The author(s) shown below used Federal funds provided by the U.S. 

Department of Justice and prepared the following final report: 

Document Title: Testing the Efficacy of SANE/SART Programs: 

Do They Make a Difference in Sexual Assault 

Arrest & Prosecution Outcomes? 

Author(s): M. Elaine Nugent-Borakove ; Patricia Fanflik ; 

David Troutman ; Nicole Johnson ; Ann 

Burgess ; Annie Lewis O’Connor 

Document No.: 214252 

Date Received: May 2006 

Award Number: 2003-WG-BX-1003 

This report has not been published by the U.S. Department of Justice. 

To provide better customer service, NCJRS has made this Federallyfunded grant final report available electronically in addition to

traditional paper copies.

 

Opinions or points of view expressed are those 

of the author(s) and do not necessarily reflect 

the official position or policies of the U.S. 

Department of Justice.
Abstract 

Statement of Purpose: To explore the impact of SANE/SART interventions on the judicial 

process. 

Goals and Objectives: The goal of this study is to test the efficacy of SANE/SART programs as 

a tool in the criminal justice system. The American Prosecutors Research Institute and Boston 

College tested the hypotheses that SANE/SART exams increase arrest and prosecution rates. In 

testing this hypothesis, the project team sought to answer five primary research questions: 

1. Is the arrest rate higher in cases where a SANE/SART exam is performed as 

compared with cases in which no exam is performed? 

2. Is the indictment/charging rate higher in such cases? 

3. Are guilty pleas more likely to be entered in such cases, and are pleas likely to be to 

the existing charge or to a lesser charge? 

4. Is the conviction rate higher in such cases? 

5. Is the sentence more severe in such cases? 

Description of Research Subjects: In each study site, the project team randomly selected up to 

125 sexual assault cases in which there was a SANE or SART intervention and 125 cases in 

which there was no SANE/SART intervention. A total of 262 SANE/SART and 268 nonSANE/SART cases were selected. 

Research Design and Methodology

Methods for Achieving Goals and Objectives: Case information was collected from 

SANE/SART, prosecution files in Monmouth County, New Jersey, Sedgwick County, Kansas, 

and Suffolk County, Massachusetts. Comparisons were made between SANE/SART and nonSANE/SART cases to determine if the intervention predicted the likelihood of criminal justice 

system outcomes including identification/arrest of a suspect, filing of charges, case disposition, 

type of penalty, and length of sentence. Descriptive, multivariate, and inferential statistics were 

used to examine the differences between cases and the relationships between SANE/SART 

intervention and case outcome. 

Results and Conclusions: The results of the study indicate that compared to non-SANE/SART 

cases, SANE/SART cases are reported more quickly, have more evidence (DNA evidence in 

particular) available, and have more victim participation, although SANE-only cases had the 

lowest participation levels. SANE/SART intervention is also a factor in the identification and 

arrest of a suspect, the strongest predictor that charges will be filed, and helps to increase the 

likelihood of conviction. Insufficient information was available to determine the impact of 

SANE/SART intervention on penalty and length of sentence. Overall, the findings are quite 

supportive of SANE/SART programs and their efficacy as a tool in the criminal justice system. 
EXECUTIVE SUMMARY

Over the past 25 years, there has been significant reform in sexual assault law and 

the protection of women. In the early 1970s, little attention was paid to the issues of 

rape, survivors of rape, and sexual offenders. As a result of a handful of very public rape 

forums and attention from feminist groups, the anti-rape movement began to take shape 

and bring about social change with regard to how the public and policy makers viewed 

sexual offenses and perhaps more importantly, how the medical community and criminal 

justice system handled sexual offenses. 

This movement highlighted some of the most significant issues with regard to the 

treatment of rape and rape survivors. In particular, rape victims were often “blamed” by 

medical and law enforcement professionals; rape examinations were humiliating and dehumanizing, were often not thorough, and lacked a systematic method for evidence 

collection (Bahm, 2001; Campbell, Wasco, Ahrens, Sefl, & Barnes, 2001; Girardin, 

2005; Holmstrom & Burgess, 1983). As these issues came to light, communities across 

the country began to involve nurses in the care of sexual assault victims (Lang, 1999; 

Ledray, 1999). Nurses were provided training on first response care to sexual assault 

victims, collecting forensic evidence, conducting evidentiary examinations, and 

maintaining the chain of evidence and evidence integrity (Campbell, 2004). These nurses 

became known as Sexual Assault Nurse Examiners (SANEs). 

Building on the success of SANE programs, communities began creating teams of

primary and secondary responders called Sexual Assault Response Teams (SARTs). 

SARTs bring together law enforcement, detectives, victim advocates, and healthcare 

providers to assist sexual assault victims through the criminal justice process. The intent 

i
is two-pronged: 1) to increase the odds of prosecution by enhancing evidence collection 

and facilitating communication between all parties in the process, and 2) to help victims 

recover from and cope with their experience through counseling and support (Girardin, 

2005; Wilson & Klein, 2005). 

Current Research on SANE/SART Interventions 

To date, research on SANE/SART interventions has been limited to descriptive 

case studies. For example, one early study showed that 90 percent of victims who had 

been served by a SANE program elected to file a police report and that 61 percent of the 

cases resulted in arrest or successful conviction (Solola, Scott, Severs & Howell, 1983). 

Another study of cases involving SANE examinations over a 3-year period in Madison, 

Wisconsin showed a 100 percent conviction rate, which was attributed to the quality of 

evidence collected and testimony by SANEs (O’Brien, 1992). Still other studies have 

shown an increase in the number of charges filed and the number of guilty pleas 

(Crandall & Helitzer, 2003). 

Other studies have shown that the consistent documentation and evidence 

collection by SANEs contributes to conviction rates and that the evidence is collected 

more accurately when collected by SANEs (Crandall & Helitzer, 2003; Ledray, 1999,

2001; Lenehan, 1991; Little, 2001; Sievers, Murphy & Miller, 2003). In addition, 

research indicates that SANE interventions increase victim participation in the justice 

process (Ledray, 2001; Ledray & Summelink, 1996). 

However, the impact of SANE/SART interventions on judicial processes is not 

always immediate. Wilson and Klein’s (2005) study of the Rhode Island SART found 

the impact on judicial processes to be negligible but did have positive results for victims. 

ii
Overall, the research to date seems to indicate that SANE/SART interventions 

have merit. However, these interventions have yet to be subject to more rigorous 

research using control groups of cases in which SANE/SART interventions were not used 

as a basis for comparing judicial outcomes. The American Prosecutors Research Institute 

(APRI) and Boston College (BC), with funding from the National Institute of Justice, 

Office of Justice Programs, U.S. Department of Justice, designed a study to examine 

SANE/SART interventions more rigorously, using a quasi-experimental design. 

Moreover, the APRI/BC study draws from data collected in three geographically and 

demographically diverse communities allowing for a comparative approach rather than a 

case study approach. 

Overview of Study Methodology 

The goal of this study is to test the efficacy of SANE/SART programs as a tool in 

the criminal justice system. In particular, the study was conceptualized to determine if 

the performance of a SANE exam or a SART response impacts sexual assault case 

outcomes by comparing cases in which there was a SANE/SART intervention and those 

in which there was not. In testing this hypothesis, APRI and BC focused on the 

following questions: 

1. Is the arrest rate higher in cases where a SANE/SART exam is performed as 

compared with cases in which no exam is performed?

2. Is the indictment/charging rate higher in such cases?

3. Are guilty pleas more likely to be entered in such cases, and are pleas likely to be 

to the existing charge or to a lesser charge? 

4. Is the conviction rate higher in such cases?

5. Is the sentence more severe in such cases?

iii
It is important to note that this study focused on the impact of SANE/SART interventions 

on the formal criminal justice response, not the victim’s decision or likelihood to report 

the assault to the police or to obtain services. 

To test the study hypothesis and answer the research questions, APRI and BC 

collected case information from SANE/SART, police, and prosecution files in three 

jurisdictions: Monmouth County (Freehold), New Jersey; Sedgwick County (Wichita), 

Kansas; and Suffolk County (Boston), Massachusetts. In each study site, the project team

randomly selected up to 125 sexual assault cases in which there was a SANE or SART 

intervention and 125 cases in which there was no SANE/SART intervention.1

 Exhibit 1 

shows the final sample of cases collected from each study site. 

Exhibit 1: Number of Cases Collected for Each Study Site2

Study Sites SANE Only SANE/SART Non SANE/ 

SART Total

New Jersey 0 79 72 151

Kansas 0 77 108 185

Massachusetts 106 0 88 194

Total 106 156 268 530

Comparisons were made between SANE/SART cases (both SANE only and 

SANE/SART combined) and non-SANE/SART cases to determine if the intervention 

predicted the likelihood of certain criminal justice system outcomes. These outcomes 

included identification/arrest of a suspect, the filing of charges, case disposition, type of 

penalty, and length of sentence. In addition, APRI and BC collected information on a 

 

1

 The study focused only on adult female victims over the age of 18 at the time of incident. 2

 SANE only cases were defined as cases in which a SANE conducted an examination of the victim; 

SANE/SART cases were defined as cases in which there was a SART response including a SANE exam or 

response. Non-SANE/SART cases were defined as those cases in which a victim refused a SANE/SART

intervention, never sought assistance from a SANE/SART, or did not have a SANE exam. NonSANE/SART cases did, however, include cases in which victims may have received treatment by nonSANE personnel in medical facilities. 

iv
number of other variables that could impact or mitigate the effect of SANE/SART 

interventions and case outcomes. These variables included the following: 

• Victim/offender relationship – stranger, non-stranger 

• Whether or not services were offered and refused 

• Number/types of services provided 

• Time between the incident and the report (in days) 

• Level of participation of the survivor in the criminal justice process – 

statement given, testified, victim impact statement, contact with prosecutor 

• Race of victim 

• Race of perpetrator 

• Use of force, particularly of a weapon 

• Previous arrests 

• Previous convictions 

• Level of evidence collected – videotape, pictures, clothing, fabric/fibers, hair 

samples, bodily fluid, nail scrapings, rape kit 

• DNA collected 

• Documented injuries by police 

• Number of witnesses 

• Suspect claimed sexual act was consensual 

• Victim refusal to move forward with charges 

The APRI and BC project abstracted information on all the variables discussed above 

from case files maintained by SANE programs, police incident/arrest reports, and 

prosecution files during intensive 5-day site visits. 

As originally conceptualized, the project team intended to conduct analyses on 

each site and then to conduct comparative analyses. However, because the sample size 

within each site was smaller than the intended 250 total (125 SANE/SART; 125 nonSANE/SART), the results would not have been reliable. Therefore, to increase statistical 

power, the information was aggregated together for all sites. The analyses included 

descriptive statistics for key variables such as victim/offender relationship, types of 

services documented, etc. These descriptive statistics included averages and a 

comparison of the averages to determine if there are differences between SANE/SART 

v
cases and non-SANE/SART cases. More complex multivariate and inferential statistics 

were used to examine the relationships between a SANE/SART intervention and case 

outcomes (arrest, charges filed, conviction, penalty, and length of penalty). 

Overview of Study Findings 

Before addressing the primary research questions, APRI and BC staff conducted 

descriptive analyses on the SANE/SART intervention itself to determine if cases 

involving a SANE/SART are statistically different from cases without a SANE/SART 

intervention. 

These analyses identified several important differences between SANE/SART and 

non-SANE/SART cases. First, SANE/SART cases are reported more quickly than nonSANE/SART cases. Specifically, an average of 3.4 days elapsed between the time of the 

incident and the report in SANE only cases. For SANE/SART-cases, the average time 

between the incident and the report was 5.6 days. For non-SANE/SART cases, however, 

an average of 33 days elapsed between the time the incident occurred and the time when 

the victim reported the assault. These findings are statistically significant, meaning that 

they did not happen by chance alone and there is a difference between SANE/SART 

cases and non-SANE/SART cases in terms of the elapsed time between the incident and 

report. 

Second, more evidence, and in particular, more DNA evidence, is available in 

SANE/SART cases as compared with non-SANE/SART cases. SANE/SART cases 

yielded an average of 3.1 types of evidence; SANE-only cases produced an average of

2.6 types of evidence; and whereas non-SANE/SART cases yielded only 1 type of 

evidence. More importantly, DNA evidence was collected in 97 percent of SANE-only 

vi
cases and 37 percent of SANE/SART cases. DNA was collected in only 10 percent of 

non-SANE/SART cases. 

Earlier research on SANE/SART interventions indicated that one of the positive 

outcomes of such interventions was increased victim participation in the system—making 

police reports and giving formal statements, testifying and/or appearing at court hearings, 

providing victim impact statements, and cooperating with the prosecution. APRI and BC 

did find that victims who received a SANE/SART intervention averaged higher 

participation levels than those who did not receive SANE/SART services (1.3 compared 

to 0.9, on a scale of 0 to 4). Surprisingly, the lowest participation levels observed were 

for victims who received SANE-only services. 

