Taking Action to Prevent 

Intimate Partner Violence 

and Sexual Violence: 

Creating Statewide Prevention Plans

TM

National Center for Injury Prevention and Control

Division of Violence Prevention
2 Taking Action to Prevent Intimate Partner Violence and Sexual Violence

Taking Action to Prevent 

Intimate Partner Violence 

and Sexual Violence: 

Creating Statewide Prevention Plans

Centers for Disease Control and Prevention

Thomas R. Frieden, MD, MPH, Director

National Center for Injury Prevention and Control

Linda C. Degutis, DrPH, MSN, Director

Division of Violence Prevention

Howard Spivak, MD, Director

Suggested Citation: CDC. Taking action to prevent intimate partner violence and sexual violence: Creating 

statewide prevention plans. Atlanta, GA: Centers for Disease Control and Prevention; 2013.
Creating Statewide Prevention Plans 3 

Background

Intimate partner violence (IPV) and sexual violence (SV) are significant public health problems that negatively 

impact physical and emotional health and have serious consequences for victims, families, and communities. 

According to 2010 findings from the National Intimate Partner and Sexual Violence Survey (NISVS)1, about 1 in 

4 women (24.3%) and 1 in 7 men (13.8%) in the U.S. have experienced severe physical violence by an intimate 

partner (e.g., hit with a fist or something hard, beaten, slammed against something) at some point in their 

lifetime. Additionally, nearly 1 in 5 women and 1 in 71 men have been raped in their lifetime.

As part of their efforts to address these two significant public health problems, the Centers for Disease Control 

and Prevention (CDC) funds state-level organizations for the prevention of the initial occurrence (primary 

prevention) of IPV and SV. Primary prevention requires comprehensive, coordinated, and sustained efforts of 

multiple, diverse organizations and stakeholders. These organizations and stakeholders further require both 

general and primary prevention specific organizational capacity to successfully adopt, implement, evaluate, 

and sustain primary prevention principles, concepts, and practices.2,3

With these requirements in mind, CDC developed two programs. The Domestic Violence Prevention 

Enhancement and Leadership Through Alliances (DELTA) program funds State Domestic Violence Coalitions 

(SDVCs) for the primary prevention of IPV. The Enhancing and Making Programs and Outcomes Work to End 

Rape (EMPOWER) program provided additional funding, technical assistance and training to a subset of the 

national Rape Prevention Education (RPE) program grantees. RPE grantees are state health departments 

funded for the primary prevention of SV. 

To build prevention and evaluation capacity while developing state primary prevention plans, both the DELTA 

and EMPOWER programs required each grantee to hire an Empowerment Evaluator (EE). The EE facilitated 

a learning-by-doing process based on the 10 empowerment evaluation principles: community ownership, 

inclusion, democratic participation, community knowledge, evidence-based strategies, accountability, 

improvement, organizational learning, social justice and capacity building.4 

DELTA

While a grassroots movement has been working for over three decades to end IPV, the traditional focus of 

these efforts has been on the provision of services to victims after the violence occurred. The Family Violence 

Prevention and Services Act (FVPSA) authorizes CDC to distribute federal funds to support coordinated 

community responses (CCRs) that address IPV. A CCR is an organized effort to prevent and respond to IPV in 

a community. It typically coordinates the work of diverse service sectors, such as organizations involved in 

victim services, law enforcement, prosecution, public health, and faith-based initiatives. Historically, CCRs 

have focused on providing services to victims, holding perpetrators accountable, and reducing the number of 

recurring assaults. 

In 2002, CDC used FVPSA funding to develop the DELTA Program, focusing on the primary prevention of 

IPV at the community level. From 2002 to 2013, DELTA funded 14 SDVCs to provide primary preventionfocused training, technical assistance, and financial support to local CCRs. Local CCRs then developed and 

implemented strategies focused on preventing first-time perpetration and victimization. The 14 SDVCs were 

located in Alaska, California, Delaware, Florida, Kansas, Michigan, Montana, New York, North Carolina, North 

Dakota, Ohio, Rhode Island, Virginia and Wisconsin. At the time of analysis (December 2010), the 14 DELTA 

Program SDVCs supported 59 local CCRs with primary prevention focused funding, training, and technical 

assistance. 
4 Taking Action to Prevent Intimate Partner Violence and Sexual Violence

CDC recognized that the long-term sustainability and expansion of IPV primary prevention work within each 

DELTA-funded state and within each DELTA-supported CCR would require broader fiscal and programmatic 

support beyond what each DELTA SDVC could provide. Hence, in the 2005 DELTA Program funding 

announcement, CDC required DELTA Program grantees to develop a data-driven, state-level IPV Prevention 

Plan with a diverse group of stakeholders acting as the state steering committee. Through the development 

of the state prevention plan, it was hoped that state-level partnerships that understood and supported 

primary prevention work would be established within each DELTA state. 

