Sexual Assault: Actions Needed to Improve DOD's Prevention Strategy and to Help Ensure It Is Effectively Implemented
Released: 2015-11-04T00:00:00


Highlights: section_title: Why GAO Did This Study
paragraphs: Sexual assault is a crime that devastates victims and has a far-reaching negative impact for DOD because it undermines DOD's core values, degrades mission readiness, and raises financial costs. DOD data show that reported sexual assaults involving servicemembers more than doubled from about 2,800 reports in fiscal year 2007 to about 6,100 reports in fiscal year 2014. Based on results of a 2014 survey, RAND estimated that 20,300 active-duty servicemembers were sexually assaulted in the prior year.

Senate Report 113-176 includes a provision for GAO to review DOD's efforts to prevent sexual assault. This report addresses the extent to which DOD (1) developed an effective prevention strategy, (2) implemented activities department-wide and at military installations related to the department's effort to prevent sexual assault, and (3) developed performance measures to determine the effectiveness of its efforts to prevent sexual assault in the military. GAO evaluated DOD's strategy against CDC's framework for effective sexual-violence prevention strategies, reviewed DOD policies, and interviewed cognizant officials.

section_title: What GAO Found
paragraphs: The Department of Defense (DOD) developed its strategy to prevent sexual assault using the Centers for Disease Control and Prevention (CDC) framework for effective sexual-violence prevention strategies, but DOD does not link activities to desired outcomes or fully identify risk and protective factors. Specifically, DOD's strategy identifies 18 prevention-related activities, but they are not linked to desired outcomes—a step that CDC says is necessary to determine whether efforts are producing the intended effect. CDC has also demonstrated that by identifying risk and protective factors—relative to the domain or environment in which they exist—organizations can focus efforts on eliminating risk factors that promote sexual violence while also supporting the protective factors that prevent it. DOD identifies five domains in its strategy and includes risk factors for three—individuals, relationships, and society—but it does not specify risk factors for the other two domains—leaders at all levels of DOD and the military community. Further, DOD does not specify how the protective factors, such as emotional health, identified in its strategy relate to the five domains. Thus, DOD may be limited in its ability to take an evidence-based approach to the prevention of sexual assault.

DOD and the military services are in the process of implementing prevention-focused activities, but they have not taken steps to ensure that installation-level activities are consistent with the overarching objectives of DOD's strategy. DOD's strategy identifies 18 activities, 2 of which DOD considers implemented while efforts to address the remaining 16 are ongoing. For example, DOD officials report that they have implemented the activity directing the development of a military community of practice. Additionally, GAO identified activities that had been developed and implemented at the four installations GAO visited, but found that they may not be consistent with DOD's strategy because it has not been communicated or disseminated to the personnel responsible for implementing the activities. Further, service policies—key conduits of such communication—do not provide the guidance necessary to unify the department's prevention efforts because they have not been updated to align with and operationalize the principles outlined in DOD's most recent strategy. Thus, DOD cannot be sure that all prevention-related activities are achieving the goals and objectives of the department's strategy.

DOD has identified five performance measures to assess the effectiveness of its prevention efforts, but these measures are not fully developed as they are missing many of the 10 key attributes that GAO has found can contribute to assessing program performance effectively, such as baseline and trend data, measurable target, and clarity. Specifically, all five performance measures demonstrate some of these attributes but collectively they are missing more than half of these attributes. All of the prevention efforts' measures demonstrate baseline and trend data but none of the measures have measurable target, clarity, and some of the other attributes. Without fully developed measures, DOD and other decision makers may not be able to effectively gauge the progress of the department's prevention efforts.

section_title: What GAO Recommends
paragraphs: GAO recommends that DOD link prevention activities with desired outcomes; identify risk and protective factors for all domains; communicate and disseminate its strategy to all program personnel; align service policies with the strategy; and fully develop performance measures. DOD concurred with all recommendations and noted actions it was taking.

section_title: Letter
paragraphs: Sexual assault is a crime that devastates victims and has a far-reaching  negative effect for the Department of Defense (DOD) because it  undermines the department’s core values, degrades mission readiness  and esprit de corps, subverts strategic goodwill, and raises financial  costs. DOD data show that the number of reported sexual assaults  involving military servicemembers more than doubled from about 2,800  reports in fiscal year 2007 to about 6,100 reports in fiscal year 2014.  However, recent data suggest that these reports represent a fraction of  the sexual assault incidents that are actually occurring. Specifically,  based on the results of its 2014 Military Workplace Study, the RAND  Corporation estimated that about 20,300 active-duty servicemembers  were sexually assaulted in the year prior to the survey. While the  increase in reports since fiscal year 2007 and the most recent estimated  number of servicemember victims are significant, sexual assault is an  underreported crime, and DOD officials believe the increase in reporting  reflects the growing confidence of servicemembers in the department’s  response to victims as opposed to a decrease in the effectiveness of its  prevention efforts. According to DOD, sexual assault continues to  represent a significant and persistent problem within the department and  DOD has considerable interest in better preventing it.

For over a decade, Congress and DOD have taken a variety of steps to  prevent sexual assault in the military. In 2004, following a series of high- profile sexual assault cases involving servicemembers, Congress  required the Secretary of Defense to develop, among other things, a  comprehensive policy for DOD on the prevention of sexual assaults  involving servicemembers. In response to statutory requirements, DOD  established its sexual-assault prevention and response program in 2005,  and has taken a variety of other steps aimed at improving the  department’s efforts to prevent sexual assault. For example, in 2008,  DOD published its first sexual-assault prevention strategy. In April 2014,  DOD updated its strategy (calling it the 2014–16 sexual-assault  prevention strategy). For additional information on efforts identified by  DOD in its 2014 Report to the President of the United States on Sexual  Assault Prevention and Response that it took to improve the prevention of  sexual assault in the military since 2013, see appendix I.

Since 2008, we have issued multiple products and made numerous  recommendations related to DOD’s efforts to prevent and respond to  incidents of sexual assault. Most recently, in March 2015, we reported on  the extent to which DOD has taken actions to prevent and respond to  sexual assaults of male servicemembers. We found that DOD had not  used all of its data to inform program decision making, had not  established goals or metrics to gauge sexual assault–related issues for  male servicemembers, and had generally not portrayed male sexual- assault victims in its sexual-assault prevention training material. Based on  our findings, we recommended that DOD, among other things, develop a  plan for using its data to inform program development, develop  associated goals and metrics, and revise training to address male victims.  DOD concurred with all six of the recommendations in our 2015 report  and is in the process of implementing them. For additional information on  our prior work related to sexual assault in the military, see appendix II as  well as the Related GAO Products page at the end of this report.

In June 2014, the Senate Armed Services Committee report  accompanying a bill for the National Defense Authorization Act for Fiscal  Year 2015 included a provision that we report on various efforts by DOD  to prevent sexual assault in the military. This report addresses the extent  to which DOD has (1) developed an effective prevention strategy, (2)  implemented activities department-wide and at service-specific and joint  installations related to the department’s effort to prevent sexual assault in  the military,  and (3) developed performance measures to determine the  effectiveness of its efforts to prevent sexual assault in the military.

For our first objective, we reviewed DOD’s 2014-16 Sexual Assault  Prevention Strategy and other relevant guidance and requirements from  DOD and the military services on the prevention of sexual assault and  interviewed officials in DOD’s Sexual Assault Prevention and Response  Office (SAPRO) and from each military service on their efforts to  implement this guidance and prevent sexual assault. We also interviewed  officials from the Centers for Disease Control and Prevention (CDC) who  are the federal government’s focal point for sexual-violence prevention  and have experience working with sexual-violence prevention programs.  We used CDC’s social-ecological model and public-health model to  assess DOD’s 2014-16 Sexual Assault Prevention Strategy and  associated documents. Specifically, we used these models to assess the  extent to which DOD’s 2014–16 prevention strategy and related  documents contain elements that CDC has identified as providing a  framework for developing and implementing effective sexual-violence  prevention programs. We used Office of Management and Budget  guidance on conducting agency strategic reviews and mitigating risks  related to achieving strategic objectives and performance goals. We also  used our prior work on effective agency strategic reviews, which has  shown that it is important to review progress toward strategic objectives in  that it can help to determine subsequent actions and that leaders and  responsible managers should be held accountable for knowing the  progress being made in achieving outcomes.

For our second objective, we reviewed DOD and military service sexual- assault prevention and response policies and guidance, which included  DOD’s 2014-16 Sexual Assault Prevention Strategy, to identify activities  related to the prevention of sexual assault. We also interviewed various  officials with responsibilities related to the prevention of sexual assault at  four military installations in the United States—two for the Army, one for  the Marine Corps, and one joint base that included the Navy and the Air  Force—to obtain their perspectives on DOD’s efforts to prevent sexual  assault. During our visits to these installations, we met with  commanders, sexual-assault response coordinators (SARC), sexual  harassment/assault response and prevention program managers, victim  advocates, chaplains, criminal investigators, legal personnel, and  medical- and mental-healthcare providers to obtain their perspectives on  DOD-wide prevention efforts as well as those being developed and  implemented within their respective service.