Likelihood of Identification and Arrest

Previous studies have shown that SANE/SART cases tend to increase the 

likelihood of arrest; however, no comparative data existed that allowed researchers to 

determine if increased arrests were related to a SANE/SART intervention. By 

incorporating a control group (i.e., the non-SANE/SART cases), APRI and BC were able 

to examine if having a SANE/SART intervention increases the likelihood of arrest, given 

a host of other factors such as: 

• The number and types of services offered to victims 

• The time between incident and report 

• Victim participation in the justice process 

• Victim and offender race 

• Victim/offender relationship 

• Use of force 

• Use of weapon 

Overall, 39 percent of the cases resulted in arrest, and an additional 71 suspects 

were issued a summons to appear or were indicted at Grand Jury but not arrested. The 

vii
analysis showed that a SANE/SART intervention is a factor, but not the strongest 

predictor, in the identification and arrest of a suspect. SANE/SART cases are 1.7 times 

more likely to result in an arrest than cases in which there was no intervention. However, 

victim/offender relationship (i.e., if the victim knew her assailant) and higher levels of

victim participation were the strongest predictors of arrest. The use of force was also a 

factor. 

Likelihood that Charges will be Filed 

Overall, 62 of the 208 cases in which an arrest was made (12%) were not charged, 

either because the case was administratively dismissed by law enforcement (6.5%), the 

prosecutor decided not to file charges (40.3%), or the Grand Jury returned a no true bill 

(53.2%). Nearly 60 percent of these cases were non-SANE/SART cases. In addition, 

there were 251 cases in which no arrest was made and no charges were filed. The victim

refused to move forward with charges in 135 of these 251 cases (54%). In 81 of these 

cases (32%), a suspect was never identified. 

APRI and BC found that a SANE/SART intervention is the strongest predictor 

that charges will be filed in an adult female sexual assault case. In fact, SANE/SART 

cases are 3.3 times more likely to result in the filing of charges than cases without a 

SANE/SART intervention. SANE-only cases are 2.7 times more likely to result in 

charges being filed. 

Likelihood of Guilty Pleas and Convictions 

In this study, the majority of cases that were charged resulted in convictions (68% 

compared to 32%). Nearly half of the cases (47.7%) were disposed via guilty plea, and a 

viii
third (33%) were disposed at trial—23 percent of which were convicted at trial as shown 

in the Exhibit below. 

Exhibit 2: Disposition of Charged Cases 

Disposition Number of Cases Percentage of Cases 

Dismissed 28 18.8%

Plea (lesser charge) 48 32.2% 

Plea (existing/most serious charge) 23 15.5% 

Hung jury/retrial 2 1.3% 

Not guilty at trial 14 9.4% 

Guilty (lesser charge) 11 7.4% 

Guilty (existing/most serious charge) 23 15.4% 

Basic analyses indicate that SANE/SART interventions are more likely to result 

in convictions than cases without a SANE/SART intervention. However, when other 

factors are taken into consideration, the relationship between a SANE/SART intervention 

and a conviction is diminished significantly. It would appear that although having a 

SANE/SART intervention helps to increase the likelihood of conviction, the strongest 

predictors of conviction are the victim’s participation in the process and the relationship 

between the victim and offender. 

Impact of SANE/SART Interventions on Penalty and Length of Sentence

Unfortunately, the amount of information about penalties and sentences was 

limited in the data set. However, of the 73 cases for which information was available, the 

majority of convictions (43.8%, n=35) resulted in a sentence of incarceration, followed 

by a combination of incarceration and probation (33.8%, n=27). The average sentence 

length was 85 months or just over 7 years. 

It does not appear that having a SANE/SART intervention impacts either the 

sentence or the length of penalty. However, this conclusion is drawn with caution, based 

on a very small number of cases overall, and warrants further examination. 

ix
Summary 

Overall, the study findings are quite supportive of SANE/SART interventions as 

valuable tools in the criminal justice system’s ability to respond to adult female sexual 

assault cases. Of particular note are the following: SANE/SART interventions are 

effective tools in collecting and preserving valuable evidence for prosecution, including 

DNA evidence. This may be due in part to the amount of time that elapses between 

incident and report in SANE/SART cases. 

SANE/SART interventions significantly increase the likelihood that charges will 

be filed in sexual assault cases. This is a particularly important finding in that it parallels 

findings from earlier studies and provides the first comparative evidence supporting the 

hypothesis that SANE/SART interventions are a valuable tool in the criminal justice 

system and for prosecutors in particular. In addition, although not the strongest predictor 

of arrest, the study’s findings that SANE/SART interventions are more likely to lead to 

arrest than cases in which there is no intervention. These are particularly important 

findings because they affirm what earlier case studies showed. 

The findings are less clear with regard to the hypothesis that SANE/SART 

interventions increase the likelihood of conviction. While the study did find an 

association between SANE/SART interventions and convictions, it is not necessarily a 

direct association, and in fact, other factors were more likely to predict conviction than a 

SANE/SART intervention. Another factor not included in this study that might shed 

additional light on the relationship between SANE/SART interventions and convictions is 

the inclusion of SANE testimony at court proceedings. 

x
Another important, albeit negative finding, with regard to the efficacy of 

SANE/SART interventions, deals with victim participation in the criminal justice 

process. Earlier studies suggested that SANE/SART interventions, because of their more 

sensitive treatment of victims, increased the likelihood that victims would participate 

more fully in the justice process. The APRI and BC did find that a combined SANE and 

SART response yielded higher levels of participation than non-SANE/SART cases. 

However, SANE-only cases showed the lowest levels of participation. This finding has 

implications for SANE programs and the types of services and support given to victims 

by SANE nurses. It also affirms that coordinated approaches, involving first responders 

from different disciplines, help to keep victims informed and engaged in the process. 

Despite this last major finding, the results overall are in favor of SANE/SART 

programs and help to establish their efficacy as a tool in the criminal justice system. As 

is often the case, research findings beget new questions to be answered, and the current 

study’s findings are no exception. In particular, questions about victim’s motivation for 

seeking out SANE/SART services are important not only for understanding why some 

women get services and some do not but also for potentially examining the extent to 

which this motivation carries over to their willingness to participate in the justice system

process. 

xi
REFERENCES

Bahm, T. (2001). Winning sexual assault cases with sexual assault examiners. 

Alexandria, VA: American Prosecutors Research Institute. 

Campbell, R. (2004). Sexual assault nurse examiner programs: Evidence of psychological 

and legal effectiveness. National Electronic Network on Violence Against 

Women Applied Research Forum, VAWNet document: 

http://www.vawnet.org/SexualViolence/Research/VAWnetDocuments/AR_Sane.

pdf. 

Campbell, R., Wasco, S., Ahrens, C., Sefl, T., & Barnes, H. (2001). Preventing the 

“Second Rape”: Rape Survivors Experiences with Community Service Providers. 

Journal of Interpersonal Violence, 16(12), 1239-1260. 

Crandall & Helitzer (2003). An Impact Evaluation of a Sexual Assault Nurse Examiner 

(SANE) Program. National Institute of Justice. From

http://www.ncjrs.org/pdffiles1/nij/grants/203276.pdf. 

Girardin, B. (2005). The Sexual Assault Nurse Examiner: A Win-Win Solution. Topics 

in Emergency Medicine, 27(2), 124-131. 

Holmstrom, L.L. & Burgess, A.W. (1983). The Victim of Rape. New Brunswick, NJ 

Transaction Books. 

Lang, K. (1999). Sexual assault nurse examiner resource guide for Michigan Coalition 

against Domestic and Sexual Violence. 

Ledray, L. (2001). Evidence Collection and Care of Sexual Assault Survivors. Violence 

Against Women Online Resources. From http://www.vaw.umn.edu.

Ledray, L. (1999). Sexual assault nurse examiner (SANE) development & operations 

guide. Washington, DC: Office for Victims of Crime, U.S. Department of Justice. 

Ledray, L. & Summelink, K. (1996). Service utilization among sexual assault clients. 

Minnesota Sexual Assault resource Service, unpublished data. 

Lenehan, G.P. (1991). Editorial: Sexual Assault Nurse Examiner: A SANE way to care 

for rape victims. Journal of Emergency Nursing, 17: 1-2. 

Little, K. (2001). Sexual Assault Nurse Examiner (SANE) Programs: Improving the 

Community Response to Sexual Assault Victims. Washington D.C.: Office for 

Victims of Crime of the Office of Justice Programs of the U.S. Department of 

Justice. 

xii
O’Brien, C. (1992). Medical and forensic examination by a sexual assault nurse examiner 

of a 7 year-old victim of sexual assault. Journal of Emergency Nursing, 18: 199-

204. 

Sievers, V., Murphy, S., & Miller, J. (2003). Sexual assault evidence collection more 

accurate when completed by sexual assault nurse examiners: Colorado’s 

experience. Journal of Emergency Nursing, 29, 511-514. 

Solola, S., Scott, C., Severs, S., & Howell, J. (1983). Rape: Management in an 

institutional setting. Obstetrics and Gynecology 61: 373-378. 

Wilson, D. and Klein, A. (2005). An Evaluation of the Rhode Island Sexual Assault 

Response Team (SART). National Criminal Justice Research Service, U.S. 

Department of Justice. 

xiii
Testing the Efficacy of 


SANEISART Programs 


Do They Make a Difference in Sexual 

Assault Arrest & Prosecution Outcomes? 

Report Authors: 

American Prosecutors Research Institute: 

M. Elaine Nugent-Borakove 

Patricia Fanflik 

David Troutman 

Nicole Johnson 

Boston College: 

Ann Burgess 

Annie Lewis O'Connor 
This project was supported by Grant No. 2003-WG-BX-1003 awarded by the National 

Institute of Justice, Office of Justice Programs, U.S. Department of Justice. Points of 

view in this document are those of the authors and do not necessarily represent the 

official position or policies of the U.S. Department of Justice, the National District 

Attorneys Association, or the American Prosecutors Research Institute. 
The authors would like to acknowledge the contributions of numerous individuals 

who aided in this study and without whose commitment and support, this research study 

would not have been possible. 

The following prosecutors for allowing APRI access to their case files: 

Daniel Conley, District Attorney, Suffolk County, Massachusetts 

Nola Foulston, District Attorney, Sedgwick County, Kansas 

Bob Honnecker, Acting County Prosecutor, Monmouth County, New 

Jersey 

Eileen Allen, RN, MS, Director of SANE Program, Monmouth County, New 

Jersey, for facilitating and aiding with collection of study data. 

Kathleen M. Brown, RN, PhD, Adjunct Assistant Professor and Director of the 

Forensic Program, University of Pennsylvania School of Nursing, for helping to 

identify study sites and aiding with the collection of study data. 

Margaret A. McIntire, Senior Assistant District Attorney, Eighteenth Judicial 

District, Sedgwick County, Kansas for helping to identify cases and assisting in 

data collection. 

Diana Schunn RN, BSN, SANE-A, SANEISART Director, Via Christi Regional 

Medical Center in Wichita, Kansas with data collection efforts on SANE cases in 

Wichita. 

Christina Stevens, Senior Criminalist, Boston Crime Laboratory Unit for assisting 

with data collection on SANE cases in Boston. 

Donald R. Hayes, Jr., Director, Boston Crime Laboratory Unit for allowing the 

study team access to the crime laboratory files. 

Thomas P. Maloney, Sergeant Detective, Boston Police Department, Sexual 

Assault Unit for helping to identify cases for the study and aiding in data 

collection. 

David A. Deakin, Chief, Family Protection and Sexual Assault Unit, Suffolk 

County District Attorney's Office for helping the study team identify and extract 

information from the case files. 

