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The Effect of Child Sexual Abuse Prevention Song Among Elementary School Children:Pilot Study

Child Sexual Abuse (CSA) becomes a problem in the world that is quite large and has adverse effects, both short and long term. The prevalence continues to increase every year. Generally, elementary school-age likes to sing a song. Meanwhile, school-age is the time to study. A song is expected to increase knowledge of skills in preventing sexual violence. The objective of this study to assess the effect of education through songs on the level of skill knowledge about preventing CSA in school-age children. The type of research was quasi-experiment with one group pre and post-test design. The sample size used a total sampling that all students became the sample. The study involved 323 students in grades 4-6 at SDN Dayeuhkolot, Bandung Regency. The treatment was an education on prevention of the CSA on school-age children, it was given using the jargon "TANGKIS" with the method of giving songs through a video about the prevention of sexual violence against children. The instrument was adopted from the Aprilaz design (2016) which was modified by Suhenda (2019). Data analysis using univariate analysis with frequency and percentage distribution, and bivariate analysis using t-test. The study showed that 289 students (89.5%) were able to have good knowledge about the prevention of CSA before the intervention and after the intervention increased to 319 (98.8%) (p= 0.001). Education through songs influences students' knowledge regarding the prevention of CSA. Suggestion: this research is to be able to make education programs to prevent CSA of school-age children regularly and explore other educational methods that can effectively influence the improvement of knowledge, attitudes, and skills in protecting themselves from the threat of CSA.


