{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T06:16:22Z","timestamp":1778566582838,"version":"3.51.4"},"reference-count":47,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T00:00:00Z","timestamp":1778544000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Psychiatry"],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>The volume of Child Sexual Abuse Material (CSAM) available online and the global demand for it has reached unprecedented levels. Increasing numbers of individuals concerned about their online behaviour are contacting therapeutic providers for help and support outside of the criminal justice system. Previous research asking individuals what would help them to stop viewing CSAM suggests that the availability of a technological solution to voluntarily self-manage access to CSAM could be an effective tool.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To explore the findings from the user-centered design (UCD) of the \u2018Salus\u2019 prototype -\u00a0a technological prevention tool to support effective self-management of individuals at risk of committing a first or further CSAM offence(s).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>In this two-year, European Commission funded project we conducted research in four European countries: Belgium, Germany, the Netherlands, and the United Kingdom (UK). For the UCD phase of the project we conducted semi-structured interviews with 31 at-risk individuals in Belgium (n=10), Germany (n=10) and the UK (n=11), to explore the specific needs, design features, deployment methods, and concerns and barriers for the design, functionality and deployment of Salus. Additionally, four focus group discussions (FGDs) were held in Belgium, the Netherlands, and the UK with service providers (primarily therapists and managers) with extensive experience of supporting individuals at risk of committing CSAM offences to explore the same questions at the service level.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In terms of privacy and security, the potential discovery of apps such as Salus, data security and legal consequences of app usage are the main concerns of potential app users. There was consensus on the value of blocking CSAM, but opinions on the inclusion of an optional adult sexual content (pornography) filter in Salus design were not unanimous. Users should be able to switch a pornography filter on and off at their convenience. Blocking notifications should be quiet and subtle. Interactivity features are welcomed by potential users \u2013 these may include a diary function; a personal CSAM statistics page; a resources section; and a function to allow users to provide feedback to the app developers. Such features should be optional for users in order to prevent any unintended consequences of app usage. Finally, app deployment must be safe and secure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Based on these findings, we propose seven evidence-based design principles for user-centered harm-reduction technology: privacy-by-default architecture; discretion through design ambiguity; adaptive notification systems; optional interactivity with user control; trusted-channel deployment; progressive trust building; and fail-safe harm prevention. These principles provide a framework for app developers and researchers working on similar technologies to develop interventions that reduce harmful behaviours.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpsyt.2026.1595063","type":"journal-article","created":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T05:45:22Z","timestamp":1778564722000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Adopting a user-centred design approach for the development of on-device technology to prevent the viewing of child sexual abuse material: app design insights and principles from the development of \u2018Salus\u2019"],"prefix":"10.3389","volume":"17","author":[{"given":"Deanna","family":"Davy","sequence":"first","affiliation":[{"name":"Anglia Ruskin University","place":["Chelmsford, United Kingdom"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Suzanne","family":"Beaufoy","sequence":"additional","affiliation":[{"name":"StopSo UK","place":["Rochester, United Kingdom"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefan","family":"Bogaerts","sequence":"additional","affiliation":[{"name":"Tilburg University","place":["Tilburg, Netherlands"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Minne","family":"De Boeck","sequence":"additional","affiliation":[{"name":"Antwerp University Hospital","place":["Antwerp, Antwerp, Belgium"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elien","family":"De