Sexual Assault Clinical Trial
Official title:
Sexual Assault Resistance Education for University Women: A Trial in Three Canadian Universities
More than one in six women will be sexually assaulted in their lifetimes, most by men they know. The risk of sexual assault by men is greatest for girls and women between the ages of 14 and 24 making this a critical time for intervention. Sexual assault has many immediate and long-term negative consequences for victims. Even a small increase in the ability of women to resist sexual assault will result in a substantial improvement in the mental and physical health of women. Recent research has suggested that many young women delay their resistance to unwanted sexual advances because they are not sure that they are reading the situation correctly, they do not want to hurt the man's feelings, or they are unsure whether they have the right to say no to some sexual activity and say yes to other activity. Earlier work from the researchers resulted in the development of a program affecting these critical areas. This program was shown to be effective in helping participants build skills and a knowledge base to help them resist sexual assault and to prepare them for better recovery following sexual assault. The randomized controlled trial (RCT) builds on this prior work. We will establish whether the demonstrated short term effectiveness of this theoretically and empirically sound rape resistance intervention for university women extends to longer periods. We will determine whether the program can reduce the one year incidence of sexual assault by 30% among women attending Canadian universities. The results will also be used to indicate how long the effects of the program last and will indicate at which point in time refresher sessions may be necessary. A lay summary of the findings of the trial with a focus on application will be provided to all Canadian universities and to Provincial/Territorial Ministries of Education. This will be followed up with contact with those most likely to be involved in current campus education efforts.
Violence against women costs Canadians at least $1.5 billion each year in health related
expenses (Day, 1995). The associated physical and mental health effects are extensive and
the social and economic costs are staggering. The aim of this project is to reduce a very
common form of violence against women, sexual assault, at Canadian universities. At least 1
in 6 women will experience an attempted or completed rape in their lifetimes (Tjaden &
Thoennes, 2000). The situation on university campuses is even more startling with as many as
1 in 4 women experiencing rape or attempted rape while enrolled in university (Fisher,
Cullen, & Turner, 2000). Reductions in sexual assault will have a direct impact on the
mental and physical health of university women.
The proposed trial builds on the Principal Investigator's CIHR-funded research which
developed, revised, and then tested the basic sexual assault resistance program against a
non-random control. It also builds on the Ontario Women's Health Council funded RCT which
evaluated the basic program against an enhanced version, and a no-program control. Our pilot
work (N=214) revealed that women who had the program experienced lower rates of completed
sexual assault (40 - 50% lower) at 3 and 6 months than women who did not. The program also
produced measurable improvements in knowledge, attitudes, and skills related to sexual
assault resistance and to better recovery following sexual assault. This testing was within
one university setting and with only short-term (1 week,3 and 6 month post) follow-up. This
RCT extends this evaluation by expanding the participant population and examining the longer
term efficacy of the program. First year female students from three Canadian universities
will be randomized to receive our education program or to be part of a current practice
exposure condition. Outcome measures will be completed at baseline, 1 week, 6, 12 months.
The four session sexual assault resistance program under study is based on the best theories
and evidence available.Three of the four sessions address steps in a woman's emotional and
cognitive processes as they relate to male acquaintances who are acting in a way that makes
sexual coercion or sexual assault more likely. The units provide information, skills, and
practice aimed at a) decreasing the time needed for women to assess the situation as
dangerous and take action, b) reducing emotional obstacles to taking action, and c)
increasing the use of the most effective methods of verbal and physical self-defense. The
enhanced program piloted in the OWHC project includes a fourth unit which focuses on
facilitating a stronger positive sexuality from which women may resist sexual coercion by
male intimates more successfully.
The primary objective of this study is to establish whether a novel, small-group education
program can reduce the one-year incidence of sexual assault by 30% (absolute difference of
7.5%). The secondary objectives are to assess whether changes in knowledge, attitudes, and
skills related to the process of sexual assault resistance are improved in the short term,
and, along with the primary outcome, maintained for the longer term. The tertiary objective
is to assess whether the education program can also reduce the one-year incidence of forced
sexual contact and sexual coercion.
The results of the trial will be used either to: (a) produce a maximally effective rape
resistance education program package which can be adopted by universities across Canada or;
(b) provide direction for further research into which aspects of the program need to be
strengthened before such broad dissemination. The results will also be used to indicate how
long the effects of the program last and will indicate at which point in time refresher
sessions may be necessary.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Prevention
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