Sexual Assault Resistance Training for Adolescent Girls

(SARE-A Trial)

Overseen By Sara E Crann, PhD

Age: < 65

Sex: Any

Trial Phase: Academic

Sponsor: University of Windsor

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Approved in 1 Jurisdiction This treatment is already approved in other countries

Compensation: Varies

Number of Visits: 4

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial tests the A-EAAA Sexual Assault Resistance Education Program, designed to help high school girls resist sexual assault. It aims to determine if a modified version of a successful university-level program can reduce sexual violence among girls aged 14 to 18 in high school. Participants will either begin the program immediately or after a 6-month waiting period. Girls who speak and understand English and are willing to attend scheduled sessions are encouraged to consider joining. As an unphased trial, this study offers participants the chance to contribute to important research that could create safer environments for high school girls.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications.

What prior data suggests that this program is safe for adolescent girls?

Research shows that the Enhanced Assess, Acknowledge, Act (EAAA) program, designed for young women in college, has been well-received and effective. Previous studies found that this program reduced the risk of rape by 50%. Initially intended for women aged 17-24, the program has been adapted for younger girls (ages 14-18) as the Adolescent Enhanced Assess, Acknowledge, Act (A-EAAA).

The EAAA program teaches young women to identify risky situations, recognize danger, and protect themselves. Reports indicate no physical harm from participating in this program. Instead, it empowers and educates participants on staying safe. Given its positive feedback and the absence of negative effects, the A-EAAA program is expected to be safe for teenage girls. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about the A-EAAA Sexual Assault Resistance Education Program because it takes a proactive approach to empowering adolescent girls before an assault occurs. Unlike standard options, which often focus on post-assault care and education, this program emphasizes prevention through a comprehensive, interactive curriculum. The A-EAAA program includes four in-depth, three-hour sessions that equip girls with the skills to assess situations, acknowledge potential risks, and take action to protect themselves. By starting immediately after randomization or six months later for the control group, the program aims to strengthen resistance skills at a critical developmental stage, potentially reducing the risk of sexual assault.

What evidence suggests that the A-EAAA program is effective for reducing sexual violence among adolescent girls?

Research has shown that the original EAAA (Enhanced Assess, Acknowledge, Act) program for university women effectively reduced sexual assault attempts and completions by 50% over one year. This program teaches young women to assess risks, recognize danger, and use self-defense strategies. In this trial, participants will be divided into two groups: one group will immediately receive the adolescent version, A-EAAA, designed for girls aged 14-18 and adapted for high school settings. The other group will receive usual care immediately and the A-EAAA program six months post-randomization. The success of the original EAAA provides strong evidence that A-EAAA may also help reduce sexual violence among younger girls. ^{1 2 5 6 7}

Who Is on the Research Team?

Charlene Senn, PhD

Principal Investigator

University of Windsor

Sara E Crann, PhD

Principal Investigator

University of Windsor

Are You a Good Fit for This Trial?

This trial is for self-identified girls aged 14 to 18 who haven't graduated high school, can understand and communicate in English, and are able to attend the program during the data collection period. There are no specific exclusion criteria mentioned.

Inclusion Criteria

Have not graduated high school

Competence in spoken and written English

Provide informed consent

Exclusion Criteria

Not applicable.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Intervention

Participants receive the A-EAAA program, consisting of 4 sessions of 3 hours each, aimed at reducing sexual violence victimization

4 weeks

4 visits (in-person)

Waitlist Control

Participants in the control group receive a 30-minute session on consent/sexual assault and access to local resource pamphlets, followed by the A-EAAA program at 6 months

6 months

Follow-up

Participants are monitored for changes in sexual violence victimization and other outcomes

12 months

What Are the Treatments Tested in This Trial?

Interventions

• A-EAAA Sexual Assault Resistance Education Program
• Usual care + A-EAAA at 6 months

Trial Overview The study tests an adapted version of the Enhanced Assess, Acknowledge, Act (EAAA) sexual assault resistance education program for younger girls. It compares immediate participation with a delayed start at six months to see if it reduces sexual violence.