For our third objective, we reviewed relevant program guidance and  related documents and met with DOD and military-service officials to  discuss the performance measures that DOD developed to assess its  overall efforts to prevent sexual assault in the military. In addition, we  compared DOD’s prevention-focused performance measures with GAO  criteria on key attributes of successful performance measures.  Additionally, we met with DOD and military-service officials to discuss the  performance measures identified and how DOD plans to use them to  assess the effectiveness of their strategy for and efforts to prevent sexual  assault.

We conducted this performance audit from August 2014 to October 2015  in accordance with generally accepted government auditing standards.  Those standards require that we plan and perform the audit to obtain  sufficient, appropriate evidence to provide a reasonable basis for our  findings and conclusions based on our audit objectives. We believe that  the evidence obtained provides a reasonable basis for our findings and  conclusions based on our audit objectives. Further details of our scope  and methodology are presented in appendix III.
subsections: section_title: Background
subsections: section_title: Definition of Sexual Assault
paragraphs: DOD defines sexual assault as intentional sexual contact, characterized  by use of force, threats, intimidation, abuse of authority, or when the  victim does not or cannot consent. The term includes a broad category of  sexual offenses consisting of the following specific Uniform Code of  Military Justice offenses: rape, sexual assault, aggravated sexual contact,  abusive sexual contact, forcible sodomy (forced oral or anal sex), or  attempts to commit these acts.

section_title: Centers for Disease Control and Prevention (CDC) and Its Sexual Violence Prevention Efforts
paragraphs: CDC is one of the major operating components of the Department of  Health and Human Services, which serves as the federal government’s  principal agency for protecting the health of all U.S. citizens. As part of its  health-related mission, CDC serves as the national focal point for  developing and applying disease prevention and control, environmental  health, and health promotion and education activities. Specifically, CDC,  among other things, conducts research to enhance prevention, develops  and advocates public-health policies, implements prevention strategies,  promotes healthy behaviors, fosters safe and healthful environments, and  provides associated training.

In 1992, CDC established the National Center for Injury Prevention and  Control as the lead federal organization for violence prevention. The  center’s Division of Violence Prevention focuses on stopping violence,  including sexual violence, before it begins, and it works to achieve this by  conducting research on the factors that put people at risk for violence,  examining the effective adoption and dissemination of prevention  strategies, and evaluating the effectiveness of violence-prevention  programs. In addition, CDC operates the Rape Prevention and Education  grant program in all 50 states, the District of Columbia, Puerto Rico, and  four U.S. territories to strengthen sexual-violence prevention efforts at the  local, state, and national level.

In 2004, CDC published a framework for effective sexual-violence  prevention strategies. This framework includes prevention concepts and  strategies, such as identifying risk and protective factors (i.e., factors that  may put a person at risk for committing sexual assault or that,  alternatively, may prevent harm). CDC suggests that grantees of the  Rape Prevention and Education program use this framework as a  foundation for planning, implementing, and evaluating activities  conducted.

section_title: DOD’s Sexual Assault Prevention and Response Program
paragraphs: Since fiscal year 2004, Congress has mandated, and in response DOD  has implemented, a number of improvements to its sexual-assault  prevention and response program. For example, in 2004, Congress  required the Secretary of Defense to develop a comprehensive policy for  DOD on the prevention of and response to sexual assaults involving  servicemembers and to submit an annual report that includes, among  other things, data on reported incidents within each military service and  the results of an evaluation of the effectiveness of DOD’s sexual-assault  prevention and response policy. In 2005, DOD established its sexual- assault prevention and response program to promote the prevention of  sexual assault, to encourage increased reporting of such incidents, and to  improve victim response capabilities; and DOD has issued annual reports  tracking the number of sexual assaults reported each year.

Since that time, DOD has undertaken a variety of activities both to  prevent sexual assaults from occurring and to increase the department’s  visibility over and awareness of sexual-assault incidents that do occur.  Specifically, in response to statutory requirements, DOD has provided  active-duty servicemembers with two options for reporting a sexual  assault: (1) restricted and (2) unrestricted. DOD’s restricted reporting  option allows sexual-assault victims to confidentially disclose an alleged  sexual assault to select individuals and receive medical and mental  health-care treatment without initiating an official investigation. In cases  where a victim elects restricted reporting, first responders may not  disclose confidential communications to law-enforcement or command  authorities unless certain exceptions apply, and improper disclosure of  confidential communications and medical information may result in  discipline pursuant to the Uniform Code of Military Justice or other  adverse personnel actions. In contrast, DOD’s unrestricted reporting  option triggers an investigation by a military criminal-investigative  organization. In an effort to increase victims’ confidence in the military- justice process and to encourage reporting, DOD revised its sexual- assault prevention and response policy in January 2012 to protect victims  of sexual assault from coercion, retaliation, and reprisal.

section_title: DOD Entities with Key Roles and Responsibilities in the Prevention of Sexual Assault
paragraphs: Various offices and organizations within DOD play a role in preventing  and responding to sexual assault within the military. The Under Secretary  of Defense for Personnel and Readiness is responsible for developing the  overall policy and guidance for the department’s sexual-assault  prevention and response program, except for criminal-investigative policy  matters assigned to the DOD Inspector General and legal processes in  the Uniform Code of Military Justice. Accordingly, the Under Secretary of  Defense for Personnel and Readiness oversees SAPRO, which serves as  the department’s single point of authority, accountability, and oversight for  its sexual-assault prevention and response program. The responsibilities  of the Under Secretary of Defense for Personnel and Readiness and  SAPRO with regard to sexual-assault prevention and response include  providing the military services with guidance and technical support and  facilitating the identification and resolution of issues; developing  programs, policies, and training standards for the prevention of, reporting  of, and response to sexual assault; developing strategic program  guidance and joint planning objectives; overseeing the department’s  collection and maintenance of data on reported alleged sexual assaults  involving servicemembers; establishing mechanisms to measure the  effectiveness of the department’s sexual-assault prevention and response  program; and preparing the department’s mandated annual reports to  Congress on sexual assaults involving servicemembers.

Each military service has established a sexual-assault prevention and  response office that is responsible for overseeing and managing the  service’s sexual-assault program. Each military service has also  established the SARC position to serve as the single point of contact for  ensuring that sexual-assault victims receive appropriate and responsive  care and are generally responsible for implementing their respective  services’ SAPR program. According to DOD’s instruction, commanders,  supervisors, and managers at all levels are responsible for the effective  implementation of both the policy and the program. Other responders  include victim advocates, judge advocates, medical and mental health- care providers, criminal-investigative personnel, law-enforcement  personnel, and chaplains.

The Secretaries of the military departments are responsible for  establishing policies to implement the sexual-assault prevention and  response program and procedures, and ensuring compliance with DOD’s  policy. Further, they are responsible for establishing policies that ensure  commander accountability for program implementation and execution.  Each military service maintains a primary policy document on its sexual- assault prevention and response program. Much like DOD’s directive  and instruction on sexual-assault prevention and response, the service  policies outline responsibilities of relevant stakeholders, including  commanders, SARCs, and victim advocates, and training requirements  for all personnel.

section_title: DOD Used CDC Guidance to Develop Its Sexual-Assault Prevention Strategy but It Did Not Specify How Related Activities Are Linked to Desired Outcomes or Fully Identify Factors Needed to Focus Its Prevention Efforts
paragraphs: DOD developed its sexual-assault prevention strategy in 2014 using  CDC’s framework for effective sexual-violence prevention strategies, but  DOD did not link prevention activities to desired outcomes or fully identify  risk and protective factors. Specifically, DOD identified 18 prevention- related activities in its strategy, but did not specify how these activities are  linked with the desired outcomes of the department’s overall prevention  efforts. Further, in adapting CDC’s framework to address the unique  nature of the military environment, DOD did not fully identify risk and  protective factors (i.e., factors that may put a person at risk for committing  sexual assault or that, alternatively, may prevent harm) in its updated  strategy.
subsections: section_title: DOD Updated Its Sexual- Assault Prevention Strategy to Include Some Concepts That CDC Developed for Effective Sexual-Violence Prevention Strategies
paragraphs: In April 2014, DOD published an updated prevention strategy using  concepts from CDC’s framework for effective sexual-violence prevention  strategies. Following guidance outlined by the Secretary of Defense in the  2013 Department of Defense Sexual Assault Prevention and Response  Strategic Plan, SAPRO developed and executed a sexual-assault  prevention campaign to identify evidence-based prevention practices and  lessons learned, in order to update the department’s 2008 Sexual Assault  Prevention Strategy. Though not required to do so, DOD consulted with  and incorporated CDC’s framework and prevention-related concepts into  its prevention strategy. Specifically, DOD incorporated CDC’s concept  that defines the different levels at which prevention efforts occur and  another CDC concept that describes the importance of identifying and  understanding the domains in which sexual violence takes place. For  example, in the “Defining Prevention” section of its strategy, DOD notes  that it adopted the CDC’s concept that there are three levels of prevention  based on when the prevention efforts occur:

Primary Prevention: Approaches that take place before sexual  violence has occurred to prevent initial perpetration.

