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Injury Center

Sexual Violence: Prevention Strategies

Technical Package

Sexual violence is a serious problem that can have lasting, harmful effects on victims and their family, friends, and communities. The goal of sexual violence prevention is simple—to stop it from happening in the first place. The solutions, however, are just as complex as the problem.

Prevention efforts should ultimately decrease the number of individuals who perpetrate sexual violence and the number of individuals who are victims. Many prevention approaches aim to reduce risk factors and promote protective factors for sexual violence. In addition, comprehensive prevention strategies should address factors at each of the levels that influence sexual violence—individual, relationship, community, and society.

The most common prevention strategies currently focus on the victim, the perpetrator, or bystanders. Strategies that try to equip a potential victim with knowledge, awareness, or self-defense skills are referred to as “risk reduction techniques.” Strategies focused on a potential perpetrator attempt to change risk and protective factors for sexual violence to reduce the likelihood that an individual will engage in sexually violent behavior. The goal of bystander prevention strategies is to change social norms that accept violence and empower men and women to intervene with peers to prevent an assault from occurring. Other prevention strategies address social norms, policies, or laws in communities to reduce the perpetration of sexual violence across the population.

Effective Programs

Few programs, to date, have been shown to prevent sexual violence perpetration. A systematic review conducted by CDC’s Injury Center, and updated by an ongoing review of newer evidence, has identified only three programs to date that have been shown to be effective, using a rigorous evaluation methodology, for preventing sexual violence perpetration. Only strategies focused on perpetration prevention are included here.

Safe Dates is designed to prevent the initiation of emotional, physical, and sexual abuse in adolescent dating relationships. Intended for male and female 8th- and 9th-grade students, the goals of the program include the following:

    • Changing adolescent dating violence and gender-role norms
    • Improving peer helping and dating conflict-resolution skills
    • Promoting victim and perpetrator beliefs in needing help and seeking help through community resources

Safe Dates has five components: a ten-session course, a play script, a poster contest, parent materials, and a teacher training outline. Research found reductions in sexual dating violence perpetration and victimization that continued through a four-year follow-up period.1

Shifting Boundaries is designed to reduce the incidence and prevalence of dating violence and sexual harassment among adolescents. Intended for male and female middle school students, the program has two parts: a classroom-based approach and a school-wide component. The goals of this program include the following:

    • Increasing knowledge and awareness of sexual abuse and harassment
    • Promoting positive social attitudes and a negative view of dating violence and sexual harassment
    • Promoting nonviolent behaviors and intentions in bystanders

Shifting Boundaries is a six-session classroom course with a school-wide program that involves revising school rules regarding dating violence and sexual harassment, temporary school-based restraining orders, posters to increase awareness and reporting, and student ‘hot spot’ maps of unsafe school areas to determine the placement of faculty or school security for greater surveillance. A study found that the classroom curriculum alone was not effective for reducing rates of sexual violence. The school-wide intervention, however, was effective when implemented alone or in combination with the classroom instruction, with results showing reductions in sexual harassment, peer sexual violence perpetration and victimization, and dating sexual violence victimization after six months.2

RealConsent is designed to reduce sexual violence perpetration behaviors among college men using a bystander-based model that draws on social cognitive and social norms theory. The goals of this program are to prevent sexually violent behavior toward women by:

    • Increasing prosocial intervening behaviors, including knowledge of and skills for safely intervening
    • Correcting misperceptions in normative beliefs about sex and rape
    • Changing harmful attitudes toward rape
    • Increasing knowledge of the elements of sexual consent
    • Affecting masculine gender roles

RealConsent consists of six 30-minute web-based, interactive modules that include didactic activities and episodes of a serial drama to model sexual communication, consent, and positive bystander behaviors. A study found that the program was effective in decreasing sexual violence perpetration and increasing positive bystander behavior at 6 month follow-up in a sample of college-aged men.3

Promising Programs

Other programs and prevention strategies are gathering evidence for effectiveness. Four programs have been identified as promising, based on their comprehensive program models and evidence of impact on sexual violence in a non-rigorous evaluation or risk factors for sexual violence perpetration or related behaviors in a rigorous evaluation.4