Eileen McDonough, Suffolk County District Attorney's Office for helping to 

select cases for the study and aiding with data collection. 
Colleen Van Voorhis and Kristine Somers, Evidence Technicians, Boston Crime 

Laboratory Unit 

Nicole Gaskins-Laniyan, Ph.D., Social Science Analyst, National Institute of 

Justice for her guidance and support throughout the project. 
Chapter 1: Introduction ...................................................................................................1 


The Evolution of SANEISART: Review of the Literature ......................................2 


Research on SANEISART Programs ....................................................................10 


Chapter 2: Study Methodology ......................................................................................15 


Project Goals and Research Questions ..................................................................15 


Data Collection Design and Implementation .........................................................17 


Dependent and Independent Variables .................................................................-18 


Data Collection Instruments and Methods ............................................................. 21 


Research Challenges ..............................................................................................22 


Study Sample ........................................................................................................-24 


Analysis Plan .........................................................................................................26 


Chapter 3: Results of the Comparative Analyses ........................................................29 


SANEISART Intervention .....................................................................................29 


Do SANEISART Interventions Increase the Likelihood of 

Suspect IdentificationlArrest? ...........................................................................-33 


Do SANEISART Interventions Increase the Likelihood that 

Charges will be Filed in Sexual Assault Cases? ................................................ 35 


Do SANEISART Interventions Increase the Likelihood of 

Guilty Pleas and Convictions? ...........................................................................37 


What Impact Do SANEISART Interventions Have on the 

Penalty and the Length of Sentence in Convicted Cases? ................................. 39 


Chapter 4: Conclusions ..................................................................................................40 


References 

Appendix A: Data Collection Instruments 

Appendix B: Study Sites Demographic Information 
The past twenty-five years have witnessed significant reform in sexual assault law 

and the protection of women. Many of these reforms come from the implementation of 

SANE (Sexual Assault Nurse Examiner) programs and SART (Sexual Assault Response 

Teams) (referred to hereafter as SANEfSART). SANEs are specially trained, certified 

registered nurses who have forensic training and clinical education to help victims of 

sexual assault. They offer victims compassionate care and are responsible for collecting 

evidence that could potentially lead to arrest, prosecution, and conviction of the assailant. 

SANEs often work as part of a SART-a coordinated, multidisciplinary community 

effort that includes law enforcement, detectives, victim advocates, and the SANE.' 

SANEISART programs provide victims with emotional and mental support but also make 

the task of evaluating the victim and collecting important evidence as private and 

sensitive as possible. 

There is no doubt among victims' advocates, forensic nurses, and prosecutors that 

these programs have been instrumental in assisting victims through the traumatizing 

experience of rape. However, there has been little research or empirical evidence 

establishing the efficacy of SANEISART programs in terms of the successful arrest, 

prosecution, and conviction of rapists. The American Prosecutors Research Institute 

(APRI) and Boston College (BC), with funding from the National Institute of Justice, 

U.S. Department of Justice, designed the current research to fill the gap in the literature 

and to determine if SANEISART programs make a difference in the outcomes of sexual 
assault cases. In particular, the project examines the impact of SANEISART programs 

on arrest and conviction rates and determines at what stage of the criminal justice process 

SANEISART interventions make a difference. 

The answers to these questions will assist prosecutors, policy makers, and 

practitioners to be more effective in pursuing sexual assault cases, to create and 

implement policy that protects and restores victims, and to provide information to 

maintain quality training and education for those working with sexual assault victims. 

The Evolution of SANEISART: Review of the Literature 

The Anti-Rape Movement and the Development of Rape Crisis Centers 

In the early 1970s, when police departments and rape crisis centers first began to 

address the crime of rape, little was known about rape victims or sex offenders. Feminist 

groups had just begun to raise the issue of rape, and in 1971, the New York Speak-Out on 

Rape drew widespread attention to rape. A contemporary feminist who raised the issue 

early were Susan Griffin (1 971) in her now classic article on rape as the "all-American" 

crime. Susan Brownmiller (1 975) wrote the history of rape and urged people to deny its 

future. The general public was not particularly concerned about rape victims; very few 

academic publications or special services existed; funding agencies did not see the topic 

as important; and health policy was almost non-existent. 

By 1972, the anti-rape movement began to attract women from all walks of life 

and political persuasions. Various strategies began to emerge, particularly the self-help 

' U.S. Department of Justice, Office of Violence Against Women. (September 2004). A National Protocol for Sexual 

Assault Medical Forensic Examinations: Adults/Adolescents. Washington D.C.: U.S. 
program now widely known as the "rape crisis center." One of the first such centers was 

founded in Berkeley in early 1972, known as Bay Area Women Against Rape 

(BAWAR). Within months of the opening of the Berkeley center, similar centers were 

established in Ann Arbor, Michigan; Washington D.C.; and Philadelphia, Pennsylvania. 

Concurrently, hospital-based rape counseling services began in Boston and in 

Minneapolis. Soon, centers replicated and services flourished. Although volunteer ranks 

tended to include a large number of university students and instructors, they also included 

homemakers and working women. The volunteer makeup usually reflected every age, 

race, socio-economic class, sexual preference, and level of political consciousness. 

Volunteers were, however, exclusively women. Among the women, the most common 

denominators were a commitment to aiding victims and to bringing about social change 

(Largen, 1985). 

The "Second Assault:" Early Treatment of Rape Victims by the System 

The rape crisis centers provided victims with the support and counseling that 

enabled them to move through the traumatizing experience of rape both mentally and 

emotionally. However, rape survivors would often experience "victim-blaming 

treatment from system personnel" that would often worsen the victim's physical and 

mental distress (Campbell, Wasco, Ahrens, Sefl & Barnes, 2001). Additionally, the 

physical ordeal of the medical exam and subsequent investigation could often be a 

humiliating and de-humanizing experience for the victim. These post-assault experiences 

became known as the "second assault" of the victim. 

Rape victims would often go through a series of uncomfortable experiences after 

their victimization that would constitute a "second assault." First, rape victims were 

traditionally seen in the emergency room by male physicians and generalist nurses, who 
often lacked the time and experience to do a thorough examination of the victim that 

would assist law enforcement and prosecutors (Girardin, 2005). Rape victims were not a 

high priority for emergency care, and even when medical needs were satisfied, their 

emotional needs were not. Prior to the SANE programs, medical staffs had an image of 

the "real" rape victim and much energy went into determining the "legitimacy" of the 

rape case, i.e., was the victim really raped? Rape victims often felt depersonalized, lost, 

and neglected. 

Second, the environment of the emergency department and needs of the victim 

were often at odds. Many victims complained about the long wait, having to wait alone, 

a lack of privacy, and not being informed of exam results. Rape victims were not a 

priority with emergency department physicians. Physicians were reluctant to do the rape 

examination because they lacked experience and training in forensic evidence collection 

and because they were vulnerable to being subpoenaed and required to testify (Bahm, 

2001). Physicians were able to examine the victim's body for bruises and prepare slides 

to look for sperm. However, they were often unaware of the need to collect evidence 

from clothing, carefully folding clothes to prevent dried stains from brushing off, giving 

the victim a comb to gather pubic hairs that may have been left by an assailant, or 

clipping the victim's fingernails to provide skin scrapings of the assailant. There was 

also a lack of continuity of care. Medical departments did not communicate with each 

other, so victims returning for follow-up care found it difficult to be asked again by new 

people why they needed medical attention. 

Finally, documentation collected on the victim would often include damning 

information such as prior sexual experience or phrases that included judgmental 
statements about the victim. Ultimately, victims were left on their own to cope 

financially, legally, and emotionally with the aftermath of the crime (Holmstrom & 

Burgess 1983). 

SANE/SART: Past and Present 

It was against this backdrop of problems that prompted communities throughout 

the United States to involve nurses in the care of the sexual assault victim (Lang, 1999; 

Ledray, 1999). Nurses, medical professionals, counselors, and advocates working with 

rape victims agreed that services provided to sexual assault victims in the emergency 

room were inadequate when compared with the standard of care given to other patients 

(Ledray, 2001). Thus, SANE programs and SARTs emerged in the 1970s with the first 

SANE in Tennessee. SANE programs were created whereby specially trained forensic 

nurses provide 24-hour coverage as first-response care to sexual assault victims in 

emergency rooms and non-hospital settings (Campbell, 2004). 

Nurses have always cared for patients who were victims of violence. However, 

forensic nursing has only recently been recognized as an emerging specialty area of 

contemporary nursing practice (Doyle, 2001; Taylor, 1998; Winfrey & Smith, 1999). 

Forensic nursing history has been traced to the 1 gth century when midwives were called 

into court to testify on issues pertaining to virginity, pregnancy, and rape (Lynch, 2006). 

Clinical forensic nursing practice focuses on the collection of evidence from living 

patients who have been victims of crimes or traumatic injuries. The forensic and clinical 

training SANEs receive allow them to "relieve emergency departments of a group of 

patients who typically have non-urgent physical needs but extremely urgent needs for 

evidence collection, crisis intervention, and emotional care" (Girardin, 2005). 
Today, SANE programs have grown in number and many are still reaching 

maturity. Ciancone, Wilson, Collette, and Gerson (2000) conducted a survey of SANE 

programs in the United States. Of the 58 programs that responded, 55% had been in 

existence for less than 5 years and 16% had been in existence for more than 10 years. 

Campbell and colleagues (2005) surveyed SANE programs and reported on the rapid 

growth of programs; 58% had emerged within the past 5 years. Trends noted included 

newer programs created through a joint task force or through collaboration with other 

community groups; more diverse funding available as opposed to using hospital funds; 

and significantly larger programs with more staff and serving more patients, which 

reflected organizational growth. 

The SANE soon became an integral part of a team of primary and secondary 

responders known as a SART (Sexual Assault Response Team). As previously 

mentioned, the SART includes law enforcement, detectives, victim advocates, and 

healthcare providers. The main goal of a SART is to assist the sexual assault victim 

through the criminal justice process. The second goal is to increase the odds of 

successful prosecution by enhancing evidence collection and facilitating communication 

between all parties in the process. The third goal is to help victims recover and cope 

from their experience through counseling and support (Girardin, 2005, Wilson & Klein, 

2005). 

Nationally, the SANEISART model has grown exponentially. Although virtually 

all these programs were developed to facilitate standard comprehensive and expert care 

of sexual assault survivors, the literature clearly shows that policies and procedures do 

vary from program to program. 
Structure and Operation of SANEISART Programs 

SANE programs operate out of a variety of locations including hospitals and 

community-based facilities. They also vary in terms of their community relationships, 

structure, services offered, and their development. Ciancone et al. (2000) found that the 

median number of patients seen annually by SANE programs was 95. Approximately 

75% of the programs were affiliated with a hospital, a police department, or a rape crisis 

center. More than half of the exams were conducted in a medical clinic, office or hospital 

setting. Ninety percent offered prophylaxis and treatment for sexually transmitted 

diseases (STD); however, STD cultures, HIV testing, and screening for illegal drugs and 

alcohol were selectively performed based on whether or not patients had evidence of 

active disease, requested the test, or had high-risk exposures. The authors suggested that 

best-practice protocols be designed to eliminate the inconsistencies among programs and 

that further research be conducted, particularly the collection of outcome measures in 

order to define the impact of the programs (Ciancone et al., 2000). 

Campbell and colleagues (2005) conducted a national study of the organizational 

components of SANE programs that examined four areas: 1) history of the program; 2) 

current structure, hction and operations; 3) program goals and desired outcomes; and 4) 

community relationships. A summary of the history and development included how the 

program began (by a planning committee or task force); why the program was created 

(need for better care for victims, better evidence collection, reduce waiting time); and 

funding ofprogram (hospital funds, state grant, private donations, local government 

grant). A summary of the SANE programs' structure included staffing, location for 

conducting exams, program setting, and payment for services. A summary of SANE 
programs' goals and outcomes included primary program goals (provide quality care, 

improve evidence collection, meet patient's emotional needs, empower survivors; prompt 

reporting to police). Good outcomes in a case were described as, "patient is not blamed 

or made to feel it was her fault," "patient educated about resources," "good quality 

medical care," "evidence collected correctly/professionally," "case is prosecuted and 

victim ready to talk with a counselor" (Campbell et al., 2005). The last organizational 

category was community relationships. The quality of community relationships included 

rape crisis centers; policellaw enforcement; prosecutor's office; and hospitals (for nonhospital based programs); quality of relationships with other staff in the hospital 

emergency department and hospital administrator (Campbell et al., 2005). 

The SANE programs promote a philosophy of care that is evidence-based and 

consists of the following tasks: 

1) Initial Medical Evaluation: This is not a routine physical exam. The 

emergency physician will typically take vital signs of the victim; however, the 

physician is asked not to treat injuries until the SANE documents injuries with 

pictures and collects evidence. The victim is advised of this procedure and 

must sign a consent form (Ledray, 2001). 

2) Evidentiary Exam: The SANE is responsible for conducting the evidentiary 

exam and ensures that the victim's dignity is protected and is not re-traumatized 

by the exam. Victims are a part of the decision process throughout the evidence 

collection phase. Most protocols suggest the exam be completed within 72 hours 

after the sexual assault. However, some research indicates that evidence may be 

available beyond the 72 hour time period (Protocol, 2004). There is significant 

variation in how evidence is collected. However, all evidentiary exams include 

the following (Ledray, 200 1): 

a) written consent from the victim, documentation of assault history 

b) forms of violence used and where 

c) medical information of the victim including pregnancy status of the 

victim 

d) a physical exam for trauma, genital and non-genital 

e) collecting the victim's clothing and packaging according to state policy 

f) specimen collections from the body surfaces including skin, hair, and 

nails 
g) body fluid and orifice specimen collection 

h) blood draw and urine specimen for drug analysis 

i) DNA screen 

j) prophylactic treatment of STDs or culturing 

3) Maintaining Chain of Evidence and Evidence Integrity: The SANE is 

responsible for ensuring complete documentation with signatures and the 

disposition of evidence. Additionally, the SANE is also responsible for 

identifying, collecting, and preserving evidence and for securing evidence in a 

designated area free of contaminants (Evans, 2003). 

