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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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.

Summary: 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. 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. 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.