Sexual assault resistance education for university women: study protocol for a randomized controlled trial (SARE trial)

Sexual assault is a pervasive problem, affecting a significant portion of women, with university campuses exhibiting even higher rates. First-year students are particularly vulnerable due to the transitional nature of this period. The consequences of sexual assault are far-reaching, encompassing physical and mental health issues, as well as substantial social and economic costs. Current rape prevention efforts on university campuses, often involving coeducational informational sessions or brochures, have demonstrated limited success in reducing assault rates. This study proposes a novel, targeted intervention focusing on equipping women with the skills and knowledge to resist sexual assault, building upon previous research highlighting the effectiveness of theoretically-based, single-sex programs that address cognitive, emotional, and behavioral aspects of sexual assault resistance. The proposed program incorporates elements from existing frameworks such as the "Assess, Acknowledge, and Act" (AAA) model and the Our Whole Lives (OWL) curriculum.

Extensive research highlights the high prevalence of sexual assault among women, particularly on university campuses. Existing prevention efforts, predominantly relying on coeducational information dissemination, have shown limited efficacy. Reviews of the literature advocate for single-sex, theoretically-based programs that actively engage participants and address cognitive, emotional, and behavioral aspects of resistance. Several previous trials of rape resistance programs have yielded mixed results, with some showing short-term benefits but not long-term impact. The limitations of past studies include small sample sizes, lack of rigorous methodology (e.g., absence of randomized controlled trials), and inadequate attention to the long-term impact of interventions. The current study aims to address these gaps through a large-scale, well-designed randomized controlled trial.

This study employs a multi-center, open-label, randomized controlled trial design. 1716 first-year female university students (aged 17-24) from three Canadian universities will participate. Participants are randomized into either an intervention group receiving a four-unit, 12-hour sexual assault resistance education program or a control group receiving university-provided brochures on sexual assault. The intervention, a revised and enhanced version of the AAA program, consists of four units: 1) Assess (risk assessment and risk reduction strategies); 2) Acknowledge (recognizing danger and overcoming emotional barriers); 3) Act (effective verbal and physical self-defense techniques); and 4) Sexuality (integrating sexual assault resistance knowledge into healthy sexual relationships using adapted OWL curriculum elements). The primary outcome measure is completed sexual assault, assessed using the Sexual Experiences Survey – Short Form Victimization (SES-SFV). Secondary outcomes include changes in risk perception, self-defense efficacy, knowledge of effective resistance strategies, ability to assess risk in hypothetical scenarios, and rape-related beliefs and attitudes. Outcomes are measured at baseline, 1 week, 6, 12, 18, and 24 months. The study addresses potential biases through rigorous methods such as centralized randomization, standardized recruitment materials, detailed outcome assessments using validated instruments, strategies to minimize attrition, and careful consideration of missing data mechanisms. Statistical analyses will employ log-binomial regression, Cox regression, repeated measures ANCOVA, and multiple imputation techniques to address the longitudinal nature of the data and account for clustering and missing data.

This section would detail the findings of the study, including the effectiveness of the intervention program in reducing the incidence of sexual assault among the participants. The results will show statistical comparisons between the intervention and control groups across the different time points, including the one-year and two-year follow-up periods. Specific data points, such as the percentage reduction in sexual assault rates in the intervention group compared to the control group, along with p-values and confidence intervals, will be included. Findings on secondary outcomes, such as changes in knowledge, attitudes, and skills related to sexual assault resistance, will also be described using relevant statistics and data points. The analysis would also address whether the program demonstrated different effects for women with and without previous sexual assault history.

The findings will provide crucial information regarding the effectiveness of a comprehensive sexual assault resistance education program in reducing sexual assault among first-year university women. The results will be interpreted in light of the study's aims and hypotheses, assessing the program's impact on both the primary and secondary outcomes. The discussion will explore the implications of the findings for sexual assault prevention strategies on university campuses and beyond, considering the theoretical framework guiding the intervention's design. The section will also address potential limitations of the study and suggest avenues for future research, such as refining the program based on the results or exploring the program's effectiveness in different settings or populations.

This study will provide valuable evidence on the effectiveness of a comprehensive, multi-faceted sexual assault resistance education program. The findings will inform the development and implementation of evidence-based interventions to reduce sexual assault among young women. Future research could explore program adaptations for different age groups or settings and investigate the long-term sustainability of program effects. The development of a facilitator training manual will ensure widespread implementation and dissemination of effective interventions.

Potential limitations include the open-label nature of the study, which prevents blinding of participants and researchers, and the reliance on self-reported data, which is susceptible to recall bias and social desirability bias. The generalizability of the findings may be limited to first-year female university students in similar settings. Attrition rates and the potential for differential dropout could influence the results. The study's reliance on self-reported sexual assault may not capture all instances of sexual violence.