1. Preventing SexualViolence
Kerri-Michaela Berlin
National University, COH412
5/28/16

2. SV is a serious public health problem that affects millions of people each year
SV involves a range of acts including:
– attempted or completed forced
– alcohol/drug facilitated penetration (i.e., rape),
– being made to penetrate someone else, verbal (non-physical) pressure that
results in unwanted penetration (i.e., sexual coercion)
– unwanted sexual contact (e.g., fondling
– non-contact unwanted sexual experiences (e.g., verbal harassment,
voyeurism)
Source: National Center for Injury Prevention and Control,Centers for Disease Control and Prevention, 2016
What is sexual violence (SV) ?

3. Magnitude
• Approximately 1 in 5 women (19.3%) in the United States have experienced
rape or attempted rape in their lifetime
• 43.9% have experienced other forms of SV. For instance, 12.5% have
experienced sexual coercion
• 27.3% have experienced unwanted sexual contact
• 32.1% have experienced non-contact unwanted sexual experiences.
• Approximately 1 in 15 men (6.7%) have been made to penetrate someone at
some point during their lives,
• 5.8% men have experienced sexual coercion, 10.8% have experienced
unwanted sexual contact
• 13.3% men have experienced non-contact unwanted sexual experiences
Source: National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, 2016

4. 32.3% among multiracial women
27.5% American Indian/Alaska Native
21.2% among Black women
20.5% among non-Hispanic white
13.6% among Hispanic women
Among men:
39.5% of multiracial
26.6% of Hispanic
24.5% American Indian/Alaska Native
24.4% Black men
22.2% white men
LGB:
46.1% and 13.1% of bisexual and
lesbian women, respectively
74.9% and 46.4%, respectively,
have experienced other forms of SV
Among men, 47.2% bisexual men and
40.2% gay men have experienced some
form of SV other than rape in their
lifetime
Racial/ethnic and sexual minority groups
are disproportionately impacted by SV.
CDC, 2016:

5. At Risk…
SV is connected to other forms of violence
• girls who have been sexually abused are more likely to suffer physical violence
and sexual violence re-victimization, and be a victim of intimate partner violence
later in life
• perpetrating bullying in early middle school is associated with subsequent sexual
harassment perpetration.
• Adolescents who have experienced forced intercourse at some point in their life
are more likely than those who have not been forced to have intercourse to have
thoughts of suicide.
* co-occurrence of SV and other types of violence may reflect the
presence of shared risk factors across the multiple violent
behaviors and experiences. As such, approaches that address
multiple forms of violence and/or risk factors that are shared
across the types of violence may be an effective and efficient way
to prevent violence

6. SVThroughout a Lifespan
• Among women reporting a history of completed rape, 40% first experienced
it before age 18, more than 28% indicating they were first raped between the
ages of 11 and 17
• among men who were made to penetrate someone, 71% first experienced
this before the age of 25, and 21.3% experienced this before the age of 18
• While adolescence seems to be a period of high risk, college may also be a
particularly vulnerable time. In a large, cross-sectional survey of campus
sexual assault, 20% of the undergraduate women indicated that they had
been a victim of SV since beginning college

7. SV risk and Protective factors
Risk for SV perpetration is influenced by a range of factors, including characteristics of the
individual and their social and physical environments. These factors interact with one another to
increase or decrease risk for SV over time and within specific contexts.
Examples of key risk factors for SV perpetration include:
– history of child physical abuse or exposure to parental violence
– acceptance of violence, hyper-masculinity, traditional gender role norms, excessive alcohol use
– early sexual initiation and sexual risk-taking behavior (e.g., sex without a condom), and association with
sexually-aggressive peer groups.
– Poverty or low socioeconomic status
– gender inequality
– exposure to community crime and violence, social norms supportive of SV and male sexual entitlement &
weak laws and policies related to SV are also risk factors for SV perpetration
Protective Factors to Buffer risk for SV:
• greater empathy, emotional health
• connectedness, academic achievement
• parents who use reasoning to resolve family conflicts are associated with a lower risk of
SV perpetration

8. EpidemiologicalTriad: data links perpetrator of violence to assault
‘agent’, ‘ host’ &
‘ environment’,
suggested as
‘time’ ‘place’ and
‘person with
equal influence
shows agent and
host as variables
that are dependent
on each other and
on the environment
Relates & builds upon the
characteristics of violent act in
terms of ‘time’, ‘place’ and
‘person’, which allows for a
better planned and executed
public health prevention
program
3rd aspect:
environment-
characteristics such as
cultural acceptance,
socioeconomic status,
endemic exposure to
violence, cultural
acceptance, poor social
skills, drug and alcohol
misuse

9. Overview of STOP SV
Strategies based on best available evidence to help communities
sharpen their focus on prevention activities with the greatest
potential to reduce consequences of SV.
• strategies focus on promoting social norms that protect against
violence; teaching skills to prevent SV; providing opportunities,
both economic and social, to empower and support females
• creating protective environments; supporting victims/survivors to
lessen harms.
• Strategies focus on primary prevention SV, as well as approaches
to lessen the immediate and long-term harms of SV.

