History of the Enough Abuse Campaign

MassKids, which directs the Enough Abuse Campaign, has had a long-term commitment to preventing sexual violence against children.

• In 1985, we co-produced the first statewide sexual abuse prevention media campaign in the country, fulfilling requests for prevention materials from over 5,000 citizens who called 800-4-A-Child. 
• Our three, 30-second PSAs won 4^th Place at the International Film Festival in New York City, and the Boston Art Directors Club Gold Award. 
• In 1987, in collaboration with Marvel Comics, we produced the first national PSA on child sexual abuse featuring survivor Spider Man.

Public backlash, however, triggered by the McMartin daycare case in California, the Fells Acre daycare case in Massachusetts, and fueled further by False Memory Syndrome promoters, resulted in a pivotal shift away from addressing child sexual abuse. 

Not until January 2002 when the clergy sexual abuse scandal broke in Massachusetts and it became the epicenter of what was to become an international focus on the problem did the pendulum begin to shift towards survivors and their allies. That July, the CDC issued its first ever Request for Proposals challenging applicants to address the need to “build adult and community responsibility” to address the problem. 

Two meetings were held subsequently with a small group of collaborators, including the Departments of Public Health and Social Services, the MA Society for the Prevention of Cruelty to Children, the Children’s Trust and Jane Doe, Inc. to explore the option of responding to CDC’s call. MassKids developed the proposal for MA and the group supported its submission. In September the proposal was rated highest of the three selected to receive a 5-year, $1.2 million grant. MassKids agreed to serve as lead agency for the effort.

The statewide Massachusetts Child Sexual Abuse Prevention Partnership was subsequently organized to oversee the CDC project and included public and private organizations representing experts in public health, child protection, mental health, child abuse prevention and treatment, sexual assault prevention, and juvenile and adult offender treatment and management. 

The Enough Abuse Campaign was launched as a community mobilization and citizen education initiative. Its dual mission – to prevent adults from sexually abusing children and to prevent children from developing sexually problematic behaviors in the future. Goals included mobilizing communities, educating citizens, strengthening prevention policies in schools and youth organizations, and advocating for prevention legislation.

Campaign Pilot Sites 

The Campaign selected, out of a pool of 20 communities, three that would serve as pilot sites to test various prevention strategies. These included the 7-town North Quabbin Area, the city of Newton, and the communities of Gloucester/Cape Ann. There, coalition-building efforts engaged public and private sector representatives and organizations to form local “Partnerships” to plan, implement, oversee and evaluate prevention efforts. 

In 2012, the Partnership held a strategic retreat led by Lightbox Collaborative consultants and supported by the Ms. Foundation, to acknowledge its accomplishments and to plan its future efforts. Two key recommendations supported MassKids’ view that the Partnership, which it had chaired for over a decade, should consider establishing “a clear rotation schedule and cycle, so that a wide array of Partnership members have the opportunities to share in the responsibilities that come with network leadership.”  Secondly, there was agreement that the Enough Abuse Campaign, the grassroots community education and organizing effort, would continue to remain as a program of MassKids. 

Enough Abuse Frameworks

Complex public health problems such as child sexual abuse require comprehensive solutions that go beyond simple education programs. The design and implementation of the Enough Abuse Campaign is grounded in three recognized frameworks for community and social change: the Socio-ecological model promoted by CDC; the Spectrum of Prevention framework promoted by the Prevention Institute; and the Framework for Collaborative Public Health Action in Communities developed by CDC and the National Academy of Sciences, Institute of Medicine.  These frameworks support the efficacy of our approach and its promise as a model for other communities and states.  

The Campaign operates in all of the domains critical to achieving its mission to prevent child sexual abuse. It helps organize state and local coalitions, educates parents and other citizens, trains a range of child and youth serving professionals, helps develop organizational policies for prevention, and advocates for legislative changes to prevent sexual victimization, ensure justice for survivors and accountability for abusers. 

The Socio-Ecological Model

The causes of child sexual abuse are multiple, complex, and interacting. The reason that one-dimensional solutions are inadequate on their own is because they target one cause but not the others, one piece but not the whole. To ensure that our strategies and interventions are successful and effective, Enough Abuse grounds its work in the Socio-Economic Model – a comprehensive approach to change that focuses on individuals, relationships, communities, and the larger society and culture. 