Green Dot is a bystander-based prevention program designed to increase positive bystander behavior, change social norms, and reduce sexual and other forms of interpersonal violence perpetration and victimization. The program consists of a 5-hour training in bystander behavior for peer opinion leaders and campus/school-wide “persuasive speeches” to educate and engage the population. Green Dot was designed for college populations but has been adapted for high school, community, and military populations. A study found that Green Dot was associated with reductions in unwanted sexual victimization and sexual harassment, stalking, and dating violence victimization and perpetration on a college campus implementing the program compared to two comparison campuses without the intervention.5, 6 Further, significant decreases in sexual violence perpetration and victimization, sexual harassment, stalking, and dating violence perpetration and victimization were observed among high schools implementing Green Dot compared to control high schools7.

Second Step: SSTP is a school-based, social-emotional skills based program for middle school students aimed at reducing bullying, peer victimization, and other problem behaviors. The program is delivered over 15 weeks by teachers and includes content related to bullying, problem-solving skills, emotion management, and empathy. A multi-site evaluation found that Second Step was associated with reductions in sexual violence perpetration and homophobic teasing victimization in one of the two states where it was implemented following 6th and 7th grade implementation. More research is needed to understand differences in effectiveness observed by site and the effects of the program through 8th grade.8

Coaching Boys Into Men is a dating violence prevention program that uses the relationships between high school athletes and their coaches to change social norms and behaviors. The program consists of a series of 11 brief coach-to-athlete trainings that illustrate ways to model respect and promote healthy relationships. The program instructs coaches on incorporating the themes of teamwork, integrity, fair play, and respect into their daily practice and other routines. At one-year follow-up the program showed positive effects on dating violence perpetration (including physical and sexual violence), but effects on sexual violence were not assessed.9

Bringing in the Bystander is a bystander education and training program designed for male and female college students. The program aims to engage participants as potential witnesses to violence, rather than as perpetrators or victims. Skills are provided to help when participants see behavior that puts others at risk. Skills include speaking out against rape myths and sexist language, supporting victims, and intervening in potentially violent situations. Research indicates that the program maintains a positive effect at 4.5 months following the intervention. More research is needed to understand the program’s effects on bystander behavior and sexual violence.10

Applying the Principles of Effective Prevention to Sexual Violence

Until more is known about what works to prevent sexual violence perpetration, program planners can use existing prevention principles [PDF 65.8 KB] to strengthen their approaches and evaluate the effectiveness of new or existing programs. The prevention principles identified by Nation et al., in the resources below, are common characteristics of effective prevention strategies in behavioral health.

References

  1. Foshee VA, Bauman KE, Ennett ST, Suchindran C, Benefield T, Linder GF. Assessing the effects of the dating violence prevention program “Safe Dates” using random coefficient regression modeling. Prev Sci. 2005; 6(3):245–258.
  2. Taylor BG, Stein ND, Mumford EA, Woods D. Shifting Boundaries: an experimental evaluation of a dating violence prevention program in middle schools. Prev Sci. 2013; 14(1):64–76.
  3. Salazar LF, Vivolo-Kantor A, Hardin J, Berkowitz A. A web-based sexual violence bystander intervention for male college students: randomized controlled trial. Journal of Medical Internet Research. 2014; 16(9): e203.
  4. DeGue S. Evidence-based strategies for the primary prevention of sexual violence perpetration. In Preventing sexual violence on college campuses: lessons from research and practice. 2014; Available from www.notalone.gov/schools/.
  5. Coker AL, Bush HM, Fisher BS, Swan SC, Williams CM, Clear ER, DeGue S. Multi-college bystander intervention evaluation for violence prevention. American Journal of Preventive Medicine. 2015. Advance online publication. Available from http://www.ajpmonline.org/article/S0749-3797(15)00553-X/abstract.
  6. Coker AL, Fisher BS, Bush HM, Swan SC, Williams CM, Clear ER, DeGue S. Evaluation of the Green Dot bystander intervention to reduce interpersonal violence among college students across three campuses. Violence Against Women. 2014; 21(12):1507-27.
  7. Coker AL, Bush HM, Cook-Craig PG, DeGue SA, Clear ER, Brancato, CJ, et al. RCT Testing Bystander Effectiveness to Reduce Violence. Am J Prev Med. 2017.
  8. Espelage DL, Low S, Polanin JR, Brown EC. Clinical trial of Second Step© middle-school program: Impact on aggression & victimization. Journal of Applied Developmental Psychology. 2015; 37: 52-63.
  9. Miller E, Tancredi DJ, McCauley HL, Decker MR, Virata MCD, Anderson HA, O’Connor B, Silverman JG. One-year follow-up of a coach-delivered dating violence prevention program: a cluster randomized controlled trial. Am J Prev Med. 2013; 45(1): 108–112.
  10. Banyard VL, Moynihan MM, Plante EG. Sexual violence prevention through bystander education: an experimental evaluation. J Community Psychol. 2007; 35(4); 463–481.