INTRODUCTION
Child sexual abuse (CSA) is a terrible phenomenon. CSA is defined as any use of a child for sexual satisfaction by another person (Olafson, 2011), as the involvement of children in sexual activities that they do not understand, cannot give consent, are not prepared in development, and violate the law and social society (Organization, 1999).
CSA is a problem in the world that is quite large and has adverse effects, both short and long term for its victims (Walsh, Zwi, Woolfenden, & Shlonsky, 2018). Meta-analysis studies in countries around the world estimated that 10-20% of girls and 5-10% of boys have experienced CSA in the spectrum from exposure through unwanted touch to penetration attacks before the age of 18 (Barth, Bermetz, Heim, Trelle, & Tonia, 2013;Pereda, Guilera, Forns, & Gómez-Benito, 2009;Stoltenborgh, Van Ijzendoorn, Euser, & Bakermans-Kranenburg, 2011). The same thing happened in the country of Indonesia.
Currently, the incidence of sexual violence against children in Indonesia continues to increase, the area of sexual violence is increasingly widespread and more complex, so that Indonesia is said to have entered the status of "Emergency Sexual Violence Against Children" (Erlinda, 2016). One area in Indonesia that has increased CSA was Bandung Regency which has the highest number of CSA cases in West Java (BAPPEDA, 2016). CSA cases in 2015 were found as many as 53 cases, increasing to 111 cases in 2016 (Integrated Service Center for Women's and Children 's Empowerment (P2TP2A, 2016).
Actually, there is a possibility that the actual CSA incidence rate is higher than reported. According to London, Bruck, Ceci, & Shuman (2005), two-thirds of people have never revealed the victimization that occurred to them (London, Bruck, Ceci, & Shuman, 2005), Most cases of sexual assault are not reported to the authorities (Wyatt, Burns Loeb, Solis, Vargas Carmona, & Romero, 1999). Thus, it has been imagined how many CSA victims will suffer terrible effects.
The anticipation of child sexual abuse is a serious public health concern (Hammond, 2003;Daniel J Whitaker, Lutzker, & Shelley, 2005). Efforts are needed to overcome CSA problems, one of which is by increasing children's knowledge in an effort to protect themselves from the threat of CSA. Education the children to avoid child molesters is such programs can be important(D. J. Whitaker et al., 2008). One such effort can be done at school. Russell (2020) explained that the greatest empirically evaluated interventions in developing nations have focused on preschool and primary school-aged children (Russell, Higgins, & Posso, 2020). Finkelhor (2009), describes that school-based educational programs explain the children's ability such as how to recognize unsafe situations, refuse an abuser's approach, discontinuity off an interaction, and call help(D. Finkelhor, 2009). School-based education programs for the anticipation of CSA are characteristically obtainable to groups of pupils (e.g., in classes) and are personalized to ages and cognitive levels, thru providing pupils with knowledge information and skills to know and avoid possibly sexually abusive conditions and with plans to physically and verbally repel sexual approaches by offenders (Walsh et al., 2015). The program must be delivered in the form of methods that are interesting and preferred by children. The song accompanied by music is one of the methods favored by children.
Music plays an important role in the socialization of children and adolescents where research has reported that the perception and effect of the lyric message accompanied by music have an effect on their behavior ("Impact of Music, Music Lyrics, and Music Videos on Children and Youth," 2009). Songs that are accompanied by music have a positive impact on children. Combining songs and music into the schoolroom has been shown to have constructive effects on learning by several researchers(Fonseca-Mora, Toscano-Fuentes, & Wermke, 2011;Griffee, 1992;Lo & Li, 1998). The use of songs is believed to increase vocabulary skills and level of knowledge. Using songs to explain vocabulary to young students can effectively advance students' vocabulary and English knowledge (Burhayani, 2013). Since the effects of music and songs can improve English knowledge, this can also increase children's knowledge of CSA prevention. Music accompanied by lyric songs in the form of messages about how children's efforts to protect themselves from CSA threats and to whom they must report these threats will easily increase children's knowledge of CSA prevention efforts. Massage has to contain to minimize harm by disseminating messages about appropriate help seeking in the event of abuse or attempted abuse (Walsh et al., 2015). By being able to sing a CSA prevention song, it is hoped that children can understand the contents of the song and be motivated to apply it in their daily lives, so they can be free from the dangers of CSA. Therefore, based on the explanation above, it necessary to analyze the effect of education through songs on the level of knowledge about preventing sexual violence in school-age children METHOD Quasi Experiment Design with One group pre and posttest design. The study was conducted at Bojong Asih Elementary School, Pasawahan Elementary School, Cangkuang Elementary School, Leuwi Bandung Elementary School, Dayehkolot District, Bandung Regency. The population in this study were all students in grades 4-6 totaling 323. The sample used was total sampling. The intervention was given by teaching students to sing a song about preventing sexual violence against children entitled "Preventing Sexual Crimes in Children: Touch" (Semai.ORG, 2016) which was aired via video. Before and after the intervention, students are given a questioner to find out the level of knowledge in preventing sexual violence in children. The questionnaire consisted of 22 questions regarding the prevention of sexual violence taken from various theories including the TANGKIS method, with 2 choices of answers A and B (Suhenda, Solehati, & Mardhiyah, 2019). The "TANGKIS" jargon designed by Maharani (2015) is an abbreviation of "Your body is yours", "There are secrets behind clothes", "You can't, you can't", "Signs of danger watch out", "If forced by your opponent", "Remember not all good secret "," Always tell stories to people who are trusted ". The instrument has been tested for validity using Pearson Product Moment and reliability testing using the Kuder Richardson formula (KR-20) by Aprilaz (2016) which was modified by Suhenda (2019). The study was conducted in October 2017. Data analysis used univariate analysis of frequency distribution and bivariate analysis of t-test. Measurement of the level of knowledge is divided into two categories, namely Good (76-100%) and Less (≤75%).
To see the ability to sing a sexual abuse prevention song, all students were given a checklist sheet before the intervention, then given the intervention to sing a sexual abuse prevention song. They were encouraged to sing a song about preventing sexual abuse and display it, then do a reevaluation with a checklist after the intervention. Table 1 Distribution of the ability to sing sexual violence prevention songs to students before and after the intervention 2017 (n = 323).  Table 1 Data showed that no one (0%) student was able to sing a song about sexual abuse prevention. After the intervention was obtained that all 323 students (100%) could sing the song correctly. Table 2 data showed that 289 students (89.5%) who were able to have good knowledge about the prevention of sexual violence and after the intervention increased to 319 (98.8%). Table 3 Showed that there were differences in the average level of knowledge before and after intervention in students (p = 0,001).

