Sexual Violence Research 15 Years After VAWA

Karen J. Bachar: I'm from the Violence and Victimization Research Division of NIJ, and if you're here for the impression evidence talk, you're in the wrong room. This is actually the Sexual Violence Research 15 Years After VAWA.

Now, in the mid '70s, rape was commonly thought of to be perpetrated by men at the fringe of society who sought social and economic control of women. Forty years later, we have a dramatically larger understanding. Researchers have documented that rape is one of the most under-reported crimes in the United States, that perpetration of sex offenders are found at all levels of the social spectrum, and that the majority of rapes and attempted rapes are committed by — attempted or committed by somebody that the victim knows.

Sexual violence has been designated as a national problem in need of a governmental response. So, in 1994, President Clinton established the Office of Violence Against Women in the U.S. Department of Justice. Also in 1994, Congress passed the Violence Against Woman Act as part of the Violent Crime Control and Law Enforcement Act.

Since that time, enormous work has been done to service providers, with law enforcement, with federal government work, at the state level, at coalition levels to make women and children safer in their lives.

At that time, too, in 1993, the National Institute of Justice in collaboration with the Office of Violence Against Women began steadying domestic violence and sexual assault and doing research in collaboration with OVW and with other federal partners. We thought that it is time to take a pause after 15 years of federal funding to look at what NIJ has done, look at how the field has moved forward, look at what some of the important issues are and how we have done and also to see how we can move forward.

And to do this, I have three wonderful women who have worked in various capacities in the field. I have Dr. Rebecca Campbell, who is a professor of community psychology and program evaluation at Michigan State University. Her research examines violence against women, specifically sexual assault, and how the legal, medical and mental health systems respond to the needs of rape survivors. She is currently conducting collaborative research with the Sexual Assault Nurse Examiner programs and is the author of Emotionally Involved: The Impact of Research and Rape.

Dr. Bonnie Fisher is a professor of the Division of Criminal Justice and Research Fellow in the Center for Criminal Justice Research at the University of Cincinnati. She is a nationally recognized expert in stalking and sexual victimization of college women, repeat victimization, self protection effectiveness, fear of crime and the response of postsecondary schools to reports of sexual victimization.

Last but definitely not least, we have Delilah Rumburg who is the executive director of the Pennsylvania Coalition Against Rape. She has managed PCAR's tremendous growth and outreach across Pennsylvania and throughout the nation. Rumburg has co chaired the U.S. Military Department of Defense Task Force on Sexual Harassment and Violence in the Military Service Academies and served as deputy co chair of the Defense Task Force on Sexual Assault in the Military.

How we're going to do this is Dr. Campbell is going to get up and speak for approximately 10 minutes to do Part A of her talk, and then Dr. Fisher will get up and give her talk, and then Dr. Campbell will give Part B of her talk. We just thought we'd keep everybody post lunch a little more engaged this way. And then Delilah is going to take moderator or discussant's prerogative and give her commentary and questions from her chair. We will take about an hour of your time in giving these talks, after which we will open the floor up to questions from the field.

Rebecca Campbell: Good afternoon, everyone. Thanks for coming out after lunch. I hope this will be entertaining enough to compete with what's going on in your stomachs.

OK. First, a bit of context. I'm going to begin with a little bit of background information, a little bit of overview that will set the stage for all of our remarks today. And the context that I want to talk about is the National Institute of Justice's violence against women research portfolio.

The Violence and Victimization Research Division fairly recently compiled all of the research that NIJ has funded on violence against women into a really marvelous compendium that expands from 1993 to 2010, and it's current through April of this year. And it is an exhaustive review and categorization of all NIJ funded projects on violence against women.

So what I wanted to do was to take a look at this compendium through the perspective of sexual violence research, so what in this portfolio has been done on sexual violence research.

Now, it turns out that's a pretty simple question to ask until you crack the compendium open and then you take a real good look at it. It's beautifully organized, but it's very hard to get an answer to that question. And the primary reason why it's hard to do that is because women don't experience one form of violence in their lifetime. They experience it throughout their lifetime, and they're often co occurring.

For example, women who are experiencing domestic violence often experience sexual violence as well, but the difference, though, is that some intimate partner violence research explicitly examines that, but sometimes it doesn't, so how do you account that.

