Sexual Violence and the Spectrum of Prevention: = Towards a Community Solution

Sexual Violence and the Spectrum of Prevention: Towards a = Community=20 Solution

National Sexual Violence Resource Center

The National Sexual Violence Resource Center (NSVRC), with = funding from=20 the Centers for Disease Control and Prevention, developed as the = nation=92s=20 principle information and resource center regarding all aspects of = sexual=20 violence. It collects and disseminates a wide range of resources = on sexual=20 violence, including statistics, research, statutes, training = curricula,=20 prevention initiatives and program information.

The NSVRC, which opened in July 2000, assists coalitions, local = programs and others working to end and prevent sexual violence. = Allied=20 organizations, government agencies and the general public also = turn to the=20 NSVRC for information and resources. The NSVRC provides national=20 leadership by generating and facilitating the development and flow = of=20 information on sexual violence intervention and prevention = strategies. It=20 has become a critical resource to the nation, providing technical=20 assistance and professional consultation to sexual violence = prevention=20 programs and allied professionals.

The NSVRC develops a variety of resources such as booklets, = toolkits=20 and directories in addition to annual national Sexual Assault = Awareness=20 Month campaign materials, and its bi-annual news publication, = The=20 Resource. These resources and other useful listings, = including=20 funding announcements, job opportunities and scheduled trainings = around=20 the country, appear on its website. The NSVRC also maintains an = extensive=20 online library.

NSVRC
123 North Enola Drive
Enola, PA=20 17025
resources@nsvrc.org
www.nsvrc.org
Toll free:=20 877-739-3895

Sexual Violence and the Spectrum of Prevention:
Towards a = Community=20 Solution

National Sexual Violence Resource Center

By
Rachel Davis, Lisa Fujie Parks, Larry Cohen

=A9 NATIONAL SEXUAL VIOLENCE RESOURCE CENTER 2006. ALL RIGHTS=20 RESERVED

ACKNOWLEDGEMENTS

This publication was commissioned by the NSVRC and developed in = conjunction with the Prevention Institute. The Prevention = Institute is a=20 non-profit national
center dedicated to improving community = health and=20 well-being by building momentum for effective primary prevention. = Primary=20 prevention means taking action
to build resilience and to = prevent=20 problems before they occur. The Institute's work is characterized = by a=20 strong commitment to community participation and promotion of = equitable=20 health outcomes among all social and economic groups. Since its = founding=20 in 1997, the organization has focused on injury and violence = prevention,=20 traffic safety, health disparities, nutrition and physical = activity, and=20 youth development. The NSVRC wishes to express its appreciation to = the=20 following people for their assistance in the development of this = booklet.=20 Special appreciation is given to Leah Aldridge, Karen Artichoker, = Shelley=20 V. Bearman, Mark Bergeron-Naper, Yvonne Cournoyer, Marci Diamond, = Lori B.=20 Girshick, Paul Kivel, Alisa Klein, Patrick Lemmon, Amy Okaya, = Barri=20 Rosenbluth, Abby Sims, and Sally Thigpen for providing information = about=20 inspiring sexual violence prevention activities and successes and = to=20 Elizabeth Berger and Ryu Chen for assistance with research.

This publication was supported by Grant/Cooperative Agreement = Number=20 H28/CCH324095-02 from the Centers for Disease Control and = Prevention.=20 Its
contents are solely the responsibility of the authors and = do not=20 necessarily represent the official views of the Centers for = Disease=20 Control and Prevention.

ADDITIONAL RESOURCES

Cohen L., Swift S. The spectrum of prevention: developing a=20 comprehensive approach to injury prevention. Injury = Prevention.=20 1999; 5:203-207.
www.preventioninstitute.org/spectrum_injury.html.=20
For additional examples of how the Spectrum of = Prevention=20 has been used to prevent other forms of violence, see=20
- Cultivating peace in Salinas (www.preventioninstitute.org/pdf/Salinas_Exec_Summary.pdf<= /A>)=20
- First steps: taking action early to prevent = violence (www.preventioninstitute.org/firststeps.html).=20
For details about the programs mentioned in this booklet and = further=20 technical assistance see, National Sexual Violence Resource = Center: http://www.nsvrc.org/.=20
For online opportunities to discuss the primary prevention = of=20 violence against women visit Prevention Connection: The Violence = Against=20 Women Prevention
Partnership: http://www.preventconnect.org/.

INTRODUCTION

Building on the Vision to End Sexual Violence

esistance to sexual violence has been occurring for centuries. = Building=20 on these acts of opposition, women began a movement to end sexual = violence=20 more than 30 years ago. The movement has made strides in breaking=20 society=92s collective silence, addressing issues of oppression = and=20 inequity, and forging new policies, all while supporting = survivors,=20 families, and friends. The rich history of advocacy provides a set = of=20 tools, knowledge, networks, and skills for intervention after = sexual=20 violence, as well as prevention before violence has = occurred =96=20 that is, primary prevention. Primary prevention helps create = environments=20 where we can be more confident that people are safe in their=20 relationships, homes, neighborhoods, schools, work places =96 in = any=20 environment.