4) Crisis Intervention and Counseling: This includes a mental health assessment 

and referral for follow-up counseling. This is usually the primary role of the rape 

crisis center advocate. However, the SANE also provides crisis intervention and 

ensures that follow up counseling services are available (Ledray, 2001). 

In addition, SANE programs utilize specialized forensic equipment such as a 

colposcope, which is a non-invasive, lighted, and magnifying instrument for examining 

the perineum and anogenital area for the detection of small lacerations and bruises 

(Voelker, 1996). Other equipment may include a camera attached to the colposcope, and 

some use toluidine blue dye for the detection of micro lacerations and abrasions. SANEs 

also document bruises and injuries using photography. Today, many are using digital 

cameras. SANEs are also trained in identifying and documenting patterned injuries, 

treatment of injuries, maintaining chain-of-evidence, and providing expert witness 

testimony (Ledray, 1999). 

Building on the success of the SANE model, many communities have established 

a SART, which is a coordinated community approach to deal with the multiple needs of 

rape survivors and to prosecute offenders. Under this approach, SANEs work in a team 

with police and sheriffs, prosecutors, rape crisis advocates or counselors, and emergency 

department medical personnel to better collect evidence and provide services to victims. 

Some variations exist with the structure of SART programs. For instance, some 
programs are hospital-based and others consist of medical teams that contract with police 

or sheriffs departments (Lewis, DiNitto, Nelson, Just & Ruggard 2003). In addition, 

some states have SART programs that do not have a formal SANE component. The state 

of Rhode Island relies on medical personnel who are not SANEs, to collect forensic 

evidence as part of their SART (Wilson & Klein, 2005). 

Research on SANE/SART Programs 

The U.S. Department of Justice, Office for Victims of Crimes (2001) reported that 

SANE programs have made a profound difference in the quality of care provided to 

sexual assault victims by offering prompt, compassionate and comprehensive forensic 

evidence collection. This report traced the establishment of the first SANE programs in 

the mid-1 970s in Minneapolis, MN; Memphis, TN; and Amarillo, TX. By 1991, 

approximately 20 SANE programs existed in the United States; in 1996, there were 86 

known programs; by 1997, that number rose to 1 16, and by 1999 it was estimated that 

there were more than 300 programs in existence. 

More recently, Campbell, Patterson, and Lichty (2005) examined the 

effectiveness of SANE programs across five areas: 1) promoting the psychological 

recovery of survivors; 2) providing comprehensive and consistent post rape medical care 

(e.g., emergency contraception, sexually transmitted disease [STD] prophylaxis); 3) 

documenting the forensic evidence of the crime completely and accurately; 4) improving 

the prosecution of sexual assault cases by providing better forensics and expert 

testimony; and 5) creating community change by bringing multiple service providers 

together to provide comprehensive care to rape survivors. Campbell, Patterson, and 

Lichty found that SANE programs are effective across these areas; however, the authors 
note that most research on SANEISART programs has not included "adequate 

methodological controls" to establish empirical evidence attesting the effectiveness of 

such programs. 

Early studies of SANEISART programs were descriptive case studies that did not 

use control samples of non-SANEISART cases. For example, Solola and colleagues 

(1983) studied the management of rape cases by the SANE program in Memphis and 

reported that more than 90% of the victims elected to file a police report of the sexual 

assault. However, in 38% of the cases, prosecution was not possible because the 

assailant was unknown. Arrest and successful prosecution was possible in 61.4% of the 

cases with identified suspects or in only about a quarter of all rape cases. O'Brien (1992) 

reported a 100% conviction rate for cases involving SANE examinations over a 3-year 

period in Madison, Wisconsin, citing the quality of evidence collected and testimony by 

SANEs. Solola observed increases in the number of guilty pleas in cases with SANE 

intervention. 

Several researchers have explored the possible reasons for the increase in 

conviction rates that may be associated with SANEISART model. The World Health 

Organization, reported that a study in Canada found that documentation by trained 

forensic or other medical providers can increase the likelihood that a perpetrator will be 

arrested, charged, and convicted (World Health Organization, First World Report on 

VioIencc and I Iealth 166,2002). In addition, Ledray (1992, 1997), Lenehan (1 991), and 

Little (2001) reported that relevant consistent documentation and evidence collection 

contributed to an increase in convictions. There is also evidence indicating that when a 

SANE intervenes there is a higher rate of victim participation in the criminal justice 
system (Ledray 200 1 ;Ledray & Summelink, 1996). Researchers have further 

demonstrated that evidence collection is more accurate when collected by a SANE 

(Crandall & Helitzer, 2003; Ledray, 2001; Sievers, Murphy & Miller, 2003). Atney and 

Bishai (2002) studied the quality of medical care of rape victims, Crandall and Helitzer 

(2003) reported on the impact of SANE programs in New Jersey. Crandall and Helitzer 

(2003) also found that in Albuquerque, New Mexico, the SANE program established in 

1996 improved patient care, improved the job quality of care providers, and increased the 

number of charges brought against rapists and the number of entered guilty pleas. 

However, the impact of SANE programs on judicial processes is not always immediate. 

Wilson and Klein (2005) found in Rhode Island that the impact of the SART program on 

judicial processes as applied to sexual assault cases was negligible. They attribute the 

findings to the fact that the Rhode Island program is still maturing. However, the 

program was found to have immediate and positive results for victims. 

The research on SANEISART programs and forensic research in the area of rape 

and sexual assault has also focused on forensic markers of injury to rape victims 

(Burgess, Hanrahan & Baker, 2005). The early research (outside of descriptive reporting 

of injuries) has been on the use of the colposcope. Slaughter and Brown (1 992) reported 

finding 87% of rape victims they examined (n=13 1) had identifiable injury via 

colposcope. Slaughter et al. (1997) reported findings on 3 1 1 women and children and 

compared them to 75 controls. They found positive anogenital findings in 68% as 

compared to 1 1 % in the control group having consensual sex (n=75). However, the 

study included several methodological issues, including the fact that the time from rape to 
examination varied with the rape victims (up to 72 hours post assault) while the controls 

were examined within 24 hours following intercourse. 

Sommers, Fisher, & Karjane (2005) analyzed the role of colposcopy in the 

forensic examination of adolescent and adult women and noted that identifying an injury 

pattern to predict rape remains problematic. Patel, Curtner & Forster (1992) warned that 

if colposcopy was required to support a claim of rape, there was the risk that courts 

would doubt a woman's history if injury was absent. Injury has been noted to play a role 

in the reporting of rapes. Bachman (1993) found that the level of injury sustained in a 

rape increased the likelihood of the rape being reported to police. Finally, the issue of 

injury has been studied following consensual sex or tampon use. Fraser and colleagues 

(1 999) reported on an international sample of 107 women, aged 18-35, followed over a 6- 

month period to look for changes in vaginal and cervical appearance. Colposcopy noted 

56 alterations during 3 14 inspections with the most common lesions being petechiae (30 

of 134), erythema (9 of 3 14), abrasions (5 of 134) and edema (4 of 314). The incidence 

of these conditions was highest when the inspections followed intercourse in the previous 

24 hours or after tampon use. Two primary issues are critical in rape cases: 1) 

identification of the assailant and 2) consent (or lack thereof). The issue of identification 

is being addressed by rape kit DNA evidence. The issue of non-consent is being 

addressed by research on differentiating injuries based on visual inspection, contrast 

media, or colposcopy. One such study is underway by Sommers, Schafer and Zink 

(2005). 

The literature clearly shows how SANEISART programs have been instrumental 

in helping rape survivors. These programs provide the emotional and mental support to 
empower victims while also helping victims navigate the criminal justice process. 

However, there is little empirical evidence that attests to the efficacy of SANEISART 

programs and their impact on judicial processes. The majority of present research lacks a 

control for non-SANEISART cases and tends to focus on variations in program structure, 

victim impact, and the use of forensic equipment. In addition, the research is largely 

descriptive and based on testimony and case studies (Ledray, 2001). The American 

Prosecutors Research Institute (APRI) and Boston College (BC) project examines both 

SANEISART programs and non-SANEISART programs to determine differences in 

impact. Moreover, this research focuses on geographically and demographically diverse 

jurisdictions allowing for a comparative approach rather than a case study method. 

Finally, the project considers several control variables that have not been included in 

previous research examining the connection between SANEISART programs and case 

progress within the criminal justice system. The findings fill a critical void by 

establishing systematic evidence that will help strengthen existing programs, serve as a 

guide for establishing new programs, and facilitate better criminal justice response. 
Project Goals and Research Questions 

The goal of this study is to test the efficacy of SANEISART programs as a tool in 

the criminal justice system. In particular, the study was conceptualized to determine if 

the performance of a SANEISART exam impacts sexual assault case outcomes by 

comparing cases in which there was a SANE exam and/or SART response and those in 

which there was not. In testing this hypothesis, the project team sought to answer the 

following research questions: 

1. Is the arrest rate higher in cases where a SANEISART exam is performed as 

compared with cases in which no exam is performed? 

2. Is the indictmentkharging rate higher in such cases? 

3. Are guilty pleas more likely to be entered in such cases, and are pleas likely to 

be to the existing charge or to a lesser charge? 

4. Is the conviction rate higher in such cases? 

5. Is the sentence more severe in such cases? 

It is important to note that this study focused on the impact of SANEISART 

interventions on the formal criminal justice response, not the victim's decision or 

likelihood to report the assault to the police or to obtain services. Understanding the 

victim's motivation and decision-making is clearly an important study. However, given 

the challenges faced by prosecutors in securing convictions in sexual assault cases, the 

research team believed that research focusing on programs that impact actual case 

outcomes would have the most significant impact, particularly with the proliferation of 

SANEISART programs across the country. As such, the cases examined were only those 
in which a report had been made to law enforcement. The victims may or may not have 

had a SANEISART intervention, which serves as the theoretically relevant independent 

variable in the study. As will be discussed in the following section, the research team 

collected data that allowed the team to control for any selection bias that may have arisen 

from cases not processed through the SANEISART system. 

The data collected enabled the research team to draw conclusions regarding the 

impact of SANEISART programs on arrest and conviction rates as well as where in the 

criminal justice process a SANEISART intervention made a difference. The examination 

of dependent variables followed a temporal sequence, i.e., there was a report, then an 

arrest, then charges filed, and so on. If the case file information indicated a negative 

response at one point, then there would be a negative response on all later points. 

In addition, the project team examined the participation of the victim in the 

criminal justice process and the types of services that were offered to victims. As a large 

portion of SANEISART programs focus on understanding victims' reactions to sexual 

assault and ensuring proper treatment to minimize the chance of further trauma to the 

victim, a central hypothesis to be tested is that improved case outcomes may be a result 

of increased participation by the victim in the identification, apprehension, and 

prosecution of the perpetrator. Moreover, the level of services offered and provided to 

victims, particularly those related to prosecution would likely affect case outcomes as 

well. Both the victim's participation in the criminal justice system and specifics of 

SANEISART services, including evidence collection, were considered in determining the 

true impact of SANEISART interventions on case outcomes. 
Data Collection Design and Implementation 

APRI and BC chose a quasi-experimental design for the study as the performance 

of a SANEISART exam could not be randomly assigned, thus making an experimental 

design impossible. The research study focused on differences in case outcomes in 

selected prosecutorial districts between cases in which a SANE exam was performed or 

there was a SART response and cases in which a SANE or SART intervention was not 

performed. 

SANEISART and non-SANEISART cases between 1997 and 2001 were drawn 

randomly from police incident reports and the data were then matched to records in the 

SANEISART programs andlor the prosecutor's office. Although every attempt was made 

to follow this protocol, the sampling strategy was not able to be implemented in one site 

because the prosecutor's office tracked cases by victim and defendant name, not by a 

police report or incident number. Working with the police department and the state crime 

lab, a list of adult female sexual assault victims was identified. The police department 

and a SANE nurse culled the list into a SANE and a non-SANE sample and provided the 

list of victim names to the prosecutor's office so files could be matched. One the match 

occurred, a unique case identifier was assigned to the file to maintain victim anonymity 

and confidentiality. In all sites, the project team also made distinctions between cases 

involving only a SANE exam and cases in which a SART responded as well. 

