Please take our brief survey

Blueprints Programs = Positive Youth Development

Return to Search Results

Promising Program Seal

EAAA (Enhanced Assess, Acknowledge, Act) Sexual Assault Resistance Education

Blueprints Program Rating: Promising

A four-unit program to help first-year college women resist acquaintance sexual assault by providing them with information and resistance training.

  • Sexual Violence
  • Violent Victimization

    Program Type

    • Skills Training

    Program Setting

    • School

    Continuum of Intervention

    • Universal Prevention (Entire Population)

    A four-unit program to help first-year college women resist acquaintance sexual assault by providing them with information and resistance training.

      Population Demographics

      The program is designed for first year female college students (ages 17-24).

      Age

      • Early Adulthood (19-22)

      Gender

      • Female only

      Gender Specific Findings

      • Female

      Race/Ethnicity

      • All Race/Ethnicity

      Race/Ethnicity/Gender Details

      The program focuses on women only. The evaluated sample was nearly three-quarters white. Based on subgroup analyses run specifically for Blueprints, there is no statistical evidence to conclude that the program is not effective in any specific racial and ethnic category and in any specific sexual identity category.

      The program aims to improve knowledge and resistance skills of potential victims.

      • Individual
      Risk Factors
      • Individual: Substance use
      • Peer: Romantic partner violence
      Protective Factors
      • Individual: Problem solving skills, Prosocial behavior, Refusal skills

      The sexual assault resistance program is designed to help first-year university women resist acquaintance sexual assault. The program consists of four 3-hour units that involve information-providing games, mini-lectures, facilitated discussion, and application and practice activities. Participants can attend group sessions for all the units in one weekend (two units each day) or for one unit per week for 4 weeks.

      The sexual assault resistance program is designed to help first-year university women resist acquaintance sexual assault. The program consists of four 3-hour units that involve information-providing games, mini-lectures, facilitated discussion, and application and practice activities. Participants can attend group sessions for all the units in one weekend (two units each day) or for one unit per week for 4 weeks.

      Unit 1 (Assess) focuses on improving women’s assessment of the risk of sexual assault by male acquaintances and developing problem-solving strategies to reduce perpetrator advantages. Unit 2 (Acknowledge) assists women to more quickly acknowledge the danger in situations that have turned coercive, explore ways to overcome emotional barriers to resisting the unwanted sexual behaviors of men who are known to them, and practice resisting verbal coercion. Unit 3 (Act) explores and provides opportunities to overcome personal obstacles to resisting known men and offers instruction about and practice of effective options for resistance, including 2 hours of self-defense training focused entirely on situations involving acquaintances. Unit 4 (Sexuality and Relationships) aims to integrate content from the previous units into participants’ sexual lives by providing sexual information, including the slang and scientific terms for a wide range of possible sexual activities beyond intercourse and health and safer-sex practices, and a context to explore their sexual attitudes, values, and desires and to develop practices and strategies for sexual communication.

      The program draws on the "cognitive ecological" model (Nurius & Noris, 1996), which provides a framework for the environmental and psychological factors that affect women's responses to acquaintance sexual assault and interfere with early acknowledgement of danger and self-protection. It also draws on social psychology theories of persuasion (e.g., Elaboration Likelihood Model for the design of process/delivery and some content (e.g., personal relevance). The "Enhancement" (Relationships and Sexuality unit) is included based on the rationale that emancipatory sexuality education focusing on women's sexual desires and alternatives to intercourse is critical to women's increased ability to seek out sex they do want, and to reject and actively resist sex that they do not want.

      • Cognitive Behavioral
      • Skill Oriented

      The study recruited female students from three Canadian colleges and randomized 916 subjects to an intervention or control group. Subjects completed surveys at baseline, 1-week after program completion, 6 months after baseline, and 12 months after baseline in which they reported on completed rape, attempted rape, coercion, and non-consensual sexual contact. The analysis examined the occurrence of each type of sexual event over 12 months. An 18- and 24-month follow-up is forthcoming.

      Relative to the control group, the intervention group showed significantly fewer completed rapes (5.2% versus 9.8%), attempted rapes, attempted coercion, and non-consensual sexual contact.

      Relative to the control group, the intervention group showed significantly fewer

      • completed rapes
      • attempted rapes
      • attempted coercion
      • non-consensual sexual contact

      Not examined.

      The study presented figures on relative risk reduction (ranging from 34.1% to 63.2%) and number needed to treat (ranging from 8 to 22).

      The sample is limited by reliance on volunteers from Canadian universities and a low consent rate.

      • One of 17 baseline comparisons differed significantly across conditions, with no control for this variable in the analysis

      • Blueprints: Promising

      Senn, C. Y., Eliasziw, M., Barata, P. C., Thurston, W. E., Newby-Clark, I. R., Radtke, H. L., & Hobden, K. L. (2013). Sexual assault resistance education for university women: Study protocol for a randomized controlled trial (SARE trial). BMC Women's Health, 13, 25. DOI: 10.1186/1472-6874-13-25.

      Senn, C. Y., Eliasziw, M., Barata, P. C., Thurston, W. E., Newby-Clark, I. R., Radtke, H. L., & Hobden, K. L. (2015). Efficacy of a sexual assault resistance program for university women. New England Journal of Medicine, 372 (24), 2326-35.

      Senn, C. Y., Eliasziw, M., Barata, P. C., Thurston, W. E., Newby-Clark, I., Radtke, L., ... SARE team. (2014). Sexual violence in the lives of first-year university women in Canada: No improvements in the 21st century. BMC Women’s Health, 14, 135, 1-8. doi:10.1186/s12905-014-0135-4.

