Photo by Michele Massetani, 2008, http://bit.ly/9Y41zk

In my work to prevent sexual and domestic violence, I see links to many other related topics such as child maltreatment, sexual harassment and bullying, Yet, often there are different people engaged in each of these types of work, different funders, discrete groups of researchers and separate conferences to address these issues. We are trapped in out silos.

I agree with my colleagues at the Prevention Institute who say that “a good solution often solves multiple problems.”  In the recent issue of Journal of Women’s Health, Vivolo and her colleagues at the Centers for Disease Control and Prevention call for linking different issues to build effective sexual violence prevention efforts.

In the article Developing Sexual Violence Prevention Strategies by Bridging Spheres of Public Health, the authors examine risk factors that are common with perpetration of sexual violence and other issues. For example they stated:

Early initiation of sexual intercourse is an example of a developmental experience that is a risk factor for both SV perpetration and negative sexual health outcomes, such as unintended pregnancy and HIV/STD transmission.

Of course, risk factors are not necessarily the same as causes of a problem.  I would not want to suggest that early initiation of sexual intercourse is a cause of sexual violence perpetration. Nonetheless, we can consider the links with other health issues.

I appreciate their call to break down the silos and coordinate prevention efforts:

…although the evidence base for SV prevention is still growing, the SV field stands to benefit from the knowledge of our neighbors in public health, spefically HIV/STD and teen pregnancy prevention. Current programs that are aimed at reducing sexual risk behaviors and increasing protective factors against HIV/STD and pregnancy in high school populations could be modified to include messages that simultaneously target SV perpetration. The core components of effective SV prevention programs could be integrated into effective prevention strategies from other health areas.

Back to a good solution solving multiple problems. I want to go beyond looking at risk factors. If we focus on common protective factors we can link our efforts to build healthy lives and communities.

Below is the full abstract and link to the article on the journal’s web site:

Developing Sexual Violence Prevention Strategies by Bridging Spheres of Public Health.

Vivolo AM, Holland KM, Teten AL, Holt MK. Journal of Women’s Health, Volume 19, No. 10, 2010

Click here for a link to this article.

(Copyright © 2010, Mary Ann Liebert Publishers)

Abstract Sexual violence (SV) is a significant public health problem with multiple negative physical and emotional sequelae for both victims and perpetrators. Despite substantial research and program activity over the past 20 years, there are few programs with demonstrated effectiveness in preventing SV. As a result, the field may benefit from considering effective approaches used with other risk behaviors that share risk factors with SV. The Division of Violence Prevention (DVP) at the Centers for Disease Control and Prevention (CDC) has taken several steps to identify and understand the breadth of risk factors for sexual violence and to delineate the implications of these factors in the development of effective prevention strategies. This report from CDC will highlight several risk factors that, although not traditionally included in SV prevention efforts, may be important areas on which to focus and may ultimately prevent youth from embarking on trajectories resulting in SV perpetration.

I find the social ecological model to be a helpful framework to highlight that prevention work needs to look beyond the individual.  So I am pleased to see research that examines risk and protective factors that go beyond individual attitudes, beliefs and experiences.

In the recent article appearing in the Journal of Youth and Adolescence, authors Casey and Beadnell examine the links between male adolescent peer networks and the risk to perpetrate intimate partner violence.  Using data from the National Longitudinal Study of Adolescent Health (initially collected in 1995 on teen peer networks and in 2001 for IPV perpetration), this study explores different peer networks for male teens.

While the results are uneven (some relationship were shown while other were not), Casey and Beadnell suggest

…some peer-level factors did emerge as relevant to IPV perpetration, which suggests that selected prevention programming targeting specific risk factors at the peer level may be warranted. Speci?cally, depressed, socially isolated youth in small, dense male networks appeared to be at greater risk of future perpetration than youth with much more numerous, gender-balanced, pro- social ties. It may be that structural prevention programs that aim to reduce some teens’ social isolation, build social competencies and generate positive opportunities for exposure to variety of peers may expand the range of behaviors, attitudes and relationship expectations to which youth are exposed.

I support research that challenges prevention programs to make changes to social networks as a means to change.  What do you think?

The full citation and abstract follow:

The structure of male adolescent peer networks and risk for intimate partner violence perpetration: findings from a national sample.

Casey EA, Beadnell B. Journal of Youth and Adolescence 2010; 39(6): 620-33.