Originally the study sites were selected based on the date of SANEISART 

program implementation, geographic and demographic diversity, volume of sexual 

assault cases, and availability of data on the proposed variables. However, due to 

challenges faced by the research team, as discussed later in this chapter, the final sites 
were determined based on availability of data and likelihood of obtaining a sufficient 

non-SANE sample. 

Dependent and Independent Variables 

As the focus of the study was the impact of SANEISART interventions on case 

outcomes, case outcomes served as the dependent variables and the performance of a 

SANEISART program as the independent variable. For cases in which no exam was 

performed, the study team collected data on whether or not SANEISART services were 

offered. In addition, the project team collected data on several case-specific control 

variables to determine their impact on any observed relationship between the dependent 

and the independent variables. The variables that were examined included the following: 

Dependent Variables - Criminal Justice Outcomes: 

* Arrest - arrest, no arrest - dichotomous 

Charges Filed - charges filed, no charges filed - dichotomous 

Convicted - conviction, no conviction - dichotomous 

* Penalty - suspended sentence, probation, incarceration and probation, 

incarceration - ordinal 

Length of penalty - number of months - interval 

Independent Variable: 

Was a SANEISART intervention done - SANE only, SANEISART, no exam 

- nominal 

Was a SANEISART intervention done - SANEISANE SART, no exam - 

dichotomous 

Control or Intervening; Variables: 

Victimloffender relationship - stranger, non stranger - dichotomous 

Whether or not services were offered and refused - dichotomous 

Numberltypes of services provided - intervallnominal 

Time between the incident and the report (in days) - interval 

- - - 

In the event of a SANE exam conducted in conjunction with a SART response, or conversely a SANE 

exam done without a SART response, an alternative measure of the theoretically relevant dichotomous 

independent variable was formed and entered in separate models. These alternative measures were as 

follows: Non-SANE were coded as "0"; SANE exam and SANEISART interventions were grouped 

together and coded as "1". 
Level of participation of the survivor in the criminal justice process -

statement given, testified, victim impact statement, contact with prosecutor -

interval 

Race of victim -nominal (White as reference group) 

Race of perpetrator -nominal (White as reference group) 

Use of force, particularly of a weapon -dichotomous 

Previous arrests -interval 

Previous convictions -interval 

Case outcome -guilty of most serious charge at trial, guilty of lesser charge at 

trial, not guilty at trial, dismissed, plea to lesser charge, plea to most serious 

charge, no charges filed, administrative dismissal, no true bill, referred to 

another jurisdiction, and other -ordinal 

Level of evidence collected -videotape, pictures, clothing, fabriclfibers, hair 

samples, bodily fluid, nail scraping, rape kit -interval 

DNA collected -dichotomous 

Documented injuries by police -dichotomous 

Number of witnesses -interval 

Suspect claimed sexual act was consensual -dichotomous 

Victim refusal to move forward with charges -dichotomous 

(Appendix A contains copies of the three data collection forms used: the 

incident form, case abstraction form, and the SANEISART data collection 

form) 

Exhibit 1, on the following page, shows the number of responses, minimum and 

maximum values, means, and standard deviations for ordinal and dichotomous variables. 

Prior to and during site visits, project staff also conducted interviews with staff in 

the prosecutors' offices and the SANEISART programs to obtain qualitative information 

about the legislative and criminal justice context during the time period, using a semistructured interview guide. In particular, the project team sought information about 

changes in legislation regarding sexual assault such as revisions to the criminal code, 

sentencing guidelines, or civil commitments of sexually violent predators; police 

department policies regarding the handling of sexual assault cases; prosecution policies 

such as no plea policies; and other relevant changes with regard to the handling of sexual 

assault victims or perpetrators. 
-- 

Exhibit 1: Descriptive Statistics for Interval and Dichotomous Variables 

- - - -

N Minimum Maximum Mean Std. Deviation 

Arrest (no = 0; yes = 1) 

Charges filed 

(no = 0; yes = 1) 

Convicted 

(no = 0; yes = 1) 

Length of penalty in months 

Victimloffender relationship 

(stranger = 0; 

non-stranger = 1) 

Were services offered by 

police to victim? 

(no = 0; yes = 1) 

Number of services 

provided 

Time between the incident 

and the report (In Days) 

Level of participation 

Use of force 

(no = 0; yes = 1) 

Was a weapon used 

against victim? 

(no = 0; yes = 1) 

Number of previous arrests 

Number of previous 

convictions 

Level of evidence collected 

DNA collected 

(no = 0; yes = 1) 

Were injuries documented 

by police? (no = 0; yes = 1) 

Number of witnesses 

Did suspect claim sexual 

act was consensual? 

(no = 0; yes = 1) 

Did victim refuse to move 

forward with charges? 

(no = 0; yes = 1) 
Data Collection Instruments and Method 

The research team developed three standardized records abstraction forms to 

collect data: 1)the incident form, 2) the case abstraction form, and 3) the SANEISART 

data collection form (see Appendix A for all three forms.) Staff members in the 

SANEISART programs and members of the project team were responsible for extracting 

the data fiom the various reports and files in each of the prosecutorial districts, as 

discussed below. 

The incident form was designed to collect data from police reports and the 

prosecution files about the actual sexual assault. Specifically, details about the incident 

collected included the time between incident and report, use of force; victimloffender 

relationship, types of evidence collected, types of services offered to victim, previous 

suspect arrests and convictions, and other demographic information about the victim and 

the perpetrator the. 

Prosecution data and case outcome data were drawn from the prosecutors' case 

files, using the case abstraction form. Most case files contained a case summary and 

disposition sheet that served as the primary source of data. The key variables that were 

extracted from the files were whether or not charges were filed, the specific charge(s) 

filed, whether or not there was a guilty plea and to what charge, whether or not a trial was 

held and the outcome, whether or not there was an appeal and the outcome of the appeal, 

what the sentence was, and participation of the victim in the prosecution. With regard to 

participation of the victim in the prosecution, the team extracted information regarding 

the victims' cooperation with the prosecutor, whether or not the victim appeared at Grand 
Jury proceedings or testified at trial, and whether or not the victim gave a victim impact 

statement (where applicable). 

Information about the SANEISART intervention was abstracted from the 

SANEISART files, using the SANEISART data collection form. Specific information 

regarding the evidence collected during the victim's exam, nature of the assault, 

evidencelforensic kits collected, victim's demeanor, weapon(s) used, number of 

assailants, and the victimloffender relationship were collected. 

Data to address the primary questions of the study were gathered on-site by the 

SANEISART program staff and members of the project team. A 5-day site visit was 

required as project team members physically reviewed each case file to extract the data. 

To facilitate the site visit, the cases were selected in advance and assigned a unique 

identifier to the case to ensure confidentiality. 

Research Challenges 

Although the proposed study was reviewed by the Boston College Institutional 

Review Board (IRE3) to assess human subjects' protection issues, the study team 

encountered IRE3 obstacles at many study sites that required additional time to address. 

Access to law enforcement and prosecution files for most sites selected was granted; 

however, in some jurisdictions, to collect information from the SANEISART file, which 

was typically a part of a medical report, an additional hospital IRB approval was 

required. As each SANEISART exam was performed by a medical professional, 

hospitals required the study team to submit a proposal for a hospital IRE3 review. 

Although supporting the study, hospital officials were obligated to maintain the 

requirements of the Health Insurance Portability and Accountability Act of 1996 or 
HIPAA, which provides extensive privacy rights to patients' medical information and 

records. 

To ensure confidentiality, the proposed study was designed in a manner to 

preserve the privacy of persons with whom information related. Unfortunately, as with 

any study, time was limited and the review boards involved only met at specified times 

during the year to review studies thus limiting access to certain sites. To pursue these 

sites would have been cost prohibitive as these sites required much more time dedicated 

than originally budgeted. 

In addition, matching police and prosecution files proved a difficult task in some 

jurisdictions and thus required additional time. For some jurisdictions, prosecutorial case 

files and law enforcement files were numbered in way that allowed the research team to 

track designated files from the police department to the prosecutor's office with ease. 

Data were collected from the law enforcement agency that handled the greatest 

percentage of sexual assault cases in the jurisdiction. Among the three jurisdictions 

studied, the largest agencies were the city police departments. For one jurisdiction, the 

police department and the prosecutor's office numbered files differently thus making it 

impossible to track cases from the entry point in the criminal justice system (i.e., sexual 

assault reported to the police or a SANEISART exam performed) through to case closure. 

Moreover, when examining case file information in the police and the prosecution files, 

pivotal case data was missing thus restricting the number of cases that could be included 

in the sample. In addition, although many prosecutor's offices have now moved to 

automated systems to track case file information, typically these offices are burdened 

with archived or a backlog of older cases that required personnel to manually enter data 
into the system. As such, the study team encountered problems with obtaining older files 

as these were typically archived and access was limited. 

Another major challenge encountered dealt specifically with identifying a nonSANEISART sample. For example, in some jurisdictions, the SANE program had been 

operational since the mid-1 990s and the initial review of sexual assault files indicated 

that very few cases handled by the prosecutor's office did not have a SANE exam, 

making it difficult, if not impossible, to draw a large enough sample of non-SANE cases. 

As a result, as part of the selection criteria for study sites, the study team selected sites 

where the SANE program was implemented in the late 1990s thus making it possible to 

collect a sufficient number of non-SANE cases. 

Study Sample 

Originally, when the study was first conceptualized, APRI proposed five study 

sites. However, due to the challenges mentioned, the study team reduced the proposed 

number of study sites to three. As previously stated, the final sites were determined 

based on availability of data and likelihood of obtaining a sufficient non-SANE sample. 

As a result, the three study sites selected for the study were Sedgwick County (Wichita), 

Kansas; Suffolk County (Boston), Massachusetts; and Monmouth County (Freehold), 

New Jersey. Appendix B contains information about each of the study sites, including 

the following: 

Number of rapes and violent crime reported during the time frame studied 

Per capita income and population 

Raciallethnic breakdown 
These data were gathered from secondary data sources such as the Uniform Crime 

Reports or the National Incident Based Reporting System, National Crime Victimization 

Survey, and the U.S. Census. 

Cases that were opened and closed between 1997 and 2001 were randomly 

selected from police incident reports in New Jersey and Kansas and the state crime lab in 

Massachusetts as all sexual assault reports were automatically sent to the crime lab. 

From these data sources, the project team obtained a list of adult female sexual assault 

reports during the time period. It is important to note that the data collected from the 

police incident forms were from the largest police departments in the participating 

jurisdiction^.^ Staff from the SANEISART program in each jurisdiction reviewed the list 

and identified all cases in which a SANEISART exam was performed. The project team 

then split the list into two groups (non-SANEISART cases and SANEISART cases) and 

then randomly selected up to 125 cases in each category. Exhibit 2 shows the breakdown 

of SANE/SART and non-SANEISART cases collected by each study site. 

Exhibit 2: Number of Cases Collected for Each Study Site 

Study Sites SANE Only SANEISART Non SANE1 

SART 

Total 

New Jersey 0 79 72 151 

Kansas 0 77 108 185 

Massachusetts 106 0 88 194 

Total 106 156 268 530 

In total, data were collected data on 530 cases-106 SANE cases, 156 

SANEEART, and 268 non-SANE cases. Although significantly lower than the proposed 

3 In selecting the study jurisdictions, the research team found that the largest police department in the three 

jurisdictions handled the majority of sexual assault cases. Because many jurisdictions have numerous law 

enforcement agencies that can refer cases to the prosecutors' offices, it would be cost-prohibitive to select 

cases &om all the law enforcement agencies in each jurisdiction. 
total sample size of 1,250 cases, the quality of data was very good and a review of the 

data demonstrated that the analysis plan as originally proposed was still valid. More 

importantly, unlike other similar studies, APRI and Boston College were able to maintain 

a non-SANE sample, thereby maintaining the integrity of the quasi-experimental design 

and the ability to conduct comparative analyses. 

The major impact of basing the findings on three sites is on the study team's 

ability to generalize to a larger population. Because of contextual differences, APRI and 

Boston College maintained that generalization may be difficult and based on the final 

sample size, would caution that some findings should be interpreted with care. Also, due 

to the smaller sample size, the analyses did not include within-site and cross-site 

comparisons. Rather, the analyses focused on a comparison of differences between 

SANE only, SANEISART, and non-SANEISART cases across all sites. 

Analysis Plan 

The project team used SPSS to analyze the data, using descriptive, multivariate, 

and inferential statistics to answer the research questions. Analyses were not generated 

for specific jurisdictions but rather aggregated together to increase statistical power. 

Descriptive statistics were generated using the SPSS Crosstabs and the Tables commands 

for key model variables (e.g., victim-offender relationship, types of services received by 

the victim, and types of evidence documented). 