EMPOWER

A grassroots movement also has been working for over three decades to end SV, and as with IPV, the historical 

focus has been on the provision of services to victims. In 1994, as a component of the Violence Against Women 

Act (VAWA), the RPE Program was established at CDC. The RPE Program is intended to promote the prevention 

of sexual violence in all 50 states, the District of Columbia, Puerto Rico, and six U.S. territories. In 2005, CDC 

made substantial changes to the RPE Program, adding social change elements and emphasizing primary 

prevention of sexual violence. RPE grantees are state health departments and are strongly encouraged to work 

closely with their state sexual violence coalitions. RPE grantees are expected to implement comprehensive, 

multi-faceted programs that address multiple levels of the social ecology and adhere to the public health 

model.5 To support these changes, CDC increased efforts to build the primary prevention capacity of RPE 

grantees and the larger prevention system.6,7

Given the importance of understanding the 

opportunities, challenges, and needs in building 

the primary prevention capacity of RPE grantees, 

CDC launched the EMPOWER Program in 2005 as 

a capacity building demonstration project. The 

purpose of EMPOWER was “to build comprehensive 

prevention program planning and evaluation 

capacity among selected Rape Prevention 

and Education (RPE) funded sexual violence 

prevention programs and to assess short-term 

and intermediate capacity building outcomes for 

each program.”8

 The EMPOWER Program provided 

additional funding, technical assistance, and 

training to a subset of RPE grantees. Six states, 

Colorado, Kentucky, Massachusetts, New Jersey, 

North Carolina, and North Dakota, were selected 

through a competitive request for applications.7

EMPOWER Program grantees were required to 

convene a diverse state planning committee, 

called the state prevention team, to develop a 

comprehensive state plan for sexual violence 

prevention programming and evaluation, contract 

with an in-state evaluator to support planning 

efforts, and develop a state capacity building team 

that included, at minimum, the evaluator, the state 

EMPOWER coordinator and another member of the 

state prevention team.7
Creating Statewide Prevention Plans 5 

Location of DELTA and EMPOWER States

DELTA

EMPOWER

AK

CA

OR

WA

AZ

HI

NV

UT

ID

NM

CO

WY

MT ND

SD

NE

KS

OK

TX

LA

AR

MO

IA

MN

WI

IL

MI

IN OH

KY

TN

MS

AL GA

FL

SC

NC

WV

PA

NY

VA

VT

NH

ME

MD DE

NJ

CT RI

MA

Method

State plan documents were submitted to CDC by each of the six states participating in the EMPOWER 

Program and each of the fourteen states participating in the DELTA Program. In total there were nineteen 

plans, because North Dakota (a DELTA & EMPOWER grantee) submitted a joint state prevention plan for IPV 

and SV. While the analyses of the plans from DELTA and EMPOWER programs were conducted separately, 

parallel methods were followed. For each program (i.e. DELTA and EMPOWER), open coding of two state plan 

documents was initially conducted by a team of coders. Coding categories were then refined for each program 

and further limited to address specific themes of interest to CDC. All of the state plans within each program 

were then coded based on the revised coding scheme, each by a minimum of two coders. A summary report 

was developed for each state based on themes identified in the coding. The findings from the coding of the 

state plans from both programs, the state summary reports, and an additional review of the original state 

plan documents were then combined to develop a set of meta-themes based on common successes and 

challenges. 
6 Taking Action to Prevent Intimate Partner Violence and Sexual Violence

Successes

Across the DELTA and EMPOWER state plans for IPV and/or SV, a number of promising findings emerged. Overall, 

the state plans demonstrated grantees’ knowledge and skills for planning, implementation and evaluation 

utilizing public health principles, processes and concepts. For both the DELTA and EMPOWER programs, the state 

plans represent a significant departure from previous planning efforts or were a new endeavor in their own right. 

The following meta-themes that emerged from the plan analyses further illustrate this. 

Use of Data and Evidence to Inform Primary Prevention Planning

DELTA and EMPOWER grantees developed state 

plans using many sources and types of data, 

with attention to identifying strategies based 

on the best available research evidence and 

focusing on approaches intended to prevent the 

initial occurrence of IPV and SV. In many cases, 

the plans demonstrate a shifting of attention to 

perpetration as reflected in identification of a 

lack of data on perpetration-related risk factors, 

the identification of selected populations at 

greater risk for perpetration, and the selection 

of strategies focused specifically on primary 

prevention of perpetration (rather than general 

awareness, risk reduction, victimization response 

and other types of secondary and tertiary 

prevention). Most plans include an examination 

of state-specific contextual issues and the 

inclusion of preliminary evaluation concepts. 

The plans also document numerous points in the 

planning process that required new information 

and data for the state.

•North Dakota EMPOWER and DELTA Program

Often, in conducting a needs and resource assessment, planning committees end up focusing more on 

needs than resources. In an effort to ensure that this did not happen in North Dakota, the state capacity 

building team conducted an extensive process for asset mapping. Working with the Resource Subgroup 

of the state prevention team, the state capacity building team identified numerous local and state 

level resources for IPV and SV prevention. Resources fell into six categories: community organizations, 

youth organizations, law and legal enforcement, school-based resources, data sources, and medical 

resources. Each of the categories was then subdivided into state, tribal, county and local resources. Once 

the resources were identified, a detailed eco-map was constructed and potential links with each of the 

categories were articulated. For example, in reviewing school-based resources, the state prevention team 

noted that schools provide an excellent venue for conducting prevention programming and often have 

existing violence prevention programs, providing a natural opportunity to build partnerships. By using 

community and demographic data to identify places of shared interest and opportunities for collaboration, 

the North Dakota IPV and SV prevention team was able to keep these considerations at the forefront as 

they developed the state plan. 
Creating Statewide Prevention Plans 7 

•Rhode Island DELTA Program

In order to ensure that the planning process was data-driven, the Rhode Island IPV prevention plan 

draws on demographic and community data. Several statewide surveys, including the Behavioral Risk 