Secondary Prevention: Immediate responses after sexual violence  has occurred to address the early identification of victims and the  short-term consequences of violence.

Tertiary Prevention: Long-term responses after sexual violence has  occurred to address the lasting consequences of violence and sex- offender treatment interventions.

According to DOD, primary prevention is at the core of its focus in  developing prevention-related activities, which seek to reduce, with the  goal of eliminating factors leading to or associated with, sexual violence,  thereby stopping the crime before it occurs. DOD further states that its  prevention programs will not rely solely on the training and education of  individuals considered to be at risk. Rather, DOD states that its focus on  primary prevention will involve empowered and competent individuals  interacting in an environment that has been sustained to promote the best  possible outcomes.

DOD’s strategy also incorporates CDC’s concept that there are risk and  protective factors that influence the occurrence of sexual violence.  According to CDC, identification of risk factors and protective factors is a  key step in developing an effective prevention strategy in that it helps to  build an understanding of the circumstances—both positive and  negative—that may play a role in the perpetration of such incidents. To  further enhance the effectiveness of its efforts, CDC categorizes these  factors relative to the four domains in which they are identified to exist: (1)  society; (2) community; (3) relationship; and (4) individual. According to  CDC, this enables an organization to tailor its prevention strategy based  on the characteristics of a specific population.

In its 2014–16 prevention strategy, DOD adapted CDC’s approach by  identifying five domains in which it would focus its prevention efforts: (1)  society; (2) the military community (DOD/services/units); (3) leaders at all  levels; (4) relationships; and (5) individuals. As depicted in figure 1,  while DOD’s model largely mirrors the one created by CDC, it also  included “leaders” as a distinct domain of influence because, according to  its 2014–16 strategy, the department wanted to recognize the essential  role of leadership and to highlight the necessity that commanders and  their staffs develop and execute tactics that target this “center of gravity”  for prevention efforts. DOD further notes in its strategy that the inherent  complexities of preventing sexual assault necessitates that a number of  interventions that span multiple levels must take place to achieve the  greatest, and most lasting impact.

DOD’s strategy also incorporates key concepts that CDC has identified as  being included in the public health approach to prevention. We reviewed  DOD’s 2014–16 prevention strategy and found that it identifies, and  categorizes according to the applicable domain, the four concepts that  CDC identified as being included in effective public health strategies,  including (1) inputs, (2) activities, (3) outputs, and (4) outcomes. For  example, within its society domain, DOD identifies inputs, or the  resources on which the effectiveness of an effort depends, such as  community volunteers and collaboration with federal partners, coalitions,  and other primary prevention experts. In addition, DOD’s strategy  specifies outputs, which are the direct products of implemented activities  and are different from outcomes, which are also included in DOD’s  strategy and defined as the intended effect of these activities. For  example, DOD identifies the development of courses that instruct and  empower members as one of the outputs of its efforts, whereas it notes  that the establishment and maintenance of a culture that supports the  prevention of sexual assault is a desired outcome of its efforts within the  “leaders” domain.

section_title: DOD’s Sexual Assault Prevention Strategy Does Not Link Activities to Desired Outcomes
paragraphs: DOD’s strategy identifies 18 prevention-focused activities that it plans to  implement as part of its effort to prevent sexual assault, but it does not  link these activities to desired outcomes. According to CDC, effective  public-health strategies establish a link between activities and their  intended outcomes to help determine whether the actual events that take  place as part of a program will logically lead to the intended effect.  Further, providing a step-by-step roadmap can help identify gaps in  program logic that might not otherwise be apparent; persuade skeptics  that progress is being made in the right direction, even if the destination  has not yet been reached; and aid program managers in identifying what  needs to be emphasized right now or what can be done to accelerate  progress. In addition to CDC guidance, DOD’s Strategic Management  Plan for Fiscal Years 2014–2015 identifies the alignment of activities and  goals as a key step in achieving desired outcomes. Our prior work on  effective agency strategic reviews has also shown that it is important to  review progress toward strategic objectives in that it can help to  determine subsequent actions, and that leaders and responsible  managers should be held accountable for knowing the progress being  made in achieving outcomes.

In DOD’s 2014–16 prevention strategy, DOD identifies 18 targeted  activities, the general time frame in which they are to be accomplished,  and the office(s) responsible for their implementation. Specifically, DOD’s  strategy includes activities such as conducting specialized leader sexual- assault prevention training, establishing collaboration forums to capture  and share prevention best practices and lessons learned, and  incorporating specific sexual-assault monitoring, measures, and  education into normal command training, readiness assessments, and  safety forums. In a different section of DOD’s strategy, it lists five general  outcomes of its prevention efforts such as acceptance and endorsement  of the values that seek to prevent sexual assault and an environment in  which servicemembers’ networks support a culture of sexual-assault  prevention. Although both are identified in the strategy, DOD does not  discuss what, if any, connection exists between activities and outcomes in  the department’s efforts to prevent sexual assault.

During our review, we spoke with DOD officials responsible for  developing the department’s strategy who acknowledged that while it was  modeled after CDC’s guidance on effective public-health strategies, it did  not specify how the activities and outcomes identified in the strategy are  linked. According to these officials, the department did not link its  prevention activities with outcomes because of a complex interplay that  exists between these elements. For example, officials described a  scenario in which a single prevention activity could be connected with  multiple outcomes. We recognize that such a scenario is possible and  believe that it reinforces the importance of understanding how specific  activities are expected to contribute to desired outcomes. Thus, without a  defined link, DOD may not be able to determine which activities are  having the desired effect or, when necessary, to make timely and  informed adjustments to its efforts to help ensure it continues to progress  toward desired outcomes. Furthermore, DOD may lack the information  that is needed to conduct a rigorous evaluation of the effectiveness of its  efforts to prevent sexual assault.

section_title: DOD’s Strategy Does Not Fully Identify Risk and Protective Factors That May Put a Person at Risk for Committing Sexual Assault or, Alternatively, That May Prevent Harm
paragraphs: DOD’s strategy is based on CDC’s framework for effective sexual- violence prevention strategies, and it addresses some but not all of the  elements that CDC identified as necessary to maximize the effectiveness  of prevention efforts. According to CDC, there are factors that may put a  person at risk for sexual-violence perpetration and victimization while  other factors may prevent them from harm. Specifically referred to as risk  factors and protective factors, CDC’s work has demonstrated that by  identifying such influences—relative to the domain or environment in  which they exist—organizations can focus their efforts on eliminating  factors that promote sexual violence while also supporting the factors that  prevent it. In addition to CDC’s work on prevention strategies, the Office  of Management and Budget issued guidance in 2015 on agencies’  strategic reviews in which it acknowledged that while agencies cannot  mitigate all risks related to achieving strategic objectives and performance  goals, they should identify, measure, and assess challenges related to  mission delivery, to the extent possible.

As noted previously, DOD adapted CDC’s framework for sexual-violence  prevention strategies by identifying five domains to which it would tailor its  prevention program, including: (1) society; (2) the military community  (DOD/services/units); (3) leaders at all levels; (4) relationships; and (5)  individuals. We reviewed DOD’s strategy and found that it includes risk  factors identified by CDC for three of these domains—individuals,  relationships, and society. For example, within the individual risk domain,  DOD identified factors such as alcohol and drug use and hostility toward  women as risks that may influence sexual violence. Within the  relationship domain, DOD identified factors such as associating with  sexually aggressive and delinquent peers and having an emotionally  unsupportive familial environment as possible influences on the incidence  of sexual violence. However, DOD does not specify risk factors for the  two domains over which it potentially has the greatest influence—leaders  at all levels of DOD and the military community (i.e., DOD/services/units).  For example, the strategy does not identify potential risk factors  associated with these domains, such as recognizing that the inherent  nature of certain types of commands or units may cultivate an  environment in which there is an increased risk of sexual assault.

While not specifically tailored to its military-community domain, DOD’s  prevention strategy includes risk factors that CDC had identified as  generally applicable to the community domain. For example, DOD’s  2014–16 prevention strategy identifies general tolerance of sexual  violence within the community and weak community sanctions against  sexual-violence perpetrators as risk factors for that category. While these  risk factors may generally apply to DOD, they do not meet CDC’s criteria  for effective prevention programs because DOD did not identify risk  factors and mitigation techniques based on the unique aspects of the  military-community domain.

According to officials with DOD SAPRO, they did not identify risk factors  specific to DOD’s military community and leaders domains because  insufficient research existed on risk factors for these domains and the  department did not independently take steps to identify relevant risk  factors prior to the strategy’s publication. A senior DOD official added that  DOD asked the RAND Corporation, after the strategy was published, to  analyze risk factors, including the military community and leaders  domains, as a part of its work on the 2014 Military Workplace Study. In  its fiscal year 2014 Department of Defense Annual Report on Sexual  Assault in the Military, DOD reported on the findings of RAND’s analysis,  which included several risk factors for the military-community domain  such as differences between service branches as well as between the  active-duty and reserve components. RAND did not conduct a similar  analysis to identify risk factors for DOD’s leader domain.