Multivariate and inferential statistical tests were used to examine the relationship 

between the independent and dependent variables and to control for the effects of the 

intervening variables among all sites. The theoretically-relevant independent variable of 

whether or not a SANEISART exam was performed was included in all multivariate, 
inferential tests. In each of the multivariate models (for the differing dependent 

variables), the unit of analysis was the case. 

Analyses of the variance (ANOVA) were conducted to determine if the level of 

victim participation in the criminal proceedings, level of evidence collected, services 

received by victims, and the length of time between incident and report differed based on 

SANEISART interventions and non-SANEISART interventions. 

A series of logistic regression analyses were employed for dichotomous 

dependent variables to predict the probability and odds ratio that offenders were arrested, 

charged, or convicted based on independent and control variables. The statistical 

analyses were conducted across all study sites. A hierarchical logistic regression was 

employed to determine the association between the likelihood of offender arrest and 

SANEISART intervention. The predictor variables entered in step 1 were number of 

services, time between the incident and the report (in days), level of participation in the 

criminal proceedings, race of victim (dummy coded -White as reference group), race of 

offender (dummy coded -White as reference group), number of previous arrests, number 

of previous convictions, force used during the assault, and use of weapon. The 

SANEISART dichotomous independent variable was entered in step 2. 

A hierarchical logistic regression was employed to determine the association 

between the likelihood of charges filed and SANEISART intervention. The same control 

variables used in step one of the previous regression model were used in step 1 of this 

regression model. However, the SANEISART categorical independent variable 

(reference group -Non SANEISART) was entered in step 2. 
A hierarchical logistic regression was conducted to determine the association 

between offender conviction and SANEISART intervention. The predictor variables that 

were entered in step 1 were time between the incident and the report (in days), level of 

participation in the criminal proceedings, force used during the assault, and use of 

weapon. SANEISART dummy coded independent variable (reference group -Non 

SANEISART) was entered in step 2. 

A hierarchical linear regression was used to test the relative influence of 

SANEISART interventions on the sentence length in convicted cases. However, due to 

missing data for sentence and length of penalty, post hoc analyses of the variance 

(ANOVA) was conducted to determine if the type of sentence and length of sentence 

differed based on SANEISART interventions and non-SANEISART interventions. 
As described in the methodology section of this report, the study was designed to 

answer several key questions about the efficacy of SANEISART interventions as a tool in 

the criminal justice system. In particular, the study was designed to answer four 

questions: 1)what is the impact of SANEISANE interventions on the likelihood of 

suspect identification and arrest, 2) are guilty pleas more likely to occur in SANEISART 

cases, 3) what is the likelihood of conviction increases for SANEISART cases, and 4) 

does a SANEISART intervention increase the "severity" of the penalty (i.e., probation 

versus incarceration) and the length of penalty. 

The following sections describe the results of the analyses in terms of the study 

questions. The general characteristics of the SANEISART intervention are discussed 

first, followed by the SANEInon-SANE comparative analyses. The bifurcation of the 

sample into SANEInon-SANE created small cell counts for some variables, which is 

noted in the discussion. For this reason, some variables and questions were collapsed to 

increase the reliability and validity of the results. 

SANEISART Intervention 

The study yielded a total of 530 adult female sexual assault cases. As designed, 

the study sample was split into SANE cases, SANE/SART cases, and non-SANE cases. 

Exhibit 2 shows the breakdown of cases in each category: 
Exhibit 2: Study Sample 

Frequency Valid Percent 

SANE only 156 29.4% 

SAN ElSART 106 20.0% 

Non SANEISART 268 50.6% 

SANE only cases were defined as those cases in which a SANE performed an 

exam or attended to the victim. SANE/SART cases included cases in which a SART 

response occurred including a SANE exam or response. Non-SANE/SART cases were 

defined as those cases in which a victim refused a SANEISART intervention, never 

sought assistance from a SANEISART, or did not have a SANE exam. NonSANEISART cases did include cases in which the victims received treatment from nonSANE personnel in medical facilities. 

Before addressing the primary research questions, it is important to understand the 

characteristics of the sample in terms of the key differences between SANEISART 

interventions and non-SANEISART interventions. These differences form the foundation 

for the variables of interest both in terms of independent and control variables. 

One of the defining characteristics of SANEISART interventions is that the victim 

is engaged very early in the process and evidence is collected within a matter of days to 

increase the likelihood that useful forensic or biological evidence is not destroyed. 

Among the cases in the study sample, an average of 33 days elapsed between the time of 

the incident and the initial report in non-SANE cases. For SANEISART cases, the 

average length of time between incident and report decreased to 5.6 days, and for SANE 

only cases, the average was 3.4 days. ANOVA statistics show that the difference in 

means between the three types of cases is statistically significant at the .000 level. 
Another important element of the SANEISART intervention is the collection of 

evidence. SANE practitioners, law enforcement, and prosecutors report that 

SANEISART cases have more and better quality evidence than cases in which there is no 

SANEISART intervention. In fact, among the cases in this study, it would appear that 

SANEISART cases do result in the collection of more evidence. Overall, there are 1.9 

types of evidence collected on average for all cases. However, cases in which there is a 

combined SANEISART intervention yielded an average of 3.1 types of evidence; SANE 

only cases produced an average of 2.6 types of evidence, whereas non-SANEISART 

cases yielded only 1 type of evidence. The differences in means are statistically 

significant at the .000 level. 

Types of evidence documented in this study included photographs, videotapes, 

clothing, fibers, hair samples, rape kits, and DNA samples. Of the various types of 

evidence, it is DNA evidence that can be most useful in the prosecution of sexual assault 

cases. Overall, only 35% of the cases in the sample had DNA evidence. One would 

expect that if SANEISART interventions yielded more useful evidence, this evidence 

would include DNA evidence. This notion is supported by the study findings, as the 

results show statistically significant differences in the number of cases involving DNA 

evidence (pi.OOO). DNA evidence was available in 97% of SANE only cases and in 37% 

of SANEISART cases. On the other hand, DNA was available in only 10 percent of nonSANEISART cases. 

Related to evidence collection is the documentation of injury to the victim. 

Injuries were documented in 37% of SANEISART cases and only 20% of non- 
SANEISART cases. As with the findings about amount of evidence, this fmding is 

statistically significant at the .000 level. 

Another presumed benefit of a SANEISART intervention is that it will increase 

the likelihood that the victim will cooperate and participate in the justice process. For the 

purposes of this study, participation was operationalized as making formal statements to 

law enforcement, testifying andor appearing at court hearings, providing a victim impact 

statement, and cooperating with the prosecution. In fact, participation in the process is 

highest among cases in which there was a SANEISART intervention (1.3 on a scale of 0 

to 4), followed by non-SANEISART cases (0.9). Of note is the fact that SANE only 

cases yielded the lowest average participation (pi.01). 

The types of services that sexual assault victims receive can be important in 

avoiding "re-victimization" and encouraging continued involvement in the justice process 

APRI and BC staff abstracted information from the case files on the various services 

offered to victims. These services included: 

Transportation to the emergency room 

General transportation (e.g., to home, the police station, etc.) 

Shelter provided 

Rape crisis counseling 

Law enforcement/crisis intervention 

Clothing 

Making phone calls for victims 

Provision of information, flyers, andor phone numbers 

Referral to SANEISART 

Overall, very few services were offered to victims on average. Statistically, 

SANE and SANWSART cases were offered more services than non-SANE cases (an 

average of 1 service for SANEISART cases and 0.7 services for SANE only cases, 

compared with 0.5 services for non-SANE cases, pl.000). 
In terms of characteristics about the cases, the two most relevant variables based 

on the literature were use of a weapon and the relationship between the victim and the 

offender. Very few cases in the study sample involved the use of a weapon (only 17%, 

n=74) and thus the study team was unable to conduct any analysis by type of case (e.g., 

SANE, SANEIS ART, non-SANE). 

Descriptive analysis of the victidoffender relationship shows that in the largest 

percentage of cases the perpetrator was a friend or an acquaintance as shown in Exhibit 3 

below. The next largest category was a stranger relationship at 32%. 

Exhibit 3: VictirnlOffender Relationship 

Relationship Frequency Percent 

Intimate parVCohabitantlMarried1Dating 75 14.20% 

Child in cornmonlFormerly marriedlformer intimate partner 50 9.40% 

RelativelStep-parent1Caregiver 14 2.60% 

FriendlAcquaintance 203 38.30% 

CoworkerlEmployer 17 3.20% 

Stranger 171 32.30% 

For the purpose of the inferential analyses, the victidoffender relationship was recoded 

into a dichotomous variable of strangerlnon-stranger. 

Do SANEISART Interventions Increase The Likelihood of Suspect 

Identification/Arrest? 

Overall in the sample, 208 of the 530 cases resulted in an arrest of a suspect 

(39%). There were an additional 71 cases in which a suspect was identified and issued a 

summons to appear in court or was indicted but not arrested. No arrest was made in 25 1 

cases (47%). In nearly a third of these cases (n=8 I), arrest was not made because a 

suspect was never identified. 
When comparing the difference between SANEISART cases and nonSANEJSART cases, the analysis showed an apparent relationship between the conduct of 

a SANE exam or the existence of a combined SANEISART intervention and the 

likelihood that a suspect would be arrested. A case in which a SANE exam occurred is 

1.5 times more likely to result in the arrest of a suspect than a case in which no SANE 

exam occurred (p5.05). However, these results only account for 1 percent of the 

variance. Cases in which there is a combined SANEISART intervention are 3 times more 

likely to be arrested as compared with non-SANEISART cases (p5.000). 

Logistic regression was used to control for several variables to further determine 

the likelihood of arrest. Variables included in the equation included: 

Services offered to the victim 

Number of services offered 

Time between incident and report 

Level of victim participation in the criminal justice system 

Victim and offender race 

Victimloffender relationship (e.g., strangerlnon-stranger) 

Use of force 

Use of weapon 

Overall the model explains 30 percent of the variation in likelihood of arrest. 

However, a SANEISART intervention is not the strongest predictor of arrest. In fact, 

when controlling for other variables, a case involving a SANEISART intervention 

(Sane2Category) is only 1.7 times more likely to result in arrest than a case in which 

there was no intervention (p5.05). As shown in Exhibit 4, victirdoffender relationship, 

previous arrest of the suspect, and level of victim participation in the process have the 

greatest effect on the likelihood of arrest (p5.000). The use of force is also statistically 

significant in the model (p5.01). 
Exhibit 4: Predictors of Arrest 

Dependent Variable: Arrest B S.E. Wald df Sig. Exp(B) 

Step 1 Services offered to 

victim 

0.015 0.418 0.001 I 0.971 1.016 

Step 1 Number of services 

received by victim 

Step 1 Time between 

incident and report 

Victim level of 

Step 1 participation in 

criminal proceedings 

Step 2 Victim race (White) 

Step 2 Victim race (Hispanic) 

Step 2 Victim race (Black) 

Step 2 Victim race (Other) 

Step 2 Suspect race (White) 

Step 2 Suspect race 

(Hispanic) 

Step 2 Suspect race (Black) 

Step 2 Suspect race (Other) 

Step 3 Offenderlvictim 

relationship 

Step 4 Use of force 

Step 4 Weapon 

Step 5 Sane2Category (a) 

Constant 

a: Sane2Category: SANE only & SANEISART combined =I; non-SANE = 0. 

Do SANEISART Interventions Increase the Likelihood that Charges Will Be 

Filed in Sexual Assault Cases? 

Overall, a total of 62 cases of the 208 in which an arrest was made (12%) were 

not charged either because the case was administratively dismissed by law enforcement 

(6.5%), the prosecutor decided not to file charges (40.3%), or the Grand Jury returned a 

no true bill (53.2%). Nearly 60% of these cases were non-SANEISART cases. In 

addition, there were a total of 25 1 cases in which no arrest was made and no charges were 

filed. Of these 25 1 cases, the victim refbsed to move forward with charges in 135 of the 
cases (54%). In 81 of the cases (32%)) a suspect was never identified, and thus no arrest 

was made or charges filed. 

Using the same control variables as in the previous model, logistic regression was 

run to determine if SANEISART interventions increase the likelihood that charges will be 

filed. As shown in Exhibit 5, SANEISART cases (Sane3Category(l)) are 3.3 times more 

likely to result in the filing of charges than cases without a SANEISART intervention 

(Sane3Category) (p5.000); SANE-only cases (Sane3Category(2)) are 2.7 times more 

likely to result in charges being filed. The level of victim participation (p< .000) and use 

of force (p5.05) were also significant factors in the model. 