Caluw\u00e9","sequence":"additional","affiliation":[{"name":"Antwerp University Hospital","place":["Antwerp, Antwerp, Belgium"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erifili","family":"Efthymiadou","sequence":"additional","affiliation":[{"name":"Lucy Faithfull Foundation","place":["Stoke Prior, United Kingdom"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rhea","family":"Joy","sequence":"additional","affiliation":[{"name":"HM Prison and Probation Service","place":["London, United Kingdom"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lea","family":"Kamitz","sequence":"additional","affiliation":[{"name":"Anglia Ruskin University","place":["Chelmsford, United Kingdom"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manon","family":"Kleijn","sequence":"additional","affiliation":[{"name":"Tilburg University","place":["Tilburg, Netherlands"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julia","family":"Nentzl","sequence":"additional","affiliation":[{"name":"Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin\u2019s Institute of Sexology and Sexual Medicine","place":["Berlin, Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lee","family":"Smith","sequence":"additional","affiliation":[{"name":"Anglia Ruskin University","place":["Chelmsford, United Kingdom"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Larissa","family":"Van Puyvelde","sequence":"additional","affiliation":[{"name":"Antwerp University Hospital","place":["Antwerp, Antwerp, Belgium"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah","family":"Wefers","sequence":"additional","affiliation":[{"name":"Lucy Faithfull Foundation","place":["Stoke Prior, United Kingdom"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samantha","family":"Lundrigan","sequence":"additional","affiliation":[{"name":"Anglia Ruskin University","place":["Chelmsford, United Kingdom"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,5,12]]},"reference":[{"key":"B1","unstructured":"Internet watch foundation annual report\n          \n          \n          \n          2023"},{"key":"B2","volume-title":"Production and active trading of child sexual exploitation images depicting identified victims","author":"Seto","year":"2018"},{"key":"B3","doi-asserted-by":"crossref","DOI":"10.1145\/3308558.3313482","article-title":"Rethinking the detection of child sexual abuse imagery on the internet","author":"Bursztein","year":"2019"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1016\/j.fsidi.2020.301022","article-title":"Detecting child sexual abuse material: A comprehensive survey","volume":"34","author":"Lee","year":"2020","journal-title":"Forensic. Sci Intl.: Dig. Invest"},{"key":"B5","doi-asserted-by":"publisher","first-page":"197","DOI":"10.1080\/23738871.2019.1635178","article-title":"Online child sexual exploitation: towards an optimal international response","volume":"4","author":"Baines","year":"2019","journal-title":"J Cyber. Policy"},{"key":"B6","doi-asserted-by":"publisher","first-page":"1","DOI":"10.52922\/ti78894","article-title":"How to implement online warnings to prevent the use of child sexual abuse material","volume":"669","author":"Hunn","year":"2023","journal-title":"Trends Issues Crime. Crim. Justice."},{"key":"B7","volume-title":"Combating sexual abuse of children directive 2011\/93\/EU: European Implementation Assessment","author":"Scherrer","year":"2017"},{"key":"B8","unstructured":"A public health approach"},{"key":"B9","unstructured":"Mapping of current practice and treatment approaches of perpetrators of sexualised violence against minors. Berlin: WWP EN [European Network for the Work with Perpetrators of Domestic Violence]\n          \n          \n            \n              Rossoni\n              I\n            \n            \n              Vall\n              B\n            \n            \n              Pauncz\n              A\n            \n          \n          \n          2024"},{"key":"B10","unstructured":"Psychological treatment of adults convicted of sex offences against children\n          \n          \n          \n          2019"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.f4630","article-title":"Preventing sexual abusers of children from reoffending: systematic review of medical and psychological interventions","volume":"347","author":"L\u00e5ngstr\u00f6m","year":"2013","journal-title":"BMJ"},{"key":"B12","unstructured":"Number of people seeking support about online child sexual abuse triples since the first lockdown\n          \n          \n          \n          2023"},{"key":"B13","unstructured":"Don\u2019t offend"},{"key":"B14","unstructured":"CSAM