Click here for a link to the article on the journal’s web site.

(Copyright © 2010, Springer Science+Business Media)

Although peer networks have been implicated as influential in a range of adolescent behaviors, little is known about relationships between peer network structures and risk for intimate partner violence (IPV) among youth. This study is a descriptive analysis of how peer network “types” may be related to subsequent risk for IPV perpetration among adolescents using data from 3,030 male respondents to the National Longitudinal Study of Adolescent Health. Sampled youth were a mean of 16 years of age when surveyed about the nature of their peer networks, and 21.9 when asked to report about IPV perpetration in their adolescent and early adulthood relationships. A latent class analysis of the size, structure, gender composition and delinquency level of friendship groups identified four unique profiles of peer network structures. Men in the group type characterized by small, dense, mostly male peer networks with higher levels of delinquent behavior reported higher rates of subsequent IPV perpetration than men whose adolescent network type was characterized by large, loosely connected groups of less delinquent male and female friends. Other factors known to be antecedents and correlates of IPV perpetration varied in their distribution across the peer group types, suggesting that different configurations of risk for relationship aggression can be found across peer networks. Implications for prevention programming and future research are addressed.

In a study recently epublished in the Journal of Sex Research, the authors examined the relationship between sexual assault histories and how much people drank that evening.

In examining research it is important to understand how the study was conducted and understand how much we can generalize the findings in order to integrate the understanding of the research into prevention practice.

For this study the data was collected at the San Diego, California border with Tijuana, Mexico. Sexual Assault histories were determined by asking four questions derived from Koss and Oros’ Sexual Experiences Survey:

Have you ever been in a situation where you became so sexually aroused that you could not stop yourself even though the person didn’t want to have sex?

Have you ever persuaded someone to have sexual intercourse with you by giving her drugs or alcohol?

Have you ever persuaded someone to have sexual intercourse with you when she did not really want to by pressuring her with continual arguments?

Have you ever been in a situation where you used some degree of physical force (twisting an arm, holding down, etc.) to try to make a person engage in kissing or petting when they did not want to?

The study found that individuals who having sexually assaulted someone in the past drank more during their evening in Tijuana.  However, the study did not demonstrate a link between drinking that evening and committing acts of sexual assault.

Here is the full citation and abstract:

Sexual Assault Histories and Evening Drinking Among Young American Men in a High-Risk Drinking Environment.

Mumford EA, Kelley-Baker T, Romano E. Journal of Sex Research 2009; ePublished December 29, 2009

Click here for a link to the abstract on the journal’s web site.

(Copyright © 2009, Society for the Scientific Study of Sexuality)

This study surveyed young American men traveling to Tijuana, Mexico from San Diego, California for a weekend night out, collecting responses both southbound at the outset of the evening and northbound upon return at the end of the evening. Among 650 males, we examined the relationship between sexual histories and attitudes and alcohol use, both historically and on their night in Tijuana. Respondents with a history of coercing sex drank more in Tijuana and were more likely to binge drink. Although estimating sexual assaults committed by these males on the evening in question was not possible, this research establishes the link between a history of sexual assault and the blood alcohol concentration of young men resulting from an evening in a timeout environment.

Abuse on the internet is in the news now.  While the topic may be sexting or online predators, how do violence prevention efforts address online risks?  Prevention efforts need to do more than provide warnings.  Not many years ago anti-online abuse campaigns cautioned people not to put their pictures online. As the online environment changes so do our prevention efforts need to change. That’s Not Cool is one example of reaching out to teens on this issue.

An article in the recent issue of the journal Pediatrics examines risk factors of internet-initiated victimization of adolescent girls.

Here is the full abstract and link to the journal’s web site:

Childhood abuse, avatar choices, and other risk factors associated with internet-initiated victimization of adolescent girls.

Noll JG, Shenk CE, Barnes JE, Putnam FW. Pediatrics 2009; 123(6): e1078-83.

Click here for the abstract of the article on the journal web site.

(Copyright © 2009, American Academy of Pediatrics)

OBJECTIVE: The objective of the study was to determine the risk factors for Internet-initiated victimization of female adolescents. In particular, it was expected that girls who experienced childhood abuse would show higher vulnerability than their nonabused peers. In addition, the study examined how provocative self-presentations might be related to online sexual advances and offline encounters.