So, in going through this content analysis of the compendium, we had to use — my colleague, Jessica [indistinguishable] had to use kind of a range, if you will, of how to do these counts. Our primary goal was to look at each study and say, “Did this have a strong and explicit focus on sexual violence?” regardless of whether it called itself domestic violence, sexual assault, stalking, some other form of violence against women. Our goal was to count up in each of these categories how many of these studies had a strong focus on sexual violence, whatever they called themselves.

And so what I want to do right now is share with you some of the results from that content analysis and give you a feel for what the compendium looks like through the perspective of sexual violence research.

First off, very briefly, the portfolio is very nicely organized into nine major categories, and I am not going to go through all major — all nine categories. I'm just going to highlight three that are particularly relevant for sexual violence research.

The first one I want to take a look at is definition and measurement. If we're going to try to do something about sexual violence, it helps if we know what it is we're defining it to be and then how we're going to measure it.

Now, within the definition and measurement category, there's two subcategories: research that was related to developing risk assessment instruments — trying to figure out who is going to perpetrate — and then studies that tried to dig a little deeper and look at context, meaning, and motive beyond perpetration.

Now, again, trying to figure out how many of these were sexual violence related, in the first subcategory, the risk assessment, 20 percent of the studies, and this is where percentages sometimes can give you a slightly skewed view of things. That's one study. That's one study that looked at development of an instrument to assess risk of juvenile sex offender perpetration, so we have one study there, and we have zero studies in the portfolio that looked at context, meaning and motive with regard to sexual violence, OK?

Well, we didn't leave that category with a real clear sense of definitions and measurements, but there's hope because there's epidemiology, and if you're going to try to measure the prevalence and incidence of sexual violence, it won't necessarily make you think about definition and measurement, so let's take a look at that.

Again, it divides into four major categories: national surveys, databases, secondary analysis of those national surveys, and then studies that looked at risk factors for homicide and serious injury.

Now, with respect to national surveys, 67 percent — again, the percents give us a bigger picture than what it is, two of the three — two of the three studies in the portfolio did have a strong and explicit focus on sexual violence. It was the National Violence Against Women Survey and Bonnie Fisher's Sexual Victimization in College Women Survey. So, from that, we have a pretty good feel for nationally how common rape is.

And databases, research on constructing databases, 75 percent of the portfolio had a focus on sexual violence, and most of these are creating state level databases to track incidence of sexual assault.

In terms of secondary analysis of the national dataset, so going back into them to try to look in things in a more nuanced way, only four studies in the portfolio did that, and those were reanalyses that looked at risk factors or consequences of sexual violence.

And in terms of the last category, risk factors for homicide or serious injury, we have one study in the portfolio with a sexual violence perspective, and that looked at women's risk of injury for using different kinds of avoidance of fighting back strategies if they are sexually attacked.

So, if we come out of the measurement category, the definition of measurement category and the epidemiology category, we're kind of left with a little bit of a mixed message. Some projects had a very strong sexual violence theme or focus, but many really didn't. So then I wanted to look at Category A because this is, in many respects, the sort of classic history of the National Institute of Justice. This is justice and related systems.

We know that sexual violence is extremely common, so what are we going to do about it, what is the justice system response going to be to this, what is the medical system, what's advocacy, how are we going to work together. So, from this particular category, again, looking at it through a sexual violence perspective, this gives us a feel of how the portfolio looks in terms of what are we doing to help victims of sexual assault.

As you might expect, because this is a major focus with NIJ, the portfolio breaks down into multiple categories here, nine categories. And here's what the percentages look like, and, again, there's some ranges here because you can count this slightly different ways. It doesn't dramatically change the nature of what the story is, though.

How many studies in the portfolio looked at advocacy services for sexual assault survivors? Zero; How many looked at arrest and prosecution for sexual violence? Eleven to 13 percent. Offender interventions for rapists, 17 percent of the studies examined that. Courts in the criminal justice system, 7 to 8 percent; civil, zero. Forensic and investigative methods, much higher, 62 to 73 percent. Protection orders, zero. Policy and legislation, 50 percent. Victim services 25 to 33 percent. So you can count this a lot of different ways, but the overall picture remains pretty consistent. There's two categories where there's a number of studies in the portfolio that have a strong sexual violence focus. The majority do not.

So the ones that do, forensic and investigative methods, NIJ has funded eight studies in this area. It's the one category where the focus on sexual assault is stronger than any other form of violence against women. These are studies that looked at police investigational techniques, techniques for DNA recovery and studies of the efficacy of Sexual Assault Nurse Examiner programs.