Factor Surveillance System (BRFSS), the Youth Risk Behavioral Survey (YRBS), and several school-based 

assessments, were used to attempt to identify state-specific risk factors to inform plan development. A 

prevention system capacity assessment1 was conducted to identify strengths and challenges and to drive 

goal development for increasing prevention system capacity. As a result, DELTA Program participation 

has led to the development of the state’s first data-driven plan to prevent first-time perpetration of IPV, 

including elements designed to promote sustainability and problem-solving capacity development.

•Massachusetts EMPOWER Program

Although EMPOWER grantees were tasked with engaging in a data-informed planning process, the 

lack of state-specific data relevant to sexual violence primary prevention was a universal challenge. 

The Massachusetts state prevention team in conducting their needs and resource assessment faced a 

number of challenges. Some areas of archival data did not exist. In other cases, while the data existed, 

key subpopulations were not included so the data could not be broken down to assist in identifying 

selected populations. Additionally, most archival data had significant limitations, making it difficult to 

create a comprehensive picture of sexual violence in Massachusetts. Despite these difficulties, the state 

prevention team was creative and persistent. In developing their state profile, the prevention team inserted 

“placeholders” where data for a particular subpopulation was missing. For example, in reporting on the 

gender distribution for the state, no information was available for transgender populations. The planning 

team inserted this category and listed the data as missing, thus drawing attention to areas for improved 

data collection. Additionally, as the prevention team identified other gaps in the data, they sought to 

collect new data when possible. For example, since no data sources existed regarding resources for sexual 

violence prevention, the state prevention team surveyed professionals and community members. While the 

state prevention team was not able to address all of the data limitations, they were still able to engage in a 

data-driven planning process, creating goals and outcomes tied to identified needs and resources within 

the state.

•North Carolina DELTA Program

The lack of evidence-based programs specific to IPV primary prevention created a challenge for evidencebased planning. To support the state steering committee’s work in North Carolina, the state Project Coordinator and evaluation team developed a catalog of evidence-based programs, drawing from other fields. 

Beginning with an extensive review of the published literature and program registries, the group identified 

programs that might have relevance for preventing IPV based on shared risk and protective factors, outcomes that decreased IPV-related risks, and outcomes that increased positive change related to IPV prevention. The list of potential programs for inclusion was further narrowed based on considerations such as the 

extent to which the program had been evaluated, the public availability of the program, and other factors. 

Programs in the catalog were then organized around the characteristics of the program, setting, evaluation outcomes, implementation characteristics, level of the social ecology, life stage and relevancy to plan 

goals, with a summary of each program provided. To further support the steering committee in selecting 

programs from the catalog, the evaluation team and Project Coordinator also introduced and expanded 

the selection criteria to include more applied considerations, such as cost, sustainability, transferability and 

adaptability. The resulting state plan incorporated a high degree of evidence-based decision-making and 

resulted in a tool to support evidence-based program selection for communities across the state.

_____________________________________

1

 Prevention system capacity is defined as a network of individuals, groups, and/or organizations that, through their interaction, works to address and 

prevent a public health problem. The system consists of the following dimensions: overall system profile, leadership, strategic planning, information, 

community/constituency focus, human resources, system operations and documented results/outcomes. A prevention system capacity assessment tool 

was developed by the CDC and EMPOWER grantees and shared with both EMPOWER and DELTA grantees.
8 Taking Action to Prevent Intimate Partner Violence and Sexual Violence

Prioritization of the Need to Improve Prevention System Capacity 

for IPV and SV Primary Prevention

The EMPOWER grantees, in collaboration with CDC, developed and 

used a tool for assessing prevention system capacity. Some of the 

DELTA grantees used the same tool as is, some of them modified the 

tool, and some of them developed their own tool. Both EMPOWER 

and DELTA grantees identified a number of areas for improvement, 

so state prevention teams/steering committees often developed 

state-specific criteria for prioritizing system development. For 

example, almost all states included plan goals intended to improve 

existing data to inform SV and IPV primary prevention efforts since 

improved data was seen as critical to effective prevention planning. 

This prioritization reflects both recognition of the importance of 

data-driven prevention efforts and commitment to improving 

prevention system capacity. According to the Interactive Systems 

Framework for Dissemination and Implementation there is a 

link between prevention system capacity and successful primary 

prevention efforts. Hence, the increased attention to prevention 

system capacity among grantees suggests potential improvements 

in SV and IPV primary prevention efforts over time.