DOD also included six protective factors identified by CDC in its  prevention strategy, but it does not specify how they relate to the five  domains. For example, emotional health and connectedness were listed  as protective factors for high-school boys that may help to curb the  initiation of sexual violence. For high-school girls, academic achievement  was listed as a factor that may reduce their exposure to sexual violence.  However, the protective factors that DOD included in its strategy are  grouped together in a general category rather than being listed under the  domain to which they corresponds. During our review, we spoke with a  senior DOD official responsible for developing the strategy who  acknowledged that more research is needed to identify risk and protective  factors for each of the domains in its model. Without a more  comprehensive list of such factors that correspond to each of the domains  in its strategy, DOD may be limited in its ability to take an evidence-based  approach to the prevention of sexual assault. Further, DOD may not be  able to accurately characterize the environment in which sexual assaults  occur or to develop activities and interventions to more effectively prevent  them. Table 1 provides additional details about the risk factors identified  by domain in DOD’s 2014-16 Sexual Assault Prevention Strategy.

section_title: DOD and the Services Are Implementing Prevention Activities but They Have Not Taken Steps to Help Ensure That Installation- Developed Activities Are Consistent with the Objectives of DOD’s Prevention Strategy
paragraphs: DOD and the military services developed and are in the process of  implementing prevention-focused activities, but they have not taken steps  to help ensure that activities developed at the local level are consistent  with the overarching objectives of DOD’s strategy. As noted previously,  DOD’s 2014–16 prevention strategy identifies 18 prevention-focused  activities and, according to SAPRO officials, 2 have been implemented  and efforts to address the remaining 16 are ongoing. In addition to the  activities listed in DOD’s strategy, installation-based personnel have  developed and implemented various prevention activities at military- service installations. However, these installation-developed activities may  not be consistent with DOD’s prevention strategy because DOD and the  services have not communicated the purpose of the strategy and  disseminated it to the installation-based personnel responsible for  developing and implementing activities at the local level. Further, the  military services’ SAPR policies—key conduits of such communication— have not been updated to align with the guidance in the strategy. During  visits to selected installations, we also found that there is limited  collaboration taking place on the prevention activities developed locally,  which could further affect the effectiveness and efficiency of the  department’s efforts to prevent sexual assault within the military.
subsections: section_title: DOD’s Implementation of Most Activities in Its Prevention Strategy Are Ongoing
paragraphs: DOD and the military services are in the process of implementing the  prevention-focused activities noted in DOD’s 2014-16 Sexual Assault  Prevention Strategy. In its strategy, DOD specifies that one of the  department’s goals is to deliver consistent and effective sexual-assault  prevention methods and programs. In doing so, DOD believes that it will  help to instill a culture of mutual respect and trust, professional values,  and team commitment, which are reinforced to create an environment  where sexual assault is not tolerated, condoned, or ignored. To achieve  this goal, DOD identified 18 activities in its prevention strategy as well as  their general time frame for completion, their priority relative to the overall  strategy, and the office with primary responsibility for their implementation  (i.e., SAPRO, military department, or service). For example, one activity  assigns SAPRO responsibility for developing a military community of  practice focused on primary prevention within 1 year of the strategy’s  April 2014 publication. Other activities, such as implementing policies that  appropriately address high-risk situations targeted by offenders are  designated as responsibilities of the military services and are to be  completed within 3 years of the strategy’s implementation. Table 2  provides a comprehensive list of the 18 prevention-focused activities  identified in DOD’s 2014-16 Sexual Assault Prevention Strategy as well  as the time frames in which they are to be implemented and the offices  responsible for their implementation.

According to SAPRO, the office responsible for developing the  department’s strategy, 2 of the 18 activities identified in the strategy have  been fully implemented. Specifically, SAPRO officials said its activities  “Implementation of the 2014-16 Sexual Assault Prevention Strategy” and  “Develop a military community of practice focused on primary prevention  of sexual assault” are complete and the remaining 16 activities are  ongoing. Officials stated that the implementation of the 2014-16 Sexual  Assault Prevention Strategy activity was completed with its publication in  April 2014. SAPRO also noted that a military community of practice was  started with the August 2014 implementation of “SAPR Connect”—an  online community in which DOD SAPR personnel can collaborate and  share ideas, news, research, and insights from experts on issues related  to sexual assault.

In addition to the 2 activities it identified as implemented, efforts are under  way to implement the remaining 16. However, SAPRO officials said that  the remaining 16 activities identified in its strategy will never be  considered “complete” because, as the program develops, the  department will consistently revise and renew its approach in these areas.  As such, officials stated that the status of the remaining 16 activities is,  and will indefinitely remain, designated as “ongoing.” Though the  remaining activities are not considered complete, each service has taken  steps to support the ongoing efforts specified in the department’s  strategy. For example, each military service annually administers sexual- assault prevention and response training that addresses the nature of  sexual assault in the military environment using scenario-based, real-life  situations to demonstrate the entire cycle of prevention, reporting,  response, and accountability procedures. In addition, each service has  developed and implemented its own prevention-focused training. For  example, in the spring of 2014, the Air Force held a SAPR Stand-Down  Day focused on teaching airmen to identify sexual-assault offenders by  showing how they operate and to impart the effect that offenders can  have on their victims. In 2014, the Marine Corps also expanded its SAPR  training efforts to include courses that emphasize character, social  courage, and mutual respect among Marines. Specifically, the Marine  Corps instituted a 2-hour ethics course of instruction for new recruits who  are awaiting travel to their initial military training, which focuses on  developing an understanding of sexual assault, harassment, hazing, and  alcohol abuse.

The services have also taken steps to address the activity that directs  them to review and, if necessary, expand alcohol policies to address  factors beyond individual use. For example, some Army installations have  adopted more stringent alcohol policies, such as limiting the amount of  alcohol that soldiers may have in the barracks or purchase from  installation facilities, and the Navy took steps to improve its training of  alcohol providers and to engage local-community leadership and  organizations to expand prevention efforts off base. In addition, the  Marine Corps restricted on-base retail alcoholic beverage sales to the  hours of 8:00 a.m. to 10:00 p.m. and limited its availability in non– package stores to no more than 10 percent of the total retail selling floor  space, while the Air Force revised its alcoholic beverage policy to  deglamorize behavior associated with excessive drinking.

section_title: The Services Have Implemented Installation- Developed Prevention Activities Even Though DOD’s Prevention Strategy Has Not Been Thoroughly Communicated or Disseminated
paragraphs: The military services have developed and implemented activities at the  installation level, independent of DOD’s prevention strategy, in an effort to  prevent sexual assault. DOD acknowledged that the 18 activities in the  2014–16 prevention strategy are not the only required prevention  activities and encouraged the services to develop their own specific  activities. However, DOD also noted that the objectives of DOD’s  prevention strategy are to achieve unity of effort and purpose across all of  DOD in the execution of sexual-assault prevention. During our visits to  selected installations, we found that program personnel were largely  unfamiliar with DOD’s prevention strategy and hence may not be  implementing activities in a manner consistent with the objectives of  DOD’s strategy. In its 2014-16 prevention strategy, DOD highlights that it  is important for leaders to employ targeted interventions, standards, and  messaging to address issues unique to their unit climate, and that  prevention programs should be tailored to specific audiences and for  specific purposes and circumstances. However, DOD also notes that the  strategy provides a framework, means, ways, and supporting end states  to assist leaders and planners in the development of appropriate  activities. SAPRO officials stated that they have implemented several  initiatives to communicate directly with the SAPR Program Leads on  prevention strategy as well as servicemembers in the field. For example,  as of October 1, 2015 SAPRO has provided workshops to SARCs from  the Navy and Marine Corps on implementation of the prevention strategy  via webinar or face-to-face to help participants translate the strategy into  action. Other workshops’ dates are being finalized.

During the course of our review, we met with military officials and  program personnel from a joint base and three service-specific  installations who described prevention activities that had been developed  locally and were not listed in DOD’s strategy. The efforts at these  installations included a variety of activities ranging from displays of  sexual-assault awareness symbols to service-sponsored sporting events  that were generally based on the theme of preventing sexual assault.  Despite their responsibilities for and experience with coordinating and  implementing prevention-focused activities, the program personnel we  met with consistently said that DOD and their respective services had not  communicated and disseminated guidance to them on the department’s  prevention strategy and that they were generally unaware of how the  department’s 2014–16 prevention strategy related to their development  and implementation of sexual-assault prevention activities.

