Reimagining Sexual Abuse Prevention for Adolescents with Intellectual Disabilities: A Scoping Review of Educational Gaps and Inclusive Future Directions

重新构想针对智力障碍青少年的性虐待预防:教育差距和包容性未来方向的范围界定综述

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Abstract

BACKGROUND: Sexual abuse remains a pervasive global public health concern, disproportionately affecting adolescents with intellectual disabilities (ID). While numerous educational interventions have been developed, most remain fragmented, context-specific, and rarely account for cultural and systemic disparities across settings. A comprehensive and inclusive synthesis is needed to reimagine prevention strategies for this vulnerable population. OBJECTIVE: This scoping review aimed to reimagine sexual abuse prevention by systematically mapping existing educational models, identifying gaps, and outlining inclusive future directions for adolescents with ID. METHODS: Following the PRISMA-ScR guideline, a comprehensive search was conducted across PubMed, Scopus, CINAHL, and ScienceDirect, supplemented by grey literature and reference list screening. Eligibility was guided by the PCC (Population-Concept-Context) framework. Studies published between 2015 and 2025 involving adolescents with diagnosed ID (aged 12-18) were included. Data were thematically synthesized, and methodological quality descriptively assessed using the MMAT and JBI checklists. RESULTS: Sixteen studies met inclusion criteria, spanning diverse contexts from high-income to low- and middle-income countries. Interventions included school-based curricula, community workshops, digital platforms, and family-centered programs. While knowledge and awareness improved across most studies, evidence of sustained behavioral change was limited. Key gaps included inadequate cultural adaptation, limited caregiver involvement, and systemic barriers such as stigma and insufficient provider training. Although some programs demonstrated strong content validity, scalability and long-term effectiveness remain underexplored. CONCLUSION: This review reimagines sexual abuse prevention as an inclusive, multi-level endeavor that extends beyond knowledge provision to engage caregivers, educators, and health systems. Future research must prioritize longitudinal designs, cultural tailoring, and systemic integration to build sustainable, equitable, and context-sensitive interventions.

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