This article describes a primary prevention approach to = addressing=20 sexual violence. Sexual violence is a learned behavior that can = not be=20 learned in the first place. In other words, sexual violence is=20 preventable. Grounded in the belief that a single individual or = sector=20 cannot address the problem alone, it explores the conditions that = create=20 environments in which sexual violence occurs, and provides a tool, = the=20 Spectrum of Prevention, for effectively developing a=20 comprehensive prevention strategy. It is designed for advocates,=20 practitioners, and educators who are interested in advancing a = community=20 solution to preventing what is unacceptable, yet all too common=96 = sexual=20 violence.

What Leads to Sexual Violence?

Despite many accomplishments in the last few decades, sexual = violence=20 is still a major cause of injury and trauma across the country. = According=20 to the National Violence Against Women Survey, 1 in 6 women and 1 = in 33=20 men in the United States has experienced an attempted or completed = rape at=20 some time in their lives.¹ There is no single cause = that=20 accounts for sexual violence. Rather, a combination of forces =96 = both those=20 that increase the risk of violence (risk factors) and those that = reduce=20 the chances that violence will occur (protective factors) =96 = largely=20 determine whether or not sexual violence will be committed. = However, when=20 sexual violence occurs, the general public typically asks, =93What = could the=20 victim have done differently?=94 or =93What=92s wrong with the = perpetrator?=94=20 Either way, the focus is often at the individual level. Yet = individual=20 behavior is fundamentally shaped by relationship factors, such as = the=20 presence or absence of physical violence and level of emotional = support in=20 family relationships; community factors, such as employment = opportunities=20 and the strength of community sanctions against violence; and = societal=20 factors, such as the extent of oppression and gender=20 inequality.² The influence of these factors beyond the=20 individual can be so powerful that, as the Institute of Medicine = concluded=20 in its study on health promotion,=93 It is unreasonable to expect = that=20 people will change their behavior easily when so many forces in = the=20 social, cultural, and physical environment conspire = against such=20 change.=94³

Norms are one of the most powerful societal and community = influences in=20 shaping behavior.They are regularities in behavior with which = people=20 generally conform, and they foster disapproval of = deviance.⁴=20 More than a habit, norms are often based in culture and tradition. = They=20 are our attitudes, beliefs and standards that we take for granted. = In=20 other words, norms are behavior shapers. They are the way in which = the=20 environment tells people what is okay and not okay. There are at = least=20 five kinds of damaging norms that contribute to an environment in = which=20 sexual violence can occur. They are norms about: 1.women: = limited=20 roles for and objectification and oppression of women; = 2.power:=20 value placed on claiming and maintaining power (manifested as = power over);=20 3. violence: tolerance of aggression and attribution of = blame to=20 victims; 4. masculinity: traditional constructs of = manhood,=20 including domination, control and risk-taking; and, 5. = privacy:=20 notions of individual and family privacy that foster secrecy and=20 silence.

Our society glamorizes and sexualizes violence. Often sexual = violence=20 is ignored, excused, condoned, and even encouraged. While most = people do=20 not commit sexual violence, and therefore it is not = normal=20 behavior, these kinds of norms imply a level of acceptance and a = sense of=20 complacency about sexual violence. They promulgate a toxic = environment in=20 which sexual violence can take place and inhibit = appropriate=20 action while condoning inappropriate inaction. = Given=20 this, it is not surprising that some people commit sexual violence = and=20 many bystanders don=92t speak up or intervene.

We must acknowledge and change these norms if we are to make = major=20 strides in preventing sexual violence. The key is to create and = sustain=20 healthy norms in our communities. In addition to holding = individual=20 perpetrators accountable and providing quality services for = victims,=20 communities need a comprehensive prevention strategy.We must tip = the=20 balance in communities and replace current norms with norms that = promote=20 respect, safety, equality and healthy relationships and sexuality. = This=20 beckons for a primary prevention approach and a community-wide=20 solution.

Toward a Community Solution

Communities are vital in the development of violence prevention = strategies. Local initiatives can better respond to the needs of a = specific community and often receive high levels of support and=20 participation. By involving multiple partners and interventions,=20 comprehensive community approaches can reach more people than = education=20 alone. One tool that can assist advocates and practitioners in = developing=20 comprehensive sexual violence prevention initiatives is the = Spectrum=20 of Prevention, developed by Larry Cohen.⁵ Designed = for=20 broad scale change, it focuses not just on individuals but also on = changing the environment, including systems and norms. The=20 Spectrum outlines six levels of intervention (see table, = page 7).=20 By working at all six levels, communities can design an overall = strategy=20 that results in a whole that is greater than the sum of its parts. = Spectrum strategies have been applied in communities = throughout=20 the nation to a variety of issues including traffic safety, = nutrition,=20 physical activity, and violence prevention.

