Improving Prevention and Response to Sexual Misconduct on Campus: How the Data Help Us Eleanor W Davidson, MD Gwendolyn Francavillo, PhD, MPH, CHES May 29, 2015
Sources Centers for Disease Control (cdc.gov) The National Intimate Partner and Sexual Violence Survey: 2010 Summary Report (NISVS) American College Health Association Campus Violence Whitepaper 2005 National College Health Assessment (NCHA/ACHA) The Sexual Victimization of College Women (Dec 2000)
What do we know about sexual violence, stalking and intimate partner violence? These are major public health problems in the United States. NISVS 2010 Executive Summary
What is the natural history for survivors? Survivors may experience: 1. Physical injury 2. Mental health consequences 3. Other health consequences These may lead to: hospitalization, disability, death
Relatively new knowledge Violence Against Women Act (1994) mandated the study of campus victimization. In 1995, the Bureau of Justice Statistics added new items to the survey regarding student victims of crime. Violent Victimization of College Students report: 1995-2002 Students experienced most crimes at a lower average rate than non students aged 18-24. The exception was for crimes of rape and sexual assault.
What do we know now? Between 20 and 25% of college age women will be victims of rape or attempted rape during their college career. 5% of men have experienced sexual violence other than rape in the past year. More than 1 in 3 women and more than 1 in 4 men have experienced rape or physical violence by an intimate partner in their lifetime. http://www.cdc.gov/violenceprevention/nis vs/
Age of first sexual assault 42-54% of women who will experience lifetime rape have had this occur before age 18 For men who will experience sexual assault and rape, this is higher: 71% before age 18
Why do we need to know this? One of the best predictors of future victimization is past victimization. 4% of victims suffer 44% of the offenses. Child sexual abuse victims are 3-5 times more likely to experience subsequent adult victimization. http://victimsofcrime.org/
Other important factors Chronic under-reporting of crimes Some groups experience higher rates
National College Health Assessment Data What do we see on college campuses?
Summary 1. These acts of sexual violence are frequent occurrences for women in their college years. 2. Men can also be victims of sexual violence. 3. Occurrences in college will often not be the first time an individual has experienced one of these traumatic events. 4. Risk is not evenly spread out over entire population some have increased vulnerability. 5. There are often longer term health consequences associated with this kind of trauma for individuals.
Men and women who experienced: Rape Stalking Intimate partner violence Frequent headaches Chronic pain Poor physical & mental health Activity limitation s Difficulty sleeping
Higher Rates of Adverse Health Outcomes Health Outcomes Men Women Asthma * Irritable Bowel Syndrome * Diabetes * Frequent Headaches * * Chronic Pain * * Difficulty Sleeping * * Activity Limitations * * Poor Physical Health * * Poor Mental Health * * http://www.cdc.gov/violenceprevention/nisvs/
Identifying & treating students who have been the victim of intimate partner violence, sexual assault, and childhood sexual abuse is very important and central to our mission. We do this with the goal of changing the natural history of surviving sexual violence: instead of just treating symptoms, we try to understand how these got started (root cause analysis) and address these causes in treatment
Our job does not end there It s important but not enough to identify & treat affected individuals to change the natural history. We work with all members of the University community to change the campus environment and make it a safe place for students to learn. We work with campus partners and beyond (locally and nationally) to take steps to end these cycles of violence.