users in the dark web: protecting children through prevention reDirection survey report\n          \n          \n            \n              Insoll\n              T\n            \n            \n              Ovaska\n              A\n            \n            \n              Vaaranen-Valkonen\n              N\n            \n          \n          \n          2021"},{"key":"B15","doi-asserted-by":"crossref","DOI":"10.1109\/IJCNN.2018.8489100","article-title":"A machine learning-based forensic discriminator of pornographic and bikini images","author":"Moreira","year":"2018"},{"key":"B16","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1145\/3600160.3605048","article-title":"An Analysis of PhotoDNA","volume-title":"The 18th International Conference on Availability, Reliability and Security (ARES 2023)","author":"Steinebach","year":"2023"},{"key":"B17","doi-asserted-by":"crossref","DOI":"10.1145\/3339252.3341491","article-title":"Improving borderline adulthood facial age estimation through ensemble learning","author":"Anda","year":"2019"},{"key":"B18","doi-asserted-by":"crossref","DOI":"10.1109\/DSC54232.2022.9888937","article-title":"A digital forensics live suspicious activity toolkit to assist investigators with sexual harm prevention order monitoring","author":"Scholey","year":"2022"},{"key":"B19","article-title":"C3-sex: A chatbot to chase cyber perverts","author":"Trivi\u00f1o","year":"2019"},{"key":"B20","first-page":"1","article-title":"An introduction to machine learning","volume-title":"Springer eBooks","author":"Rebala","year":"2019"},{"key":"B21","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1145\/3479609","article-title":"A human-centered systematic literature review of the computational approaches for online sexual risk detection","volume":"5","author":"Razi","year":"2021","journal-title":"Proc ACM Hum Comput Interact"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1016\/j.chiabu.2014.12.009","article-title":"Web-based child pornography: The global impact of deterrence efforts and its consumption on mobile platforms","volume":"44","author":"Steel","year":"2015","journal-title":"Child Abuse Negl"},{"key":"B23","article-title":"The effectiveness of splash pages as a deterrence measure","author":"Nouwen","year":"2017","journal-title":"ECPAT. Int J"},{"key":"B24","unstructured":"Deterrence programs to prevent child sexual exploitation\n          \n          \n          \n          2015"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.1016\/j.chiabu.2024.106955","article-title":"The effect of therapeutic and deterrent messages on Internet users attempting to access 'barely legal' pornography","volume":"155","author":"Prichard","year":"2024","journal-title":"Child Abuse Negl"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0237910","article-title":"A user-centred design framework for mHealth","volume":"15","author":"Farao","year":"2020","journal-title":"PloS One"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2016.02.002","article-title":"A user-centered model for designing consumer mobile health (mHealth) applications (apps)","volume":"60","author":"Schnall","year":"2016","journal-title":"J BioMed Inf."},{"key":"B28","doi-asserted-by":"crossref","DOI":"10.1007\/978-3-642-02707-9_20","article-title":"A UCD approach towards the design, development and assessment of accessible applications in a large scale European Integrated project","author":"Van Isacker","year":"2009"},{"key":"B29","volume-title":"Content analysis: content analysis method and examples","year":""},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.1177\/1049732305276687","article-title":"Three approaches to qualitative content analysis","volume":"15","author":"Hsieh","year":"2005","journal-title":"Qual Health Res"},{"key":"B31","doi-asserted-by":"publisher","first-page":"892","DOI":"10.1186\/s12889-024-18341-z","article-title":"Design and usability evaluation of a mobile application for self-care among Iranian adolescents","volume":"24","author":"Rezaee","year":"2024","journal-title":"BMC Public Health"},{"key":"B32","doi-asserted-by":"publisher","first-page":"710","DOI":"10.1186\/s12889-024-18248-9","article-title":"Design and evaluation of child abuse web-based application for parent education & strengthen","volume":"24","author":"Para","year":"2024","journal-title":"BMC Public Health"},{"key":"B33","doi-asserted-by":"publisher","DOI":"10.1186\/s12911-016-0399-8","article-title":"Involving members of vulnerable populations in the development of patient decision aids: A mixed methods sequential explanatory study","volume":"19","author":"Dugas","year":"2017","journal-title":"BMC Med Inf. Decis. Making."