Challenges faced by parents in preventing online child sexual exploitation and abuse: a mixed methods systematic review

Introduction: Concerns about online child sexual exploitation and abuse (OCSEA) have been raised in society. Compared to adults, children and adolescents are more vulnerable as they are less able to assess risks and consequences. Prevention remains the most effective strategy for protecting children, and parents play an important role. However, many parents face barriers in recognizing and preventing OCSEA. This systematic review aims to identify parents' key challenges, ultimately informing more effective, evidence-based interventions and policy development. Methods: A comprehensive search was conducted in Medline, EMBASE, PsycINFO, CINAHL, Scopus, and the Cochrane Library. The search was conducted on March 20, 2025, covering articles published after 2018. Covidence was used for screening, with two independent reviewers and discrepancies resolved by a third. Data extraction was conducted independently by two reviewers and verified by a third. Methodological quality was assessed using JBI Critical Appraisal Tools. Findings were presented in tables alongside thematic analysis. Reporting followed PRISMA guidelines. The review was registered on OSF. Results: = 4), covering children from different regions. A convergent integrated approach was used for synthesis. Challenges were categorized into six themes: 1) limited parental knowledge and awareness of OCSEA risks, 2) barriers to parent-child communication, 3) challenges in mediation strategies, 4) technological disparities and digital literacy gaps, 5) sociocultural influences on parental responses, and 6) inadequate support systems. These challenges were examined in terms of direct difficulties parents encounter and broader systemic influences. We emphasized how these challenges interact and reinforce one another. Conclusion: This review synthesized evidence on challenges parents face in preventing OCSEA, revealing a complex interplay of individual, cultural, and systemic barriers. By understanding these challenges, we advocate for a more comprehensive prevention system to support parents as the first line of defense. Trial registration: https://osf.io/fru5k/OSF, identifier: osf.io/fru5k.