•Delaware DELTA Program

Completing thorough assessments of needs and resources and prevention system capacity highlighted the 

centrality of the prevention system for the Delaware state steering committee. After identifying initial areas 

for potential plan inclusion, a pathway map was created, illustrating that enhancing the prevention system 

was foundational to the expansion of IPV primary prevention work. As a result, the majority of plan goals 

and objectives focus on increasing prevention system capacity and these goals precede goals related to 

addressing the needs of specific groups or populations. For example, the state plan includes a goal focused 

on improving data systems, with activities and strategies such as promoting new research for IPV primary 

prevention, encouraging innovation in data dissemination, supporting program evaluation technical assistance and others. Improvements in data collection and dissemination address several dimensions of 

prevention system capacity, including strategic planning, information, community and constituency focus 

and results and outcomes. In attempting to increase and improve human resources within the prevention 

system, the plan includes strategies for engaging and building IPV prevention capacity among non-traditional partners and school systems. Accomplishing these strategies includes activities such as training and 

technical assistance, as well as advocacy for organizational changes that support workers in integrating IPV 

primary prevention in existing work. 

•Michigan DELTA Program

As part of their data-driven, comprehensive planning processes, each of the DELTA states included an 

assessment of prevention system capacity. In Michigan, as in many of the DELTA states, the state steering 

committee identified several dimensions of prevention system capacity that were in need of attention 

but chose to prioritize those that most directly supported local IPV prevention efforts. These dimensions 

consist of: constituency and community focus, human resources, and system operations. Thus, the plan 

includes an ongoing process to identify local community needs (community and constituency focus), ways 

to build the knowledge and skills of local communities for primary prevention (human resources), and 

developing support mechanisms and accessible materials for local communities undertaking IPV primary 

prevention efforts (system operations). 
Creating Statewide Prevention Plans 9 

•Kentucky EMPOWER Program

In developing a state sexual violence prevention plan, an important consideration is the capacity of 

those who will be responsible for implementing programming. In Kentucky, the primary responsibility for 

implementation fell to the local rape crisis centers. To inform the planning process regarding this key area, 

a survey was administered to the executive directors and rape prevention educators at local rape crisis 

centers. In assessing individual prevention capacity, the survey asked about experiences, knowledge and 

attitudes in six areas: program planning, implementation and evaluation concepts, principles of primary 

prevention, collaboration with partners, resources or barriers, and knowledge of sexual violence. One 

of the findings that emerged from the data was that survey participants lacked a shared understanding 

of primary prevention of sexual violence. To help address this and other resource limitations for local 

implementers, the state prevention team adopted a single, more structured program to be used by all of 

the rape crisis centers in their sexual violence prevention work. Implementation plans were also developed 

to include additional trainings and ongoing technical assistance.

Expansion of Partnerships and Increased Ownership among Diverse 

Constituencies for SV and IPV Prevention.

EMPOWER and DELTA plans reflect a rich diversity of planning committee 

participants, often extending beyond existing relationships. Diversity 

considerations included a broad array of dimensions, such as ethnicity, 

race, gender, sexual orientation, sector, geography and differing abilities. 

For many states, the planning process brought partners from areas such as 

education, tribes, local sexual and domestic violence programs, social service 

agencies, disability rights organizations, and other non-traditional partners 

together to inform the planning process and to expand potential resources 

for SV and IPV primary prevention. The diversity of prevention team/steering 

committee participants was the result of intentional efforts on the part of 

grantees. Throughout the recruitment, formation, and planning phases, 

key stakeholders involved in developing the plan continually engaged in 

intentional reviews of membership and recruited additional members as 

gaps were identified or as membership shifted over time. The engagement of 

new partners was further supported through the development of inclusive 

planning processes to encourage shared ownership in the plan. 

•California DELTA Program

California’s state planning process highlighted the need for increased funding to support IPV primary 

prevention efforts. While finding additional money for primary prevention efforts in the current economic 

climate will not be easy for any of the states, California’s DELTA Program is leveraging relationships to 

increase their likelihood of success. California has a significant history in the area of primary prevention 

of violence against women as several national technical assistance providers, such as Transforming 

Communities, Futures Without Violence (formerly the Family Violence Prevention Fund), the Prevention 

Institute, and Prevent-Connect (housed within the state sexual violence coalition), are based in California, 

and the state has a well-funded RPE Program. Participating in the DELTA Program and the state IPV 

prevention planning process have led to recognition of the state domestic violence coalition, the California 

Partnership to End Domestic Violence, as an organization that can play a meaningful role at the state level 

in promoting primary prevention. As a result, a new partnership, called the California Violence Against 

Women Primary Prevention Partnership (which includes the state health department, the state domestic 

violence coalition and the state sexual violence coalition), was created to “launch a cohesive effort to develop 

new and sustained state-level funding specifically for the primary prevention of violence against women.”
10 Taking Action to Prevent Intimate Partner Violence and Sexual Violence

•New Jersey EMPOWER Program

To build ownership in the state sexual violence prevention plan, the New Jersey state capacity building 

team sought to engage stakeholders in an inclusive planning process from the start. A wide variety of 

stakeholders were recruited for the prevention team with the intention of building new partnerships to 

support sexual violence prevention efforts. A consensus-based decision-making model was used to ensure 

that all voices were equally valued. While smaller workgroups were often convened to complete work 

on a particular aspect of plan development, all final decisions regarding the plan were made by the full 

prevention team. Local RPE Program grantees were included during the identification of strategies and 

programs to ensure that decisions reflected the experiences of frontline staff. Committee members often 

met several times a month, either by phone or in-person, to conduct planning work. When maintaining 

such a high level of prevention team participation became challenging during some of the more complex 

aspects of the planning process, members of the state capacity building team personally contacted 

prevention team members to encourage them to keep participating. Although ensuring that an inclusive 

planning process occurred was labor-intensive for the state capacity building team, the end result was a 

sexual violence prevention plan with a high level of ownership across a number of stakeholders.