Using the Spectrum of Prevention

A n activity at any of the Spectrum=92s six levels = constitutes=20 an intervention. However, when these levels are used in = combination, the=20 Spectrum becomes a more transformative force. The=20 inter-relatedness between levels of the Spectrum, or synergy, = enables=20 advocates and practitioners to maximize the result of any one = prevention=20 activity. For example, efforts to influence policy (Level 6) will = have a=20 better chance of being enacted when public awareness and support = are=20 garnered through education (Level 1, 2) and a variety of partners = in=20 different sectors are working to effect the desired change (Level = 3, 4,=20 5). The synergy between the levels also contributes to changes in = norms=20 because activities are focused not only on individuals but also on = their=20 environments, such as through organizational practice and policy = change.=20 This is important because norms both shape and are=20 shaped by organizational practices and policies (Level 4, 5). = Norms=20 emerge when institutions prescribe behavior, when individuals = agree=20 voluntarily to a new norm, or in an evolutionary = manner.⁶=20 Sometimes an institutional policy revision reflects a gradual = change in=20 attitudes and values or the discovery of new information, which = changes=20 the desirability of a given norm.⁷ Policy change can = trigger=20 norms-change by altering what is considered acceptable behavior, = by=20 encouraging people to think actively about their own behavior, and = by=20 providing relevant information and a supportive environment to = encourage=20 change.

Data and evaluation inform all levels of the Spectrum. = Successful prevention requires assessment of the community factors = that=20 increase the risk of violence and those that reduce the likelihood = of=20 violence. Once these are identified, activities can be delineated = along=20 each level of the Spectrum to reduce or bolster them,=20 respectively. Any proposed activity should be based on data = showing: 1)=20 the issue is important, 2) the population the activity is designed = to=20 reach is clear and appropriate, and 3) the intervention is = promising. Data=20 isn=92t just numbers. The experience and wisdom of survivors, = advocates,=20 educators, and practitioners should be honored as key data sources = in the=20 development of prevention strategies. Valuable information about=20 perpetration prevention can also be gained from professional = organizations=20 such as the Association for Treatment of Sexual Abusers, an = international=20 agency working to prevent sexual abuse through effective treatment = and=20 management of sex offenders.⁸ After reviewing the data = and=20 developing an appropriate approach and set of activities, ongoing=20 evaluation will ensure that activities continue to meet overall=20 objectives. As an initiative is shaped, it is helpful to identify = ways to=20 measure success and gather input from participants and the = community. The=20 impact of primary prevention efforts can be measured through = intermediate=20 markers that can be monitored over time. For example, changes in = risk and=20 protective factors can be tracked, as well as changes in = organizational=20 standards, regulations, and policies, and the level of support and = enforcement by management and leadership.While the =93big = changes=94 may be=20 hard to accomplish, progress on the interim markers will assure = steady=20 advancement.

Examples of sexual violence primary prevention activities at = each=20 Spectrum level are provided in text boxes. While an = activity at=20 one particular level of the Spectrum is highlighted in = each=20 example, all of the activities are in fact implemented in = conjunction with=20 activities at other Spectrum levels.

The Spectrum of Prevention

A tool for comprehensive action and norms change

	Level of Spectrum	Definition of Level
Level 1	Strengthening Individual Knowledge and Skills	Enhancing an individual=92s capability of preventing = violence=20 and promoting safety
Level 2	Promoting Community Education	Reaching groups of people with information and = resources to=20 prevent violence and promote safety
Level 3	Educating Providers	Informing providers who will transmit skills and = knowledge to=20 others and model positive norms
Level 4	Fostering Coalitions and Networks	Bringing together groups and individuals for broader = goals=20 and greater impact
Level 5	Changing Organizational Practices	Adopting regulations and shaping norms to prevent = violence=20 and improve safety
Level 6	Influencing Policies and Legislation	Enacting laws and policies that support healthy = community=20 norms and a violence-free = society

Level 1

Strengthening Individual Knowledge and Skills

Strengthening individual knowledge and skills involves = transferring=20 information and skills and increasing an individual=92s capacity = for=20 preventing sexual violence. In a trusting relationship with a = person who=20 is perceived to have expertise or authority, even brief comments = have a=20 lasting impact, particularly when reinforced over time or through=20 community norms and practices.⁹ Physician advice, for = example,=20 has been associated with reductions in morbidity, mortality, risk=20 behaviors, and risk factors, and increases in healthy behaviors.=20 Physicians, childcare professionals, and teachers have the = opportunity to=20 ask about behaviors that can increase safety. Healthcare = practitioners can=20 engage patients to promote healthy relationships and healthy = sexuality.=20 Further, they can dialogue with parents about appropriate = behaviors with=20 children and keeping children safe.^10,11,12,13 = Responsibility=20 for strengthening individual knowledge and skills is not limited = to health=20 practitioners and human service professionals. For example, = musicians,=20 athletes, and community leaders can speak to students about the = importance=20 of healthy relationships and healthy sexuality.