Efforts to address sexual abuse to date have focused largely on the individual through attempts to prevent children from becoming victims or to control or change the behavior of abusers. Yet influences on the individual can be so powerful that, as the Institute of Medicine concluded in its study on health promotion: “It is unreasonable to expect that people will change their behavior easily when so many forces in the social, cultural and physical environment conspire against such change.”

For example, the behavior of individuals is fundamentally influenced by interpersonal factors, e.g. whether family, peer-group, or other social relationships are supportive or abusive; organizational and community factors, e.g. the extent to which communities and organizations passively accept sexual abuse or actively work to address it; and public policy, that is the laws and public policies that are in place at a state and national level. Furthermore, societal factors, e.g. the media, entertainment, and advertising play a significant role in promoting healthy sexuality messages or in exploiting and pornifying images of children.

The strategies and interventions employed by the Enough Abuse Campaign address change at each level of the Socio-Ecological Model

The Spectrum of Prevention Framework

The Prevention Institute’s “Spectrum of Prevention” framework includes strategies designed for broad scale changes, not only of individuals but also of systems and norms. 

These activities, taken together, drive changes in social norms on a grander scale. By focusing, not only on individuals, but also on the settings that individuals live, work, and play in, by focusing efforts on socially agreed upon standards of behavior, regulations, and laws we increase the effectiveness of our efforts. Prevention – proactive and caring – becomes the norm rather than “It’s none of my business”. These norm changes are critical if we are to prevent child sexual abuse in our homes, communities and culture.

Framework for Collaborative Public Health Action in Communities

Under this Framework developed by the Institute of Medicine, National Academy of Sciences, it is recognized that when taking action to prevent complex public health issues such as child sexual abuse, no single intervention, no one program or practice targeting one behavior, is likely to improve outcomes across the population. Establishing authentic community collaborations engaged in ongoing planning, implementation and evaluation of a range of child sexual abuse prevention strategies holds the most promise for change among individuals, institutions and the larger social culture.

To those ends, the Enough Abuse Campaign has:

1. Achieved Assessment and Collaborative Planning by establishing state and local level collaborations, conducting scientific surveys to assess public knowledge/attitudes about sexual abuse, and helping community leaders assess local sexual violence data and community risk and protective factors;
2. Implemented Targeted Action and Interventions by developing high quality prevention training curricula, recruiting and selecting local leaders to become trainers, and conducting intensive “Training of Trainers” sessions to educate and certify local trainers to provide free educational workshops for parents, professionals and youth;
3. Achieved Community and Systems Change by implementing prevention programs, policies and practices that were successfully institutionalized in the community;
4. Accomplished Behavior Change and Risk Reduction, i.e. more people taking action to address child sexual abuse before it occurs by teaching children healthy body boundaries, being vigilant about adult behaviors that pose risks to children, identifying potential victims, and taking actions to change unacceptable community norms. Effectively carried out, these combined strategies are intended to support and lead to;
5. Improvements in Population-level Outcomes, i.e. a reduction in the occurrence of child sexual abuse – the Enough Abuse Campaign’s goal.

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Enough Abuse Campaign Today

Since the CDC-supported initiative was launched in 2002, the Campaign’s work has expanded to several communities and areas of the state and thousands of parents, teachers, childcare providers, and professionals have been trained by certified Enough Abuse trainers. Leaders in other states have adopted the Enough Abuse model, including Maryland, New Jersey, New York, Nevada, California, Maine, South Dakota, Missouri. With pro bono technical assistance from MassKids, the Campaign has also been launched in the West African nations of Nigeria and Sierra Leone. 

Today, citizens, communities, schools and youth-serving organizations In these sites are benefitting from the Campaign’s training and policy work around safe child policies that support identifying and responding to boundary-violating behaviors before they can escalate to reportable, illegal sexual offenses. Legislative proposals supported and promoted by the Campaign are succeeding in giving survivors opportunities to seek justice through the courts, holding abusers accountable, and preventing the future sexual abuse of more children.

The CDC has called the Campaign “a trailblazing effort to prevent child sexual abuse by building a movement of concerned citizens, community by community.”  The Ms. Foundation says it “goes beyond a limited set of trainings to foster the building of real and lasting relationships among diverse stakeholders. Its emphasis on community collaboration sets it apart from previous efforts.”  Another state reviewed programs across the country and concluded: “The Enough Abuse Campaign emerged as the most comprehensive and compelling program available.”  

The Enough Abuse Campaign continues to partner with community, state and national leaders, citizens, survivors, providers and funders to build the movement to end child sexual abuse in communities everywhere.