In the absence of such guidance, we discussed with SAPR personnel at  the installations we visited their processes for determining which  prevention-focused activities to sponsor. For example, we spoke with  program personnel at one installation who said that while they were  aware of DOD’s prevention strategy, they had not received any  headquarter-level guidance or direction on the types of activities they  should sponsor in support of their efforts to prevent sexual assault. At  another installation, we spoke with program personnel who stated they  didn’t think that the communication flow between the headquarters-level  SAPR office and the installation was as fast or as formal as it needs to be  to address a constantly changing program. In addition, SAPR personnel  provided a briefing on their program in which prevention-focused activities  were categorized according to the five domains identified in DOD’s 2014- 16 prevention strategy. When we asked how they became familiar with  DOD’s prevention strategy, a program official said she had found the  information during a self-initiated search through documents on SAPRO’s  website. Such an action is noteworthy; however, without a plan to  communicate the prevention strategy and roles and responsibilities for its  implementation, DOD and the military services cannot be sure that all  installation-based program personnel are implementing activities that are  designed to achieve the goals and objectives of the department’s  prevention strategy.

We also found that the services’ SAPR policies—a key conduit for  communicating a program’s purpose and corresponding roles and  responsibilities to relevant personnel—have not been updated to reflect  the tenets of DOD’s most recent prevention strategy. DOD’s 2014-16  Sexual Assault Prevention Strategy specifies that one of the department’s  objectives is to achieve unity of effort and purpose across all of DOD in  the execution of sexual-assault prevention and also directs the DOD  components and the Secretaries of the military departments to align their  implementing plans and policies with the department’s prevention  strategy. While the services’ SAPR policies generally address the  prevention of sexual assault, they have not been updated to align with  and operationalize the principles outlined in DOD’s most recent  prevention strategy. Specifically, the Army and Air Force have revised  their policies after the issuance of DOD’s 2014–16 prevention strategy,  but neither incorporates specific elements of DOD’s prevention strategy.  The Navy and Marine Corps SAPR policies were issued in 2013 prior to  the issuance of DOD’s 2014–2016 prevention strategy and have yet to be  updated..

We recognize that DOD’s most recent prevention strategy was published  approximately a year and a half ago and that it takes time for its  prevention strategy to take root in an organization as large as DOD.  However, there may be a disconnect between DOD’s SAPR policies and  what is being implemented by the services—something that has  previously been identified within the department as a challenge. Notably,  in May 2012, the Joint Chiefs of Staff issued its Strategic Direction to the  Joint Force on Sexual Assault Prevention and Response in which it noted  that evidence clearly indicated that gaps remain between the precepts of  the DOD’s SAPR program and its full implementation at command and  unit levels. Thus, without SAPR policies that are aligned with the  department’s prevention strategy, the military services will be limited in  their ability to promote consistency in the prevention efforts that are being  developed and implemented throughout DOD.

section_title: Challenges Identified in Cross-Service Collaboration at Selected Sites
paragraphs: During site visits to a joint base and three service-specific installations in  the same geographic location, we found limited collaboration among the  services on their efforts to prevent sexual assault. DOD’s 2014-16 Sexual  Assault Prevention Strategy directs the military services to collaborate so  they can capture and share best practices and lessons learned related to  the prevention of sexual assault. This direction is further reinforced in  both the 2013 and 2015 versions of its SAPR strategic plan, which note  that it is the department’s objective to deliver consistent and effective  prevention methods and programs. Further, the May 2012 Strategic  Direction from the Joint Chiefs of Staff, which predates DOD’s current  prevention strategy, directed commanders and leaders across the military  services to synchronize their respective sexual-assault prevention and  response programs to increase unity of effort through a joint perspective  and consistent application of prevention, intervention, and response.

During our site visits, we met with military officials and SAPR program  personnel who consistently acknowledged the need to improve cross- service collaboration on the prevention of sexual assault. However, they  added that the different structures and processes of their respective  services’ SAPR programs complicated such collaboration. For example,  during a visit to an Army base, program personnel informed us of an  attempt to collaborate with the other services on SAPR activities.  However, they added that the other services declined to collaborate  because the other services, whose programs were solely focused on  addressing sexual assault, thought it would be confusing to collaborate  with the Army since their program now addressed both sexual  harassment and assault. During a visit to another installation, a military  official stated that the extent of cross-service collaboration on SAPR is  based on the individuals involved and the level of importance that they  place on pursuing joint activities. The official added that he was not aware  of any overarching headquarters-level guidance that promoted such  collaboration when the cross-service relationship and desire to work  together did not exist.

In addition to the structural differences of each service, program  personnel said that they do not have the number of personnel needed to  cultivate more cross-service SAPR activities. Specifically, program  personnel said that their SAPR offices were consistently understaffed and  that the staff who are available are focused on the needs of their  respective service’s program. For example, we met with SAPR personnel  at one installation who said that there is one SARC and one victim  advocate assigned to serve a population of 1,200 servicemembers.  Additionally, SAPR personnel from another installation said that it can be  difficult to maintain a sufficient number of SAPR personnel because many  of their staff and volunteers are servicemembers who become  unavailable, and in some cases, not replaced when they deploy.

During the course of our review, we met with headquarters-level officials  in SAPRO who explained that, during joint-base negotiations, the services  decided that SAPR programs would remain separate. Specifically,  SAPRO officials said that while the Army has made an effort to develop  joint response centers, all of the military services wanted procedures,  such as sexual-assault investigations, to be handled by their respective  service. SAPRO officials stated, however, that one of the assessment  tasks in its strategic plan is to conduct a review of joint environments and  that they have added questions on joint basing for the military services to  respond to and include as part of their input to DOD’s Annual Report on  Sexual Assault in the Military.

section_title: DOD Has Identified Prevention-Focused Measures, but They Are Missing Some Key Attributes Needed to Successfully Assess Program Performance
paragraphs: DOD has identified performance measures to assess the extent to which  its prevention efforts are achieving its goal to eliminate sexual assault in  the military, but these measures are missing many of the 10 key attributes  that our prior work has shown can contribute to assessing program  performance effectively. Specifically, DOD has identified 12 performance  measures that it will use to assess the overall effectiveness of its sexual- assault prevention and response program, and 5 of these measures are  specifically designed to gauge the effectiveness of its prevention line of  effort. While all 5 of DOD’s prevention-focused measures demonstrate  some of the key attributes, collectively they are missing more than half of  these attributes.
subsections: section_title: DOD Has Identified Performance Measures to Assess Its Efforts to Prevent Sexual Assault
paragraphs: DOD has recently identified a new set of performance measures to  assess its efforts to prevent sexual assault. Since 2005, DOD’s SAPR  policy has required that the Under Secretary of Defense for Personnel  and Readiness develop metrics to measure compliance and effectiveness  of training, awareness, prevention, and response policies and programs.  Since that time, we have recommended, among other things, that DOD  develop an oversight framework that contained performance goals,  strategies to be used to accomplish goals, and criteria to measure the  progress of its prevention and response efforts. In October 2009,  Congress required DOD to submit a revised SAPR implementation plan  to include, among other things, methods to measure the effectiveness of  plans that implement DOD policies regarding sexual assaults involving  members of the armed forces. In response, in April 2010, DOD  conceptualized several measures and further directed in its 2013 SAPR  strategic plan that they be developed. In its Annual Report on Sexual  Assault in the Military Services for Fiscal Year 2013, DOD identified six  performance measures, referred to as SAPR Metrics 1.0, that had been  developed to measure the effectiveness of its SAPR program. However,  none of the six performance measures were developed specifically to  assess DOD’s progress toward preventing sexual assault.

More recently, the President directed the Secretary of Defense to develop  a comprehensive report on major improvements to DOD’s SAPR program  since August 2013 and to identify clear benchmarks and metrics that will  enable the department to measure the effectiveness of its SAPR efforts.  In response to this direction, DOD collaborated with the White House and  identified 12 performance measures that the department plans to use to  assess the effectiveness of its SAPR program and that were included in  DOD’s November 2014 report to the President. Of the 12 performance  measures, 5 were designed to specifically measure the effectiveness of  DOD’s prevention line of effort. Table 3 further describes DOD’s 5  prevention-focused performance measures.

section_title: DOD’s Prevention- Focused Measures Are Missing Many of the 10 Attributes That Contribute to Assessing Program Performance
paragraphs: We analyzed DOD’s five prevention-focused measures and found that  they are missing many of the 10 key attributes that contribute to  assessing program performance effectively. Our prior work has shown  that agencies successful in measuring performance used measures that  demonstrated results, were limited to the vital few, covered multiple  priorities, and provided information that was useful for decision making.  To determine whether DOD’s prevention-focused performance measures  satisfy these four general characteristics, we assessed the measures  using 10 specific attributes. Our work cited these specific attributes as  key to successful performance measures. Table 4 shows the 10  attributes, their definitions, and the potentially adverse consequences of  not having the attributes.