},{"key":"B34","doi-asserted-by":"publisher","DOI":"10.2196\/14197","article-title":"Barriers and facilitators to the implementation of eHealth services: Systematic literature analysis","volume":"21","author":"Schreiweis","year":"2019","journal-title":"J Med Internet Res"},{"key":"B35","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1145\/3555556","article-title":"Privacy research with marginalized groups: what we know, what's needed, and what's next","volume":"6","author":"Sannon","year":"2022","journal-title":"Proc ACM Hum Comput Interact"},{"key":"B36","volume-title":"Privacy by design: The seven foundational principles","author":"Cavoukian","year":"2021"},{"key":"B37","doi-asserted-by":"publisher","first-page":"346","DOI":"10.1007\/s42979-022-01239-1","article-title":"Accessible and inclusive cyber security: A nuanced and complex challenge","volume":"3","author":"Renaud","year":"2022","journal-title":"SN. Comput Sci"},{"key":"B38","doi-asserted-by":"publisher","first-page":"1244","DOI":"10.1186\/s12889-019-7583-6","article-title":"A systematic review of the effectiveness of digital interventions for illicit substance misuse harm reduction in third-level students","volume":"19","author":"Dick","year":"2019","journal-title":"BMC Public Health"},{"key":"B39","doi-asserted-by":"publisher","DOI":"10.1016\/j.chiabu.2024.106936","article-title":"Accessing child sexual abuse material: Pathways to offending and online behaviour","volume":"154","author":"Wortley","year":"2024","journal-title":"Child Abuse Negl"},{"key":"B40","doi-asserted-by":"publisher","first-page":"57","DOI":"10.1080\/26929953.2022.2153772","article-title":"The feasibility and impact of a brief internet intervention for pornography reduction\u2019","volume":"30","author":"Rodda","year":"2022","journal-title":"Sex. Health Compulsivity."},{"key":"B41","doi-asserted-by":"publisher","DOI":"10.1016\/j.pmedr.2018.07.004","article-title":"Predicting which type of push notification content motivates users to engage in a self-monitoring app","volume":"11","author":"Bidargaddi","year":"2018","journal-title":"Prev Med Rep"},{"key":"B42","doi-asserted-by":"publisher","DOI":"10.1007\/s40501-023-00298-2","article-title":"Moving evidence-based mental health interventions into practice: Implementation of digital mental health interventions","volume":"10","author":"Liu","year":"2023","journal-title":"Curr Treat Opt. Psychiatry"},{"key":"B43","doi-asserted-by":"publisher","DOI":"10.1016\/j.chb.2023.107843","article-title":"Effectiveness of information and communication technology (ICT) for addictive behaviors: an umbrella review of systematic reviews and meta-analysis of randomized controlled trials","volume":"147","author":"Guo","year":"2023","journal-title":"Comput Hum Behav"},{"key":"B44","doi-asserted-by":"publisher","DOI":"10.1016\/j.ypmed.2021.106532","article-title":"Personalized mobile technologies for lifestyle behavior change: A systematic review, meta-analysis, and meta regression","volume":"148","author":"Tong","year":"2021","journal-title":"Prev Med"},{"key":"B45","doi-asserted-by":"publisher","DOI":"10.1016\/j.digbus.2020.100001","article-title":"An effective approach to mobile device management: Security and privacy issues associated with mobile applications","volume":"1","author":"Hayes","year":"2020","journal-title":"Dig. Bus."},{"key":"B46","doi-asserted-by":"publisher","DOI":"10.1177\/20552076251375835","article-title":"User or patient\/human or person? Development of a practical framework for applying user-centered design to vulnerable populations for digital transformation in healthcare","volume":"11","author":"M\u00fcller","year":"2025","journal-title":"Dig. Health"},{"key":"B47","doi-asserted-by":"publisher","first-page":"374","DOI":"10.1080\/13600869.2025.2457227","article-title":"A systematic literature review of security and privacy by design principles, norms, and strategies for digital technologies","volume":"39","author":"Del-Real","year":"2025","journal-title":"Int Rev Law. Comput Technol"}],"container-title":["Frontiers in Psychiatry"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyt.2026.1595063\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T05:45:31Z","timestamp":1778564731000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyt.2026.1595063\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,12]]},"references-count":47,"alternative-id":["10.3389\/fpsyt.2026.1595063"],"URL":"https:\/\/doi.org\/10.3389\/fpsyt.2026.1595063","relation":{},"ISSN":["1664-0640"],"issn-type":[{"value":"1664-0640","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,12]]},"article-number":"1595063"}}