•Kansas DELTA Program

While the Kansas Department of Health and Environment and the Kansas Coalition Against Sexual and 

Domestic Violence have collaborated for many years and on many projects, the development of a joint 

state plan for SV and IPV primary prevention required a new depth of collaboration. Prior to 2005, both 

the DELTA Program (administered by the state domestic violence coalition) and the Rape Prevention and 

Education Program (RPE) (administered by the state health department) had advisory councils but little 

planning had been conducted by either group. While a representative of each organization served on each 

of the councils, the state health department was solely responsible for administering the RPE Program 

and the SDVC was solely responsible for the DELTA Program. The requirement for both projects to engage 

in state-level planning spurred the development of a stronger partnership between the two entities 

to develop a joint plan for the primary prevention of SV and IPV in Kansas. The collaboration between 

the state department of health and the state domestic violence coalition regarding SV and IPV primary 

prevention expanded available resources for the planning process. For example, each of the organizations 

was able to bring different stakeholders to the planning process. Additionally, the Kansas DELTA evaluation 

team was able to provide supports (such as analytical skills and the Empowerment Evaluator) for the 

planning process while the Kansas Sexual Violence Prevention and Education Program harnessed the 

data collection capabilities of the state health department. The partnership developed through the state 

planning process has continued to grow, influencing capacity development in local communities through 

such activities as the development of a joint community of practice that includes local communities 

funded for IPV and SV primary prevention efforts. Because many of the activities within the state plan have 

been assigned to the state department of health and the state domestic violence coalition jointly, this 

collaboration continues to grow. The two organizations are working to institutionalize this collaboration.

•Ohio DELTA Program

Too often, the responsibility for preventing IPV is seen as the job of a particular organization or agency, 

most often those agencies or organizations aligned with the battered women’s movement. The needs 

for social change for effective IPV prevention and resource limitations require that a broad array of 

individuals, organizations and sectors take ownership of their role in ending IPV. To build ownership in the 

development and implementation of the state IPV prevention plan, Ohio sought to engage stakeholders 

in an inclusive planning process from the start. A wide variety of stakeholders were recruited for the state 

steering committee with the intention of building new partnerships to support IPV prevention efforts. The 

state Prevention Coordinator and Empowerment Evaluator were intentional in designing group processes 

to promote active participation by committee members and to address planning issues as they arose. Ohio 

adapted and simplified planning steps while still conducting a data-driven, evidence-informed planning 
Creating Statewide Prevention Plans 11 

process, incorporating a consensus-based decision-making model to ensure that all voices were equally 

valued. While smaller workgroups were sometimes convened to complete discrete tasks, all final decisions 

were made by the full steering committee. A collaboration charter, a formalized document developed by 

the collective group, articulating expectations of how the group would work together, was used to assist 

in maintaining continuity when steering committee turnover occurred. Several state steering committee 

members from Ohio expressly commented on the excellent facilitation of the planning process. Although 

ensuring an inclusive planning process was labor-intensive, it resulted in an IPV prevention plan with 

ownership across a wide range of stakeholders.

Commitment of State Prevention Teams/State Steering Committees to Ongoing 

Planning and Improvement for IPV and SV Primary Prevention

Both EMPOWER and DELTA plans demonstrate a commitment to 

ongoing planning and improvement in a number of ways. One 

reflection of this commitment can be seen in the prevention 

system capacity assessments and the associated plan goals. All 

grantees engaged in a prevention system capacity assessment, 

evaluating strengths and challenges and developing goal(s) 

for improving system capacity. In most cases, members of the 

state prevention teams/state steering committees represented 

key components of the state prevention system. Committee 

members supported enhancing system capacity in several 

sectors, including their own. An additional reflection of 

increased commitment to ongoing planning and improvement 

is evident in prevention team/steering committee structure. 

In several states, the prevention team/steering committee 

was formed as a subcommittee of an existing state committee 

or task force. In other states planning duties were added to 

the function of an existing committee or taskforce, some of 

which report directly to the governor or other high ranking 

government official. This institutionalized the ongoing 

responsibility for planning, implementation, evaluation and 

continuous quality improvement. In most states, the prevention 

team/steering committee included high-level representatives of 

key state institutions. 