CDC Resources

Other Resources

  • Bachar K, Koss MP. From prevalence to prevention: Closing the gap between what we know about rape and what we do. Sourcebook on Violence Against Women. Renzetti C, Edleson J, Bergen RK, editors, Thousand Oaks, CA: Sage; 2001.
  • Basile KC. A comprehensive approach to sexual violence prevention. New Eng J Med. 2015; 372(24):2350-2352.
  • Basile K. Implications of public health policy on sexual violence. Ann N Y Acad Sci. 2003; 989:446–463.
  • Casey EA, Lindhorst TP. Toward a multi-level, ecological approach to the primary prevention of sexual assault: prevention in peer and community contexts. Trauma Violence Abuse. 2009; 10: 91–114.
  • Centers for Disease Control and Prevention. Preventing sexual violence on college campuses: Lessons from research and practice. 2014. Available from www.notalone.gov/schools/.
  • DeGue S, Holt MK, Massetti GM, Matjasko JL, Tharp AT, Valle LA. Looking ahead toward community-level strategies to prevent sexual violence. J Womens Health. 2012; 21(1): 1-3.
  • DeGue S, Simon TR, Basile KC, Yee SL, Lang K, Spivak H. Moving forward by looking back: reflecting on a decade of CDC’s work in sexual violence prevention, 2000-2010. J Womens Health. 2012; 21.
  • DeGue S, Valle LA, Holt MK, Massetti GM, Matjasko L, Tharp AT. A systematic review of primary prevention strategies for sexual violence perpetration. Aggress Violent Behav. 2014; 19(4): 346-362.
  • Foshee V, Bauman KE, Ennett ST, Benefield T, Suchindran C, Linder GF. Assessing the long-term effects of the safe dates program and a booster in preventing and reducing adolescent dating violence victimization and perpetration. Am J Public Health. 2004;94: 619-624.
  • Lee D, Guy L, Perry B, Sniffen CK, Mixson SA. Sexual violence prevention. The Prevention Researcher. 2007;14(2):15–20.
  • Lonsway KA, Banyard VL, Berkowitz AD, Gidycz CA, Katz JT, Koss MP, Schewe PA, Ullman SE. Rape prevention and risk reduction: review of the research literature for practitioners. January 2009 newsletter. Vawnet.org.
  • McMahon P. The public health approach to the prevention of sexual violence. Sexual abuse: a journal of research and treatment. 2000; 12:27–36.
  • Miller E, Tancredi DJ, McCauley HL, Decker MR, Virata MC, Anderson HA, Silverman JG. Coaching boys into men: a cluster-randomized controlled trial of a dating violence prevention program. J of Adolesc Health  2012;51(5), 431-438. doi:10.1016/j.jadohealth.2012.01.018
  • Morrison S, Hardison J, Mathew A, O’Neil J. An evidence-based review of sexual assault preventive intervention programs. Department of Justice. 2004.
  • National Sexual Violence Resource Center. Key Findings From “A Systematic review of primary prevention strategies for sexual violence perpetration” written by Sarah DeGue, et al. 2014. Available from www.nsvrc.org.
  • Schewe PA. Interventions to prevent sexual violence. In: Doll L, Bonzo S, Sleet D, Mercy J, Hass E, editors. Handbook of Injury and Violence Prevention. New York, NY: Springer; 2007: 183–201.
  • Wathen CN, MacMillan HL. Interventions for violence against women: scientific review. J Am Med Assoc. 2003; 289: 589–600.
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