Exhibit 5: Predictors of Charges Being Filed 

Dependent Variable: Charge B S.E. Wald d f Sig. Exp(B) 

Step 1 Services offered to 

victim 

Number of services Step 1 received by victim 

Time between Step 1 incident and report 

Victim level of 

Step 1 participation in 

criminal proceedings 

Step 2 Victim race (White) 

Step 2 Victim race (Hispanic) 

Step 2 Victim race (Black) 

Step 2 Victim race (Other) 

Step 2 Suspect race (White) 

Step 2 Suspect race 

(Hispanic) 

Step 2 Suspect race (Black) 

Step 2 Suspect race (Other) 

Step 3 Offenderlvictim 

relationship 

Step 4 Use of force 

Step 4 Weapon 

Step 5 Sane3Category (a) 

Step 5 Sane3Category(l)(a) 

Step 5 Sane3Category(2)(a) 

Constant 

a: Sane3Category: Non-Sane=O, SANEISART combined =I; SANE only = 2. 
Based on the earlier descriptive analyses of SANEISART interventions, it would 

appear that the two most defining elements of a SANEISART intervention (on average 

more evidence collected and significantly more DNA evidence collected) are the driving 

force behind the relationship between a SANEISART intervention and the likelihood of 

charges being filed. In fact, when DNA evidence and amount of evidence are added into 

the model, it mediates the relationship between SANEISART interventions and charges 

being filed. This is likely due to problems with multicollinearity between the amount of 

evidence collected and the SANE/SART status. 

Do SANE/SART Interventions Increase the Likelihood of Guilty Pleas and 

Convictions? 

Among charged cases, the majority were convicted (68% compared to 32%). As 

shown in Exhibit 6 below, almost half of the cases (47.7%) were disposed via guilty plea 

as compared with 33% of the cases that were disposed at trial. Cases were most 

frequently pled to a lesser charge. 

Plea (lesser charge) 48 32.2% 

Plea (existinglmost serious charge) 23 15.5% 

Hung jurylretrial 2 1.3% 

Not guilty at trial 14 9.4% 

Guilty (lesser charge) 11 7.4% 

Guilty (existinglmost serious charge) 23 15.4% 

Because of low cell counts, analyses examining whether or not conviction was to 

a lesser or existing charge were not reliable, particularly when the sample is partitioned 

into SANEInon-SANE cases. However, a comparison of convictions (using a 

dichotomous variable of convictedlnot convicted) in SANE only, SANEISART, and nonSANEISART cases revealed some statistically significant differences. 
Cases involving a SANEISART intervention are 3.5 times more likely to result in 

a conviction than non-SANEISART cases (p5.05). This finding, before controlling for 

other intervening variables, accounts for 12 percent of the variance in likelihood of 

conviction. The findings with regard to a SANE only case are not as reliable. The 

analysis showed that there appears to be trend compared with non-SANE cases (i.e., 

conviction may be more likely in a SANE case); however, the finding was not 

statistically significant. Moreover, low cell counts make this finding unreliable. 

When control variables are added to the model, the significance of a SANEISART 

intervention on the likelihood of conviction is negated, as shown in Exhibit 7 below. 

Level of victim participation and the victimloffender relationship have the most bearing 

on the likelihood of conviction (p1.05). The combined SANEISART intervention 

(Sane3Category(l)) increases the likelihood of conviction by 2.9 times but is not quite 

statistically significant. However, the amount of explained variance increases from 14% 

to 23% when the SANEISART intervention is added to the model. SANE-only cases 

(Sane3Category(2)) are not statistically significant in the model. 

Exhibit 7: Predictors of Conviction 

B S.E. Wald d f Sig. Exp(B) 

Step 1 Time between incident 

and report -.008 .008 .963 1 .326 .992 

Victim level of 

Step 2 participation in 

criminal proceedings 

Step 3 Offenderlvictim 

relationship 

Step 4 Use of force 

Step 4 Weapon 

Step 5 Sane3Category 

Step 5 Sane3Category(l) 

Step 5 Sane3Category(2) 

Constant 

a Variable(s) entered on step 1 : Sane3Category. 
What Impact Do SANEISART Cases Have on the Penalty and the Length of 

Sentence in Convicted Cases? 

Sentencing information was available for only 73 of the 95 cases that were 

convicted. The majority of convictions resulted in a sentence of incarceration (43.8%, 

n=35) followed by a combination of incarceration and probation (33.8%, n=27). Only 

17.5 percent of convicted cases (n=14) received only probation. The remaining cases 

either received a suspended sentence (1 case) or some other type of alternative to 

incarceration (3 cases). 

On average, convicted sex offenders were sentenced to 85 months (slightly more 

than 7 years) of either probation, probationhncarceration, or incarceration. Sentences 

ranged from 6 months to 412 months. Exhibit 8 shows the average sentence length by 

type of sentence. 

Exhibit 8: Average Sentence Length (in months) 

Sentence Mean (in months) Minimum Maximum 

Suspended sentence 22 22 22 

Probation 22.9 12 36 

Incarceration/probation 56.3 6 140 

Incarceration 134.9 6 360 

Other 37 37 37 

A comparative analysis of the penalties in SANEISART cases and in nonSANEISART cases revealed no statistically significant differences. In fact, none of the 

variables in the model influenced the type of sentence or length of sentence. However, it 

should be noted that there was a significant amount of missing data with regard to 

sentence and length of penalty in the data set. These analyses were runon only 73 cases. 
Anecdotally, members of the forensic nursing community, victim advocates, law 

enforcement, prosecutors, and even policymakers believe that the SANE/SART 

intervention has a significant impact on both the survivors of sexual assault in terms of 

their recovery and experience with the justice system, the collection of evidence, and the 

criminal justice system's ability to prosecute sexual assault cases. Overall, the APRVBC 

study found mixed results with regard to the efficacy of the SANEISART intervention as 

a tool in the criminal justice system. Nonetheless, there are a number of findings that 

deserve discussion. 

First, with regard to the intervention itself-the SANE exam or SART response, 

the data clearly demonstrate that SANE/SART interventions result in cases that are 

significantly and statistically different from non-SANE/SART cases on several different 

fronts. In particular, the protocols followed by SANE and SART personnel yield more 

evidence on average than cases in which no SANE/SART intervention occurs. More 

importantly, SANE/SART cases are much more likely to have DNA evidence than nonSANE/SART cases. This finding is further supported by the fact that the nonSANE/SART cases in the sample included cases in which rape kits and other evidence 

were collected by non-SANE/SART personnel. 

In addition, the amount of time that elapses between the incident and the report is 

much lower for victims who are seen by a SANE or a SART than for those who are not. 

As a result, the likelihood that evidence is available and preserved is much greater. 

Moreover, victims are offered more services in SANE/SART cases than in non- 
SANEISART cases. One might expect that because of the short amount of time that 

elapses between the incident and the report and the offer of more services would result in 

.an increase in victim participation in the criminal justice process-another presumed 

benefit of SANEISART interventions. While victims in combined SANEISART cases do 

receive more services on average than in non-SANEISART cases, the difference is small, 

and it does not appear to have a marked effect on victim participation in the process. In 

fact, SANE only cases yield the lowest levels of victim participation in this study. 

This finding has important implications for SANE-only programs and raises a 

number of additional questions for future study. Specifically, do victims participate less 

in the system when a SANE exam yields a useful evidence for prosecution? Do victims 

feel that by having a SANE exam, no additional participation is needed? These are 

important questions but fall outside the scope of the current study. Additionally, as noted 

earlier, many questions about the victim's motivation for having a SANE exam exist. 

Answers to these questions and others related to victim motivation may yield useful 

information about why SANE-only cases have the lowest levels of victim participation in 

the justice system. 

Second, the SANEISART intervention has the greatest impact on charging 

decisions in adult female sexual assault cases and is a contributing factor in the likelihood 

that suspects will be identified and arrested. This is a particularly important finding in 

that it parallels findings from earlier studies and provides the first comparative evidence 

supporting the hypothesis that SANEISART interventions are a valuable tool in the 

criminal justice system and for prosecutors in particular. 
As noted earlier, the case is less likely to result in an arrest of a suspect if the 

victim knows her assailant, if the suspect has a prior criminal history, andlor the more a 

victim participates in the system. These three factors have a greater impact on the 

likelihood of arrest than having a SANEISART intervention alone. However, having a 

SANEISART intervention does further increase the likelihood of arrest by 1.7 times and 

is statistically significant. Initially, this finding would seem to indicate that the 

SANEISART intervention has limited value to law enforcement in making an arrest. 

However, it is possible that the majority of suspects, who are arrested, are done so at the 

scene and thus the arrest occurs before a SANEISART response. Additional data would 

be needed to examine the likelihood of arrest after the conduct of a SANEISART 

response, as the current data set only examined arrest as a dichotomous variable and did 

not document the amount of time that elapsed between the reported incident and arrest. 

Third, for charging decisions, there is a direct association between a SANEISART 

response and the likelihood that charges will be filed by the prosecutor (either by direct 

file or through Grand Jury indictment). In fact, a SANEISART intervention is the 

greatest predictor that charges will be filed-3.3 times more likely and 2.7 times more 

likely in SANE-only cases. Because of the amount of evidence collected and the 

availability of DNA are highly correlated with a SANEISART intervention, these appear 

to be the defining characteristics that predict the filing of charges. In addition, the more 

the victim participated in the process by giving statements, cooperating with prosecutors, 

attending and providing testimony at hearings, and providing impact statements, the more 

likely the case was to result in a conviction. Likewise, use of force was a predictor of 

charges being filed. 
Fourth, the study sought to test the hypothesis that SANEISART interventions 

increase the likelihood of conviction, and the analyses show mixed results. Basic 

analysis, without controlling for the influence of various factors, show that SANEISART 

cases are 3.5 times more likely to result in a conviction than non-SANEISART cases. 

However, the impact of a SANEISART intervention on the likelihood of conviction is 

negated when other variables are included in the model. 

In general, the victim's participation in the process and the relationship between 

the victim and the offender seem to have a more direct association with conviction. 

Unfortunately, the number of cases available for analysis of convictions was 105. As 

such, it was impossible to explore these results further to determine if there is a 

relationship between different types of convictions (i.e., guilty pleas to lesser or existing 

changes and trial verdicts). In addition, the current study did not take into account 

whether or not SANEs provided expert testimony in cases, which may further explain or 

strengthen the findings with regard to conviction. Additional research on these topics is 

warranted. 

Finally, the length of sentence is not impacted by a SANEISART intervention or 

any other of the variables in the study. This finding, however, should not be considered 

conclusive as there was significant missing data in the dataset with regard to length of 

sentence. As the study team found, prosecutors' files do not always have the actual 

sentencing information as part of the formal record. Future study on this topic should 

include data gathered from official court records to supplement what information is 

available in prosecutors' offices. 
Overall, the findings are quite positive with regard to the efficacy of SANEISART 

interventions and provide the first comparative evidence of the impact of SANEISART 

interventions on adult female sexual assault case outcomes. The findings should be 

interpreted with care as some of the analyses were run with relatively small sample sizes 

(as noted in the report) and for this reason should not be generalized to the larger 

population. Nonetheless, it is clear that there are direct associations between 

SANEISART interventions and the likelihood of arrest, charges being filed, and 

conviction. As described earlier, a number of questions arise from the study findings that 

warrant more attention in the research field particularly with regard to victim motivation 

for seeking out a SANEISART intervention, the inter-relationship between the amount of 

evidence collected and SANEISART cases, and factors influencing the likelihood of 

conviction and the length of penalty. 
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APPENDIX A 

Date Collection Instruments 
SANE-SART Incident Form 

0 SAhX-SART 

0 Son SANE-SNIT 

Incident Inforn~ation 

1. Date of incident? 1 1 1 / / la. nate ofreport?m 1 11 1 CUD 

2. Tie of incident? m:rl 0 am 0 pm to I: I:/I 0 am 0 pm 

3. Location of incident? (PIN in ol[ rharqpplyj 4. Time between incident and report? 

0 vicUrn1s home 0 outside ~10rninules Ohom Odays Omonths 

0 pnvate residence 0 place of employment 

0 vehlcle 0 dorm room 5. Who initially contacted the police? 

(~~~I~~I~J~wPW 0 vlctun 0 wlmess 0 suspect 

0 hotel room 0 ist~hlhonal setting 0 neighbor 0 frlend/acquamtance 0 relattve 

0 parlung lot 0 other 0 child 0 med~cal profess~omd 0 coworker 

0 rape ems 0 caretakerlcaregwer 0 no contact \nth PD 

0 bar/restawmt 0 anonymous tip 0 other 

6. Type of force used against victim? (fiuin a~ thol appw 68. Wapon US&? 0 yes 0 no 

0 threat of force 0 hcklng 

6b. If yes, whattypc of weapon? 0 punchinghthng/slapping 0 dmgs/alcohol 0 sun 

0 grabbinglpullingldrassing 0 other 0 hfe 

0 other 

0 pwh'ing!shoving~~throwhg 0 no force indicatzd 

7. Witness present? {mr dr *or ~$9 

0 neighbor 0 relative 

0 fried'acquaintance 0 coworker 

0 child 0 not applicable 

6c. Were physical restraints used? 0 yes 0 no 

6d. If 

I 

yes; what type of restraint? 

