Sexual Violence Health Program

Health Promotion Program Proposal Sexual violence has been a longstanding issue around the world. Women and children face rape, molestation, sexual assault each year. In the United States alone, the annual national average for rape and sexual assault victims is 288,820 (age 12 or older). While the figures for child molestation may be higher than anticipated, the reported sexual assault cases reveal the majority of victims range from ages 18-34 at 54%. The age group at the highest risk for sexual violence is 12-34.

Women are at highest risk of experiencing attempted or completed rape with statistics revealing 1 out of every 6 women in America have been or have almost been raped. Of the rape victims reported, 90% are adult female and 82% of juvenile victims are female (RAINN, 2016). The age range of 16-19 is the more dangerous for a female as they are 400% more likely to be raped than at any other age. That statistic increases when females of that age range enter college.

Girls experience sexual violence at rates of 1 in 4 with victims being as young as 1-year-old. Women and girls although make up the majority of reported victims of sexual violence, do not comprise the entire victim population. Males experience sexual violence as well, especially at younger ages with 1 in 6 boys experiencing rape/molestation (NSOPW, 2016). 28% of the young male population experienced rape before the age of 10. Unfortunately, because male sexual assault victims do not report the sexual crimes perpetrated on them, the statistics are less than actual numbers.

Transgender, nonconforming, and gender queer college students also experience sexual violence with non-TGQN females reporting a 18% rape statistic out of the population. This shows just how prevalent sexual violence is across all populations and why these crimes must be prevented and stopped. One of the major reasons to prevent and stop sexual violence against women and children is the major effects that arise from being sexually assaulted or molested.

The feelings of depression and anxiety that emerge, coupled with contemplation of suicide is a very real consequence of these kinds of violent crimes. Women and children that experienced sexual violence often have low self-esteem, low self-worth, and suffer from mental health problems like PTSD, OCD, eating disorders, depression, and anxiety-related disorders. "United States age 18 or older. If 13% of American women have been raped and 31% of rape victims have developed PTSD, then 3.8 million adult American women have had rape-related PTSD" (Kilpatrick, 2016).

Statistics also show women who experience sexual violence and develop mental illness are more prone to attempt suicide. When children are sexually assaulted/molested they become less willing to engage socially with others, withdrawing themselves from the world around them. They may also develop eating disorders and suffer from substance abuse problems. "13.4 times more likely to have two or more major alcohol problems (20.1% Vs 1.5%). 26 times more likely to have two or more major serious drug abuse problems (7.8% Vs 0.3%)" (Kilpatrick, 2016).

Rape/molestation has a long-term negative effect on many of the victims that endure such a heinous crime. There is a strong need to create a support network and offer assistance to those affected by sexual violence so they may have a chance at recovery and lead normal, healthy lives. The key stakeholders involved are the women and children affected by sexual violence as well as the healthcare providers and program workers that will make the potential recovery of these victims possible.

Without the cooperation of all parties involved, this effort will be wasted. Healthcare providers like physicians, nurses, psychiatrists, therapists, and medical assistants are all part of the complex intervention needed to assess and treat any potential health problems. The Social-Ecological Model is a framework for prevention. The main objective of such a model is to thwart sexual violence before it starts. In order to prevent sexual violence against women and children, it is necessary to understand the various factors influencing the prevalence of sexual violence.

The first level is individual and recognizes personal and biological history factors that the chances of turning into a perpetrator or victim of sexual violence. Therese factors are income, substance use, age, education, or history of abuse. At the individual level, prevention methods are frequently designed to educate and promote behaviors, beliefs, and attitudes that help avert sexual violence. These strategies could include life skills training and education.

At the relationship level, examination of close relationships that could lead to a higher chance of experiencing sexual violence as a perpetrator or victim are recognized. An individual's closest social circle that includes family members, partners, and peers can influence and contribute not only their behavior but also to their range of experience. Strategies aimed at prevention include peer and mentoring programs and family-focused or parenting prevention programs. The community level aims to explore setting like neighborhoods, schools, and workplaces where social relationships are cultivated.

Here the objective is to recognize characteristics of such settings are that connected with becoming perpetrators of sexual violence or victims. Prevention strategies at this level are to improve housing and economic opportunities, minimize social isolation and provide sound policies within workplace and school settings. The last level to examine is broad societal factors, which assist in generating a climate where violence is either inhibited or encouraged.

This level includes cultural and social norms in support of sexual violence as a valid means of resolving conflicts or where sexual violence is not punished as severely or at all compared to other crimes. Big societal factors also encompass educational, economic, social, and health policies that assist in maintaining and perpetuating social or economic inequalities. There are a variety of resources available for survivors of sexual violence.

They take the form of hotlines, websites, and support groups where victims can go to educate themselves on their options legally and where to look for personal support. For children, they have programs that offer help with referral services so the children affected can get access to the help they need like therapy, foster care and so forth. For the program, the types of resources that will be given will be counseling, referral services and support groups. The counseling and referral services will be for both women and children.

The support groups will be just for women. Hospitals can donate a room or space in order for volunteers and medical professionals to start the registration process, helping program participants get signed up and informed on what options are available for them. The local government and hospital can give rape kits to the program for women and children to use should they wish to report a sexual assault performed on them with a Sexual Assault Nurse Examiner able to perform the procedure.

Then any evidence can be given to law enforcement to proceed with a criminal investigation. However, the main focus is on referral services and support groups. A therapist can come and head the support group. Social workers can be assigned cases and helps women and children find the help they need to move past their painful experience. The support group is meant to be an effective means of letting a victim know there are people in similar situations and prevent them from feeling isolated and alone.

