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.