INTRODUCTION
Gallaudet University Sexual Misconduct Developed and implemented: Task force Policies Procedures Response protocol Reporting protocol Peer advocate program Training of staff, faculty, and student leaders Programming for new and current students Collaboration with DC SANE program Research studies
Problem Statement Deaf and Hard of Hearing (HOH) individuals were found to be at higher risk for sexual assault compared to their hearing peers, not unlike other vulnerable populations Limited and insufficient sexual assault education Primarily informal sources of sexuality information Lower levels of sexual assault knowledge And higher acceptance of rape myths Communication and language barriers Experience higher rates of sexual assault
The Social Cognitive Theory Reciprocal determinism continuous interaction between the characteristics of the person, behaviors, and the environment Modeling learning and acquiring behaviors by observing others actions and outcomes (positive and negative) Expectations beliefs about the likely results of an action (anticipated outcomes precedes the behaviors) Behavioral capacity knowledge, education, and skills to perform a behavior
METHODS
Sampling Procedures / Data Collection Deaf and HOH undergraduate students at Gallaudet University Sample recruitment Facebook announcements Flyers in academic and residential buildings Blackboard announcements Booths set up with laptops Cross-sectional mixed methods (mainly quantitative) online survey via a nonprobability convenience sampling method
Procedures Online survey through GoogleDocs Completely anonymous Informed consent form Required response to complete survey Readability of Instrument Review by small group of Deaf and Hard of Hearing students to ensure comprehension Revisions to instrument based on feedback from students
Measures Sexual Assault Knowledge Facts regarding sexual assault information (12 items) Rape Myth Acceptance Attitudes regarding rape myths (16 items) Sources of Sexuality Information Formal and informal sources (qualitative) Sexual Activity Experiences of consensual sexual activity (4 items) Sexual Communication Communication with a partner regarding sexual behaviors (21 items) Sexual Assault Experience Experiences of unwanted sexual activity (12 items)
RESULTS
Demographic Characteristics 241 respondents
Sexual Assault Knowledge 1 and 2
Sexual Assault Knowledge 3 and 5
Sexual Assault Knowledge 6 and 7
Sexual Assault Knowledge 9 and 12
Sexual Assault Knowledge 8 and 10
Sexual Assault Knowledge 11
Rape Myth Acceptance 1 and 7
Rape Myth Acceptance 3 and 4
Rape Myth Acceptance 5 and 8
Rape Myth Acceptance 6 and 10
Rape Myth Acceptance 15 and 16
Rape Myth Acceptance 9 and 11
Rape Myth Acceptance 14
Rape Myth Acceptance 12 and 13
Sources of Sexuality Information Peers most frequent response (53%) (Friends/peers 30% and Partner/significant other 23%) Media common response (24%) School/sexuality education 8%
Sexual Activity Majority of respondents had engaged in consensual sexual activity (91%) The hidden curriculum
Sexual Communication 1 and 2
Sexual Communication 3 and 4
Sexual Communication 6 and 7
Sexual Communication 8 and 9
Sexual Communication 10 and 11
Sexual Communication 12
Sexual Assault Experience Sample reported high rates of experiencing sexual assault Considerably higher than rates found among hearing college students (almost double) Considerably fewer respondents acknowledged their experiences as sexual assault or rape
Anecdotal Evidence: Acknowledged Sexual Assault I was raped when I was 14. I have been raped three times in the past, long time ago... I have experience it sometime.
Anecdotal Evidence: Unacknowledged Sexual Assault I was forced to have a sex with my first boyfriend. I wasn t considered it as a raped. I was afraid and unsure but I was willing to do it anyway. I didn t make the report. I lost my virginity at age 15, it wasn't a rape. It was when someone seduced me into sex. I wasn t exactly raped I was pretty much molested by this guy who would not listen to my no s but never had sex. Someone did tried to have sex with me but I told him no and stop 4 or 5 times. He don t stop at once I said no for like 4 or 5 times I am not sure I was raped as I was blacked out that night and next morning I found out that I had sex with him the night before so we did have sex sometime before but that night I was veryyy drunk I have many guys/girls who try to do stuff with me without my consent
Cronbach s Alpha Reliability All scales had acceptable Cronbach s Alpha scores
Pearson Correlations of Variable Composite Scores and Demographics 16 significant correlations: 15, p.01; 1, p.05
Sexual Assault Knowledge Deaf and HOH females had more sexual assault knowledge than Deaf and HOH males (r = -.3, p.01) Homosexual individuals had more sexual assault knowledge than heterosexual individuals (r =.2, p.01) Deaf and HOH students who had completed more years of college had more sexual assault knowledge (r =.2, p.01)
Sexual Communication Students who had engaged in more consensual sexual activity had higher levels of sexual communication (r =.4, p.01) Students who reported higher rates of sexual assault experience had higher levels of sexual communication (r =.5, p.01)
Rape Myth Acceptance Deaf and HOH male students were found to be more accepting of rape myths than Deaf and HOH female students (r =.4, p.01) Students who had completed fewer years of college were more accepting of rape myths (r = -.2, p.01) White / Caucasian individuals were less accepting of rape myths than other ethnicities (r =.2, p.01) Deaf and HOH individuals who had experienced sexual assault at higher rates were less accepting of rape myths (r = -.1, p.05)
Sexual Assault Experience Deaf and Hard of Hearing female students were found to experience sexual assault at higher rates than Deaf and Hard of Hearing male students (r = -.4, p.01) Students who had engaged in more consensual sexual activity had experienced sexual assault at higher rates (r =.4, p.01) Homosexual individuals experienced sexual assault at higher rates than heterosexual individuals (r =.3, p.01) Students who had experienced sexual assault at higher rates had more sexual assault knowledge (r =.3, p.01)
DISCUSSION How can this data improve sexual assault prevention and response for all college students?