•Wisconsin DELTA Program

DELTA Program states used a variety of approaches in developing a state steering committee. For many 

states, this required the creation of an entirely new entity. In Wisconsin, however, the DELTA Program took 

advantage of existing structures to promote the integration of IPV prevention efforts within larger efforts 

to address IPV. The state steering committee was created through the addition of an ad-hoc subcommittee 

to the Governor’s Council on Domestic Abuse. The Governor’s Council on Domestic Abuse is a statutorily 

created, 13 member body that advises the governor, legislature, and Department of Children and Families 

on domestic abuse issues. This group includes representatives from numerous sectors with expertise with 

domestic violence, prevention, state agencies and culturally specific statewide organizations. Operating 

under the auspices of the Governor’s Council helped to add credibility to the work of the group, ensure 

recognition of IPV prevention efforts by governmental bodies, and institutionalize IPV primary prevention 

planning, implementation and evaluation efforts. Moving forward, the subcommittee will remain a 

permanent structure within the larger Council and has committed to implementing the plan, evaluating its 

effectiveness, and engaging in ongoing improvement. 
12 Taking Action to Prevent Intimate Partner Violence and Sexual Violence

•New York DELTA Program

The New York DELTA Program assessed the capacity (including knowledge, skills and motivation) of the 

steering committee itself to drive state-level capacity building efforts. The state Project Coordinator and 

Empowerment Evaluator used a modified version of the prevention system capacity assessment tool to 

assess both the prevention system and the current capacity of state steering committee members. To 

complete the system assessment, members of the committee were interviewed. Findings from the dualpurpose assessment helped to inform capacity building efforts with the committee, as well as state plan 

development. Capacity building with the steering committee focused primarily on “learning by doing,” 

but additional trainings were also provided to committee members. The state Project Coordinator and 

evaluator anticipate continuing capacity development among steering committee members for IPV 

primary prevention. As the work of the committee continues, capacity of steering committee members 

will be assessed and the findings used to continually improve planning, implementation and evaluation 

processes. 

Consideration of Social Determinants of Health in IPV and SV Primary Prevention

Across the two programs, grantees demonstrated 

an understanding of considerations related to 

social determinants of health in efforts to prevent 

IPV and SV and incorporated these into their 

plans. Each of the DELTA and EMPOWER grantees 

addressed social determinants of health, health 

disparities, social justice or intersectionality in 

their plan development. The consideration of such 

issues is important because both IPV and SV have 

disproportionate impacts on certain segments of 

the population, and some socio-economic issues, 

such as poverty, are among the risk factors for 

IPV and SV. The attention to social determinants 

is reflected in different ways across the plans, 

including examples such as the development of state 

demographic profiles, data collection and analysis 

for incidence and prevalence, the identification of 

selected populations, prioritization of plans goals 

and outcomes, adaptations of programming or plan 

elements, and planning team membership. Attention 

to such issues by grantees was particularly supported 

by the Empowerment Evaluation framework that was 

provided by CDC to grantees for planning efforts, 

which emphasized public health principles such as 

social justice, community knowledge, inclusiveness 

and accountability. The consideration of issues such 

as social determinants of health and intersectionality 

when developing primary prevention plans has led 

to plans that acknowledge and plan for the different 

needs of various groups within each state.
Creating Statewide Prevention Plans 13 

Montana DELTA Program

Native American women report significantly higher rates of SV and IPV than do women of other racial 

backgrounds. Seven recognized tribes are located in Montana, representing 60,000 individuals within a 

state with a population of less than one million people. Thus, attention to tribal populations constituted a 

significant and consistent consideration in the Montana planning process. The state steering committee 

used an evaluative tool during each phase of the planning process, designed to ensure that issues related 

to oppression, diversity and cultural relevancy were incorporated into plan development. The evaluative 

tool asked a number of key ethical questions and was used to ensure all plan elements met certain basic 

criteria. One example question was “Does it adequately address the impact of multiple discriminations on 

individuals and groups in our state (gender, ethnicity, age, able-ism, etc.)?” Plan elements reflect success 

in this area. For example, the Montana state plan includes the following goal: “By 2015, Montanans will 

have a better understanding of the impact of intimate partner and sexual violence – as well as equity and 

respect issues – among and between ethnic and racial groups (primarily Native Americans) in Montana.” 

Other goals, around youth and healthy relationship development, for example, include specific provisions 

related to cultural relevancy. The development of the “ethical screening” tool not only supported the work 

of Montana’s state steering committee, but was also borrowed by other states, such as North Carolina, 

seeking to incorporate issues of intersectionality in their planning processes.

•Colorado EMPOWER Program

While sexual violence crosses all socio-economic and cultural boundaries, communities of color often 

experience differential rates of victimization. Working from a lens of intersectionality and anti-oppression, 

the Colorado state prevention team quickly identified a number of historically underserved communities as 

the focus of their state plan. The state capacity building team was intentional in recruiting prevention team 

members that represented the diversity of the state, emphasizing historically underserved populations. In 

the work of the prevention team, a decision was made to prioritize the voices of partners and prevention 

educators of color. Committee members participated in collecting original data from several communities 

of color in the state, conducting key informant interviews and focus groups with members of these 

communities including youth, activists and educators. The new data were used to supplement information 

from the published literature and archival data. Throughout the needs and resource assessment and 

the development of the state profile, information regarding historically underserved populations 

was highlighted. Risk and protective factors specific to the priority populations were identified. This 

information, and the expertise of committee members, guided the prevention team in developing a state 

sexual violence prevention plan that prioritizes prevention initiatives in communities of color and seeks to 

adapt and implement prevention programming that is culturally relevant.

