Title: Prospective evaluation of follow-up and outcomes following adolescent sexual assault.
Funder: Department of Health (England)

Abstract: Background In London in 2006/2007, 29% of all reported rapes and 41% of other sexual offences were committed against young people under 17. Black, minority ethnic and refugee groups and adolescents in same-sex partnerships may be disproportionately affected and there is increasing awareness of the high prevalence of sexual violence within intimate partner relationships. Adolescent sexual assault victims are a vulnerable group with a high baseline prevalence of mental health problems and low follow-up rates. The adult literature (predominantly US data) and rare adolescent studies (none prospective) highlight the importance of post-assault mental health difficulties and sexual/reproductive health outcomes like unintended pregnancy/sexually transmitted infection. Most have used cross-sectional research designs, creating a notable void of longitudinal information. It is not known whether existing services meet individuals’ needs, what the longitudinal mental/sexual health and social outcomes of assault are among adolescents, and what predicts good/poor outcome. Aims We aim to : 1. describe the epidemiology of acute adolescent sexual assault in a large representative clinical population accessing a Sexual Assault Referral Centre; 2. describe short-/medium-term outcomes of recent adolescent sexual assault in relation to sexual/physical/mental health, judicial outcome and social functioning; 3. provide information on adolescents’ perception of their needs and experiences of sexual assault follow-up; 4. evaluate the impact of baseline characteristics, outcomes and user views/experiences on the likelihood of engagement in follow-up following recent sexual assault; 5. evaluate the acceptability of different research methods in this population to inform design of future studies; 6. disseminate these results to inform health service provision, government policy and new interventions for young victims of recent sexual assault. Research plan Design/study population : Prospective 4-year longitudinal cohort study of all male/female police-/self-referrals aged 13-17 presenting to a London Haven Sexual Assault Referral Centre (SARC) following acute sexual assault. Overlapping complementary quantitative and qualitative elements will address the study aims Plan : Baseline data collection at recruitment with follow-up assessments at T1 (3-4 months post-assault) and T2 (13-15 months post-assault), plus a qualitative element involving 20 semi-structured interviews evaluating user views/experiences after T2. Primary outcome : presence of mental health disorder at T1 Secondary outcomes : a) at T1: sexual health outcomes/uptake of sexual health services; b) at T2: uptake of mental health services compared with pre-assault, educational/employment and judicial outcomes and user evaluation of how/whether their needs were met, and access to/experience of services since assault. Ethical considerations will be addressed carefully. Patient/public involvement will be central to study design/management and support dissemination of results. Research team Team members have: (i) Clinical expertise in adolescent sexual/psychosocial/mental health and sexual assault; (ii) Strong academic credentials in adolescent health/health services research; (iii) Experience in undertaking/completing/disseminating large-scale policy-relevant UK research projects (iv) Safeguarding expertise (v) Extensive qualitative research experience (vi) Experience in developing cross-agency initiatives for adolescents with complex needs. We have the support of the NHS and Metropolitan Police: joint funders of the London Havens acute sexual assault referral service. Potential impact Our study will provide: 1. The first high quality data on the epidemiology/outcomes of adolescent sexual assault in the UK; 2. The first mixed methods data on adolescent user experiences of NHS sexual assault services These data will inform: a. Acute and follow-up care provided by SARCs, influence patterns of communication with/referral to other services and identify wider gaps in service provision. b. Policy to support the above developments. c. Research to support development of new/modified interventions for adolescent victims of sexual assault that seek to improve patients’ experience, outcomes and engagement with services d. Future service evaluations e. More effective targeting of sexual assault prevention programmes to vulnerable adolescent groups


Research activity codes: 7.1 INDIVIDUAL CARE NEEDS;8.1 ORGANISATION AND DELIVERY OF SERVICES
Health categories: MENTAL HEALTH;REPRODUCTIVE HEALTH AND CHILDBIRTH