The social workers help with getting children into programs that helps with mental health problems from the sexual violence and help with any school issues. Counselors will also be available to help victims understand what their options are and how to pursue a healthy and happy life away from the trauma that comes from sexual violence. Internal stakeholders would consist of mainly medical professionals that could come from or partner up with hospitals, local government, and law enforcement.

This is because the kinds of services external stakeholders require (women and children exposed to sexual violence) involve collaboration with the local government and law enforcement. For example, if a woman comes in, in need of a rape kit or counseling/referral services, she can then have the counselor or social worker send that information to law enforcement who can then begin a criminal investigation against the alleged perpetrator.

If a parent and child come in, in need of counseling and potential witnesses for a future criminal case, this can also be done with collaboration with law enforcement and the court system. The local government and hospitals can also provide a space for the program to run in along with possible free medical supplies, all of which can help victims get the medical care they deserve.

Although medical care in one aspect of the program, the man focus is on mental health services with therapists and counselors taking the majority of the case load in the program. They would have to collaborate with volunteers in order to run the program smoothly. Internal stakeholders such as medical professionals and government workers are key to getting program participants the high quality care they need.

Although the program may require communication with several public and private agencies, such collaboration can lead to prevention of sexual violence and offer treatment options to women and children who experience sexual violence (Brunger, 2015). Additional key stakeholders could be researchers and evaluators that can help determine if proposed strategies are effective and continue to be effective in the long run. Goal: To increase participation and awareness of community stakeholders in preventative efforts in connection with sexual violence. The first part of this goal is to identify and recognize community stakeholders.

This involves private and public local organizations, local government, and local law enforcement. The next step is forming partnerships with these local community agencies to increase support towards sexual violence prevention efforts. Then, identify policies and laws that permit or overlook the continuation of sexual violence. This is followed by collaboration with social marketing specialists in order to formulate education materials that will help prevent sexual violence.

From the collaborations, research, and development of educational material the main objective will be to develop a community tool-kit to maximize community ability to implement primary sexual violence prevention strategies via creation and distribution of tool-kit within the time span of one year. The tool-kit will include information of hotlines, organizations, and services that are legally free for victims of sexual violence. In those tool-kits information about the program will be offered along with what kinds of services are offered in the program.

This is meant to increase awareness as well as increase capacity of the community being serviced to know how to prevent and acknowledge sexual violence in their area. Through collaboration with community stakeholders, recognition of detrimental laws and policies, and research of relevant information, the tool-kit is a 'one stop shop' of education and information. This is the first and most crucial step for the program to reach the target population and make progress towards success within the community.

Awareness and education are the most important aspects of program development and participation. Without which, any program would fail. While preventative efforts are an important aspect to stopping and decreasing the prevalence of sexual behavior, few know how to actually go about doing so. Some suggest using certain behavior change theories to provide a better understanding of why sexual violence occurs. "Prochaska and DiClemente's change theory, social cognitive theory" (Henry & Powell, 2014, p. 84).

Behavior change theories "seek to explain individual pathways of change for people who engage in behavior that negatively impact their own physical health" (Henry & Powell, 2014, p. 84). When perpetrators of sexual violence engage in sexual assault or molestation, they are engaging in a behavior that not only negatively impacts the perpetrator, but also severely, negatively impacts the victim. For any program or community to successfully alter behaviors and longstanding problems within a slow-moving world, it must be done in a very controlled and calculated way.

Some like Lewin advise three stages of change management to help implement impactful and long-term change. 1. Unfreezing and loosening current sets of behaviors, mental models and ways of looking 2. Moving by making changes in the way people do things, new structures, new strategies and different types of behaviors and attitudes. 3. Refreezing by stabilizing and establishing new patterns and organizational routines (Khosrow-Pour, 2013). Introducing new methods, new structures will help combat an old structure and old methods that were conducive to sexual violence.

A good example is the patriarchal society of many cultures. These cultures diminish the value of women and make women more like property and sexual objects. This then sends the signal to men that it is okay to treat women as things rather than people, which helps perpetuate sexual violence. Intervention strategies should deal with keeping the public informed.

"The task force also is encouraging increase efforts to enforce legislate regarding campus sexual assault and to make information on enforcement, prevalence of sexual assault, and other activities conducted by the Office for Civil Rights more available to the public" (Wooten & Mitchell, 2015, p. 172). By making the public aware of the statistics of sexual violence, who are at greatest risk, and who is to blame for the crime, intervention and preventative efforts can be maximized.

Because without raising awareness and education the public on sexual violence, adult victims of sexual violence often are too scared to report the crime or seek help. While reporting of child sexual abuse is more common in society, because of morality, it is different for adult cases. "Qualitative information suggests that higher reporting rates of child sexual abuse are related to the community's perception that sexual violence against a child is a crime and not the child's fault" (Reyes & Jacobs, 2006, p. 41).

In the case of adult sexual violence, the victim may be blamed for the crime. The community is an important part of preventing and stopping sexual violence towards women and children. Without the community actively engaged, sexual violence will continue to permeate society. People must be informed of the problems women and children go through when they become victims of sexual violence. They need to see and understand the negative and detrimental effect of sexual violence not just on victims, but on society as a whole.

This is the main intervention strategy that will not only hopefully change society, but also help prevent new cases of sexual violence from occurring annually. Going back to support groups, this is an important aspect to helping victims of sexual violence. More specifically, cognitive processing therapy could help women who have experienced rape be.