PATIENTS AND METHODS: Adolescent girls aged 14 to 17 years who had experienced substantiated childhood abuse (N = 104) were demographically matched with nonabused girls (N = 69) and surveyed regarding Internet usage, maternal and paternal caregiver presence, substance use, high-risk sexual attitudes, and involvement with high-risk peers. To measure online self-presentation, participants each created avatars, which were quantified according to the degree of provocative physical features.

RESULTS: Forty percent of the sample reported experiencing online sexual advances, and 26% reported meeting someone offline who they first met online. Abused girls were significantly more likely to have experienced online sexual advances and to have met someone offline. Having been abused and choosing a provocative avatar were significantly and independently associated with online sexual advances, which were, in turn, associated with offline encounters.

CONCLUSIONS: A history of childhood abuse may increase Internet-initiated victimization vulnerability. Parents should be aware of the ways in which their adolescents are presenting themselves online. Making adolescent girls and their parents aware that provocative online self-presentations may have implications for sexual solicitation might help to ward off sexual advances and might help prevent Internet-initiated victimizations. Practitioners should consider standard inquiry into Internet and media usage an aspect of comprehensive care.

To prevent sexual violence, we need to understand both factors that contribute to the problem; and develop a theory on how our efforts can prevent it. Donna Garske of Transforming Communities talks about having a “Theory of the Problem” and a “Theory of Change.”

I find this to be a very helpful set of concepts.  While each of these theories need to compliment each other, they are not the same.  For example, it is not reasonable to expect that understanding why rape happens (theory of the problem) is sufficient to change behavior.  What we have learned from behavior theory is that more than information is necessary to change someone’s behavior.

First, how do we develop our theory of the problem? I thought about this when I saw the first line of the abstract of the new article Sexually Coercive Behavior in Male Youth: Population Survey of General and Specific Risk Factors: “Little is known about risk/protective factors for sexually coercive behavior in general population youth.”

If we want to prevent perpetration of sexual violence, we need to draw on lessons learned on why people rape.  Some people look at David Lisak’s work on the “Undetected Rapist.”  Recently VAWnet put out a Applied Research brief on Using Rapist Risk Factors to Set an Agenda for Rape Prevention I am part of a newly developed Prevention Committee of the Association for the Treatment of Sex Offenders (ATSA) to bridge the work of sex offender management and prevention.

Lets get a better understanding of what we are trying to prevent. Then we have to develop our “theory of change” that fits.

Here is the full abstract and a link to the article on the journal’s web site.

Sexually Coercive Behavior in Male Youth: Population Survey of General and Specific Risk Factors.

Kjellgren C, Priebe G, Svedin CG, Langstrom N. Archives of Sexual Behavior 2009; ePublished November 4, 2009

(Copyright © 2009, Springer Science+Business Media)

Little is known about risk/protective factors for sexually coercive behavior in general population youth. We used a Swedish school-based population survey of sexual attitudes and experiences (response rate 77%) and investigated literature-based variables across sexually coercive (SEX), non-sexual conduct problem (CP), and normal control (NC) participants to identify general and specific risk/protective factors for sexual coercion. Among 1,933 male youth, 101 (5.2%) reported sexual coercion (ever talked or forced somebody into genital, oral, or anal sex) (SEX), 132 (6.8%) were classified as CP, and the remaining 1,700 (87.9%) as NC. Of 29 tested variables, 25 were more common in both SEX and CP compared to NC youth, including minority ethnicity, separated parents, vocational study program, risk-taking, aggressiveness, depressive symptoms, substance abuse, sexual victimization, extensive sexual experiences, and sexual preoccupation. When compared to CP youth only, SEX youth more often followed academic study programs, used less drugs and were less risk-taking. Further, SEX more frequently than CP youth reported gender stereotypic and pro-rape attitudes, sexual preoccupation, prostitution, and friends using violent porn. Finally, in a multivariate logistic regression, academic study program, pro-rape attitudes, sexual preoccupation, and less risk-taking independently remained more strongly associated with SEX compared to CP offending. In conclusion, several sociodemographic, family, and individual risk/protective factors were common to non-sexual and sexually coercive antisocial behavior in late adolescence. However, pro-rape cognitions, and sexual preoccupation, were sexuality-related, specific risk factors. The findings could inform preventive efforts and the assessment and treatment of sexually coercive male youth.

In order to develop programs to prevent men from committing sexual assault, we need to understand what we want change.  If all we so is educate men to know that sexual violence takes place, we cannot succeed.  An article “Male sexual coercion: Analysis of a few associated factors” appearing in October 2009 issue of Psychology Reports looks at some potential risk and protective factors among male college students in El Salvador.