Sexual Assault Prevention and Response Implement sexual assault prevention programs and rape educational tools in all sexuality education programs on all school levels for all ages Target males, younger students, all sexual orientations, and all ethnicities with sexual assault and rape myth information Utilize credible role-models for students to emulate Refer to others experiences of sexual assault, including speakers who are survivors of sexual assault someone just like them
Sexual Assault Prevention and Response Develop guidelines for more effective sexual assault education programs Include the following in health prevention programs: comprehensiveness, variety of methods, adequate dosage, theoretical basis, positive relationships, appropriate timing of interventions, cultural sensitivity, competency, trained staff members, and continuous outcome evaluations Specific to sexual violence primary prevention programs, include: sexual assault attitudes, healthy relationships, communication with sexual partners, consent, respect of personal boundaries, conflict resolution, and skills building Ensure sexual assault information is age, language, and cultureappropriate
Sexual Assault Prevention and Response Promote healthy behaviors and cultural norms Communication with partners, respect, assumptions Change social environments concerning gender roles and expectations, rape myth acceptance, and perceptions of sexual violence Dispel rape myths Lying, reputation, desire, individual responses to sexual assault False sense of security Acquaintance rape, same ethnicity, at home Title IX assisting with reporting of sexual assault Resources Support system
Sexual Assault Prevention and Response Develop peer health programs to deliver interventions and support other students Establish a well-promoted response network of individuals for students to approach about their experiences (with buy-in at all levels) Update sexual assault visual resources, materials, and sexuality curricula to include: videos, books, brochures, training and educational materials, computer programs, and learning tools Develop clear definitions (and give examples!) of sexual assault and rape to ensure that individuals will be able to acknowledge a sexual assault experience
How would you define these terms? Sexual Activity Consent Non-consent Sexual Assault Rape Date Rape Survivor Offender Sexual Assault Knowledge Rape Myth Acceptance Sexual Communication
Definitions I Sexual Activity: consensual sexual behaviors Consent: when both partners want to and agree to the sexual activity that is occurring--saying yes Non-consent: saying no, not saying yes, use of alcohol, being convinced, coerced, threatened, or forced to participate in sexual activity Sexual Assault: a wide range of unwanted, pressured, coerced, or forced sexual acts without the consent of a person Rape: force or incapacitation, non-consent, and sexual penetration Date Rape (Acquaintance rape): a rape committed by a person the survivor knew
Definitions II Survivor: a positive term used to empower victims of sexual assault or rape Offender (Perpetrator): a person who forced or coerced another to participate in sexual behaviors against their will Sexual Assault Knowledge: sexual assault factual information Rape Myth Acceptance: attitudes and beliefs about rape, rape survivors, and rapists that are generally false yet widely and persistently held creating a climate hostile to rape survivors Sexual Communication: assesses the ability of an individual to state her/his accurate sexual behavioral intentions openly with a partner wanted or unwanted sexual activity
Further Investigation Revictimization of sexual assault survivors Alcohol as a predictor for acquaintance rape Alcohol has been found to be used twice as often as force in date rape among hearing students Replication of the study with hearing college students and compare the results Knowledge and attitudes to start Investigate sexuality education specific to rape and sexual assault in all secondary schools Quality and content of sexual assault education
Thank You! Eleanor W Davidson, MD Gwendolyn Francavillo, PhD, MPH, CHES