Level 1 - Individual Skill-building in Action: Wingspan, = Tucson,=20 Arizona While the majority of sexual violence does not occur = within the=20 lesbian, gay, bisexual and transgender communities, sexual = violence does=20 occur within LGBT communities, and LGBT people are often targets = of sexual=20 violence based on their sexual orientation and gender = identity.Wingspan, a=20 lesbian, gay, bisexual and transgender (LGBT) community center in = Southern=20 Arizona works to promote healthy sexuality and prevent sexual = violence=20 affecting LGBT communities. For example, Eon, a youth program = offered=20 through a collaboration between Wingspan, Pima County Health = Department,=20 Southern Arizona AIDS Foundation and CODAC, reached 136 youth in = 2004=20 through monthly sexual health workshops. Behavioral health staff = and youth=20 advocates facilitate workshops in which relationship dynamics is a = frequent discussion topic of choice. Peer support is combined with = information about sexual health and activities to build = communication and=20 negotiation skills in sexual situations. 74% of youth participants = reported they felt =93 more comfortable talking with their sexual = partner(s)=20 since becoming involved with Eon.=94¹⁴

Level 2

Promoting Community Education

Through community education, groups of people are reached with=20 information and resources for improving safety and preventing = sexual=20 violence. Effective community education not only alerts = individuals to new=20 information, but also helps build a critical mass of support for = safer=20 behavior, norms, and policies. For example, Communities Against = Rape and=20 Abuse in Seattle, Washington organizes =93Community Action = Teams=94 that=20 create spaces for people of color, people with disabilities, and = other=20 marginalized communities to build strategies for community safety, = support, and accountability. The NSVRC=92s coordination of Sexual = Assault=20 Awareness Month (SAAM) activities throughout the country each year = is an=20 example of how local community education efforts can be = strengthened by=20 national support.

Mass media campaigns have been shown to increase awareness, = change=20 attitudes, and build support for successful implementation of = prevention=20 policies.¹⁵ Media coverage can foster public support by = reflecting community involvement and activism. For example, at = Utah State=20 University in 2005, male students, faculty and staff donned = women=92s=20 footwear for =93Walk a Mile in Her Shoes,=94a hike to raise = awareness about=20 sexual violence, invited men to become allies in prevention, and = raised=20 money for peer education. By creating an unusual spectacle, the = event=20 attracted local media attention including an article in the Salt = Lake=20 Tribune.¹⁶ Media coverage can also garner the interest = of=20 legislators and policymakers and serve as a catalyst for broader=20 change.

Level 2 - Community Education in Action: Men Can Stop Rape, = Washington,=20 DC Men Can Stop Rape (MCSR)=92s Strength Campaign is a nationally = and=20 internationally successful educational outreach campaign to raise=20 awareness of sexual and other violence in youth dating = relationships and=20 highlight the vital role young men can play in fostering healthy, = safe=20 relationships. Organized around the theme line, =93My Strength is = Not for=20 Hurting,=94 the campaign emphasizes how men can be strong without = using=20 intimidation, force, or violence. The campaign posters convey a = fresh look=20 and emphasize young men taking positive action in public spaces = with women=20 and other men. The campaign=92s positive images also counter false = myths and=20 stereotypes about men of color as perpetrators of violence. The = community=20 education efforts are explicitly linked to activities at many = other levels=20 of the Spectrum.¹⁷

Level 3

Educating Providers

Providers have influence within their fields of expertise and=20 opportunities to transmit information, skills, and motivation to = clients,=20 community members, and colleagues. For instance, human service=20 professionals are increasingly being trained to advise children,=20 adolescents, and parents about the illness and injuries associated = with=20 unsafe behaviors.¹⁸ It is essential, therefore, that = providers=20 receive education to improve their own understanding of sexual = violence=20 prevention.¹⁹ To respond to this type of need, the = Virginia=20 Department of Health offers trainings and customized consultation = for=20 human service providers =96 for example, on how to involve men and = boys in=20 sexual violence prevention. Training and networking between = advocates and=20 practitioners can be strengthened through innovative, affordable=20 approaches. For example, the California Coalition Against Sexual = Assault=92s=20 Prevention Connection project organizes web conferences and web = dialogues=20 and moderates a listserv to advance primary prevention of sexual = and=20 domestic violence against women, all free of charge.²⁰ = Beyond=20 their role in transmitting knowledge and skills, with appropriate=20 training, providers such as doctors, teachers, law enforcement = officers,=20 childcare workers, and others, can also be highly effective = advocates for=20 prevention policies.

By expanding the notion of provider, it is possible to mobilize = a=20 broader group in advancing sexual violence prevention. Providers = can=20 include journalists, building owners/managers, movie producers,=20 librarians, staff at senior centers and recreation centers, radio = station=20 DJ=92s, prison guards, bar tenders, and insurance policy agents. = With sexual=20 violence prevention training, these groups are better able to = incorporate=20 sexual violence prevention into their practices. For example, = journalists=20 will be better equipped to report on sexual violence from a = prevention=20 perspective, asking questions that contribute to an understanding = of=20 community solutions as opposed to reinforcing myths and fear. = Librarians=20 can be trained to acquire books that focus on healthy and = equitable=20 relationships and healthy sexuality across the lifespan.