Such research does not necessarily indicate the causes of male sexual violence; instead it demonstrates associations.

The findings are generally not surprising: anger, double standards about gender and favorable attitudes toward the use of violence against women are shown to be risk factors. The authors do suggest that religious involvement may be a protective factor.  I am cautious to draw too much from that observation. I wonder if this is specific to religious life in El Salvador or based on some factor common among men who partcipate n religious practice.

The full citation and abstract from SafetyLit appears after the jump:

male sexual coercion: analysis of a few associated factors.

Sierra JC, Gutiérrez-Quintanilla R, Bermúdez MP, Buela-Casal G. Psychology Reports 2009; 105(1): 69-79.

(Copyright © 2009, Ammons Scientific)

The purpose of this study was to assess, in a sample of 700 university students ages 18 to 40 years in El Salvador, the importance of sociodemographic variables (age, having a partner, and frequency of religious practice), personality traits (anger, hostility, and aggressiveness), sexual attitudes, and male chauvinist attitudes (erotophilia, double standard, and rape supportive attitudes) in explaining male sexual coercion. All these variables were assessed. Once the effect of social desirability had been controlled, the analysis showed the importance of trait anger along with a favorable attitude toward the use of violence against women, double standard, and negative attitudes toward sexuality in explaining male sexual coercion. Religious involvement, however, may act as a protective factor against such violence. Multidimensional models are needed to explain sexual violence against women by men in heterosexual relationships.

For the article, search for “male sexual coercion” here.

It is complicated examining the relationship between early childhood trauma and abuse in future relationships.  We do know about the profound impact of early trauma; and, at the same time, we recognize that being abused as a child does not condemn everyone to becoming abused as an adult.

Recently I was looking at some public service announcements that said, in effect, child who witness abuse are condemned to repeat it. This conclusion is overly simplistic and problematic for a public service announcement.  While research can show risk factors, the presence of those risk factors does not necessarily mean it causes the future behavior.

Yet, I still want to examine the research to think about what issues should be addressed in our prevention programs.  Sometimes, I have to be somewhat skeptical of the research.

The journal Child Abuse & Neglect has recently ePublished an article titled Men’s and women’s childhood sexual abuse and victimization in adult partner relationships: A study of risk factors based on a large sample of Canadians. This study found an association only for women, and then concludes the need to teach at-risk women about protective strategies. I am not opposed to this, but it seems an incomplete strategy for prevention.

The full citation and abstract from SafetyLit follow the jump.

Men’s and women’s childhood sexual abuse and victimization in adult partner relationships: A study of risk factors.

Daigneault I, Hebert M, McDuff P. Child Abuse & Neglect 2009; ePublished October 6, 2009.

Click here to see the article from the journal website or from the DOI.

(Copyright © 2009, Elsevier Publishing)

OBJECTIVES: (1) Document the prevalence of childhood sexual abuse (CSA), childhood physical assault, psychological, physical and sexual intimate partner violence (IPV) in a nationally representative sample. (2) Assess the predictive value of CSA and other characteristics of the respondents and their current partners as potential risk factors for IPV. (3) Assess factors predicting IPV in adulthood in a subsample of women reporting CSA.

METHODS: The role of CSA as a risk factor for adult IPV was examined using data from the 1999 Canadian General Social Survey. A national stratified sample of 9170 women and 7823 men with current or previous partners were interviewed by telephone by Statistics Canada. Multiple logistic regressions were used.

RESULTS: CSA consistently predicted IPV for women and men, although this relationship was weaker for men. Age, current marital status and limitations due to physical or mental condition or chronic illness were also predictors of IPV for men and women. For women reporting CSA, age (being younger) or being in a more recent relationship and being limited due to either physical, mental conditions or chronic illness were predictive of adult victimization.

CONCLUSIONS: These findings indicate that CSA is associated with a greater risk of IPV beyond sociodemographic risk factors.

PRACTICE IMPLICATIONS: To prevent IPV in women already at risk because of CSA, education about protective strategies seems important, particularly for women with physical or mental limitations, in the beginning stages of intimate relationships or for women with partners who drink excessively.

