Prevention Strategies|Sexual Violence|Violence Prevention|Injury Center|CDC

Prevention Strategies|Sexual Violence|Violence Prevention|Injury Center|CDC

Sexual Violence: Prevention Strategies

Sexual violence is a serious problem that can have lasting, harmful effects on victims and their family, friends, and communities. The goal of sexual violence prevention is simple—to stop it from happening in the first place. The solutions, however, are just as complex as the problem.

Prevention efforts should ultimately decrease the number of individuals who perpetrate sexual violence and the number of individuals who are sexual violence victims. Many prevention approaches aim to reduce risk factors and promote protective factors for sexual violence. In addition, comprehensive prevention strategies should address factors at each of the levels that influence sexual violence— individual, relationship, community, and society.

The most common prevention strategies currently focus on the victim, the perpetrator, or bystanders. Strategies that try to equip the victim with knowledge, awareness, or self-defense skills are referred to as "risk reduction techniques." Strategies focused on the perpetrator attempt to change risk and protective factors for sexual violence to reduce the likelihood that an individual will engage in sexually violent behavior. The goal of bystander prevention strategies is to change social norms supporting sexual violence and empower men and women to intervene with peers to prevent an assault from occurring. Other prevention strategies address social norms, policies, or laws in communities to reduce the perpetration of sexual violence across the population.

Effective and Promising Programs

Few programs, to date, have been shown to prevent sexual violence perpetration.  A systematic review conducted by CDC's Injury Center identified only two programs that have been shown, using a rigorous evaluation methodology, to prevent sexual violence perpetration.

• Safe Dates

Safe Dates is designed to prevent the initiation of emotional, physical, and sexual abuse in adolescent dating relationships. Intended for male and female 8th- and 9th-grade students, the goals of the program include the following:

• • Changing adolescent dating violence and gender-role norms
  • Improving peer helping and dating conflict-resolution skills
  • Promoting victim and perpetrator beliefs in needing help and seeking help through community resources

Safe Dates has five components: a ten-session course, a play script, a poster contest, parent materials, and a teacher training outline. Research found reductions in sexual dating violence perpetration and victimization that continued through a four-year follow-up period.1

• Shifting Boundaries

Shifting Boundaries is designed to reduce the incidence and prevalence of dating violence and sexual harassment among adolescents. Intended for male and female middle school students, the program has two parts: a classroom-based approach and a school-wide component.  The goals of this program include the following:

• • Increasing knowledge and awareness of sexual abuse and harassment
  • Promoting positive social attitudes and a negative view of dating violence and sexual harassment
  • Promoting nonviolent behaviors and  intentions in bystanders

Shifting Boundaries is a six-session classroom course with a school-wide program that involves revising school  rules regarding dating violence, and sexual harassment, temporary school-based restraining orders, posters to increase awareness and reporting, and student 'hot spot' maps of unsafe school areas to determine the placement of faculty or school security for greater surveillance. A study found that the classroom curriculum alone was not effective for reducing rates of sexual violence.  The school-wide intervention, however, was effective when implemented alone or in combination with the classroom instruction, with results showing reductions in sexual harassment, peer sexual violence perpetration and victimization, and dating sexual violence victimization after six months.2

Other programs and prevention strategies are gathering evidence for effectiveness.  Two programs have been identified as promising, based on their rigorous evaluation methods, comprehensive program models, and evidence of impact on risk factors for sexual violence perpetration or related behaviors.3

• Coaching Boys Into Men

Coaching Boys Into Men is a dating violence prevention program that uses the relationships between high school athletes and their coaches to change social norms and behaviors. The program consists of a series of 11 brief coach-to-athlete trainings that illustrate ways to model respect and promote healthy relationships. The program instructs coaches on incorporating the themes of teamwork, integrity, fair play, and respect into their daily practice and other routines. At the one-year follow-up in a study, the program showed positive effects on dating violence perpetration (including physical and sexual violence), but effects on sexual violence were not assessed.4

• Bringing in the Bystander

Bringing in the Bystander is a bystander education and training program designed for male and female college students.  The program aims to engage participants as potential witnesses to violence, rather than as perpetrators or victims. Skills are provided to help when participants see behavior that puts others at risk. Skills include speaking out against rape myths and sexist language, supporting victims, and intervening in potentially violent situations. Research indicates that the program maintains a positive effect at 4.5 months following the intervention.5 More research is needed to understand the program's effects on bystander behavior and sexual violence. 

Applying the Principles of Effective Prevention to Sexual Violence

Until more is known about what works to prevent sexual violence perpetration, program planners can use existing prevention principles to strengthen their approaches and evaluate the effectiveness of new or existing programs.  The prevention principles[PDF 67KB] identified by Nation et al., in the resources below, are common characteristics of effective prevention strategies in behavioral health.