With respect to policy and legislation, again, that was the other category that had higher representation at 50 percent. Those were three studies that were evaluations of sex offender notification laws.

So where does this leave us in terms of our analysis of the NIJ research portfolio from a sexual assault perspective? This is a phrase that has a lot of meaning to a lot of us in this room, dot, dot, dot, and sexual assault. It is a joke that's not a funny one for many of us in the room. I've seen this on T shirts. I've seen this on signs. I've even seen it on coffee mugs. It refers to the extent to which sexual assault researchers and practitioners often feel like the afterthought in the violence against women movement. Is that similar for other forms of violence against women? Probably. I talk to my colleagues who do stalking, and they say, dot, dot, dot, hey, at least you're mentioned.

And, you know, it's a sad thing, and the goal here isn't to try to create a hierarchy of which form of violence against women is worse. It's all bad. It's all atrocious. But the important thing to keep in mind as we talk specifically about the history of the sexual violence movement since VAWA is to keep in mind that the majority off VAWA funds, both service and research, did not go into sexual violence research, and that's important context for us to keep in mind in terms of what we have accomplished, what we did do with some pretty limited funds, what we have been able to figure out and then where we want to go in the future and try to really understand the complexity of women's lives and that all forms of violence — that women experience multiple forms of violence throughout their lifetime.

So, with that context, I'm going to go ahead and turn it over now to my colleague, Bonnie.

Bonnie S. Fisher: When Karen e-mailed me in April and asked me to be part of the panel on the Sexual Violence Research 15 Years After the Violence Against Women Act, I was in my office at the University of Cincinnati working with two graduate students. I shared Karen's invitation with them and told them about the NIJ annual conference, and as I was talking with them, two thoughts crossed my mind.

My first thought went back to when I was a graduate student in political science at Northwestern University during the 1980s. I worked closely with Wesley Skogan. I recalled him telling me about invitations that he had received from NIJ to give presentations about victimization related topics, and at the time, I thought, wow, this is what old professors must get to do.

[Laughter.]

Fisher: Reflect on the progress made in the field.

Now, Karen had just asked me to do what Wes had told me about when I was a graduate student, and I quickly thought that, well, maybe he wasn't so old back then, right?

[Laughter.]

Fisher: I mean, at the time, I was much younger, and I didn't have the perspective or experiences that I have now, more than two decades out of graduate school.

Since the passage of the Violence Against Women Act, I had grown older — OK, let's say more mature — into a full professor who had been working in the area of sexual victimization of women for a majority of my career. My second thought was a bit more quantitative. I realized that 15 — one, five — years had passed since the passage of the Violence Against Women Act.

That time had gone by like a blink of an eye. It seemed like just yesterday, many of us here today were celebrating this major legislative accomplishment. I remember celebrating because the first time in my early career, federal funds were earmarked for the purpose of addressing violence against women.

I also remember vowing that I would incorporate the 1994 passage of the Violence Against Women Act and its progress into all of my victimology classes, all one that I teach, right? Because remember I'm in the Criminal Justice Department.

And I wanted to do this, so students would not forget the importance of this legislation and would come to realize and appreciate its positive effects on women's safety and well being. Now every time I teach a victimology class, my violence against women lecture — excuse me — my Violence Against Women Act lecture gets longer and longer as I add another year's worth of research and my commentary about the accomplishments of the Act.

When I first started including this material in my lecture, I did not stop to think that there would come a time when most of my students did not know a time without the Violence Against Women Act, but that time is just around the corner. In just two years, 2012, those born in 1994 will enter college having never known life without the Violence Against Women Act.

Let's now turn our attention to addressing the topic Karen asked me to address, Sexual Violence Research 15 Years After the Violence Against Women Act, advances, so what's and future direction. After some thought, I decided to go on my reflections in two topics that I consider to be major advances 15 years after the passage of the Violence Against Women Act. The first one is the publication and dissemination of sexual violence resources, and the second one is methodology, specifically the measurement of sexual violence.

So I'm going to turn to the first topic, the publication and dissemination of sexual violence resources. When I first started researching the sexual victimization of women in the late 1980s, the reading list was quite short. There were only four must read publications: Brownmiller's Against Our Will, Diana Russell's seminal study of rape among a large sample of women living in San Francisco in the early 1980s; of course, Mary Koss' path-breaking National Level Study of the Sexual Victimization of College Women; and Eskridge's book, Real Rape, which was published in 1987.

