Highlights:

  • We highlight recent results of a randomized controlled trial (RCT) of a sexual assault resistance program for first-year female university The RCT found that the program nearly halved the incidence of rape over a 12-month period, from 9.8 percent for the control group to 5.2 percent for the treatment group (statistically significant, p=0.02).
  • We believe these findings are unusually credible because (i) the study was a well-executed RCT; (ii) it included a diverse student sample across three Canadian universities of different sizes and characteristics, suggesting the findings may generalize to many other university campuses; and (iii) it found a sizable effect on an ultimate outcome of clear policy importance—incidence of rape—and not just “surrogate” outcomes such as women’s knowledge of resistance strategies.
  • While there is reason to believe that the effects would successfully replicate if the program were faithfully implemented at other universities, such success is not a given as positive findings like these can sometimes appear by chance. We believe it would be important for researchers to include a replication RCT as part of the program’s expansion to hopefully confirm these findings and establish that they generalize to other campuses.
  • A brief comment from the study team follows the main report.

As we have written earlier, most programs claiming to be “evidence based”—including many of those listed in various web-based repositories of evidence-based programs—are backed by only preliminary or flawed findings that would likely not hold up in a more definitive evaluation. One consequence of these pervasive evidence claims is that the relatively few programs that do have credible evidence of important effects on people’s lives can get lost in the noise, as policymakers often have no ready way to distinguish true claims of demonstrated effectiveness from the rest.

For that reason, some of our evidence reports—including this one—seek to highlight programs with highly-credible evidence of meaningful effects. In this report, we highlight the Enhanced Assess, Acknowledge, Act (EAAA) Sexual Assault Resistance program—a brief program for first-year female university students aimed at reducing the likelihood they will be sexual assaulted. The resistance program consists of four units, each three hours long, in which information is provided and skills are taught and practiced, with the goal of enabling participants to assess risk from acquaintances, overcome emotional barriers to acknowledging danger, and engage in effective verbal and physical self-defense.

The EAAA program was evaluated in a well-conducted randomized controlled trial (RCT), which found sizable reductions in the incidence of rape and attempted rape. Our full two-page review of this study and its findings is linked here. The following is a short overview:

This was a well-conducted multi-site randomized controlled trial (RCT) of the EAAA sexual assault resistance program for first-year female university students. The study, which had a sample of 899 women at three diverse Canadian universities, found that the program produced a sizable, statistically-significant reduction in the incidence of rape over a 12-month follow-up period. Specifically, women who received the program—i.e., the treatment group—were about half as likely as women in the control group to be raped during the 12 months after random assignment (5.2 percent of treatment group women vs. 9.8 percent of control group women, p=0.02). In a secondary analysis, the study measured outcomes over 24 months after random assignment for the subsample of women enrolled early in the study’s recruitment period and found no significant effect on rape occurring in months 12-24 (possibly because the overall incidence of rape was much lower in the second year of college). The study also found that the program significantly reduced the incidence of attempted, but not completed, rape, and this effect endured over the full 24 months.
 
Source: Senn et. al. 2015 and 2017 (see references below). 

Why do we regard this evidence as highly credible? Three main reasons:

First, this was a very well-executed RCT, with a large sample, low sample attrition, and use of a well-established, validated measure to assess sexual assault outcomes, as we describe in our full review.

Second, the study had a demographically diverse sample across three universities of different sizes and characteristics, suggesting the findings may generalize to many other North American university campuses.

Third, the study found sizable effects on an ultimate outcome of clear policy importance—incidence of rape—and not just so-called surrogate outcomes, such as women’s knowledge of resistance strategies or perceived self-efficacy in defending themselves. As we have discussed previously, surrogate outcomes are often unreliable predictors of ultimate outcomes; the history of medicine and social policy is replete with examples of interventions found to produce large effects on surrogate outcomes yet no significant effects on ultimate, important measures of health or well-being.

So if a university chooses to implement this program, and does so with close adherence to the program’s key elements, would it produce a sizable reduction in the incidence of rape among first-year women on its campus? There is good reason to believe that it would, given the unusually high credibility of this study, but it’s not a given as statistically-significant positive findings can sometimes appear by chance even in a well-conducted RCT (as we discuss here). We believe that expanded implementation of this program is warranted based on the current evidence, but we would also encourage a replication RCT as part of such an expansion to rule out the possibility of a chance finding or other factor that might make the findings irreproducible. The replication RCT could also test whether a second-year booster session for participating women can extend the program’s effect in reducing the incidence of completed rape beyond the first year of college. In any case, a successful replication—with or without the booster—would provide a high level of confidence in this program’s ability to generate large-scale reductions in rape if widely (and faithfully) disseminated across North American university campuses.


Comment provided by Charlene Senn, the lead study author, on behalf of the study team

Since the EAAA program was first made available in June of 2016, universities in Canada, the United States, and New Zealand have begun implementing the program on their campuses. Our research team is now carrying out an implementation effectiveness trial (funded by the Canadian Institutes of Health Research) involving up to nine Canadian universities over the next three years. This study will help us to assess which variations in campus characteristics, training, delivery, or other practices in these natural implementation settings lead to the best participant outcomes. Replications and adaptations for different audiences within and outside North America are underway or being planned by other researchers.


References:

Senn, C.Y., Eliasziw, M., Barata, P.C., Thurston, W.E., Newby-Clark, I.R., Radtke, H.L. & Hobden, K.L. (2015). Efficacy of a Sexual Assault Resistance Program for University Women. The New England Journal of Medicine 372:2326-35.

Senn, C.Y., Eliasziw, M., Hobden, K.L., Newby-Clark, I.R., Barata, P.C., Radtke, H.L., and Thurston, W.E. (2017). Secondary and 2-Year Outcomes of a Sexual Assault Resistance Program for University Women. Psychology of Women Quarterly 41(2):147-62.