Level 3 - Educating Providers in Action: SafePlace, Austin, = Texas

SafePlace=92s Expect Respect program promotes safe and healthy=20 relationships through counseling and educational programs in K-12 = schools.=20 Participating schools form a Leadership Team, consisting of an=20 administrator, counselor, resource officer, teachers, parent=20 representatives, and others. This team develops guidelines and = coordinates=20 school-wide activities to promote a positive school climate and = prevent=20 bullying, sexual harassment and gender violence. A critical = element is=20 training for school staff on how to respond to and prevent = harassment.=20 During the 2003-2004 academic year, 3,575 school administrators, = faculty,=20 parents and other professionals were trained. An overwhelming = majority of=20 participants strongly agreed or agreed that the training raised = their=20 awareness, expanded their skills, and helped them to better meet = the needs=20 of their students.^{21, 22}

Level 4

Fostering Coalitions and Networks

Coalitions and networks bring together the necessary = participants to=20 ensure an initiative=92s success. They increase the =93critical = mass=94 behind a=20 community effort, help groups to trust one another, and reduce the = likelihood of resource squandering through unnecessary competition = among=20 groups.²³ Partnerships across sectors and fields can be = especially useful for accomplishing a broad range of goals that = reach=20 beyond the capacity of any single organization. A creative example = is the=20 =93Take Back the Music=94 campaign launched by Essence magazine to = engage=20 hip-hop artists in dialogue and education about sexism and = misogyny in=20 music lyrics and videos and the connections to sexual=20 violence.²⁴ Across the country, formal local coalitions = are=20 expanding their membership to include faith institutions, prisoner = rights=20 organizations, disability rights organizations, elder abuse = prevention=20 councils and businesses. Like a jigsaw puzzle, each piece of a=20 collaboration is important, and only when all of the pieces are = put=20 together is the whole picture complete. By working together, = coalitions=20 can conserve resources by reducing duplication and sharing = expenses,=20 foster cooperation between diverse sectors of society, and = increase the=20 credibility and impact of their efforts.

Level 4 - Coalitions in Action: Minnesota Sexual Violence = Prevention=20 Action Council, Minnesota

A broad array of organizations and agencies recently formed the = Minnesota Sexual Violence Prevention Action Council to promote = primary=20 prevention of sexual violence through communication, = collaboration, and=20 changing systems, policies and organizations. Using the = Spectrum of=20 Prevention to inform its work, initial efforts are focusing = on youth=20 development, healthcare/public health systems and male leadership=20 development. Members include representatives from public systems,=20 including human services, education, public safety, corrections = and public=20 health, as well as advocates for victims, rural communities and = women of=20 color, offender treatment providers, researchers, and prevention=20 consultants.²⁵

Level 5

Changing Organizational Practices

Changing the practices of institutions =96 business, = government,=20 faith-based organizations, schools, law enforcement, sports = organizations,=20 the media, funding organizations, health services and others =96 = can have an=20 enormous impact. By changing its own regulations and practices, an = organization can have a broad effect on community norms. It can = set=20 expectations for, incentivize, and model behavior; serve as an = example for=20 other organizations; inform related policy; build awareness and = buy-in;=20 and affect norms. Yet this is usually the least understood and = most=20 frequently ignored component of the Spectrum.

Changes in organizational practice can also catalyze other = sexual=20 violence prevention efforts. For instance, a media outlet may = choose to=20 restrict advertising with negative portrayals of women and men of = color,=20 which could raise awareness and influence advertising campaigns.=20 Healthcare institutions can establish work place policies in = alignment=20 with ending sexual violence, including anti-harassment policies = and=20 modeling of egalitarian relationships. Movie theaters could not = show=20 movies that normalize or promulgate sexual violence or sponsor = discussion=20 groups on healthy sexuality for moviegoers who view these movies. = Sports=20 organizations could reduce alcoholic beverage sales at games, = require=20 athletes to participate in violence prevention training, and = create=20 opportunities for athletes to work with youth as positive role = models.=20 Consumers can reinforce these practices by supporting = organizations and=20 business that build healthy community norms.

Level 5 - Changing Practices in Action: Kehilla Community = Synagogue,=20 Oakland, California

Kehilla Community Synagogue developed and adopted, =93Policy = Guidelines=20 on the Prevention of and Response to Abuse,=94 to address sexual = assault,=20 sexual harassment, domestic violence, child abuse, elder abuse, = abuse of=20 dependent adults, abuse of people with disabilities, and clergy=20 misconduct. The policy outlines the congregation=92s intention to = help=20 community members to learn to relate in non-abusive ways within=20 interpersonal and organizational relationships and support those = who are=20 abused. It specifies that abuse education will be integrated into=20 religious services, programs, and counseling.²⁶ The = policy is=20 distributed to all members and posted on the website. Clergy,=20 administrators, and teachers have been trained and educational = events and=20 an annual healing service have been held.²⁷

Level 6

Influencing Policies and Legislation

Changes in local, state, and federal laws, as well as the = adoption of=20 formal policies by boards and commissions, fall under the umbrella = of=20 influencing policy and legislation. This level presents = opportunities for=20 the broadest improvement in outcomes. Policies can affect large = numbers of=20 people. In some cases, laws and policies already exist that could = protect=20 public safety, but could be strengthened by an additional law or = change in=20 policy. In other cases, better enforcement or a change in an=20 organization=92s practices (see level 5) may be necessary to = ensure the=20 effectiveness of existing laws.