RESULTS OF STUDY
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DISCUSSION
Based on the results of research on students obtained results that the ablity to sing a song and the level of student knowledge has increased after being given an educational intervention through songs about the prevention of CSA. Participants are children of school age who at the elementary school age have quite high characteristics of knowledge. Students have a high desire to memorize the song about the prevention of CSA that is given, where the results are from no one student (0%) is able to sing the song to be all able to sing the song (100%). This happens because music is considered important for children where the prevalence of listening to music in teenagers is quite high ("Impact of Music, Music Lyrics, and Music Videos on Children and Youth," 2009). So that the song accompanied by music is easily accepted by children and increases their ability to sing the song. A study with 100 students in grades 4-6 showed that 98% of children listen to music, 72% of them listen to it every day (Christenson, 1992). Research in children ages 8 to 10 showed that they listening to music for an average of 1 hour per day (D. F. Roberts, 2005). In a study in the United States conducted to assess media used of children aged 8 to 18 years, it was found that 85% of children aged 8 to 18 years listen to music with an average of 1.5 to 2.5 hours per day (D. F. Roberts, 2005). About 2,465 teenagers in the UK reportedly listened to music for an average of 2.45 hours per day (North, Hargreaves, & O'Neill, 2000). The songs that are accompanied by music will increase children's interest to memorize the contents of the messages contained in the song, because music makes children receive messages cheerfully and fun. Songs accompanied by music have proven to be effective in increasing learning in children (Fonseca-Mora et al., 2011;Griffee, 1992;Lo & Li, 1998). The ability to sing song lyric is expected to increase the understanding of the contents of the song, where they will try to appreciate, be motivated, and follow the message content invitation contained in the song so that it is expected to improve their behavior to protect themselves from the threat of CSA. According to the American Academy of Pediatrics (2009), the perception and effect of lyric messages in a song accompanied by music has an effect on behavior in a child ("Impact of Music, Music Lyrics, and Music Videos on Children and Youth," 2009).
The results of the education carried out were significantly different between the pretest and post-test (p <0.05). It is intended that education through the singing method is very necessary for students to increase their level of knowledge which so far has never been exposed to what is called CSA prevention. Children love to sing, some of the appearances of songs are fun and can keep the students happy. The greatest important feature of songs is repetition (Džanić & Pejić, 2016). Through songs, educational materials can be easily received by students, they were seen singing with enthusiasm and movement in accordance with the content. They received information cheerfully. Songs belong to the cluster of enjoyable activities (Džanić & Pejić, 2016). Numerous studies showed that there was a relationship between music and emotions (Crust & Clough, 2006;Field et al., 1998;Gibson, Aust, & Zillmann, 2000;Hakanen, 1995;K. R. Roberts, Dimsdale, East, & Friedman, 1998;Strasburger, 2005). Songs are suitable for children's learning styles, encourage positive learning experiences, and enhance their knowledge, they inspired in this way are imaginative, creative, and ready to learn and succeed (Džanić & Pejić, 2016).
Education through this song is certainly not only limited to CSA prevention materials but also for other things where it needs to increase knowledge is needed in various aspects because so far, they are faced with problems that they themselves need to get help, such as communication theory and motivation. With the theories, they get they are expected to be able to apply CSA prevention behavior in their daily lives and be able to influence others to behave alertly to the threat of CSA.
Although the interventions in this study have shown success in increasing the knowledge of most students, in the results of this study there were four students out of 323 students who still had poor knowledge about CSA prevention. Although the amount is very small, it cannot be ignored, considering that children are a group that is at high risk of experiencing CSA threats. So, we need a combination of educational methods through this song with other methods.

CONCLUSION AND SUGESTION
Based on the results of the study, it is evident that education through songs influences the level of knowledge about the prevention of CSA in elementary school-age children. To achieve the success of CSA prevention programs in schools, coordination is needed from various parties involved, both from the puskesmas and UPTD Pendidikan so that the program can run well and be sustainable. In addition, given that there are still groups of students who are at risk from CSA threats, it is necessary to develop comprehensive methods to further increase the level of knowledge, and research is needed relating to the influence of these comprehensive methods on attitudes and skills in defending themselves from CSA threats by CSA prevention.

ACKNOWLEDGEMENT
The authors would like to extend our gratitude to the Rector of UNPAD and the Director of Research and Community Service of UNPAD who has funded this research through the IBW scheme. We would like to Authors express appreciation to all patients who participated in the study.

Conflicts of interest
None