Our analysis determined that all five of DOD’s prevention-focused  performance measures demonstrate some of the key attributes, but  collectively they are missing more than half of the key attributes of  successful performance measures that we identified in our prior work.  Specifically, DOD’s performance measures have linkage in that they are  aligned with the prevention line of effort set forth in DOD’s 2014–16  prevention strategy, include baseline and trend data, and exhibit little to  no overlap with other measures. We also found, however, that DOD’s  prevention-focused performance measures’ usefulness to the department  may be limited because they each do not have between 5 and 7 of the 10  key attributes that we identified as necessary to successfully measure  program performance. Table 5 shows the results of our evaluation of  DOD’s prevention-focused performance measures using the 10 key  attributes of successful performance measures.

As shown in table 5, all of DOD’s prevention-focused performance  measures are missing the attribute of measurable targets. Leading  practices in federal agency performance management state that, where  appropriate, performance measures should have quantifiable, numerical  targets and that agencies could use baselines to set realistic but  challenging targets. As noted previously, DOD has established baseline  and trend data for each of its prevention-focused performance measures,  but none of these measures have measurable targets because it has not  used these data to set numerical goals nor has it provided the information  needed to appropriately interpret the results of the measures and  determine program achievements. For example, for its “Prevalence  versus Reporting” measure, while DOD has expressed that it aims to  close the gap by decreasing the prevalence of sexual-assault incidents  and increasing the number of victims willing to report a sexual assault, it  does not identify—in either case—a numerical target for the department  to work towards. DOD officials told us that the department has not  established numerical targets for its prevention-focused performance  measures, because it instead uses indicators such as positive results  from surveys or a decrease in the sexual-assault prevalence rate when  compared to previous years as measures of success. Further, officials  stated they have not established numerical targets because there is not  enough research to determine what an appropriate target should be for its  measures related to prevalence.

We recognize the challenges associated with measuring the progress of  activities with complex outcomes and limited examples to replicate, such  as DOD’s efforts to prevent sexual assault. In these instances, our prior  work on effective agency strategic reviews has shown that setting  measurable targets is an evolutionary process involving trial and error  and that agencies may need to break their strategic objectives into pieces  that can be more easily be measured or assessed. Further, for activities  with long-term, scientific discovery–oriented outcomes, agencies can also  rely on underlying multiyear performance goals, annual performance  indicators, and milestones to better plan for and understand near-term  progress towards those objectives. Without a numerical target, DOD  and other decision makers may be unable to gauge the extent of progress  from the department’s prevention efforts because there are no goals that  can be used to compare projected performance with actual results.  Furthermore, without targets against which it can measure its progress,  DOD may not be able to ensure that it is allocating resources to its most  effective activities—a key determination given the increasingly limited  fiscal resources across the federal government.

Our analysis also determined that all five of DOD’s prevention-focused  performance measures are missing the attribute of clarity because the  corresponding methodology is not clearly defined. For example, DOD did  not specify that it would assess program performance by gender or rank;  however, we found that three of DOD’s five prevention-focused  performance measures assessed performance both by gender and by  rank, while another was focused solely on results broken out by  servicemember gender. According to a senior official, DOD chooses to  measure performance by gender and rank because data show that  women and junior enlisted servicemembers in general are at higher risk  of sexual assault. However, DOD did not use gender or rank when  calculating its “Prevalence versus Reporting” measure. In our March 2015  report focusing on male-servicemember sexual-assault victims, we  reported that developing clear goals and associated metrics related to  male victims and articulating them throughout the department would  provide DOD with additional information to assess its progress and  determine whether any adjustments are needed in its approach for  addressing sexual assault in the military. Similarly, DOD would benefit  in developing clear goals and associated performance measures by  gender and rank so it can effectively assess its progress of preventing  sexual assaults from occurring in the military.

Further, DOD’s Prevalence versus reporting measure is not clearly  defined. Specifically, the measure’s name and definition suggests that the  department intends to compare the estimated prevalence of unwanted  sexual contact with the number of sexual assaults reported by  servicemembers while serving in the military by fiscal year. However,  DOD’s annual data on sexual-assault incidents reported to the military  services by fiscal year include assaults that occurred prior to the fiscal  year in which they were reported. As a result, DOD is comparing the  prevalence of unwanted sexual contact that occurred in the past year to  reported sexual assaults, regardless of when they occurred. Given the  lack of available data on the fiscal year in which the sexual-assault  incidents occurred, we are unable to accurately compare the prevalence  of unwanted sexual contact to reported sexual assault by fiscal year.  However, our analysis of DOD’s annual reports since fiscal year 2008  shows an increase in the percentage of unrestricted reports of sexual  assault made for an incident that occurred prior to the fiscal year it was  reported, with about 12 percent reporting a prior-year incident in fiscal  year 2008 compared to at least 24 percent reporting a prior-year incident  in fiscal year 2013. The lack of clarity of what actually is being measured  may lead decision makers to believe that performance was better or  worse than it actually was.

Our analysis also determined that objectivity and reliability may be  limited for three of the five prevention-focused performance measures,  because they are based on the results of a convenience sample of  servicemembers who respond to the Defense Equal Opportunity  Management Institute (DEOMI) Organizational Climate Survey request  and voluntarily complete the command-climate survey. As such, the  aggregated results are not generalizable to the larger servicemember  population. According to a senior DOD official, DOD is still determining  the usefulness of using the command-climate survey at the department  level by exploring ways to make the results more representative and  meaningful at the department level. Performance measures lacking  objectivity and reliability may affect the conclusions about the extent to  which progress has been made.

Additionally, our analysis determined that DOD’s overall suite of  prevention-focused performance measures does not identify core  program activities that relate to its prevention efforts, does not address  government-wide priorities such as cost, quality, and timeliness, and,  as a result, is not balanced among priorities. For example, DOD identifies  SAPR education and training as a key component of its prevention  program, but it is unclear how DOD will determine their effectiveness  given that none of DOD’s measures are designed to gauge the  effectiveness of such activities. Senior DOD officials acknowledged that  DOD has more work to do on refining its sexual-assault prevention  metrics. However, until DOD has fully developed its prevention-focused  performance measures, DOD and other decision makers may be unable  to effectively gauge the progress of the department’s prevention efforts.

section_title: Conclusions
paragraphs: Since our first report in 2008 on sexual assault in the military, DOD has  made progress in improving its efforts to prevent and respond to sexual  assault across the department. For example, to further develop its  strategy to prevent sexual assault, DOD consulted with CDC and  incorporated CDC’s framework and prevention-related concepts into its  prevention strategy. This included, among other things, defining the  different levels at which sexual-assault prevention efforts occur and  describing the importance of identifying and understanding the domains in  which sexual violence takes place. However, DOD’s 2014-16 Prevention  Strategy does not provide a linkage between its prevention-focused  activities and their desired outcomes and it does not identify risk factors  for two of its domains. These actions could help DOD ensure that it is  taking an evidence-based approach to the prevention of sexual assault.  Further, the prevention strategy has not been systematically  communicated or disseminated to the installation-based program  personnel responsible for its implementation, and the services’ SAPR  policies—another means for communicating direction to program  personnel—have not been aligned with the strategy to reinforce its  purpose. Finally, while DOD has identified performance measures, the  measures are not, in all cases, in line with the key attributes of successful  performance measures, which make it difficult for the department to  reliably determine which activities are helping to prevent sexual assault.  Without fully developing its strategy to prevent sexual assault by linking  prevention activities to desired outcomes, identifying risk factors for all  domains, and including fully developed performance measures,  leadership at all levels of DOD may face challenges in determining the  best prevention efforts to implement in order to prevent sexual assault.  Further, without communicating, disseminating, and aligning the  department’s overarching strategy to prevent sexual assault with the  installation level of the military services, DOD could encounter difficulties  in carrying out its vision to eliminate sexual assault in the military. Lastly,  at the three service-specific and one joint installation we visited, we found  challenges related to collaboration in implementing sexual-assault  prevention activities across the services. While this may not be indicative  of all service-specific or joint installations, it may require DOD’s attention  in the future.

section_title: Recommendations for Executive Action
paragraphs: To improve the effectiveness of DOD’s strategy for preventing sexual  assault in the military, we recommend that, as part of the department’s  next biennial update to the 2014–16 sexual-assault prevention strategy,  the Secretary of Defense direct the Under Secretary of Defense for  Personnel and Readiness, in conjunction with the Secretaries of the  military departments, take the following five actions:  link sexual-assault prevention activities with desired outcomes, and identify risk and protective factors for all of its domains, including the  military community and its leaders.

To help ensure widespread adoption and implementation of DOD’s  sexual-assault prevention strategy and to fulfill its role as a framework  that can assist leaders and planners in the development of appropriate  tasks, we recommend that the Secretary of Defense direct the Under  Secretary of Defense for Personnel and Readiness, in conjunction with  the Secretaries of the military departments, to  communicate and disseminate DOD’s prevention strategy and its  purpose to the appropriate levels of program personnel as well as  their roles and responsibilities for its implementation, and ensure the military services’ SAPR policies are aligned with the  department’s prevention strategy.