Each of these works reported that sexual victimization, in particular rape, was not a rare occurrence. Each also identified rape as a serious social problem that was not committed by a stranger jumping out of the bushes at night, as most females had been socialized to believe, but rather rape was committed by males women knew and trusted as intimate partners, dates, friends or acquaintances.

Collectively, these works not only laid the foundation of our current knowledge about sexual violence, but they also sparked lively debates and discussions about measuring the extent, correlates and impacts of sexual violence against women as well as, quote, “what works” in terms of prevention and intervention.

This discourse included members of two communities. The first was scholars from a variety of disciplines who wanted to more fully understand the extent and nature of violence against women. The second was the community of service providers and advocates who wanted to promote the safety of these women and to be able to effectively address their needs. Both communities helped document the wide reaching, negative toll on women's lives, including their mental well being, their physical health and their economic sustainability.

Research has also confirmed that professionals, therapists and victim advocates who help women recover from rape experience vicarious trauma. Rebecca Campbell's work also has shown that those who study rape can become emotionally affected by investigating the devastating effects of rape.

As evident at this NIJ conference and the numerous other violence against women conferences that are held annually both in the United States and abroad, the passionate drive of these two communities is as much alive today as it was back in the 1980s and the early 1990s. Importantly, the collaboration between these two communities, at least my experience since the passage of the Violence Against Women Act, has grown and matured over the course of the last 15 years. This is perhaps due to the increasing number of women who have enrolled in colleges and universities, especially those who are being educated in a range of disciplines that examine violence against women issues.

Each community has grown separately to develop its own identity, but these two communities have also grown together because each has come to recognize and appreciate the complexity of sexual violence and the benefits of each other's efforts. We recognize that to effectively reduce violence against women, research needs to be translated into practices, and practices need to inform future research.

Lessons learned from each community and their collaborations need to continue to be disseminated through a variety of means, so that good research and practice remain well integrated throughout both communities.

These two communities have also moved to develop a vocabulary to communicate effectively with each other. Having a vocabulary to describe and explain sexual violence has helped to facilitate public awareness and discussion on sexual violence not only in general but also in schools, among children and teens, and among employers and employees in workplaces.

The fruits of researcher and practitioner relationships are quite apparent when looking at the amount of publications and Web based resources. Both communities have helped to facilitate the growth of the publication and the dissemination of sexual violence resources that are readily available and relatively cost free to the public via electronic bibliographies such as the National Crime Victimization Reference Service or even Google Scholar.

In preparing for this panel, I went to the NIJ home page and found myself immersed for quite some time in the amount of information that they had organized under such titles as “Rape and Sexual Violence” and “Violence Against Women.” There is a plethora of written, video and audio training materials available on the NIJ Web page, as well as lists of conferences, workshops, webinars and forensic training for sexual assault.

NIJ has certainly changed its appearance from its early Web presence in the past 15 years. I don't know how much Violence Against Women Act monies went into producing and disseminating this information, but I can tell you it's well worth visiting the NIJ website to see what information they have to offer at a click of a mouse.

The number of academic journals devoted to violence against women issues has grown from less than a handful of journals in the late 1980s that included JIPV and Violence and Victims to more than two or three dozen, including Feminist Criminology which was launched in 2006.

Much has changed in the last 15 years. Library shelves would groan over the weight of the numerous articles that are being published annually. Fortunately, these articles are now being stored electronically on servers that appear to have an infinite storage capacity. I must admit that it is challenging for me to keep up with all the latest published works that address issues concerning rape and other forms of sexual violence against women. In talking with others, I don't think I'm alone in this challenge.

Carol Jordan's recently published Results in Violence Against Women indicate that the incidence of the keywords, “sexual assault,” “sexual violence,” “IPV” and “stalking,” in five major bibliographic databases in the behavioral, biomedical and legal disciplines have increased substantially over the course of the Violence Against Women Act. For example, the number of database hits for the keywords, “sexual violence” and “sexual assault,” each increased about 200 percent from 1997 to 2007.

In light of her results showing increased publication productivity and ease of access to these materials for many, not too surprisingly, I would predict that the sustained interest in violence against women issues will remain, and that the growth in the amount of information produced by researchers, practitioners, advocates and their collaborations will also continue to grow.