In recognition of the high rates of sexual violence committed = against=20 Native women and the need for policy change, Cangleska, in Kyle, = South=20 Dakota, directly engages with the nine districts in their local=20 reservation, actively participates at state committee hearings, = maintains=20 relationships with key members of Congress, and takes leadership = in the=20 South Dakota Domestic Violence and Sexual Assault = Coalition.²⁸=20 Other sexual violence prevention policy efforts have focused on = changing=20 the mindset of policymakers to address their skepticism about = primary=20 prevention. For example, advocates in Massachusetts are = considering=20 working on a cost effectiveness report on sexual and domestic = violence=20 prevention for the state.²⁹ While traditionally = grassroots=20 groups haven=92t had full access to policymakers, finding ways to = ensure=20 their voices are heard about the value of primary prevention could = be an=20 important way to influence legislation.

When advocates and practitioners think about policy, often they = think=20 about state and federal policy. But useful policy is often = developed=20 locally.
Local policies can be tailored to individual community = needs,=20 raise awareness and support, and act as a laboratory for broader = policy=20 change, providing
valuable clues about the most effective and=20 appropriate models. Further, local communities are not burdened = with the=20 bureaucracy that often inhibits
progress at the state and = national=20 levels. Years ago, the Los Angeles Commission on Assaults Against = Women=20 recognized that implementing pilot programs and getting sexual = violence=20 prevention policies passed one school site at a time would be = effective=20 and more achievable, given the political climate, in addition to = pushing=20 for district-wide and state-wide policy change.³⁰

Another example of local policy change is in South Los Angeles, = California. Though not focused explicitly on sexual violence, the = goal was=20 to reduce the availability of alcohol, a risk factor for = perpetration,=20 through the reduction of outlets allowed by the zoning ordinances. = The=20 coalition was able to change zoning laws and prohibited 200 liquor = stores=20 from opening within a three year period. Evaluation documented a = 27%=20 reduction in violent crime and felonies, drug-related felonies and = misdemeanors, and vice, including prostitution, within a = four-block radius=20 of each liquor store that was closed.³¹ Other models of = local=20 policy change include restricting permits for use of government=20 facilities, such as fair grounds, convention centers, and sports = arenas.=20 Many violence prevention advocates had success, for example, in=20 restricting gun shows at county fair grounds. Similar strategies = could be=20 applied to events and/or their advertising which promulgate norms = that=20 contribute to an environment in which sexual violence occurs.

Level 6 - Influencing Policy and Legislation in Action: Wichita = Area=20 Sexual Assault Center and the Safe Communities Coalition, Wichita, = Kansas

Working with an alternative school for students ranging in age = from 11=20 -18,Wichita Area Sexual Assault Center and the Safe Communities = Coalition=20 developed an innovative curriculum, =93Steppin=92 Up to Violence = Prevention,=94=20 which includes lessons on sexual violence prevention and healthy = behavior=20 through lectures, role-playing and art projects. The curriculum = was so=20 successful that support spread among teachers and eventually = garnered the=20 attention of the school district leadership. In 2002 the = superintendent=20 invited program staff to work together to design a policy on = bullying and=20 sexual harassment prevention for the entire school district. = Policy change=20 within the Wichita school district has served as a model for other = school=20 districts throughout the state.³²

Synergy of the Spectrum of Prevention in Action: Stop It = Now!

Stop it Now! is a national organization with affiliate sites = that uses=20 multitiered strategies to promote adult and community = responsibility for=20 child sexual abuse prevention.³³ Stop it Now! = recognizes that=20 many adult behaviors foster acceptability of inappropriate = boundaries with=20 children=96 for example, forcing a child to sit on an adult=92s = lap when they=20 don=92t want to or opening the door when an adolescent is bathing. = They=20 challenge norms that suggest that adults=92 questioning the = behavior of=20 other adults is inappropriate or that discussion of healthy = sexuality is=20 improper.³⁴

