Sexual violence (SV) perpetrated by dating partners and male acquaintances is common among adolescent girls in high school. Girls and young women who experience SV are likely to encounter negative mental and physical health consequences as well as lowered academic performance. While educational interventions to address the problem of SV are numerous, when evaluated, few show any capacity to reduce sexual violence victimization or perpetration. The Enhanced Assess, Acknowledge, Act (EAAA) sexual assault resistance program for female university students (ages 17-24) is a rare exception; in a rigorous trial, EAAA reduced attempted and completed rape by 50% in the following year. The current randomized controlled trial (RCT) will test whether a version of EAAA that has been adapted for younger girls (age 14-18) who have not graduated high school (called the Adolescent Enhanced Assess, Acknowledge, Act \[A-EAAA\]) will result in similar benefits within a 6-month follow-up. The current RCT will be conducted across three sites in Ontario, Canada.
Sexual violence (SV), which occurs along a continuum from unwanted sexual contact to rape, is common among adolescent girls and young women: research suggests 1 in 7 teen girls experiences SV. Perpetrators of SV are overwhelmingly male; however, the programs that exist to address boys'/men's perpetration are not sufficiently effective nor are they widely available. Other approaches to sexual assault prevention for adolescents, such as bystander programs, have not been shown to reduce sexual violence victimization or perpetration. Given the numerous negative consequences associated with SV, developing effective SV prevention and resistance programs targeting teens is critical for reducing victimization and improving health outcomes for adolescent girls. The Enhanced Assess, Acknowledge, Act (EAAA) sexual assault resistance program has been shown to substantially reduce rates of SV (50% for rape and attempted rape) in young women attending university (ages 17-24), but since it was designed for university students in a different developmental stage, an evidence-based adaptation was necessary. The purpose of the current study is to test the efficacy of the newly adapted Adolescent Enhanced Assess, Acknowledge, Act (A-EAAA) program in reducing sexual violence victimization among adolescent girls within 6-months of trial entry. We will continue to follow participants for one-year to evaluate whether changes in tertiary outcomes (e.g., mediators) are maintained to 12-months. A-EAAA is a 12-hour psychoeducational intervention that provides information, skills, and practice aimed at a) decreasing the time needed for girls to assess sexually coercive situations as dangerous and to take action, b) reducing emotional obstacles to taking action, c) increasing the use of the most effective methods of verbal and physical self-defense, and d) identifying sexual and relationship values and boundaries and reinforcing the right to defend them.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
NONE
Enrollment
900
Adapted from the EAAA program created for university women, A-EAAA is designed for teen girls of all sexual identities and experience levels. It focuses on resisting sexual assault (SA) committed by male acquaintances with 4, 3-hour units: Unit 1(Assess) strengthens girls' ability to detect risk in contexts involving male acquaintances and helps develop strategies to reduce it. Unit 2(Acknowledge) helps girls explore ways to overcome their own emotional barriers preventing them from acknowledging risk and employing effective resistance strategies with males they know. Unit 3(Act) provides evidence on effectiveness of various resistance strategies and teaches verbal and physical self-defense focused on common acquaintance SA situations. Unit 4 (Relationships\&Sexuality) is an adaptation of Our Whole Lives curriculum and aims to increase girls' comfort talking about sex/sexuality and identify their sexual values/desires and explore possibilities for sexual practices beyond intercourse.
Participants assigned to the waitlist control group will immediately receive a brief educational session on sexual assault that represents the current 'standard of care' at Canadian high schools (often presented by local Sexual Assault Centres or Public Health nurses). This 30-min session will involve a brief 15 - 20-minute presentation on sexual consent, respect in relationships, and sexual assault (e.g., definitions, prevalence statistics). This will be conducted by a well-trained and knowledgeable Research Assistant. Following the presentation, participants will be invited to take and read brochures provided on sexual assault, and to ask questions about the content of the presentation and brochures. At 6-months, participants will be scheduled to receive A-EAAA.
University of Windsor
Windsor, Ontario, Canada
Completed Rape
The Sexual Experiences Survey Short Form Victimization (SES-SFV) will be used to measure the primary sexual assault outcomes. Completed rape will have occurred when a participant indicates she has had at least one experience of threatened, forced, or drugged completed (not attempted) sexual activity (oral, anal, or vaginal intercourse - answered 'once' or more to any of 9 questions (2c, 2d, 2e, 3c, 3d, 3e, 4c, 4d, or 4e) in the period between the baseline measurement and the 6-month survey measurement.
Time frame: Six months after randomization
Attempted Rape
The SES-SFV will also be used to measure secondary sexual assault outcomes: Attempted rape will have occurred when a participant indicates she has had at least one experience of threatened, forced, or drugged attempted (not completed) sexual activity (oral, anal, or vaginal intercourse - answered 'once' or more to any of 9 questions (5c, 5d, 5e, 6c, 6d, 6e, 7c, 7d, or 7e) in the period between the baseline and the 6-month survey.
Time frame: Six months after randomization
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.