03 in 5 Women Are Raped in College

At Stanford University, a varsity swimmer was convicted of sexually assaulting an unconscious young woman behind a dumpster. At Columbia University, a student carried a mattress around campus for a year, a performance art piece designed to rebuke the school for its failure to discipline a fellow student she claimed had assaulted her. At Baylor University, the president, athletic director and head football coach resigned or were fired after an investigation revealed yearsof neglecting to follow up on claims of sexual assaults by football players.

Over the past few years, the list of these and other big-name schools roiled by big-time sexual assault scandals has mushroomed. And the headlines only begin to reveal the extent of the problem. There are no definitive numbers—it's notoriously tough to gather data on the prevalence of sexual violence on campus, and most assaults go unreported. But the most common estimate is that about one in five college women will be the victim of a sexual assault during her years in school, an estimate backed up by surveys from the U.S. Department of Justice's Bureau of Justice Statistics and the Association of American Universities, among others. (Estimates on male victims of sexual assault are more variable, but they range from about one in 10 to one in 20 students.)

The growing public awareness of these numbers—and a 2014 legislative mandate from Congress to address them—has sent colleges and universities looking for solutions. That's not entirely new: Efforts to educate college students about sexual assault date back at least to the 1970s, when community and student activists began organizing Take Back the Night marches and, later, Sexual Assault Awareness Month events in cities and on campuses. "In the past few years," however, "schools have been moving away from just these 'awareness' options and thinking much more about primary prevention," says psychologist Sarah DeGue, PhD, a senior scientist in the Division of Violence Prevention at the U.S. Centers for Disease Control and Prevention.

Prevention isn't easy. Schools face many challenges, including inadequate resources, students' limited attention spans and simply gathering accurate data on the scope of the problem. But increasingly, administrators have been turning to psychologists and other researchers to figure out what might work.

From awareness to action

For many years, there were few evidence-based sexual assault prevention programs for schools to consider. Awareness events like Take Back the Night were among the only tools at their disposal, along with some risk-reduction strategies—like encouraging female students not to drink or walk alone at night—that put the onus on women to prevent assault. And there was scant evidence that these strategies worked.

Psychologist Dorothy Edwards, PhD, says that when she arrived at the University of Kentucky to found the Violence Intervention and Prevention Center in 2005, "I'd already been doing work on campus sexual assault for about a decade, and the common theme of that decade was my failure. I couldn't help but notice that my work wasn't gaining momentum, and the numbers of sexual assaults weren't coming down."

Frustrated by the inadequacy of available resources, Edwards went on to develop the Green Dot program, now one of the nation's most widely used sexual violence prevention programs. In the multipart program, some students—men and women selected because they are student leaders or social influencers—take a six-hour, multisession class that teaches them how to be an "active bystander." They learn to recognize high-risk situations in which someone nearby is at risk of becoming a victim of sexual assault, to understand the social and other barriers that might keep them from intervening and to overcome those barriers to stop the potential assault. The program also includes a one-hour training for the rest of the students on campus, as well as a faculty/staff training portion.

The idea, Edwards says, came from digging into the psychology literature on how to change behaviors and shape social norms. "We'd only been talking about two characters: the potential victim and the potential perpetrator," she says. "And because of disproportionate statistics, we lumped all men into perpetrators and all women into victims. But there's a third character—the bystander. And that third character can be the most important, because if you can mobilize those folks, it allows you to change what will and will not be tolerated."

For example, a young man might see his fraternity brother about to take a drunk young woman upstairs during a party. The young man could intervene directly, but if that feels too risky, he could also distract the potential perpetrator, even saying something like, "Hey, man, your car is being towed."

"It's not about convincing [the bystanders] to do something they don't want to do; it's about giving them the tools to do what they want to do anyway," Edwards says. "It's about doing what we can to make the university a less hospitable environment for assault, and everyone has a part to play in that."

Edwards was inspired by a similar program developed in the late 1990s and early 2000s at the University of New Hampshire called Bringing in the Bystander. The two programs differ in details—for example, Bringing in the Bystander began by training men and women in separate groups, while Green Dot programs have always been co-ed—but the philosophy is similar.

"They are getting at the same core components," says Vicki Banyard, PhD, a psychology professor at the University of New Hampshire who has conducted several evaluations of the Bringing in the Bystander program.

Over the past decade or so, her studies and others have found evidence that bystander-intervention programs can change students' attitudes and behavior. In one of the first rigorous trials, Banyard and her colleagues studied 389 undergraduates randomized to either an intervention group that received Bringing in the Bystander training or a control group that did not. They found that those who completed the training were less likely to accept "rape myths"—for example, that women are responsible for being assaulted—and were more likely to say they would intervene in risky situations than students in the control group who hadn't received the training (Journal of Community Psychology, Vol. 35, No. 4, 2007). A larger follow-up study found that those effects could last up to a year after the intervention, and that they were effective at both a rural and an urban college (Journal of Interpersonal Violence, Vol. 30, No. 1, 2015).