How Is the Trial Designed?

Group I: A-EAAA (Adolescent Enhanced Assess, Acknowledge, Act) immediately Experimental Treatment 1 Intervention

Adolescent adaptation of EAAA sexual assault resistance education (4, 3-hr sessions) begun immediately after baseline randomization

Group II: Waitlist Control Active Control 1 Intervention

Usual care 30-min session (brief presentation on consent/sexual assault; access to local resource pamphlets) immediately after baseline randomization; A-EAAA (4, 3-hr sessions) at 6-months post-randomization

A-EAAA Sexual Assault Resistance Education Program is already approved in Canada for the following indications:

Approved in Canada as Enhanced Assess, Acknowledge, Act Sexual Assault Resistance Program for:

• Sexual assault prevention for adolescent girls and young women

Who Is Running the Clinical Trial?

University of Windsor

Lead Sponsor

Trials

14

Recruited

7,400+

Public Health Agency of Canada (PHAC)

Collaborator

Trials

51

Recruited

101,000+

Published Research Related to This Trial

In a study of 445 university women who completed the Enhanced Assess, Acknowledge, Act (EAAA) sexual assault resistance program, 42% reported using at least one strategy from the program within two years, with many finding these strategies effective in preventing attacks.

The women employed various resistance strategies, such as avoiding dangerous situations and assertive communication, which helped them feel empowered and challenged traditional gender norms, countering the notion that such programs place the responsibility solely on women.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

"I Felt Powerful and Confident": Women's Use of What They Learned in Feminist Sexual Assault Resistance Education. Crann, SE., Senn, CY., Radtke, HL., et al.[2023]

An interprofessional simulation event involving 195 medical and nursing students significantly improved their skills in conducting sexual assault interviews and effective communication with patients, as assessed by standardized patients.

Confidence in assessing sexual assault cases increased notably after the simulation, with medical students closing the gap in confidence levels compared to nursing students, highlighting the effectiveness of simulation training in preparing healthcare providers for sensitive assessments.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Interprofessional Healthcare Student Training in the Care of Sexual Assault Patients Utilizing Standardized Patient Methodology. Lee, WJ., Clark, L., Wortmann, K., et al.[2019]

The Dating Assertiveness Training Experience (DATE) program significantly reduced the likelihood of sexual victimization among 139 female college students compared to a no-treatment control group.

Participants who completed the DATE program were more likely to respond assertively to acts of sexual aggression, suggesting that assertiveness training can empower young women in potentially dangerous situations.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Enhancing women's resistance to sexual coercion: a randomized controlled trial of the DATE program. Simpson Rowe, L., Jouriles, EN., McDonald, R., et al.[2015]

An online curriculum aimed at educating health and social service providers about the psychological responses of women post-sexual assault was effective, with 175 participants showing significant improvements in knowledge and perceived competency after training.

The training resulted in a positive response from participants, indicating that it successfully enhanced understanding of the complex reactions and behaviors of survivors, which are often misunderstood by professionals.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Recognizing and Responding to the Commonly Misunderstood Reactions to Sexual Assault: Evaluation of an Online Curriculum. Mason, R., Du Mont, J., Lanthier, S., et al.[2021]

A sexual assault prevention program for first-year college students significantly reduced the likelihood of sexual assault victimization, with students exposed to the program being 1.74 times less likely to report assaults compared to those who were not exposed.

The program was effective for both male and female students, but it did not show the same benefits for those with a prior history of sexual assault, highlighting the need for tailored interventions for at-risk groups.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The effect of a college sexual assault prevention program on first-year students' victimization rates. Rothman, E., Silverman, J.[2007]

A 3-hour training program on sexual assertiveness for high school girls significantly improved their sexual assertiveness scores compared to a control group, demonstrating its effectiveness.