To help improve DOD’s ability to measure the effectiveness of the  department’s efforts in preventing sexual assault in the military, we  recommend that the Secretary of Defense direct the Under Secretary of  Defense for Personnel and Readiness, in collaboration with the  Secretaries of the military departments, to fully develop the department’s  performance measures for the prevention of sexual assault so that the  measures include all key attributes of successful performance measures.

section_title: Agency Comments and Our Evaluation
paragraphs: In written comments on a draft of this report, DOD concurred with each of  our five recommendations. DOD’s comments are summarized below and  reprinted in appendix IV. DOD also provided technical comments on the  draft report, which we incorporated as appropriate.

DOD concurred with our first and second recommendations that seek to  improve the effectiveness of the department’s strategy for preventing  sexual assault by linking sexual assault prevention activities with desired  outcomes and identifying risk and protective factors for all of its domains,  including the military community and its leaders. In its comments, DOD  agreed that linking prevention activities to desired outcomes is important  and stated that it had developed a methodology to identify the full range  of risk and protective factors for the five domains in which it will focus its  efforts to prevent sexual assault. DOD also stated that in future phases of  the study, it will attempt to link future prevention activities with changes in  indicators for risk and protective factors as well as the occurrence of  sexual assault. We are encouraged by the efforts DOD has underway to  more comprehensively identify risk and protective factors and believe that  these efforts will better position the department to focus on eliminating  factors that promote sexual assault and to support the factors that may  prevent it.

Regarding the implementation of DOD’s prevention strategy and its use  as a framework to develop appropriate tasks, DOD concurred with our  third and fourth recommendations that it communicate and disseminate  the prevention strategy and its purpose to the appropriate levels of  program personnel as well as their roles and responsibilities for its  implementation, and ensure the military services’ SAPR policies are  aligned with the department’s prevention strategy. In its comments, DOD  identified several efforts that it had initiated related to the communication  and implementation of its sexual assault prevention strategy. For  example, DOD described a prevention roundtable that includes  representatives from the military services, the National Guard Bureau,  and the Coast Guard and meets quarterly to collaborate on sexual assault  prevention requirements and to share their efforts to prevent sexual  assault. DOD also highlighted that, for more than 2 years, it has hosted  quarterly webinars on topics that can assist with the implementation of its  prevention strategy. We are encouraged by the variety of forums that  DOD sponsors to facilitate information-sharing on prevention initiatives  and, in particular, its recent institution of workshops that help participants  to operationalize the prevention strategy. However, as we noted in our  report, it is important for DOD to develop a plan for communicating the  prevention strategy and its purpose to all personnel to help ensure that it  achieves its goal of department-wide unity of effort in the prevention of  sexual assault.

With regard to the department’s ability to measure the effectiveness of its  efforts to prevent sexual assault, DOD concurred with our fifth  recommendation that it fully develop its performance measures for the  prevention of sexual assault so that they include all key attributes of  successful performance measures. In its comments, DOD stated that  CDC and leading researchers have recognized sexual assault is a non- standard public health issue that requires different metrics to determine  the causal linkages that exist between preventive indicators and  prevention-related outcomes. DOD also stated that it would continue to  monitor best practices in civilian prevention initiatives, and translate them  to military populations as appropriate. As noted in our report, we  recognize the challenges associated with measuring the progress of  activities with complex outcomes, such as DOD’s efforts to prevent sexual  assault. In these instances, our prior work on effective agency strategic  reviews has shown that the development of performance measures is an  evolutionary process that involves trial and error, particularly for activities  with long-term, scientific discovery-oriented outcomes such as the  prevention of sexual assault. We also recognize the difficulties that are  posed to emergent initiatives—such as the prevention of sexual assault in  the military—by the limited number of examples from civilian initiatives  that may exist to be replicated. However, given the substantive  differences between military and civilian culture, we encourage DOD to  pioneer measures that will most effectively depict the department’s  performance.

We are sending copies of this report to the appropriate congressional  committees, the Secretary of Defense, the Under Secretary of Defense  for Personnel and Readiness, the Secretaries of the Army, the Navy, and  the Air Force, and the Commandant of the Marine Corps. In addition, this  report will also be available at no charge on the GAO website at  http://www.gao.gov.

If you or your staff have any questions regarding this report, please  contact me at (202) 512-3604 or farrellb@gao.gov. Contact points for our  Offices of Congressional Relations and Public Affairs may be found on  the last page of this report. GAO staff who made major contributions to  this report are listed in appendix V.

section_title: Appendix I: Prevention-Focused Program Improvements since 2013 That DOD Highlighted in Its November 2014 Report to the President
paragraphs: In a December 2013 letter, the President of the United States directed the  Secretary of Defense to provide a comprehensive report—by the  following December—on the Department of Defense’s (DOD) progress in  addressing the issue of sexual assault. Specifically, the report was to  address major programmatic improvements made by DOD since August  2013, including those related to the prevention of sexual assault.  Accordingly, in November 2014, DOD submitted its report to the  President in which it noted that the department had increased its focus on  prevention and had demonstrated progress in preventing sexual assault,  and that it planned to intensify its prevention-focused efforts in the coming  years. Table 6 provides further details about the prevention-focused  efforts highlighted in DOD’s November 2014 report.

section_title: Appendix II: Timeline of Selected GAO Reports and DOD and Congressional Actions on Sexual Assault Prevention and Response in the Military
paragraphs: Appendix II: Timeline of Selected GAO Reports  and DOD and Congressional Actions on  Sexual Assault Prevention and Response in  the Military We also made one recommendation related to the Coast Guard’s efforts to prevent and respond to  incidents of sexual assault.

section_title: Appendix III: Scope and Methodology
paragraphs: To determine the extent to which the Department of Defense (DOD)  developed an effective strategy to prevent sexual assault in the military,  we obtained and reviewed DOD’s 2014-16 Sexual Assault Prevention  Strategy. We also obtained and reviewed DOD’s 2008 Sexual Assault  Prevention Strategy, its 2012 Strategic Direction to the Joint Force on  Sexual Assault Prevention and Response, its 2013 Sexual Assault  Prevention and Response Strategic Plan, and relevant provisions in DOD  and military service policies and guidance pertaining to the prevention of  sexual assault incidents. We interviewed officials in the Under Secretary  of Defense for Personnel and Readiness’s Sexual Assault Prevention and  Response Office (SAPRO) as well as SAPR program officials with the  Army, the Navy, the Marine Corps, and the Air Force to obtain an  understanding of their respective roles in developing DOD’s prevention  strategy and the extent to which current military-service policies and  guidance are consistent with the department’s goals and objectives for  preventing sexual assault. We also interviewed officials from the Centers  for Disease Control and Prevention (CDC) about their work developing  and evaluating sexual-violence prevention programs and we reviewed  and used CDC’s social-ecological model and public-health model to  evaluate the extent to which DOD identified elements such as domains,  risk factors, and protective factors. Further, we used CDC’s program  planning and development model to assess the extent to which DOD’s  2014–16 prevention strategy and related documents contain all of the  elements of a framework for effective sexual-violence prevention  programs identified by CDC. We used Office of Management and Budget  issued guidance on the budget preparation, submission, and execution,  which, among other things, includes information regarding agency  strategic reviews and mitigating risks related to achieving strategic  objectives and performance goals. We also used our prior work on  effective agency strategic reviews, which has shown that it is important to  review progress toward strategic objectives in that it can help to  determine subsequent actions and that leaders and responsible  managers should be held accountable for knowing the progress being  made in achieving outcomes. We compared DOD’s strategy with prior  related GAO reports to determine the extent to which the strategy  addressed any of our previous recommendations on the prevention of  sexual assault in the military. We discussed the results of our analyses  with officials in DOD SAPRO and officials in each of the military services  responsible for developing and implementing DOD’s strategy to prevent  sexual assault in the military.

To determine the extent to which DOD implemented activities  department-wide and at service-specific and joint installations related to  the department’s efforts to prevent sexual assault in the military, we  reviewed DOD’s 2008 and 2014-16 Sexual Assault Prevention Strategies,  its 2012 Strategic Direction to the Joint Force on Sexual Assault  Prevention and Response, its 2013 Sexual Assault Prevention and  Response Strategic Plan, and relevant provisions in DOD and military  service policies and guidance and the National Defense Authorization  Acts for fiscal years 2004–2015 to identify any required prevention  activities. We also used CDC’s evaluation model for public health  programs to assess whether DOD’s 2014-16 Sexual Assault Prevention  Strategy included the six key elements of effective public health strategies  identified by CDC. To determine the extent to which the military services  have implemented activities to prevent sexual assault, we visited three  service-specific installations—Fort Shafter (Army), Schofield Barracks  (Army), and Marine Corps Base Hawaii—and 1 joint base—Joint Base  Pearl Harbor-Hickam (Navy and Air Force)—on Oahu, Hawaii. We chose  these locations based on the reported high numbers of unrestricted  reported sexual assaults relative to other installations within the same  branch of military service and their close proximity to each other. During  these visits, we met with military officials and program personnel who  were identified as having a role in preventing sexual assault, including  commanders, sexual-assault response coordinators, sexual  harassment/assault response and prevention program managers, victim  advocates, chaplains, criminal investigators, legal personnel, and medical  and mental health-care providers to discuss their familiarity with DOD’s  prevention strategy and whether it had a role in the prevention activities  sponsored at their respective installations. We also discussed the extent  of cross-service collaboration on sexual-assault prevention activities at  these installations and compared them with guidance from the Joint  Chiefs of Staff and leading practices on interagency collaboration to  determine whether the military services have taken the steps necessary  to effectively collaborate on similar prevention efforts.