10. STOP SV package is the complementary, but
potentially synergistic impact of the strategies and
approaches.
• Promote Social Norms that
Protect againstViolence
• Bystander approaches
• Mobilizing men and boys as allies
• Social-emotional learning
• Empowerment-based training
Primary
• Create Protective
Environments
• Improving safety and
monitoring in schools
• Establishing and consistently
applying workplace policies
Secondary • Support Victims/Survivors to
Lessen Harms
• Victim-centered services
• Treatment for victims of SV
• Treatment for at-risk children
and families to prevent
problem
Tertiary
STOP SV Strategies & Approaches delineate prevention efforts that impact various SV-
related outcomes. Approaches within any one strategy sometimes have components
that cross other strategies.

12. Evaluation Process for STOP SV
STOP SV. programs are monitored for effectiveness ( information on what does and does not work
to reduce SV rates and risk and protective factors) via:
• Evaluation data, produced through program implementation and monitoring
• Theories of change and logic models that identify short, intermediate, and long-term
outcomes
• Researchers test the effectiveness of combinations of the strategies and approaches
*Most existing evaluations focus on approaches implemented in isolation. However, there is potential to
understand the synergistic effects within a comprehensive prevention approach. Additional research is
needed to understand the extent to which combinations of strategies and approaches result in greater
reductions in SV than individual programs, practices, or policies.

13. These illustrative examples of approach levels, targeting high-
risk individuals or whole populations, and ecological model;
demonstrate a health promotion strategy that is not only aimed
at prevention but is, in parts, more pro-active and seeks to
educate and, in a sense, transform cultural norms and attitudes
towards violence.
SV Prevention Strategies: Public Health
Perspective

14. SexualViolence Prevention Approach Proposal
Campus programming:
• generally offer structured educational experience for students
in the form of a lecture, theatre presentation, film and
discussion, or skill building workshop.
• Programming based on the argument that sexual assault is
culturally constructed and supported
Objectives:
• reducing attitudes that support rape
• increasing knowledge about sexual violence
• building empathy for survivors of sexual assault
• increasing resistance strategies and skills
• increasing the likelihood that participants will intervene in potentially
abusive or violent situations

15. Levels of Prevention
decrease number perpetrators of sv & number of
victims at each of the levels that influence sexual
violence; individual, relationship, community, and
society.
Tertiary
Secondary
Primary
risk education for all schools;
targeting communities where
violence is more endemic:
street lighting, surveillance
cameras and community
policing, reduction in mass
media portrayal of violence
Support/post-traumatic
counseling for victims of
violent crime, peer mediation,
home visits to families
identified as having a high risk
of DV/child abuse
adequate shelter provision for
victims of domestic violence,
training for health and social
care professionals, referring
victims of family violence
,increase penalties for
perpetrators of violent crime

16. A comprehensive approach with preventive interventions at multiple
levels of the social ecological model (i.e., individual, relationship,
community, and societal) is critical to having a population level impact
on SV.

17. Target Population & Challenges
College-age Students
• Females
– gender statistically more at risk
• Men
– allies in the primary prevention efforts
Can be perpetrators AND victims
Population Challenges:
– Age and community environment are considered high-risk indicators for sexual misconduct.
– Other pop. demographics do not apply as environments, such as college campuses, often
encourage rigid gender roles and culture that often supports violence and dismisses of victims
regardless of social status ,geographic location, income, race or ethnicity
– Social settings and situations where drugs and alcohol are common and living in
residential halls are examples of additional risk factors for possible incidence of sexual
violence

18. Challenges
SOCIOCULTURAL RELEVANCE
– sensitive to and reflective of community
norms and cultural beliefs may be more
successful in recruitment, retention, and
achieving outcomes
SEXUALVIOLENCEON COLLEGE CAMPUSES
• complex social problem that requires a multi-faceted response built from
prevention, intervention, and enforcement.
UNIQUE SITUATIONS
• Make the incidence of sexual victimization on college campuses more
complicated
FOCUS And PRIORITIZATION
• Effective strategies for primary prevention and robust improvements to
existing programs

19. Sector Involvement
• Implementing proposed strategy will require the engagement & investment of multiple sectors
• Public health agencies are well positioned to bring leadership and resources to implementation
efforts.
• Public health can serve as an important collaborator (e.g., strategies addressing community and
societal level risks),
• Leadership and commitment from other sectors such as business/labor is critical to implement a
particular policy or program (e.g., campus policies).
Stakeholders will include; university officials, community partners and local law enforcement.
Communication Channels will include update on status of evaluation, invitations to meetings, and
sharing final findings.