The 6-hour program also improved sexual assertiveness scores but did not show any additional benefits over the 3-hour program, suggesting that shorter training may be sufficient and more convenient for clinical use.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

[Effects of a sexual assertiveness training program in high school girls]. Chang, SB., Lee, SK., Kim, YR.[2019]

The Enhanced Assess, Acknowledge, Act (EAAA) program significantly improved first-year women university students' perception of personal risk, self-defense self-efficacy, and knowledge of resistance strategies, with these benefits lasting for up to 24 months after the intervention.

The program led to a substantial reduction in the incidence of sexual assault, with decreases of 30% to 64% in completed and attempted rape, attempted coercion, and nonconsensual sexual contact over the two-year follow-up period.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Secondary and 2-Year Outcomes of a Sexual Assault Resistance Program for University Women. Senn, CY., Eliasziw, M., Hobden, KL., et al.[2019]

In the first 3 years of a pediatric sexual assault response team (SART) program, 184 patients were evaluated, with 89.1% undergoing forensic evidence collection, highlighting the program's effectiveness in ensuring thorough examinations.

The study found that menarchal girls were more likely to receive appropriate testing and prophylaxis for sexually transmitted infections and pregnancy, indicating that the SART program improved care tailored to specific patient needs.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Enhancing the emergency department approach to pediatric sexual assault care: implementation of a pediatric sexual assault response team program. Goyal, MK., Mollen, CJ., Hayes, KL., et al.[2023]

A survey of 186 adult emergency departments in New England revealed that while two-thirds of respondents have access to dedicated or non-dedicated sexual assault forensic examiners (SAFEs), consistent access is limited, with only 17.3% always having a dedicated SAFE available.

The study highlights that despite the recognized importance of SAFEs in providing quality care for sexual assault survivors, their availability and coverage in emergency departments are insufficient, indicating a need for improved implementation of these critical resources.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Characteristics of acute sexual assault care in New England emergency departments. Barron, RJ., Faynshtayn, NG., Jessen, E., et al.[2023]

Citations

1. blueprintsprograms.org blueprintsprograms.org/programs/1032999999/eaaa-enhanced-assess-acknowledge-act-sexual-assault-resistance-education/print/

EAAA (Enhanced Assess, Acknowledge, Act) Sexual ... A four-unit program to help first-year college women (ages 17-24) resist acquaintance sexual assault by providing them with information and resistance training.

2. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC10732193/

Testing the effectiveness of a sexual assault resistance ... The EAAA programme designed for first year university women (17–24 years old) was shown to reduce the likelihood of any (attempted and completed) rape in the ...

3. crimesolutions.ojp.gov crimesolutions.ojp.gov/ratedprograms/enhanced-assess-acknowledge-act-sexual-assault-resistance-program-canada

Enhanced Assess, Acknowledge, Act Sexual Assault ... The program is designed to teach young women how to assess risk, overcome barriers in acknowledging danger, and engage in self-defense to reduce the risk of ...

4. uwindsor.ca uwindsor.ca/prevent-resist-support/flip-the-script

The Flip the Script with EAAA® Program The Flip the Script with EAAA program is a sexual assault resistance education program for young women that has been extensively researched.

5. sarecentre.org sarecentre.org/the-program/flip-the-script-with-eaaa

Flip the Script with EAAA A 12-hour small-group, evidence-based intervention designed specifically for 17–24-year-old university students of all sexual identities who identify as women.

6. share.stanford.edu share.stanford.edu/title-ix/education-and-outreach/education-and-outreach-programs/flip-script

Flip the Script - SHARE Title IX and Title VI Office In the spring of 2018, Stanford University offered the Enhanced Assess, Acknowledge, & Act (EAAA) Sexual Assault Resistance Education Program ("Flip the Script") ...

7. evidencebasedprograms.org evidencebasedprograms.org/programs/enhanced-assess-acknowledge-act-eaaa-sexual-assault-resistance-program/

Enhanced Assess, Acknowledge, Act (EAAA) Sexual assault resistance program for first year female college students. Evidence based outcomes show a 50% reduction in incidence of rape.