      Karen Hobden
      SARE Centre
      University of Windsor
      Windsor, Ontario, Canada N9B 3P4
      info@sarecentre.org
      sarecentre.org

      Study 1

      Senn, C. Y., Eliasziw, M., Barata, P. C., Thurston, W. E., Newby-Clark, I. R., Radtke, H. L., & Hobden, K. L. (2015). Efficacy of a sexual assault resistance program for university women. New England Journal of Medicine, 372 (24), 2326-35.

      Senn, C. Y., Eliasziw, M., Barata, P. C., Thurston, W. E., Newby-Clark, I. R., Radtke, H. L., & Hobden, K. L. (2015). Efficacy of a sexual assault resistance program for university women. New England Journal of Medicine, 372 (24), 2326-35.

      Evaluation Methodology

      Design:

      Recruitment: The study enrolled first-year female students, 17 to 24 years of age, at one large university in western Canada and two midsized universities in central Canada, from September 2011 to February 2013. Participants were recruited through e-mail messages and telephone calls, posters or flyers around campus, e-mail messages forwarded by professors, and presentations in classes and at student events. Of the 3241 women assessed, 916 (28.3%) were deemed eligible (i.e., able to attend one of the scheduled intervention sets) and agreed to participate.

      Assignment: At the baseline session, the 916 participants completed a computerized survey, underwent randomization, and immediately attended their first resistance session or control session. Randomization was performed in permuted blocks of two. Intervention subjects received the 4-session treatment, while control subjects were invited by a research assistant to take and read brochures on sexual assault and were offered the opportunity to have questions answered in the group session or privately.

      Attrition: Participants completed computerized surveys at baseline, and 1 week after completion of the intervention (control participants were matched to the same interval). They also completed offsite web-based surveys at 6 months and 12 months. Of the 916 randomized, 23 (2.5%) withdrew or were found to not meet eligibility requirements and were not included in the analysis, while an additional 43 (4.7%) were lost to follow-up or withdrew but were included in the analysis sample of 893.

      Sample: The sample of first-year female college students in Canada had a mean age of 18 years and were 73% white or of European descent. Most were sexually active and about 23% reported having been raped since age 14.

      Measures: The student self-report measures came from the Sexual Experiences Survey–Short Form Victimization, a widely used behavioral measure that is reported to have high reliability and validity. Responses from all three follow-up surveys were used to assess the occurrence during the 12 months of follow-up of particular experiences classified into one of five sexual victimization categories: completed rape, attempted rape, coercion, attempted coercion, or non-consensual sexual contact. The primary outcome was completed rape; other outcomes were pre-specified as tertiary. The secondary outcomes measuring psychological variables were not examined in the paper. The authors noted (p. 2333) that “Women in the resistance group might have underreported sexual assaults (perhaps believing that they should have been able to resist them); however, it is also possible that reporting of outcomes would be increased in women sensitized to sexual assault by the resistance training.”

      Analysis: The primary analysis of the incidence (first occurrence) of completed and attempted rapes used Kaplan-Meier failure curves (indicating the cumulative percentage of completed rapes among women in the respective groups) and the log-rank test. To account for the correlation among observations within group sessions, variance estimates were inflated for within-session clustering with estimates of the design effect. Analysis of the other outcomes – the incidence of coercion, attempted coercion, and nonconsensual sexual contact – used discrete-time survival analyses with a complementary log-log regression model and variance estimates inflated for within-session clustering.

      Intent-to-Treat: The study used a “modified intention-to-treat population, which included all eligible participants who completed one or more postrandomization surveys.” It appears that 6 subjects who withdrew were not followed due to IRB protocols and 17 subjects discovered after randomization to not meet eligibility requirements were dropped, but they made up only a small part (2.5%) of the sample. Another 43 did not complete the 12-month follow-up but were apparently included in the analysis (perhaps as censored observations).

      Outcomes

      Implementation Fidelity: One quarter of the recordings from both groups were randomly selected and scored for fidelity. The intervention fidelity averaged 94% and the control fidelity averaged 86%. Attendance in the resistance group was 91%. There were no crossovers between groups, and cross-contamination was low: 14.5% of the participants in the control group and 10.4% of the participants in the resistance group shared facts or skills learned in their group with participants in the other group.

      Baseline Equivalence: Of 17 baseline sociodemographic, relationship, past victimization, study recruitment, and previous training measures, one showed a significant difference between conditions. Past non-consensual sexual contact was higher in the control group.

      Differential Attrition: The 1-year follow-up analysis included 442 of 452 in the control group (97.8%) and 451 of 464 in the intervention group (97.2%). Although included in the analysis, 43 subjects did not complete the follow-up. No tests for differential attrition were presented.

      Posttest: Relative to the control group, the intervention group showed significantly fewer completed rapes (5.2% versus 9.8%), attempted rapes, rapes of either type, attempted coercion, and non-consensual sexual contact. The most benefit came in the first 4 months, with the gains maintained afterward through the 12-month follow-up. Only 1 of the 6 outcomes, coercion, did not differ significantly across conditions.

      Two prespecified tests for subgroup analyses examined whether the intervention effect differed by prior rape victimization or program timing (i.e., weekend vs. weekday sessions). Neither interaction reached statistical significance.

      Long-Term:  Given the one-weekend or 4-week length of the program, the 12-month follow-up comes close to meeting the Blueprints criteria. A 24-month publication is in progress.

      Limitations:

      • One of 17 baseline comparisons differed significantly across conditions, with no control for this variable in the analysis