Meanwhile, a study of nearly 7,500 undergrads by epidemiologist Ann Coker, PhD, of the University of Kentucky, and colleagues found that students who had completed a Green Dot training were significantly less likely to believe rape myths and more likely to engage in bystander interventions than students who didn't undergo the training (Violence Against Women, Vol. 17, No. 6, 2011).

Spurred in part by research like this, the 2013 Campus Sexual Violence Elimination (SaVE) Act required all schools that receive Title IX funding to provide bystander training to their students, though it did not specify what that training should include.

Still, bystander training is not an all-purpose solution to sexual assault on campus, researchers say—and there is still much work to be done in refining and evaluating the programs. For one thing, while there is good evidence that the training can change students' attitudes and self-reported behaviors, there is not yet as much evidence that the programs work to actually reduce the number of assaults on campus. That's simply because it is difficult to get those data, Banyard says.

Some evidence is beginning to emerge. In a five-year randomized controlled trial that included nearly 90,000 students at 26 Kentucky high schools, Coker and her colleagues found that schools that implemented a high-school-adapted version of the Green Dot program saw rates of student-initiated sexual violence drop by the third and fourth years of the program (American Journal of Preventive Medicine, Vol. 52, No. 5, 2017).

And in a smaller (nonrandomized) study that surveyed students at three universities, Coker and her colleagues found that students at the University of Kentucky, which had a bystander-training program in place, reported rates of sexual violence victimization 17 percent lower than students at two comparison schools that did not have the program (American Journal of Preventive Medicine, Vol. 50, No. 3, 2016).

Now that the SaVE Act requires many colleges and universities to implement some form of bystander training, the time is ripe for more research to find out how well it is working, according to Coker. She and her colleagues are in the midst of a four-year study to evaluate bystander programs at 24 universities. The schools use a range of programs, including Green Dot, Bringing in the Bystander, "home-grown" adaptations of each, and other in-person and online-only training. Coker and her colleagues are using administrative and survey data to figure out what the schools are doing and whether it's working.

"We're looking at attributes of the programs—how they're delivered, to whom, and the efficacy of those programs," she says.

Teaching resistance

Even at its best, however, bystander training cannot work in every situation and cannot stop every assault.

"Bystander programs help all the students on campus take responsibility to intervene—but there isn't usually a bystander there," says Charlene Senn, PhD, a psychology professor and Canada Research Chair in Sexual Violence at the University of Windsor in Ontario, Canada. A young woman alone in her dorm room with a potential assailant—be it a friend, an acquaintance or a date—needs other tools to resist coercion.

That's where Senn's work comes in. She has developed a 12-hour sexual assault resistance program for young women called the Enhanced Assess, Acknowledge, Act (EAAA) program, based in feminist social psychological theory. The intervention includes group discussions and role-playing activities and aims to teach women to understand their own sexual and relationship desires and to recognize factors—like isolation, or sexual entitlement in men's behavior—that can raise the risk of sexual assault. It helps the young women recognize and overcome emotional barriers that might keep them from resisting coercion from men they know, and also learn effective verbal and physical self-defense strategies.

So far, research suggests that the program works. In a randomized controlled trial with almost 900 undergraduate women, Senn and her colleagues found the program cut the incidence of rape almost in half: After one year, 5.2 percent of women who had completed the program reported being the victim of a rape, compared with 9.8 percent of those in the control group who received only informational brochures on sexual assault. In addition, just 3.4 percent of those in the EAAA intervention reported experiencing an attempted rape, compared with 9.3 percent of the control group (The New England Journal of Medicine, Vol. 372, No. 24, 2015).

Two years later, Senn and her colleagues surveyed the same group of women and found that the program's effects persisted: Students who took part in the intervention were 30 percent to 64 percent less likely to experience rape, attempted rape or nonconsensual sexual contact over the two years than women in the control group (Psychology of Women Quarterly, Vol. 41, No. 2, 2017).

The program has been hailed as a rare clear-cut success in the field, but it has also attracted controversy. Some feminist activists believe it hearkens back to the kind of risk-reduction strategies that place too much of a burden on women for preventing assault.

Senn doesn't see it that way. "I am a feminist who has been appalled at the kind of interventions that tell women what they shouldn't do—that they shouldn't drink, shouldn't go where they want," she says. "But that's not what this is about. I don't find the term 'risk reduction' helpful; I use the word 'resistance.' It's about saying, 'We know the risks are there and we can trust our instincts when we feel things are going wrong. We have the right to live freely and to have our rights respected, and we don't need to be "nice" about standing up for ourselves.'"