•Virginia DELTA Program

In developing the state plan for IPV prevention, the Virginia state steering committee centralized antioppression efforts and sought out ways to highlight the need for attention to these issues. The committee 

began with the development of a detailed state profile, placing particular attention on disparities 

(including in such areas as health, education, power and resources) and minority populations. They 

included data that was difficult to obtain, such as statistics on LGBT populations, inserting “place holders” 

when the information was not available to draw attention to less visible populations. Their focus on antioppression efforts continued through goal and strategy development, including efforts such as increasing 

the number and diversity of communities in Virginia engaging in effective programs that promote healthy 

relationships, increasing economic equity for women in Virginia, and increasing the resources available to 

youth-serving professionals for building healthy relationship skills and positive racial identity for African 

American youth in pre-K through elementary school.
14 Taking Action to Prevent Intimate Partner Violence and Sexual Violence

•North Carolina EMPOWER Program

Persons with disabilities experience sexual violence at a significantly greater rate than that of the general 

population. With this in mind, the North Carolina EMPOWER Program identified persons with intellectual 

disabilities (PWID) as one of the selected populations for their state sexual violence prevention plan. As the 

planning process proceeded, the state prevention team sought to identify strategies and programming to 

address sexual violence in the selected population. In reviewing existing resources, the prevention team 

found very few evidence-based models for addressing the prevention of perpetration against PWID. In 

an attempt to ensure that they utilized strategies most appropriate for the population and with the most 

promise of success, prevention team members sought the input of members of the PWID community. A 

survey was drafted for caregivers and professionals. The survey was then reviewed and vetted by a smaller 

group of individuals affiliated with the PWID community. Data collected through discussions and the 

survey continue to inform the state prevention team as they work to prevent sexual violence among PWID.

Consideration of Strategies across the Social Ecology

Many of the DELTA and EMPOWER state plans include goals related to implementing strategies at various and 

multiple levels of the social ecology, seeking to promote the development of comprehensive and synergistic 

prevention programs. In a number of states, specific prevention strategies that focus on community and 

societal level change, such as the development of media campaigns to change social norms or educating 

policymakers about the advantages and disadvantages of public policies and the efficacy and possible 

ineffectiveness of certain prevention strategies, were identified to complement the work of local communities 

and leverage resources that local communities do not have. To increase the quality of IPV and/or SV 

prevention strategies to be implemented, some states promoted specific criteria for prevention programs or 

particular curricula that align with promising prevention practices. Several state plans include elements for 

improving the quality of strategy implementation through activities designed to build local or state capacity 

for IPV and/or SV primary prevention, including training, technical assistance and materials development. 

Many plans include blueprints for expanding the number of the entities implementing IPV and/or SV 

prevention strategies in the state, including a specific focus on underserved populations or populations with a 

greater number of modifiable risk factors.

Societal Community Relationship Individual

Social Ecological Model
Creating Statewide Prevention Plans 15 

•Alaska DELTA Program

Alaska’s state steering committee sought to increase prevention work for specific populations through 

a combination of state and local initiatives. At the state level, the Alaska plan includes two populationspecific goals. The first, intended to increase youth leadership in primary prevention efforts, includes 

strategies and activities such as providing youth leadership training events, expanding formal leadership 

positions for youth, and fostering youth-led prevention initiatives. The second, intended to foster media 

promotion of healthy relationships and equality, include strategies and activities to improve media 

coverage and a statewide media campaign geared towards youth. At the local level, the Alaska state plan 

includes goals and outcomes designed to encourage the adoption of prevention work in each community.

•Florida DELTA Program

Building from the IPV primary prevention efforts of local DELTA communities in Florida, the state 

steering committee included two goals in their state plan related to addressing the needs of a specific 

group or population. Specifically, Florida focused on increasing influences on youth to promote 

healthy relationships. The first goal, building on the literature base regarding youth development and 

community organizing, seeks to promote youth-driven prevention work through the development of a 

youth leadership council, increased participation by youth in state prevention summits, and engaging 

youth in selecting additional prevention strategies. The second goal seeks to promote a modified social 

norms strategy for youth, with state level activities aimed at identifying sources of youth influence and 

the development of a social marketing campaign flexible enough for local adaptation to contextual 

circumstances. Florida’s state plan goals related to IPV primary prevention seek to increase prevention work 

intended to address the needs of a specific group or population while supporting existing efforts of local 

communities.

Challenges

Each of the DELTA and EMPOWER Program states faced a variety of challenges in developing comprehensive, 

data-driven IPV prevention plans, many of which have significant implications for future implementation, 

evaluation and sustainability. Common themes include:

Existing data systems often fail to capture necessary 

information for effective prevention planning. 

In order to maximize limited resources and improve the likelihood of 

successful primary prevention efforts for SV and IPV, state planning 

groups required state-specific data regarding the magnitude of the 

problem and the prevalence of potential risk factors within the state’s 

population. State planning groups were creative and persistent in 

seeking out archival and published data for planning purposes but 

were rarely able to find the necessary information. Data that did exist 

were often subject to many limitations and existing data sources rarely 

(if ever) use shared definitions, so comparison becomes extremely 

difficult. In some cases, data that existed could not be broken down 

by certain subpopulations, making it unhelpful for identifying 

selected populations. Finally, while much is known in the published 

literature regarding victims of SV and IPV, much less is known about 

perpetrators. Planning efforts in every state highlighted the need for 

improved data systems.
16 Taking Action to Prevent Intimate Partner Violence and Sexual Violence

Few evaluated, effective IPV and SV strategies and programs exist. 