- 

8. What was the principle sex charge? I 

9. Other arrest charges? 
Victim Information 

1. Victimloffender relationship? !RNin dI& appiy) 

0intimate partner 0stranger 

0cohabitant 0relative 

0married 0friendiacquaintance 

0chld in common 0coworkerlemployer 

0formerly mm~edlseparated 0step-parent'step-grandparent 

0dating 0caregiver/caretaker 

0foner intimate partner 0other--. ----

2. Race of the victim? dlIN all rtmt app@ 

0white 0asianlpacific islander 0hispanic 

0african american 0native american 0other 

3. Age of the victim? m0unknown 

4. Services given by the police? 0yes 0no 0unknown 

4a. If yes, what services were provided? cfi~ntd that 

0kansportatlon to the emergency room 0provide clorhlng for vlctlm 

0transportat~onm general 0phone calls on behalf of vxtm 

0shelter 0mformatloniflyors'phone numbers 

0referral to rape crw 0referral to SAhTE-SART 

0law enforcemen~cnsls rntewentlon 0other I. 


5. Victim dcmeanor at time of report? (pillin dl thd npp9 

0tearfulhying 0withdrawdflat 

OW 0hysterical 

0shakitrembling 0afraid 

0nervous 0other 

0upset 0rnfonnation not provided 

6.Were injuries documented by the police? 0ya 0no 

6a. What types of injuries did the victim sustain? iff rn dl rr~arqply) 

0bmi,d 0bums 0broken bones 00th 

0cuts!abras~ons 0sprmns 0hair pulled out 
6b. Were pictura taken of injuries? 0yes 0no 0unknown 

Gc. What type of physical evidence was collected? (Win o~thnr~&~ 

0v~deotape 0bodily fluid 

0pictures 0nail scraping 

0clothing 0rape ht 

0fabriclfibers 0other 

0hair samples 0none collected 

6d. Was DKA evidence obtained? 0yes 0no 0unknown 

Susaect Information 

1.Raceof suspect?(~i~r IndJ tl~mpprd 

0white 0asian/pacific islander 0hffipanlc 

0african american Onative american 0other-----.-.-----

2. Age of suspect'? m 0unknown 

3. Did suspect claim sexual act was consensual? 0yes 0no 0unknown 

3a. Was suspect arrested? 0yes 0no 0unknown 

3b. If suspect was pnted exceptional clearance, state the reason: 

4. Previous sexual assault incidents with the same victim and defendant? 

0yesidocumented 0allegedhot documented 0no 

.la. If yes, what was the result of the incident'? (Fill in all rllatapply) 

0arrest 0prosecution 0conviction 0under investigation . 0information not available 

4b, Previous domestic violence incidents with the samc victim and defendant? 

0yes/documented 0allegedhot documented 0 no 

k.If yes, what was the result of the incident? 

0arrest 0prosecution 0conviction 0under investigation 0 informationnot wallable 
5. Number of arrests for felony offenses, including sexual assault and domestic violence? 

53. Numbcr of ill~ests for misdemeanors? lm 

5b. Number of mests, class unknown? 

5c. Number of arrests for sexual assaults? 

5d. Number of arrests for domestic violence? m1 

5e. Was prior arrest history available? 0yes 0no 

6. Number of convictions for felony offenses? mi 

6a. Number of convictions for misdemeanors? 171 

6b. Number of convictions, class unknown? 

6c. Number of convictions for sexual assaults? rr]q 

6d. Number of convictions for domestic violence? 

6e. \Vas prior conviction information available? 0yes 0no 
Case Abstraction Form 

"Case Identification umber 111 0SANE Only 

(*i o .Complaintnumb Inaden1Numb- PoliccRcpwlNumbcr.ete ) 0SANE-SART 

Jurisdiction: 

DJ~nry) 0Non SANErSART 

Police Depament: Date of Incident: 

('hirial reqmse) 

Victim Participation 

1. Was an initial statement made by the victim to the police? 0yes 0no 

la. Was a formal statement made by the victim to the police? 0yes 0no 

2. Did the victim tatify... 0no proceedings requiring testimony 0reW to testify 0at grandjury 

0incourt hearing 0unknown 0other 

3. Did the victim provide an impact statement? 0 yes 0no 0unknown 

1.Did the victim appear for hearingdwas she pi'esent in court? 0 yes 0no 0unknown 

5. Did the victim provide restitution information? 0yes 0no 0unknown 

6. Was the victim in contact with the prosecutor's staff! 0yes 0no 0unknown 

7. Didvictim refuse to move forward with charges? 0yes 0no 0unknown 

8.0ther victim participation? 0yes 0no Specify: 

9. Was a protection from abuse order issued against the suspect prior to the incident? 0yes 0no 0 

10. Was DNA evidence available? 0yes 0no 0unknown 

Susnect Information - Arrest and Char~es 

1.Was the suspect? (fill in dl ~/utup$$ 2 Charges at arrest: 

0held in jail (Includecode wu?nber$ 

0arrested/issued an arrest wanant 

0issued a true bill/indictmmt 

Charges put forth by prosecutor1Grand Jury: 

0issued a bench warrant 

0issued a summonsto appearkubpoena 
-- -- 

2a. Was the principal sex charge at arrest or summonsthe principal sex charge filed or presented to Grand Jury? 

0greater than 0same as 0less than 0not applicable 

!b. Was the principal sex charge filed or returned in an indictment -the principal sex charge at disposition? 

0greater than 0same as 0less than 0not applicable 

3. Case outcome: (chooszO~~~~EJPOHJP) 

0administrattve drsmissal by law enforcement 0hung jurylno retnal 

0no charges filed 0hung jurylretnal 

0 &missed 0not gully @ tnal 

0pre-tnaljud~cial dismtssal 0guilty of lesser charge @ tnal 

0plea to lesser charge 0guilty of most senous charge @trial 

0plea to exlsbng charge 0referred to another jurisdrction 

0plea to most senous charge 0other 

0no true bill 

3a. Was the case appealed? 

0yes, appeal affumed 0yes, ludgment overturned 0yes outcome unknown 0no 

3h. If yes, reason for the appeal? 

4. ]Penalty: Gmsz on&~~ rerponrfel 

0suspended sentence 0probat~on 0mcarceratlon and probation 0marceration 0other 

5. Length of penalty months or 1IImontIls to [TImonths 
i&n Infomation: 

1. DOB of victim: 

2. Race of victim: 

rl 1 ml/m i 

month day Year 

0Native American 

0Hispanic 0Other: 

0African American 0Not Documented 

0AsianPacific Islander 

3. Was an interpreter used? 0Ycs 0KO 0Not Nadcd 

4. Fill in dl that apply: 5. Where was the exam conducted'? 

0SANE exam 0Hospital Emergency Department 

0No SANE exam 0Hospital Clinic 

0Rape Crisis Response (check if yes, blank if no) 0Intensive Care Unit 

0Do not how if Rape Crisis responded 0OBGYN 

0DNA Evidence Collected 0Other: 

0Other: 

6. Name ofthe facility where the exam was petionned? 

7. Date of Assault: 8. Time of~ssault: m]:m: ~ 1 11 

9. Date of exam: 10. Timc of exam: m:m : 

11. Reported assault on day of exan? 0Yes 0No 

12. Reported assault on: 13. Reason(s) given for not reporting inmledialely? 

0Day of Incident 0Yes 

0Day after Incident 0lio 

02 Dap after Incident 0Information not available 

03 Days after Incident 

04 Days afta Incident 

05 Day ah Incident 

0Imger than 5 days after incident 
Pstient/VietimInformation (continued): 

14. Victim demeanor atthe time ofthe exam? 15. Where did the assault occur? 

0TearfuSCrying 0Afiaid 0HousdAparttnent 0IloteYmotel 

Ohgy 0Nervous 0Outdoors 0Unsure 

0Hysterical 0Upset 0Dormitory 0Other: 

0ShalcingiTnmbling 0Other: 

0Withdrawnylat L 

16. Numbcr of .&sailants? 0One 0Two 0Three 0Four 0Fie or more 

Assailant Information: 

1. Assailant relationship to patienthidim? 

0SpousdLive-in Partner 0AcquaintancelFriend 

0Ex-spouseEx-live-in Partner 0Relative 

0Stranger 0Child in common 

0Boyfriend 0Co-worker 

0Date 0Other: 

2. DOB of'assailant? / )l/

month day Year 

3. Race of assailant? 

0White 0Native Amaican 

0Hispanic 0Other: 

0African American 0Kot Documented 

0AsianPacific IsIsnda 

4. Was there penetration however slight of. .. 

...Vagina?: Yes, by: 

0No 0Unsure 0Attanpt 0Pen~s 0Flnger 0Tongue 0Obje~~Othrn 

...Anus? Yes,by: 

0NO 0Unsure 0Attanpt 0Pems 0Finger 0Tongue 0Objec~Other 

...Mouth?: Yes, by: 

0No 0Unsure 0Attempt 0Pens 0Fmgcr 0Tongus 0Ob~ectIOther 
Assailant Informution(continued): 

5. During the assault, were acts performed by the patienthictini upon the assailant? 

0yes ONo OUnsure 

6. Did ejaculation occur? 

OYes ONo OUnsurc 

7. Was a condom used? 

OYes ONo OUnsure 

8. Did the assailant use any substance as lubrication? (saliva is considered lubrication) 

0Ycs 0x0 OUnsurc 

9. Did the assailant kiss, lick, spit, or make other oral contact with the patientkictim? 

OYes ONo OUnsure 

10. Did the assailanttouch the patienthidim with bare hands or fingers? 

6Ycs ONo 0Unsurc 

11. Any injuries to the patientivictim? 

OYes ONo 0Z;nswe 

12. Were photographs taken of the victim's injuries? 

OYes 0x0 OUnsure 

13. Who took photographs ofthe victim's injuries? (leave blank zj nophotos taken) 

0Police 0Medical Professional 0Other: 

14. Any injuries to assailant? 

=Yes ONo OUnsure 

15. Use of weapon: 0Yes ONo 0Unsure 

15a. If yes,what was the weapon (gun, knife, blunt objcct etc.)? 

16. Threats? 0Yes ONo OUnsure 

16a. If yes, were threats: 0Physical 0Verbal OBoth OOther: 

17. Choking? 0Yes 0No 0Unsure 

18. Bites? 0Yes 0No 0Onsure 

19. Restraints? 0Ycs 0No 0Vnsurc: 

19a If yes, what types ofrestraints were used? 

20. Any other intbrmation not ottienvise provided: 
Case Status at time of exam: 

1. Evidence Collection Kit conlpleted: 0Yes 0No 0OJnsure 

2. Toxicology Kit wed: 0Yes 0No 0Unsure 

3. Restraining Order in place before assault? 0Y@ 0No 0Unsure 

4. Restraining Order in place after assault? 0Ya 0No 0Unsure 

5. Elder Abusz Report? 0Yes 0NO 0Unwe 

6. Disabled Person Report? 0Yes 0No 0Urnwe 

7. Weapon Report? 0Ya 0No OUnsure 
APPENDIX B 

Study Sites Demographic Information 
1997-2001 National Numbers of Violent Crimes and Forcible 

Rapes Compared to State Study Sites* 

Justice Data. 

** Note: Since complete data were not available for 1993-2000, Kansas's crime counts for those years 

are estimated. 

National Annual Income Compared to Study Sites by State* 

National Kansas Massachusetts 

Total # of Total # of Total # of 

Households Households Households Households 

I 

$35,000 to $49,999 17,446,272 16.5 187,850 18"% 355,195 14.5% 

$50,000 to $74,999 20,540,604 19.5 21 1,014 20'3% 490,998 20.1% 

$75,000 to $99,999 10,799,245 10.2 99,933 9'6% 312,741 12.8% 

$100'000 $149y999 8,147,826 7.7 62,926 '.'% 267,300 10.9% 

$150,000 to $199,999 2,322,038 2.2 16,106 '"% 80,640 3.3% 

$200,000 or more 2,502,675 2.4 17,352 84,494 3.5% 

Median household 41,994 $40,624 $50,502 Income (dollars) 

*Source: U.S. Census Bureau, Census 2000 
National Race Distribution Compared to County Study Sites* 

"Source: U.S. Census Bureau, Census 2000 


**Note: This also includes the total population of residents that reported a combination 

of two or more races.