To strengthen individual knowledge and skills, staff = members=20 coach adults on their national helpline to create family safety = plans that=20 foster a family culture of communication and appropriate = boundaries. From=20 their fact sheets on healthy child sexual development and guide = =93Let=92s=20 Talk,=94 adults learn to set limits with other adults. They use = multiple=20 community education channels to motivate people to action = =96 for=20 example, through organizing screenings and discussions about = relevant=20 movies, such as The Woodsman, and writing Op Ed articles = to draw=20 the attention of legislators.³⁵ The Georgia affiliate = has=20 conducted provider trainings for family support workers, = social=20 workers,teachers, and school counselors to embed prevention = concepts among=20 professionals who may not recognize their potential role in = preventing=20 child sexual abuse.³⁶ The Minnesota affiliate trained = childcare=20 licensing staff to promote appropriate boundaries and healthy = behavior in=20 childcare settings.The tremendous demand generated by these = trainings=20 catalyzed a change in organizational practice within the = state=92s=20 regional childcare resource and referral networks. Stop it Now! = will=20 conduct a training-of-trainers for these regional networks which = will=20 enable them to offer trainings themselves on an ongoing basis. = This=20 partnership approach reflects the agency=92s commitment to = fostering=20 coalitions and networks. Stop it Now! works to influence = policy=20 and legislation at the local, state and national levels. For = example,=20 the Minnesota chapter is supporting legislation to include sexual = violence=20 prevention information in school-based sex education=20 curriculum.³⁷ In sum, efforts to educate and build = skills are=20 reinforced by a broader set of activities that change = environments, such=20 as child-serving organizations and schools. Further, these kinds = of=20 activities (provider trainings, coalitions, organizational = practice, and=20 policy change) have a broader reach than would be possible one = person at a=20 time.Together, they are helping to shift public will toward = prevention and=20 foster environments in which child sexual abuse is less likely to = be=20 perpetrated.

CONCLUSION

Changing Communities, Changing Norms

It is critical that a prevention strategy addresses norms = because of=20 their power in influencing behavior. If violence is typical and = this=20 expectation is reinforced by the media, school, and community, it = is far=20 more likely to occur and will occur with greater frequency. If = norms=20 discourage safe behavior or do not support healthy, equitable and = safe=20 relationships, then programs focused on individual change will not = prevent=20 sexual violence unless related norms are changed as well. Thus, = norms=20 change is essential; it is best accomplished through a community = approach.=20 The community has a stake in preventing sexual violence and all = members=20 have a valuable role to play. By developing and implementing = interventions=20 along the Spectrum of Prevention, communities can foster = a more=20 comprehensive sexual violence prevention strategy for a community=20 solution.

Spectrum of Prevention: Sample Activities

Level 1: Strengthening Individual Knowledge and Skills

Provide multiple session skill-building programs that teach = healthy=20 sexuality and healthy and equitable relationships skills to high = school=20 students=20
Build the skills of bystanders to safely interrupt behavior = such as=20 sexist and homophobic harassment=20
Teach parents to address attitudes and behaviors in their = children=20 that support sexual violence

Level 2: Promoting Community Education

Stage community plays that reinforce positive cultural = norms,=20 portray responsible sexual behavior, and models of bystander = action=20
Hold religious and political leaders accountable for = providing clear=20 and consistent messages that sexual violence is not appropriate; = model=20 healthy, equitable relationships and healthy sexuality=20
Foster media coverage of sexual violence with a focus on = underlying=20 factors and solutions=20
Develop awards programs to publicly recognize responsible = media=20 coverage and community leadership to prevent sexual violence =

Level 3: Educating Providers

Train little league coaches to build skills to interrupt and = address=20 athletes=92 inappropriate comments and behaviors that promote a = climate=20 condoning sexual harassment and sexual violence=20
Train prison guards on rape prevention=20
Train nursing home providers on sexual violence prevention = practices=20
Educate musicians, song writer, DJ=92s, and producers about = the impact=20 of music lyrics and videos

Level 4: Fostering Coalitions and Networks

Foster partnerships between researcher/academics and = community=20 providers to strengthen evaluation approaches=20
Engage art organizations to promote community understanding = and=20 solutions=20
Engage grassroots, community-based organizations and sectors = of=20 government, including social services, health, public health, = law=20 enforcement and education=20
Engage the business sector to foster workplace solutions and = build=20 support among their peers

Level 5: Changing Organizational Practices

Implement and enforce sexual harassment and sexual violence=20 prevention practices in schools, workplaces, places of worship = and other=20 institutions=20
Implement environmental safety measures such as adequate = lighting=20 and emergency call boxes, complemented by community education = and=20 enforcement of policies=20
Encourage insurers to provide healthy sexuality promoting = resources=20 and materials

Level 6: Influencing Policies and Legislation

Promote and enforce full implementation of the Title IX law=20
Establish policies at universities to provide sexual = violence=20 prevention curriculum to all students and training to all staff, = and=20 include funding as a line item in the university=92s budget=20
Pass middle and high school policies to offer comprehensive = sex=20 education programs that include sexual violence prevention and = address=20 contributing factors in the school environment