While DELTA and EMPOWER grantees were tasked with engaging in a data-driven planning process that utilized 

the best available research evidence to identify strategies, they were hampered in this task due to the fact 

that few evaluated, effective SV and IPV prevention strategies and programs exist. Several states conducted 

extensive reviews of existing programs but since no centralized compilation of programs exists, this presented 

a challenge in itself. Existing programs and strategies also required assessment for fit and capacity for a given 

state or region. Additionally, many programs labeled as prevention are, in reality, not focused on primary 

prevention. Often, planning teams expanded their reviews to learn from evidence-based strategies in other 

fields such as HIV/AIDS prevention, substance abuse prevention, and others. This too presented challenges; 

however, because states recognized that they had limited capacity to effectively adapt the strategies to the SV 

and IPV field. State planning committees generally sought to strengthen their strategy and program selections 

based on theory. While state planning committees did their best to engage in evidence-informed planning, the 

aforementioned limitations remain a challenge.

Limited financial resources remain a challenge for plan 

implementation, evaluation and sustainability. 

The needs and resource assessments and prevention system capacity assessments conducted during 

the planning process highlighted a number of areas for improvement and enhancement. These included 

strengthening prevention system capacity across a number of domains, gaps in SV and IPV prevention 

programming, and individual and organizational capacity development at state and local levels. Having 

identified a variety of needs and gaps, state planning committees struggled to balance addressing key areas 

with developing realistic state SV and IPV prevention plans. Most states specifically identified a lack of financial 

resources as a barrier to plan implementation, particularly under current economic conditions. For example, 

while every state identified the need to strengthen existing data systems, few states have identified a source for 

the financial resources that will be necessary for such a significant undertaking. States also identified significant 

capacity building needs among local-level implementing organizations for SV and IPV prevention. Current 

funding for SV and IPV prevention is highly limited, thus, making capacity development initiatives challenging 

for state health departments, state IPV and SV coalitions, and local organizations tasked with implementation.

Extensive capacity building at the system, organizational and 

individual levels is required for plan implementation. 

While DELTA and EMPOWER grantees have already demonstrated significant gains in knowledge, skills and 

commitment to data-driven, evidence-based IPV and SV prevention efforts, further capacity development 

needs were documented in the state plan documents. While most state plans included some provisions for 

capacity development, capacity development itself presents many challenges. For example, developing the 

knowledge and skills among individual prevention practitioners will require significant investment over time 

in the creation and maintenance of a skilled workforce for SV and IPV prevention. Additionally, many states 

have noted a high degree of turnover among staff members responsible for implementing local SV and IPV 

prevention programming. Addressing these issues will require changes in not only individual practitioners, but 

also the organizations they work for, the prevention system, state health departments, and the state IPV and SV 

coalitions, and how they address capacity development. Capacity building, while essential to effective SV and 

IPV primary prevention, will require significant time, energy and resources.

Maintaining engagement during a lengthy and complex 

planning process requires significant process expertise.

Several of the state plans document the challenges associated with maintaining planning committee 

engagement during the course of a multi-year complex planning process. In some cases, the tasks involved 

in conducting the planning exceeded the perceived skills and knowledge of planning committee members, 
Creating Statewide Prevention Plans 17 

resulting in disengagement from the process. In other cases, the length of the process and the time requirements 

created barriers for the continued involvement of planning committee members. State capacity building 

teams employed a number of approaches and adaptations to help in addressing these concerns, but planning 

committee member turnover remained a consistent concern. States, with the assistance of their Empowerment 

Evaluators, attempted to design planning processes to address these issues, with varying degrees of success. 

Some states adopted an approach in which a core group of individuals carried out many of the more intensive 

aspects of the planning process and involved the larger planning group at key points. Because these core groups 

(frequently made up of a state-level program coordinator, evaluators and other individuals) often lacked resources 

as well, this approach carried additional challenges. In other states, state capacity building teams focused primarily 

on accomplishing planning tasks over process, making participation of planning committee members less of a 

priority. In most cases, the state capacity building teams had little background in process design, creating another 

area for skill development in the midst of an already-complex undertaking.

Primary prevention of IPV and SV will require individual, organizational, system and social change. Essential to 

fostering and sustaining IPV and SV primary prevention is the development of increased capacity for primary 

prevention planning, implementation and evaluation. While the scope of this document is limited, a review of 

the state plan documents produced by participants in the DELTA and EMPOWER Programs suggests substantial 

changes occurred in capacity and support for data-driven, evidence-based planning and implementation. 

Evident in a review of the plans is the level of concerted efforts by DELTA and EMPOWER grantees toward 

increasing knowledge regarding both effective IPV and SV primary prevention and capacity building, and 

a demonstrated ability to work with others to achieve better outcomes and maximize resources. Successes 

and challenges identified can serve as lessons learned for injury and violence prevention programs at health 

departments and SDVCS as they support and enhance IPV and SV violence prevention efforts in their states. 

Conclusions

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For more information please contact:

 Centers for Disease Control and Prevention 

National Center for Injury Prevention and Control

Division of Violence Prevention

4770 Buford Hwy NE, MS F-64

Chamblee, GA 30341 

1-800-CDC-INFO • www.cdc.gov/violenceprevention

08/13