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

900 Participants Needed

Trial Summary

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 data supports the effectiveness of the A-EAAA Sexual Assault Resistance Education Program treatment?

Research shows that the Enhanced Assess, Acknowledge, Act (EAAA) program significantly increases women's perception of personal risk, self-defense confidence, and knowledge of effective resistance strategies. It also reduces the risk of sexual assault by 30% to 64% over two years, making it an effective treatment for reducing sexual assault incidents. ^{1 2 3 4 5}

Is the Sexual Assault Resistance Training for Adolescent Girls safe for participants?

The available research does not provide specific safety data for the Sexual Assault Resistance Training for Adolescent Girls, but it suggests that participants felt empowered and confident after using the strategies taught in the program, indicating no reported safety concerns. ^{1 2 6 7 8}

How does the A-EAAA Sexual Assault Resistance Education Program differ from other treatments for sexual assault prevention?

The A-EAAA program is unique because it empowers adolescent girls by teaching them to recognize and respond to potential sexual assault situations through assertive communication and self-defense strategies, significantly reducing the risk of assault. Unlike other programs, it focuses on enhancing personal risk perception and self-efficacy, leading to long-lasting reductions in sexual assault incidents. ^{1 2 3 7 9}

What is the purpose of this trial?

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.

Research Team

Charlene Senn, PhD

Principal Investigator

University of Windsor

Sara E Crann, PhD

Principal Investigator

University of Windsor (on leave Feb 2023-Jan 2024)

Eligibility Criteria

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

I am a girl aged between 14 and 18.

Have not graduated high school

Competence in spoken and written English

Exclusion Criteria

Not applicable.

Timeline

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

Treatment Details

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.

Participant Groups

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+

Findings from Research

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 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]

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]

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]

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]

References

1. England pubmed.ncbi.nlm.nih.gov

"I Felt Powerful and Confident": Women's Use of What They Learned in Feminist Sexual Assault Resistance Education. [2023]

2. United States pubmed.ncbi.nlm.nih.gov

Recognizing and Responding to the Commonly Misunderstood Reactions to Sexual Assault: Evaluation of an Online Curriculum. [2021]

3. England pubmed.ncbi.nlm.nih.gov

Secondary and 2-Year Outcomes of a Sexual Assault Resistance Program for University Women. [2019]

4. United States pubmed.ncbi.nlm.nih.gov

Enhancing the emergency department approach to pediatric sexual assault care: implementation of a pediatric sexual assault response team program. [2023]

5. United States pubmed.ncbi.nlm.nih.gov

Characteristics of acute sexual assault care in New England emergency departments. [2023]

6. United States pubmed.ncbi.nlm.nih.gov

Interprofessional Healthcare Student Training in the Care of Sexual Assault Patients Utilizing Standardized Patient Methodology. [2019]

7. United States pubmed.ncbi.nlm.nih.gov

Enhancing women's resistance to sexual coercion: a randomized controlled trial of the DATE program. [2015]

8. United States pubmed.ncbi.nlm.nih.gov

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

9. Korea (South) pubmed.ncbi.nlm.nih.gov

[Effects of a sexual assertiveness training program in high school girls]. [2019]