• Applying the Principles of Prevention: What do Prevention Practitioners Need to Know About What Works[PDF 195KB]
• DeGue, S. (2014). Evidence-based strategies for the primary prevention of sexual violence perpetration.  In Preventing sexual violence on college campuses: lessons from research and practice. Available from https://www.notalone.gov/schools/.
• Nation M, Crusto C, Wandersman A, Kumpfer K, Seybolt D, Morrissey-Kane E, Davino K. What works in prevention: principles of effective prevention programs. American Psychologist. 2003;58(6/7):449-56. Available from http://209.198.129.131/images/AmPsy_WhatWorksInPrevention_6-7-2003.pdf.
• Nine Principles of Effective Prevention Programs

References

1. Foshee VA, Bauman KE, Ennett ST, Suchindran C, Benefield T,  Linder GF. Assessing the effects of the dating violence prevention program "safe dates" using random coefficient regression modeling. Prev Sci. 2005; 6(3):245–258.
2. Taylor BG, Stein ND, Mumford EA, Woods D. Shifting boundaries: an experimental evaluation of a dating violence prevention program in middle schools. Prev Sci. 2013; 14(1):64–76.
3. DeGue S. Evidence-based strategies for the primary prevention of sexual violence perpetration.  In Preventing sexual violence on college campuses: lessons from research and practice. 2014; Available from https://www.notalone.gov/schools/.
4. Miller E, Tancredi DJ, McCauley HL, Decker MR, Virata MCD, Anderson HA, O'Connor B, Silverman JG. One-year follow-up of a coach-delivered dating violence prevention program: a cluster randomized controlled trial. Am J Prev Med. 2013; 45(1): 108–112.
5. Banyard VL, Moynihan MM, Plante EG. Sexual violence prevention through bystander education: an experimental evaluation. J Community Psychol. 2007; 35(4); 463–481.

CDC Resources

• CDC's Extramural Research ProgramCDC funds universities, medical centers and other outside organizations to conduct research related to IPV prevention.
• Intimate Partner Violence and Sexual Violence Victimization Assessment Instruments for Use in Healthcare Settings[PDF 188KB]
  This document is a compilation of existing tools for assessing intimate partner violence and sexual violence victimization in clinical and healthcare settings.
• Measuring Intimate Partner Violence Victimization and Perpetration: A Compendium of Assessment Tools[PDF 2.5MB]
• National Sexual Violence Prevention Resource Center
  The National Sexual Violence Resource Center identifies and disseminates information, resources, and research on all aspects of sexual violence prevention and intervention.
• Sexual and Intimate Partner Violence Prevention Programs Evaluation Guide (order hard copy)
• Sexual Violence Surveillance: Uniform Definitions and Recommended Data Elements[PDF 2MB], Version 2.0.
  This document includes the latest information available for standardizing sexual violence surveillance definitions and data elements for policymakers, researchers, public health practitioners, victim advocates, service providers, and media professionals.
• World Report on Violence and Health[PDF 247KB]
  This report is the first comprehensive review of violence on a global scale. Chapter 6 provides detailed information on sexual violence, including prevention strategies.

Other Resources

• Bachar K, Koss MP. From prevalence to prevention: Closing the gap between what we know about rape and what we do. In: Sourcebook on Violence Against Women. Renzetti C, Edleson J, Bergen RK, editors, Thousand Oaks, CA: Sage; 2001.
• Basile K. Implications of public health policy on sexual violence. Ann N Y Acad Sci. 2003; 989:446–463.
• Casey EA, Lindhorst TP. Toward a multi-level, ecological approach to the primary prevention of sexual assault: prevention in peer and community contexts. Trauma Violence Abuse. 2009; 10: 91–114.
• Centers for Disease Control and Prevention. Preventing sexual violence on college campuses: Lessons from research and practice[PDF 918KB]. 2014. Available from https://www.notalone.gov/schools/ 
• DeGue S, Holt MK, Massetti GM, Matjasko JL, Tharp AT, Valle LA. Looking ahead toward community-level strategies to prevent sexual violence.  J Womens Health. 2012; 21(1): 1-3.
• DeGue S, Simon TR, Basile KC, Yee SL, Lang K, Spivak H. Moving forward by looking back: reflecting on a decade of CDC's work in sexual violence prevention, 2000-2010. J Womens Health. 2012; 21.
• DeGue S, Valle LA, Holt MK, Massetti GM, Matjasko  L, Tharp AT. A systematic review of primary prevention strategies for sexual violence perpetration. Aggression and violent behavior. 2014; 19(4): 346-362.
• Foshee V, Bauman KE, Ennett ST, Benefield T, Suchindran C, Linder GF. Assessing the long-term effects of the safe dates program and a booster in preventing and reducing adolescent dating violence victimization and perpetration. Am J Public Health. 2004;94: 619-624.
• Lee D, Guy L, Perry B, Sniffen CK, Mixson SA. Sexual violence prevention. The Prevention Researcher. 2007;14(2):15–20.
• Lonsway KA, Banyard VL, Berkowitz AD, Gidycz CA, Katz JT, Koss MP, Schewe PA, Ullman SE. Rape prevention and risk reduction: review of the research literature for practitioners. January 2009 newsletter. Vawnet.org.
• McMahon P. The public health approach to the prevention of sexual violence. Sexual abuse: a journal of research and treatment. 2000; 12:27–36.
• Morrison S, Hardison J, Mathew A, O'Neil J. An evidence-based review of sexual assault preventive intervention programs[PDF 188KB]. Department of Justice. 2004.
• National Sexual Violence Resource Center Key Findings From "A Systematic review of primary prevention strategies for sexual violence perpetration" written by Sarah DeGue, et al. 2014.  Available from www.nsvrc.org.
• Schewe PA. Interventions to prevent sexual violence. In: Doll L, Bonzo S, Sleet D, Mercy J, Hass E, editors. Handbook of Injury and Violence Prevention. New York, NY: Springer; 2007: 183–201.
• Wathen CN, MacMillan HL. Interventions for violence against women: scientific review. J Am Med Assoc. 2003;289: 589–600.