In a new article published online in the journal Child Abuse and Neglect, the authors focus on cultural protective and risk factors in their discussion about child sexual abuse in Kenya.  I appreciate the examination of cultural practices that may support prevention efforts as a strong method to develop a community based solution.  While this article looks at tribal cultures in Kenya, I wonder where is the work in this country to address cultural protective and risk factors?

The abstract and full citation from SafetyLit follow the jump:

Cultural protective and risk factors: Professional perspectives about child sexual abuse in Kenya.

Plummer CA, Njuguna W. Child Abuse and Neglect 2009; ePublished September 15, 2009

Click here for a link to the article.  Articles can also be found but the DOI

(Copyright © 2009, Elsevier Publishing)

OBJECTIVE: The aim of this study was to explore perspectives on cultural risks and protective factors among professionals in Kenya.

METHOD: An exploratory/descriptive survey of Kenyan professionals working to prevent or intervene with child sexual abuse was undertaken to determine their perspectives on how tribal culture impacts vulnerability to sexual abuse. Participants at a conference workshop, were grouped according to tribal affiliation and asked to list key factors that they believe increase or decrease risk to children of sexual abuse in that tribe. Participants from seven ethnic groupings (Somali, Miji Kendas, Luo, Kamba, Kikuyu, Kalenjin, Kisii) identified factors which were then categorized by themes using qualitative examination.

RESULTS: Participants identified a number of cultural factors that protect children from sexual abuse as well as those that create risk for sexual abuse. Strong similarities were identified across groups; however in some cases factors viewed as risks by some were viewed as protective by others.

CONCLUSIONS: In this exploratory study in Kenya, professionals identified many culturally supported practices that protect against or create potential risks for child sexual abuse. Awareness of traditions and practices may inform creation of interventions for preventing child sexual abuse.

PRACTICE IMPLICATIONS: Cultural/community level factors must be considered in designing prevention and intervention programs, particularly in more collective societies.

Last week over 50 people attended CALCASA’s web conference for California Rape Prevention & Education grantees on Measuring Prevention: Examining Strategies to Measure Effectiveness of Sexual Violence Prevention Program. Paul Schewe presented on approaches to evaluating prevention programs.

Evaluating the outcomes of prevention efforts is complicated because there are so many social forces that contribute to sexual violence.  Participants in the web conference brainstormed many potential risk and protective factors, as seen in the world cloud below:

Created in www.wordle.net

When it is not possible to measure a shift on the actual incidence of sexual violence , Paul Schewe suggests looking at proxy measures that may include

• healthier relationships
• improved grades
• decreases in bullying
• increased school attendance
• reduced school behavior problems
• increased use of condoms
• increased activism
• increased number of students willing to volunteer their time to prevention efforts

California Rape Prevention & Education grantees can contact David Lee and Chad Sniffen from the California Coalition Against Sexual Assault for technical assistance. (If you are from other states please contact state sexual assault coalition or state health department)

Conference Materials:

• Handout of Slides
• text chat Sept 09 evaluation web conference-revised

Recording:

A recording of this web conference, along with recordings of other CALCASA web conferences, is available at:
http://calcasa.ilinc.com/public/calcasa

The Virginia Sexual & Domestic Violence Action Alliance have just published an excellent report, Virginia’s Guidelines for the Primary Prevention of Sexual Violence & Intimate Partner Violence. The authors suggest that the guidelines be used as an “organizing philosophy” to shape primary prevention strategies.

Each of the nine guidelines detailed in this publication include examples of how sexual violence and domestic violence prevention programs address the guideline.  The guidelines are:

1. Develop prevention strategies that promote protective factors.
2. Develop prevention strategies that strive to be comprehensive.
3. Develop prevention strategies that are concentrated, and can be sustained and expanded over time.
4. Develop prevention strategies that use varied teaching methods to address multiple learning processes.
5. Develop prevention programs based on purposeful, logical rationale.
6. Develop prevention strategies that are developmentally appropriate.
7. Develop prevention strategies in collaboration with a representative cross-section of community members to incorporate diverse cultural beliefs, practices, and community norms.
8. Develop prevention strategies that include a systematic method to determine program effectiveness and promote continuous quality improvement.
9. Develop prevention strategies as an integral part of the agency mission to end sexual violence / intimate partner violence.

I especially appreciate the almost 50 pages of appendices including descriptions of example programs that address community and societal protective and risk factors.

Check out this report at http://vsdvalliance.org/secPublications/Prevention%20Guidelines%202009%5B1%5D.pdf