Sexual Assault Resistance Education for University Women
Condition: Sexual Assault
Study type: Interventional
Phase: Phase 2

Summary: 
      More than one in six women will be sexually assaulted in their lifetimes, most by men they
      know. The risk of sexual assault by men is greatest for girls and women between the ages of
      14 and 24 making this a critical time for intervention. Sexual assault has many immediate and
      long-term negative consequences for victims. Even a small increase in the ability of women to
      resist sexual assault will result in a substantial improvement in the mental and physical
      health of women. Recent research has suggested that many young women delay their resistance
      to unwanted sexual advances because they are not sure that they are reading the situation
      correctly, they do not want to hurt the man's feelings, or they are unsure whether they have
      the right to say no to some sexual activity and say yes to other activity. Earlier work from
      the researchers resulted in the development of a program affecting these critical areas. This
      program was shown to be effective in helping participants build skills and a knowledge base
      to help them resist sexual assault and to prepare them for better recovery following sexual
      assault. The randomized controlled trial (RCT) builds on this prior work. We will establish
      whether the demonstrated short term effectiveness of this theoretically and empirically sound
      rape resistance intervention for university women extends to longer periods. We will
      determine whether the program can reduce the one year incidence of sexual assault by 30%
      among women attending Canadian universities. The results will also be used to indicate how
      long the effects of the program last and will indicate at which point in time refresher
      sessions may be necessary. A lay summary of the findings of the trial with a focus on
      application will be provided to all Canadian universities and to Provincial/Territorial
      Ministries of Education. This will be followed up with contact with those most likely to be
      involved in current campus education efforts.
    

Detailed description: 
      Violence against women costs Canadians at least $1.5 billion each year in health related
      expenses (Day, 1995). The associated physical and mental health effects are extensive and the
      social and economic costs are staggering. The aim of this project is to reduce a very common
      form of violence against women, sexual assault, at Canadian universities. At least 1 in 6
      women will experience an attempted or completed rape in their lifetimes (Tjaden & Thoennes,
      2000). The situation on university campuses is even more startling with as many as 1 in 4
      women experiencing rape or attempted rape while enrolled in university (Fisher, Cullen, &
      Turner, 2000). Reductions in sexual assault will have a direct impact on the mental and
      physical health of university women.

      The proposed trial builds on the Principal Investigator's CIHR-funded research which
      developed, revised, and then tested the basic sexual assault resistance program against a
      non-random control. It also builds on the Ontario Women's Health Council funded RCT which
      evaluated the basic program against an enhanced version, and a no-program control. Our pilot
      work (N=214) revealed that women who had the program experienced lower rates of completed
      sexual assault (40 - 50% lower) at 3 and 6 months than women who did not. The program also
      produced measurable improvements in knowledge, attitudes, and skills related to sexual
      assault resistance and to better recovery following sexual assault. This testing was within
      one university setting and with only short-term (1 week,3 and 6 month post) follow-up. This
      RCT extends this evaluation by expanding the participant population and examining the longer
      term efficacy of the program. First year female students from three Canadian universities
      will be randomized to receive our education program or to be part of a current practice
      exposure condition. Outcome measures will be completed at baseline, 1 week, 6, 12 months.

      The four session sexual assault resistance program under study is based on the best theories
      and evidence available.Three of the four sessions address steps in a woman's emotional and
      cognitive processes as they relate to male acquaintances who are acting in a way that makes
      sexual coercion or sexual assault more likely. The units provide information, skills, and
      practice aimed at a) decreasing the time needed for women to assess the situation as
      dangerous and take action, b) reducing emotional obstacles to taking action, and c)
      increasing the use of the most effective methods of verbal and physical self-defense. The
      enhanced program piloted in the OWHC project includes a fourth unit which focuses on
      facilitating a stronger positive sexuality from which women may resist sexual coercion by
      male intimates more successfully.

      The primary objective of this study is to establish whether a novel, small-group education
      program can reduce the one-year incidence of sexual assault by 30% (absolute difference of
      7.5%). The secondary objectives are to assess whether changes in knowledge, attitudes, and
      skills related to the process of sexual assault resistance are improved in the short term,
      and, along with the primary outcome, maintained for the longer term. The tertiary objective
      is to assess whether the education program can also reduce the one-year incidence of forced
      sexual contact and sexual coercion.

      The results of the trial will be used either to: (a) produce a maximally effective rape
      resistance education program package which can be adopted by universities across Canada or;
      (b) provide direction for further research into which aspects of the program need to be
      strengthened before such broad dissemination. The results will also be used to indicate how
      long the effects of the program last and will indicate at which point in time refresher
      sessions may be necessary.
    

Intervention name(s): Enhanced AAA Sexual Assault Resistance Education; Brochure
Intervention type(s): Behavioral; Behavioral
Intervention description(s): Resistance Program: 4x3-hour units. Unit 1 (Assess) accurate assessment of sexual assault risk. Provides: empirically-based information on situational and (male) behavioural danger cues; practice identifying risk and counteracting it. Unit 2 'Acknowledge[ment]' of risk when present. Includes: women's sexual rights; emotional barriers; tactics used by coercive men; practice. Unit 3 (Act) includes: assessing whether or not an escape is possible; research evidence on the effectiveness of resistance strategies; physical self-defense training. Unit 4 applies content to longer term relationships covering: comfort talking about sexuality, identification of sexual values, practices beyond intercourse, and articulation of relationship goals.; Current 'standard of care' at Canadian universities. Invitation to take and read brochures on sexual assault selected from those available on their Canadian university campus. All sites' brochures include general information on sexual assault and 'date-rape' drugs and post-rape legal and medical advice. The research assistant (RA) will ask the participants to take brochures, read them over, and to ask any questions they may have. Questions will be answered in a group setting and the participant will take home any brochures that she selected. Interaction between participants and the RA on the topic will be limited to 10-15 minutes and will be audio recorded for verification.
Other intervention name(s): rape education; pamphlet
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Prevention
Keywords: rape; sexual assault; intervention; female university students