In fact, Senn's study found that after completing the training, women in the program were less inclined to believe rape myths and to engage in "women blaming" than were control participants.

Changing the social fabric

Bystander interventions and the EAAA program are very different, but they are both forms of primary prevention that target individual students to change their attitudes and behavior. Some researchers, however, are taking a different approach—looking more broadly at the fabric of campus life to figure out what kinds of institutional and cultural changes could help make sexual assault less likely.

Claude Ann Mellins, PhD, a clinical psychologist and professor in the psychiatry department at Columbia University Medical Center, teamed up with her colleague, anthropologist Jennifer Hirsch, PhD, of the sociomedical sciences department in Columbia's Mailman School of Public Health, after a sexual assault accusation and ensuing trial rocked the Columbia/Barnard community in 2013.

The two researchers had worked together in related areas, including HIV prevention. They realized, Mellins says, that the field of sexual assault prevention could benefit from a multidisciplinary approach that would garner a more nuanced understanding of students' social and sexual lives, as well as the social contexts in which campus assaults take place.

Over two years, they worked collaboratively with Suzanne Goldberg, an executive vice president at Columbia who oversees the Office of University Life, as well as an interdisciplinary team of investigators and both undergraduate and faculty/administrative advisory boards, to conduct a three-part mixed-methods study they called SHIFT—the Sexual Health Initiative to Foster Transformation.

One component was an ethnographic study that included more than 150 in-depth interviews with students, 17 student focus groups and more than 500 hours of observations in settings such as bars and fraternity parties. The researchers also asked 500 students to complete a daily diary study to gain a better understanding of the timing and context of assaults. Finally, they conducted a detailed one-time survey of 2,500 randomly selected students that asked about students' experiences, behaviors and attitudes related to sex, relationships, mental health, substance use, social life, family and other sociodemographic data. Because Columbia University faculty are mandated reporters, they also applied for and received a Title IX waiver so that they could promise students confidentiality about the information they received.

The study wrapped up last fall, and Mellins and Hirsch published their first paper in November 2017—an estimate of sexual assault prevalence and demographic risk factors at Columbia/Barnard. Overall, they found, 22 percent of students reported being the victim of a sexual assault while in college (28 percent of women and 12 percent of men). Many factors increased that risk, they also found, including nonheterosexual identity, difficulty paying for basic expenses, fraternity/sorority membership and binge drinking, among others.

Now, Mellins and Hirsch are talking to university administrators about how to interpret and use the mountains of data they collected. They have presented their findings to orientation leaders, the school's Title IX coordinator, the head of student life and the head of facilities, among others. After hearing their presentation, the head of facilities decided to keep one dining hall open all night to provide students a safe place—that is not a dorm room or bedroom—to hang out and find food at all hours if they've been drinking. Mellins says she hopes the work will lead to a continuing discussion of the complexity of the issues at hand in preventing assault. She and Hirsch are also talking to colleagues who are interested in conducting similar studies at other schools.

"We need a multisystem, multitarget approach," Mellins says. "We need interventions on the individual level, on the social level and on the institutional level. We need more than one approach on any given campus."

DeGue, the CDC scientist, agrees. "We've seen a real shift toward and growth in primary-prevention strategies, but they mostly still fall at the individual or relationship level," she says. "What we are really still missing are community-level strategies. What can we change about campus climates, the physical and social environment, to create an environment in which people's behavior can change more easily?"

Implementation challenges

If there's anything the field's researchers agree on, it's that there is no one solution to the problem of sexual assault on campus. All of these strategies—bystander programs, resistance programs, structural changes on campus—have a role to play. And in fact, the best programs and strategies will differ from school to school, they say.

Meredith Smith, JD, is the assistant provost for Title IX compliance at Tulane University in New Orleans. She and other administrators like her are on the front lines of this issue, charged with surveying their options and choosing the best prevention programs for their schools. At Tulane, for example, the city's drinking culture and lax enforcement of the minimum drinking age is a particular problem, she says.

Other issues are more universal. Among them is burnout: Right now, for example, Tulane students participate in a mandatory sexual assault education program during orientation. Fraternity members go through another one when they join a Greek organization, as do student athletes.

"So, some students have gone through this three times," says Smith. "By that time, where is their level of engagement?"

"Higher education is starting to learn that prevention is different at different schools," she adds. "We all want each other to succeed, and so there is an element of 'Here, this worked for me … take it.' But we need to make sure that it actually fits our campuses' needs."

03 in 5 Women Are Raped in College

Source: https://www.apa.org/monitor/2018/10/campuses-safer

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