tell
someone compared with 76.6% of male students. A higher percentage of
White students (80.2%) reported that they would tell someone compared with
75% of students from all other races. Only a slightly higher percentage of
students who lived in a single-parent or foster family (81.4%) were likely to
report that they would tell someone about a red flag touch compared with
students from two-parent households (80.8%). No significance was found
among these three independent variables in the chi-square test or the regres-
sion model (see Table 4).
Discussion
In general, the research findings from this study indicate that many students
are retaining information presented to them in the RFGFP program. As
expected, the more time that passes from the time of participation in the
RFGFP program, students are less likely to remember the program and its
core lessons. Despite this decrease over time, 69.4% of students in all grades
are still able to recall the RFGFP program. Most (75%) of the students are
able to remember at least one of the program’s preventative steps, and over

half (65%) of all students know not to keep a red flag touch a secret. These
findings suggest that there is both long- and short-term knowledge retention
of the RFGFP program among elementary school children who participated
in the program. This finding contributes to the existing body of literature as it
suggests that some children can retain knowledge for up to 2 years after par-
ticipating in school-based sexual abuse prevention programs. Most of the
previous studies on this topic only examined student knowledge retention
from a few months up to 1 year.
It has been suggested that “booster shot sessions” provided after participa-
tion in sexual abuse prevention programs may improve student knowledge
retention (Hazzard et al., 1991; MacIntyre & Carr, 2000). It has also been sug-
gested that parents become active participants in child sexual abuse preven-
tion education as they can provide additional exposure to prevention
information at home to reinforce sexual abuse prevention skills and knowl-
edge presented in a school setting (Roberts & Miltenberger, 1999; Wurtele,
Kast, & Melzer, 1992). Continuing sexual abuse prevention education
throughout middle school and high school years can only reinforce what chil-
dren have learned about sexual abuse prevention in earlier stages of their lives.
Most studies have found no gender differences in student response to sexual
abuse prevention programs (Baker et al., 2013; Topping & Barron, 2009); how-
ever, there is some evidence that girls may retain more information provided by
school-based sexual abuse programs than boys (Finkelhor & Dziuba-
Leatherman, 1995; Hazzard et al., 1991). This was the case in the current study,
as more female students (61%) were able to identify a red flag touch as a sexual
touch (as opposed to a physical touch) compared with 48% of the male stu-
dents. Less than half (43.9%) of the male students were able to recall one or
more of the three preventative steps taught by the RFGFP program compared
with 56.1% of the female students. These findings were statistically significant
in the regression models used in this study. More research is needed on this
topic to have a clearer understanding of how boys and girls respond, retain, and
use skills presented to them in sexual abuse prevention training in school.
The current study found that 70.6% of White students reported that they
remember the RFGFP program compared with 56.3% of students from all other
races; however, this finding was not significant in the statistical model. As
schools across the country become more diverse, it is important that this type of
program is presented in a manner that is relatable to students of all races. This
should include training program instructors to be culturally sensitive and aware
of any differences based on race (Kenny, 2010; Kenny & Wurtele, 2008). Boyle
and Lutzker (2005) found that although teaching prevention techniques to stu-
dents of other cultures originally proved difficult, practice, attention to key
words, and slight adjustments to the program (letting the student politely answer

“no thank you” as opposed to the blatant “no” that the program taught) allowed
them to condition their students toward the appropriate response (resulting in
100% correct responding on a follow-up test). Their study found that although
challenging, it is possible to teach this important material to students of other
cultures or languages. It would also be helpful if program materials were avail-
able in multiple languages so that all students can understand the information
being presented to them (either lectures or the workbook that accompanies the
classroom presentation). Kenny and Wurtele (2008) found that Hispanic speak-
ing children were less likely to correctly label their genitals compared with
English speaking children; therefore, it is imperative that this type of program is
available in a variety of languages. Ideally, every student should have access to
the program in their primary language (Wurtele, 1987).
Student living arrangements did not result in any statistically significant
findings in this study. Perhaps the number of parents or guardians living with
children is less important than the frequency and quality of involvement that
parents or guardians have in their children’s lives. There is some evidence
that parental involvement is positively correlated with the success of sexual
abuse prevention programs (Kenny et al., 2008). Furthermore, Tutty (1993)
emphasizes the need for parents to make the discussion of sexual abuse with
their children a priority and not rely fully on schools to provide this critical
information to their children. Parents may feel uncomfortable talking to their
children about this sensitive topic; however, for prevention programs to be
successful, they must incorporate sexual education into the curriculum and
adopt a parental component to the program (Kenny et al., 2008).
Limitations
This study is not without limitations. First, there is always concern that there
may be a difference between what children say they will do in a given sce-
nario and what they would actually do if the same scenario actually presents
itself (Hazzard et al., 1991; Miltenberger et al., 1990). According to
Miltenberger et al. (1990),
It is therefore open to question whether children who say they would say “no,”
get away, and tell a trusted adult about a sexual abuse situation would actually
do so if confronted by the situation. Such correspondence is further open to
question given the implied or real sanctions for reporting sexual abuse by the
perpetrator. (p. 68)
While knowing this, it is impossible for researchers to attempt to include all

possible threats, sanctions, incentives, and enticements that a perpetrator
might use into their studies (Miltenberger et al., 1990).