REFERENCES

Tjaden P, Thoennes N. Full report of the prevalence, = incidence,=20 and consequences of violence against women: findings from the = national=20 violence against women survey.Washington (DC): National = Institute=20 of Justice; 2000. Report NCJ 183781.=20
Krug, EG, et. al., eds. 2002.World report on health and = violence.=20 Geneva, Switzerland: World Health Organization.=20
A social environmental approach to health and health = interventions.=20 In: Smedley BD, Syme SL, (Eds.) Promoting Health: = Intervention=20 Strategies from Social and Behavioral Research.Washington, = D.C.=20 National Academy Press; 2000:4.=20
Ullmann-Margalit E. Revision of norms. Ethics. = 1990, 100:=20 756.=20
Cohen L, Swift S. The spectrum of prevention: developing a=20 comprehensive approach to injury prevention. Inj Prev.=20 1999;5:203-207.=20
Opp, K (1982). =93The evolutionary emergence of norms=94, = British=20 Journal of Social Psychology, 21, 139-149.=20
Ullmann-Margalit E. Revision of norms. Ethics. = 1990, 100:=20 756.=20
Association for the Treatment of Sexual Abusers. Available = at http://www.atsa.com/.=20 Accessed on May 26, 2006.=20
Gruninger UJ. Patient education: an example of one-to-one=20 communication. J Hum Hypertens. 1995;9:15-25.=20
Coker A. Opportunities for prevention: addressing IPV in = health care=20 setting. Family Violence Prevention and Health = Practice. 2005;=20 1.=20
King MC. Changing women=92s lives: the primary prevention of = violence=20 against women. AWHONN=92s Clinical Issues. 1993; 4 no. = 3.=20
Sampselle M. The role of nursing in preventing violence = against=20 women. J Obstet Gynecol Neonatal Nurs. 1991 20: = 481-487.=20
Schwartz IL. Sexual violence against women: prevalence,=20 consequences, societal factors, and prevention. American = Journal of=20 Prevention Medicine. 1991 7(6): 262-373.=20
Reported by Kelli =93JC=94Olson oral communication, May 23, = 2005 and=20 Lori B. Girshick, written communication, May 26, 2005.=20
Jernigan DH,Wright PA.Media advocacy: lessons from community = experiences. J Public Health Policy. 1996;17:306-330.=20
Brunson, AN. 2005. Males don female footwear to raise sexual = assault=20 awareness. The Salt Lake Tribune, April 11, 2005. = Available at=20 http://www.sltrib.com/. Accessed on May 20, = 2005=20
Reported by Patrick Lemmon, oral communication, January 12, = 2005.=20
Richmond R, Kehoe L, Heather N, et al.General = practitioners=92=20 promotion of healthy lifestyles: what patients think. = Australian and=20 New Zealand J of Public Health. 1996;20:195-200.=20
Franklin, B. Funders forum: reaching men and boys. Moving = Upstream:=20 Virginia=92s newsletter for the primary prevention of sexual = violence.=20 March 2005; 1,1: 3. Available at http://www.vahealth.org/civp/sexualviolence/Moving%20Upst= ream.pdf.=20 Accessed on April 11, 2005.=20
Prevent Connect. Available at http://www.preventconnect.org/. Accessed on = May 26,=20 2005.=20
Expect Respect SafePlace School-based Services Program = Evaluation=20 2003-2004 Academic Year. Austin, Texas; SafePlace; 2004. = Available at http://www.austin-safeplace.org/site/DocServer/Expect_Res= pect_03_04_report.pdf?docID=3D641.=20 Accessed on May 20, 2005.=20
Reported by Barri Rosenbluth, written communication, June = 20, 2005.=20
National Committee for Injury Prevention and Control. Injury = prevention: meeting the challenge. Am J Prev Med. 1989;5:98; = Cohen L,=20 Baer N, Satterwhite P. Developing effective coalitions: an eight = step=20 guide. In: Wurzbach ME, ed. Community Health Education & = Promotion: A Guide to Program Design and Evaluation. 2nd = ed.=20 Gaithersburg, Md: Aspen Publishers Inc; 2002:161-178.=20
Essence. Take back the music. Available at www.essence.com/essence/themix/takebackthemusic.=20 Accessed on January 31, 2005.=20
Reported by Amy Okaya, oral communication, April 11, 2005.=20
Family Violence Prevention Fund. Policy Guidelines on the = Prevention=20 of and Response to Abuse in Kehilla Community Synagogue. = Available at http://toolkit.endabuse.org/Resources/PolicyGuidelines/FV= PFResource_view?searchterm.=20 Accessed on June 5, 2005.=20
Reported by Paul Kivel, written communication, May 21, 2005. =
Reported by Karen Artichoker, oral and written = communication, June=20 16 and 17, 2005.=20
Reported by Marci Diamond and Mark Bergeron-Naper, oral=20 communication, February 3, 2005.=20
Leah Aldridge and Abby Sims, oral communication, January 30, = 2005.=20
Aboelata, M. The Built Environment and Health: 11 Profiles = of=20 Neighborhood Transformation. Oakland, Calif: Prevention = Institute; 2004.=20
Reported by Shelley V. Bearman, oral communication, May 26, = 2005.=20
Reported by Alisa Klein, oral communication, June 3, 2005.=20
Reported by Yvonne Cournoyer, oral communication, June 21, = 2005.=20
Reaching the Public, Influencing Our Peers. Stop It Now! = News Spring=20 2005, Volume 13, No. 1. Available at
http://www.stopitnow.com/newsletters/sprg05.html.=20 Accessed on May 26, 2005.=20
Reported by Sally Thigpen, oral communication, June 21, = 2005.=20
Reported by Yvonne Cournoyer, oral communication, June 21, = 2005.=20