To determine the extent to which DOD has developed performance  measures to assess the effectiveness of its efforts to prevent sexual  assault in the military, we reviewed DOD’s 2013 Sexual Assault  Prevention and Response Strategic Plan, its 2014 Report to the President  of the United States on Sexual Assault Prevention and Response, its  annual report on sexual assault in the military for fiscal year 2014, its  2014-16 Sexual Assault Prevention Strategy, and other related  documents to identify performance measures that the department uses or  plans to use to assess its progress in preventing sexual assault in the  military. Additionally, we met with DOD and military service officials to  verify the performance measures identified and to discuss how they will  be used to assess the effectiveness of the department’s prevention  efforts. We also compared DOD’s five prevention-focused performance  measures with GAO criteria on key attributes of successful performance  measures.

We conducted this performance audit from August 2014 to October 2015  in accordance with generally accepted government auditing standards.  Those standards require that we plan and perform the audit to obtain  sufficient, appropriate evidence to provide a reasonable basis for our  findings and conclusions based on our audit objectives. We believe that  the evidence obtained provides a reasonable basis for our findings and  conclusions based on our audit objectives.

section_title: Appendix IV: Comments from the Department of Defense

section_title: Appendix V: GAO Contact and Staff Acknowledgments
subsections: section_title: GAO Contact

section_title: Staff Acknowledgments
paragraphs: In addition to the contact named above, key contributors to this report  were Kimberly Mayo, Assistant Director; Tracy Barnes; Elizabeth Curda;  Marcia Fernandez; Mae Jones; Ron La Due Lake; Amie Lesser; Brian  Pegram; Garrett Riba; and Stephanie Santoso.

section_title: Related GAO Products
paragraphs: Military Personnel: Actions Needed to Address Sexual Assaults of Male  Servicemembers. GAO-15-284. Washington, D.C.: March 19, 2015.

Military Personnel: DOD Needs to Take Further Actions to Prevent  Sexual Assault during Initial Military Training. GAO-14-806. Washington,  D.C.: September 9, 2014.

Military Personnel: DOD Has Taken Steps to Meet the Health Needs of  Deployed Servicewomen, but Actions Are Needed to Enhance Care for  Sexual Assault Victims. GAO-13-182. Washington, D.C.: January 29,  2013.

Military Personnel: Prior GAO Work on DOD’s Actions to Prevent and  Respond to Sexual Assault in the Military. GAO-12-571R. Washington,  D.C.: March 30, 2012.

Preventing Sexual Harassment: DOD Needs Greater Leadership  Commitment and an Oversight Framework. GAO-11-809. Washington,  D.C.: September 21, 2011.

Military Justice: Oversight and Better Collaboration Needed for Sexual  Assault Investigations and Adjudications. GAO-11-579. Washington,  D.C.: June 22, 2011.

Military Personnel: DOD’s and the Coast Guard’s Sexual Assault  Prevention and Response Programs Need to Be Further Strengthened.  GAO-10-405T. Washington, D.C.: February 24, 2010.

Military Personnel: Additional Actions Are Needed to Strengthen DOD’s  and the Coast Guard’s Sexual Assault Prevention and Response  Programs. GAO-10-215. Washington, D.C.: February 3, 2010.

Military Personnel: Actions Needed to Strengthen Implementation and  Oversight of DOD’s and the Coast Guard’s Sexual Assault Prevention  and Response Programs. GAO-08-1146T. Washington, D.C.: September  10, 2008.

Military Personnel: DOD’s and the Coast Guard’s Sexual Assault  Prevention and Response Programs Face Implementation and Oversight  Challenges. GAO-08-924. Washington, D.C.: August 29, 2008.

Military Personnel: Preliminary Observations on DOD’s and the Coast  Guard’s Sexual Assault Prevention and Response Programs.  GAO-08-1013T. Washington, D.C.: July 31, 2008.

Military Personnel: The DOD and Coast Guard Academies Have Taken  Steps to Address Incidents of Sexual Harassment and Assault, but  Greater Federal Oversight Is Needed. GAO-08-296. Washington, D.C.:  January 17, 2008.


Question-summary annotations: questions: question: What characterizes the DOD sexual-violence prevention strategy?
answer: The Department of Defense (DOD) developed its strategy to prevent sexual assault using the Centers for Disease Control and Prevention (CDC) framework for effective sexual-violence prevention strategies, but DOD does not link activities to desired outcomes or fully identify risk and protective factors.
child_questions: question: To what extent does the strategy deal with outcomes?
answer: Specifically, DOD's strategy identifies 18 prevention-related activities, but they are not linked to desired outcomes—a step that CDC says is necessary to determine whether efforts are producing the intended effect.

question: What else does the CDC framework emphasize?
answer: CDC has also demonstrated that by identifying risk and protective factors—relative to the domain or environment in which they exist—organizations can focus efforts on eliminating risk factors that promote sexual violence while also supporting the protective factors that prevent it.
child_questions: question: In what way did DOD implement these ideas?
answer: DOD identifies five domains in its strategy and includes risk factors for three—individuals, relationships, and society—but it does not specify risk factors for the other two domains—leaders at all levels of DOD and the military community.

question: What are the implications of these limitations?
answer: Thus, DOD may be limited in its ability to take an evidence-based approach to the prevention of sexual assault.

questions: question: To what extent has DOD's sexual-violence prevention efforts been successful?
answer: DOD and the military services are in the process of implementing prevention-focused activities, but they have not taken steps to ensure that installation-level activities are consistent with the overarching objectives of DOD's strategy. DOD's strategy identifies 18 activities, 2 of which DOD considers implemented while efforts to address the remaining 16 are ongoing.
child_questions: question: What is one program that DOD implemented?
answer: For example, DOD officials report that they have implemented the activity directing the development of a military community of practice.
child_questions: question: According to GAO, what characterized the implementation?
answer: Additionally, GAO identified activities that had been developed and implemented at the four installations GAO visited, but found that they may not be consistent with DOD's strategy because it has not been communicated or disseminated to the personnel responsible for implementing the activities.
child_questions: question: What did the review determine about DOD's communication?
answer: Further, service policies—key conduits of such communication—do not provide the guidance necessary to unify the department's prevention efforts because they have not been updated to align with and operationalize the principles outlined in DOD's most recent strategy.

question: What are the stakes of DOD's failure to fully implement these strategies?
answer: Thus, DOD cannot be sure that all prevention-related activities are achieving the goals and objectives of the department's strategy.

questions: question: How thorough are the DOD's measures?
answer: DOD has identified five performance measures to assess the effectiveness of its prevention efforts, but these measures are not fully developed as they are missing many of the 10 key attributes that GAO has found can contribute to assessing program performance effectively, such as baseline and trend data, measurable target, and clarity.
child_questions: question: What is the extent of this lack of development?
answer: Specifically, all five performance measures demonstrate some of these attributes but collectively they are missing more than half of these attributes. All of the prevention efforts' measures demonstrate baseline and trend data but none of the measures have measurable target, clarity, and some of the other attributes.

question: Why does fully developing the measures matter?
answer: Without fully developed measures, DOD and other decision makers may not be able to effectively gauge the progress of the department's prevention efforts.

questions: question: What is the impact of sexual assault in DOD?
answer: Sexual assault is a crime that devastates victims and has a far-reaching negative impact for DOD because it undermines DOD's core values, degrades mission readiness, and raises financial costs.

question: What is the trend in sexual assault cases?
answer: DOD data show that reported sexual assaults involving servicemembers more than doubled from about 2,800 reports in fiscal year 2007 to about 6,100 reports in fiscal year 2014.
child_questions: question: What is the estimation of sexual assault prevalence?
answer: Based on results of a 2014 survey, RAND estimated that 20,300 active-duty servicemembers were sexually assaulted in the prior year.

questions: question: What is Senate Report 113-176?
answer: Senate Report 113-176 includes a provision for GAO to review DOD's efforts to prevent sexual assault.
child_questions: question: What specifically is included in the report?
answer: This report addresses the extent to which DOD (1) developed an effective prevention strategy, (2) implemented activities department-wide and at military installations related to the department's effort to prevent sexual assault, and (3) developed performance measures to determine the effectiveness of its efforts to prevent sexual assault in the military.

question: How did GAO evaluate the DOD?
answer: GAO evaluated DOD's strategy against CDC's framework for effective sexual-violence prevention strategies, reviewed DOD policies, and interviewed cognizant officials.