The cross-sectional nature of this study is also a limitation. Without a lon-

gitudinal comparison, it is difficult to determine how much growth exists
between what information the student retained immediately following the
program compared with what was retained 1 or 2 years later. In addition, the
non-experimental design used in this study prohibited us from drawing com-
parisons from students who did not participate in the RFGFP program.
Furthermore, the data analyzed in this study are hierarchical in nature;
thus, it would be appropriate to use hierarchical linear modeling (HLM).
HLM was not used in our analysis because the older children in this study
received the program in classrooms different from the ones in which they
were in when the data were collected for the study. As a result of this prob-
lem, it is important to note that it is possible that there may be positively
biased parameter estimates because the nested nature of these data has not
been addressed in the current study.
Finally, there are some limitations regarding response rates, coding, and
selection bias. This study produced a 67% response rate. Although this
response rate is viewed as “good” for social science research (Babbie, 2005,
p. 272), for various reasons, a portion of the population sample did not par-
ticipate in the study. While efforts were made to encourage participation from
all students, it is conceivable that the children who did not participate in the
study are different from the students who did participate. Classes included in
this study were chosen by the school principal based on scheduling conve-
nience; thus, selection bias is a potential limitation. It is possible that the
children retained knowledge from the RFGFP program, and these concepts
were then reinforced by their parents, media, and other outside influences. It
is also possible that children learned prevention techniques that coincide with
the program curriculum from sources other than the RFGFP program. While
this study determined that knowledge regarding sexual assault prevention
techniques was indeed retained by the children in the sample, dichotomous
coding (particularly for questions regarding knowledge retention for the
three-step procedure for preventing a “red flag” touch) makes it difficult to
assess the extent of knowledge that was retained. Whether or not the knowl-
edge that was retained from the RFGFP program will be put into practice in
the future is also unknown (Daro, 1994). However, it is likely that students
who remembered key elements of the program will be able to call upon them
if necessary. One study found that individuals who participated in a child
sexual assault prevention program reported decreased incidences of sexual
assault into adulthood than individuals who did not participate in a childhood
sexual assault prevention program (Gibson & Leitenberg, 2000).
Despite these limitations, this study produced important findings regarding
student knowledge retention of lessons learned from a school-based sexual abuse
prevention program. But are school-based sexual abuse prevention programs

enough? When posed with the question about whether enough is being done to
prevent child sexual abuse, Sandy K. Wurtele (2009) and others before her have
adamantly said no. Wurtele (2009) suggests that a more comprehensive approach
is necessary when dealing with child sexual abuse. Specifically, she recommends
that children, parents, professionals (including teachers, childcare providers,
health care professionals, and researchers/clinicians), and the general public need
to become involved in sexual abuse prevention efforts/programs. Multifaceted
efforts that include several social institutions will broaden knowledge of preven-
tion techniques, and improve responses to incidents of child sexual abuse. As one
study reported, the responsibility for preventing child abuse should not rest solely
on the child, but instead on various individuals who act as important intercepts in
a child’s life (Renk, Liljequist, Steinberg, Bosco, & Phares, 2002). These inter-
cepts extend beyond parents, teachers, medical professionals, and law enforce-
ment to include clergy members and administrators of youth organizations, such
as Boy Scout leaders, club advisors, and coaches. For sexual abuse prevention
education and instruction to advance, it needs to extend beyond the classroom.
Declaration of Conflicting Interests

The author(s) declared no potential conflicts of interest with respect to the research,
authorship, and/or publication of this article.
Funding
The author(s) disclosed receipt of the following financial support for the research,
authorship, and/or publication of this article: The authors received a small stipend
from the Fargo-Moorhead Rape and Abuse Crisis Center to fund this evaluation. To
further clarify, the primary researcher, Dr. Archbold, received no funding for this
study. A few graduate students (including McKenzie Wood) received a small stipend
from the Fargo-Moorhead Rape and Abuse Crises Center. The Fargo-Moorhead Rape
and Abuse Crisis Center is a nonprofit organization, there is no grant number.
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Author Biographies
McKenzie Wood is a criminal justice doctoral student at North Dakota State
University. Her research interests include institutional and community corrections,
programs and policies aimed at combatting juvenile delinquency, and studying the
prevalence of sexual assault on college campuses.
Carol A. Archbold is an associate professor of criminal justice at North Dakota State
University in Fargo, North Dakota. Her research interests center primarily on the
police. She has published over 20 journal articles in policing and criminal justice
journals. She wrote Police Accountability, Risk Management, and Legal Advising
(LFB Scholarly Publishing, 2004), which features the first study of the use of risk
management by American police agencies. In collaboration with Dorothy Moses
Schulz and Kimberly Hassell, she authored Women and Policing in America: Classic
and Contemporary Readings (Aspen Publishing, 2011). She recently wrote Policing:
A Text/Reader (SAGE Publications, 2012), and is currently working on the second
edition of The New World of Police Accountability with Samuel Walker. Her current
research projects include a study of the processing of sexual assault cases by police
officers, and a study of the impact of the oil boom on police agencies in Western
North Dakota.

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McKenzie Wood1 and Carol A. Archbold1

1North Dakota State University, Fargo, ND, USA

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Despite receiving increased attention from media outlets, social institutions,

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Effectiveness of School-Based Sexual Abuse

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Living arrangement and its association with socioeconomic status impact

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The RFGFP Program

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Research Question 1: Is student knowledge retention of the RFGFP pro-

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Gender. To examine gender differences in knowledge retention of the RFGFP

Grade. To measure both short- and long-term knowledge retention of the

Living arrangement. The current study examines the extent to which living

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(0 = living arrangements include single-parent families, foster care, or some

Data Analysis Plan

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Predictor Variable B Wald p r Exp(B)

Predictor Variable B Wald p r Exp(B)

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Predictor Variable B Wald p r Exp(B)

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Predictor Variable B Wald p r Exp(B)

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While knowing this, it is impossible for researchers to attempt to include all

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The cross-sectional nature of this study is also a limitation. Without a lon-

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Declaration of Conflicting Interests

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