20. Educational, Environmental & Behavioral
Objectives:Time Frame
Outcome
• By the end of 2018, the number of sexual violence related incidences will decrease by
20%; with consistent messages across campus policies and programs.
Process
• By the end of 2017, the program planners will increase the number of campus
prevention programs offered from one to three times per year
Impact
• at least 50% of students will achieve awareness of the pervasiveness of sexual
assault on their campus; including, definitions of sexual violence, consent and
how to dispel common myths about rape.
• at least 50% of students will receive educational information regarding social
forces and destructive norms that foster a rape supportive environment.
• college students will gain knowledge regarding the role of alcohol
consumption in sexual victimization on college campuses.
• at least 50% of the participants will have increased knowledge of campus
resources for violence prevention, as well as support for survivors of rape.

21. Monitoring and Evaluation
Monitoring and evaluation are necessary components of the public
health approach to prevention; examples:
• Timely and reliable data to monitor the extent of the problem and to evaluate the
impact of prevention efforts
• Data necessary for program implementation; planning, implementation, and
assessment all rely on accurate measurement of the problem.

22. Evaluation Process
PLAN
– assess quality of content and success of implementation, this program will base the
evaluation design on case studies performed to determine effectiveness among similar
sexual prevention programs implemented on college campuses.
OUTCOME
– Design on case studies performed to determine effectiveness among similar sexual
prevention programs implemented on college campuses
DATA
– evidence-based, comprehensive, multi-level strategy, follow-up/booster session to
increase exposure and determine impacts, evaluations and refinements
REPORTING
• findings will be used to promote program awareness and emphasize success and benefits
of campus implementation.

23. Program Effectiveness
• Program success will be constituted by comparing findings against the
standards set forth by a variety of reputable and reliable guidelines
• A plan for sexual assault prevention on campuses will have better outcome if the
focus is to improve and enhance the programs that have already been
developed and show promise
• Areas of improvement include such things as increased training and education
through innovative technology with mandatory follow-up/booster sessions,
more support staff and statistical

24. Conclusion
• SV is a significant public health problem but it can be prevented
• STOP SV represents the best available evidence to address the problem of
SV. with a range of complementary strategies and approaches that ideally
would be used in combination in a multi-level, multi-sector approach to
prevent ion
• strategies and approaches that are in keeping with CDC’s emphasis on the
primary prevention of perpetrations, as well as approaches to reduce risk
for victimization and to lessen the short- and long-term harms of SV.
• The hope is that multiple sectors, such as public health, health care,
education, justice, and social services will use this technical package to
prevent SV and its consequences
• By continuing to invest in the evaluation of practice-based prevention
programs & promising practices, researchers and funders can help expand
understanding of what works to prevent SV.

25. Media Attention (optional)
"Hunting Ground" Click to view
trailer
1 is 2 Many PSA: Click toView

26. References
Basile, K.C., DeGue, S., Jones, K., Freire, K., Dills, J., Smith, S.G., Raiford, J.L. (2016).
STOP SV: ATechnical Package to Prevent Sexual Violence. Atlanta, GA.
BanyardV.L., Moynihan, M.M., & Plante, E.G., (2007). Sexual violence
prevention through bystander education: An experimental
evaluation. A Journal of Community Psychology, 35 (4), 463-481.
Centers for Disease Control and Prevention. (2014). Essentials for childhood: steps to
create safe, stable, nurturing relationships and environments. Atlanta, GA:
National
Center for Injury Prevention and Control.
Coker, a., Cook-Craig, P.,Williams,C., Fisher, B., Clear, E., Garcia, L., et al. (2011).
Evaluation of Green Dot: An Active Bystander Intervention to Reduce Sexual
Violence on College Campuses. Violence AgainstWomen , 777-796.
Cullen,T. F.; Fisher, B.S.,Turner, M.G (2000).The SexualVictimization of
CollegeWomen. U.S. Department of Justice.

27. References, cont.
Dahlberg LL, Mercy JA. History of violence as a public health problem. American
Medical Association'sVirtual Mentor February 2009;Vol 11(2):167-172.
Fisher, Bonnie S.; Cullen, FrancisT., (1999).The Extent and Nature of
SexualVictimization.
Frieden,T. R. (2014). Six components necessary for effective public health program
implementation.American Journal of Public Health, 104(1), 17-22.
Nation, M., Crusto, C., et al. (2008).What works in prevention: Principles of effective
prevention programs. American Psychologist, 58(6-7),449-456. doi:
10.1037/0003-066x.58.6-7.449.
White HouseTask Force to Protect Students from Sexual Assault.(2014). Not Alone
First Report. U.S. Federal Government, Office of theVice President &
White House Council onWomen & Girls.