This paper presents a health promotion program proposal aimed at preventing sexual violence and supporting survivors, with a focus on women and children. It examines the prevalence of sexual violence across demographic groups, the psychological and physical consequences for victims, and the key stakeholders required to implement effective interventions. Drawing on the Social-Ecological Model, behavior change theories, and Lewin's change management framework, the proposal outlines a community-based program offering counseling, referral services, support groups, rape kits, and educational tool-kits. The paper also describes a logic model linking program resources, activities, outputs, outcomes, and broader community impact.
Sexual violence has been a longstanding issue around the world. Women and children face rape, molestation, and 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, reported sexual assault cases reveal that the majority of victims range from ages 18–34, accounting for 54%. The age group at the highest risk for sexual violence is 12–34. Women are at the highest risk of experiencing attempted or completed rape, with statistics revealing that 1 out of every 6 women in America has been or has almost been raped. Of the rape victims reported, 90% are adult females and 82% of juvenile victims are female (RAINN, 2016).
The age range of 16–19 is the most dangerous for females, 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 one year old. Although women and girls make up the majority of reported victims of sexual violence, they do not comprise the entire victim population.
Males experience sexual violence as well, especially at younger ages, with 1 in 6 boys experiencing rape or molestation (NSOPW, 2016). Twenty-eight percent of the young male population experienced rape before the age of 10. Unfortunately, because male sexual assault victims often do not report the sexual crimes perpetrated against them, the statistics underrepresent actual numbers. Transgender, nonconforming, and gender-queer college students also experience sexual violence, with non-TGQN females reporting an 18% rape statistic within that population. This demonstrates 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 profound effects that arise from being sexually assaulted or molested. The feelings of depression and anxiety that emerge, coupled with contemplation of suicide, are very real consequences of these violent crimes. Women and children who have experienced sexual violence often have low self-esteem, low self-worth, and suffer from mental health problems such as PTSD, OCD, eating disorders, depression, and anxiety-related disorders. "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 that women who experience sexual violence and develop mental illness are more prone to attempting suicide. When children are sexually assaulted or 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. Research indicates survivors are "13.4 times more likely to have two or more major alcohol problems (20.1% vs. 1.5%) [and] 26 times more likely to have two or more major serious drug abuse problems (7.8% vs. 0.3%)" (Kilpatrick, 2016). Rape and molestation have a long-term negative effect on many victims who endure such heinous crimes. 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 who will make the potential recovery of these victims possible. Without the cooperation of all parties involved, these efforts will be wasted. Healthcare providers — including 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 its prevalence. The first level is the individual level, which recognizes personal and biological history factors that influence the chances of becoming a perpetrator or victim of sexual violence. These factors include income, substance use, age, education, and 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 may include life skills training and education.
At the relationship level, close relationships that could increase the chance of experiencing sexual violence — as a perpetrator or victim — are examined. An individual's closest social circle, including family members, partners, and peers, can influence their behavior and shape their range of experience. Strategies aimed at prevention at this level include peer and mentoring programs as well as family-focused or parenting prevention programs.
The community level aims to explore settings such as neighborhoods, schools, and workplaces where social relationships are cultivated. The objective is to recognize characteristics of these settings that are associated with becoming perpetrators of sexual violence or victims. Prevention strategies at this level seek to improve housing and economic opportunities, minimize social isolation, and establish sound policies within workplace and school settings.
The final level examines broad societal factors, which help generate a climate in which violence is either inhibited or encouraged. This level includes cultural and social norms that support sexual violence as a valid means of resolving conflicts, or in which sexual violence is not punished as severely — or at all — compared to other crimes. Broad societal factors also encompass educational, economic, social, and health policies that maintain and perpetuate social or economic inequalities.
"Services offered and roles of internal and external stakeholders"
"Program goals, tool-kit development, and community outreach"
"Theoretical models guiding behavior change and intervention"
"Therapy groups, logic model components, and expected impact"
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