Thankfully, each year I have a few graduate students who are interested in violence against women issues, and they help keep me abreast on the latest research results, programs, interventions in the field.

I always remind my students that they should not solely focus their readings on criminal justice or psychology based information. Rather, their readings about sexual violence against women need to expand to include a wide variety of disciplines. I credit the influence of the Violence Against Women Act and the collaborations among researchers and practitioners with helping expand interest in violence against women.

My students as well as I now have to read materials from the fields of sociology, economics, law, social work, nursing, medicine, forensic science, pharmacy, epidemiology, and local and city planning to get a full appreciation of the depth and breadth of available information.

When some of my mainstream criminal justice or criminology colleagues kid me about my research area, I remind them that they have a relatively easy job mastering one field of study, and if they want to be challenged theoretically, methodologically and even ideologically, they should consider studying the sexual victimization in women and master the works produced by at least a half dozen disciplines that influence this area. Not too surprisingly to date, none of my male colleagues have taken me up on my offer. Perhaps I need to take a different tact.

Now I'm going to turn to the second topic I want to comment on today: measurement of sexual violence. Researcher practitioner collaborations have helped to develop a greater appreciation by each community for the need of high quality measurement to inform evidence-based policies and programs. We have come to realize that understanding the extent and impact of sexual violence is complex, as are estimating the effectiveness of prevention and intervention efforts.

We need appropriate methods that can help us capture the complexity, so we are able to speak with confidence about our results. Methods are fundamental not only to pursuing our interest in violence against women but also to generating evidence-based knowledge that is respected and used both within and outside our respective fields.

In the name of time, I'm only going to comment on measurement. Since the passage of the Violence Against Women Act, there have been continued advances in the measurement of sexual victimization and perpetration. When I use the word “measurement,” I am referring to quantitative measurement; yes, all those countless columns and rows of numbers that are used to generate estimates of the prevalence and incidence of violence against women, as well as to estimate correlations and coefficients and standard errors of the predictors of violence against women as well as the effects of programs.

This type of measurement usually provides answers to how much questions about sexual violence. These numbers have been used to bring attention to the magnitude and the predictors of specific types of victimization, as was done in the National Violence Against Women Survey for forcible rape, physical violence, and stalking.

Whenever I tell people I teach statistics, I can always tell the stats people from the not so stats people by their initial reaction. To ease the not so stats person's reaction, I usually point out David Border's words that, quote, “Statistics are human beings with the tears wiped off,” end quote.

Hopefully, these words give them an indication that there are stats people who also realize that there is a person behind each data point. I can assure you this is a constant message I make clear to all my students.

Even though I try to give empirical estimates a human face, I am still very aware that quantitative measurement cannot answer all our questions. This is why I also use the term “measurement” to refer to qualitative measurement. Narrative of women's experiences of sexual violence and how they cope with these experiences are also rich sources of information. Qualitative information can be particularly useful when answering the “how” and “why” questions about sexual violence.

And it is these types of “how” and “why” and “how much” questions that have captured the attention of researchers, practitioners and advocates alike and questions that they have attempted to answer during the last 15 years of the Violence Against Women Act. Their complementary expertise has resulted in creative mixed methodologies that have helped to push our envelope of knowledge and practice across the board from basic research to service delivery to evaluations of programs.

In looking over the definition and measurement category of NIJ's Compendium of Research on Violence Against Women, 15 grants are listed under the violence and victimization research category, so let's see. That's only about one grant a year since the passage of the Violence Against Women Act.

Beyond the mere funding of these grants and the usefulness of the results to inform solutions, advances have also been made in measurement with respect to sexual victimization. Since the passage of the Violence Against Women Act, NIJ has funded or co funded three national level studies of violence against women, including, as Becky pointed out, the National Violence Against Women Survey and the National Sexual Victimization of Women Study and many smaller scale ones that have generated lots of self report survey data.

The late Linda Saltzman, a distinguished fellow and senior scientist at the Centers for Disease Control and Prevention, was a good colleague to many. Throughout my career, she reinforced and reinvigorated my interest in the importance of good measurement of sexual victimization. She persistently worked on establishing uniform definitions of sexual violence. She and her colleagues recommended data elements for consistency in data collection.

Influenced by these efforts, the CDC put together two compendiums of assessment tools respectfully titled Measuring IPV Victimization and Perpetration and IPV and Sexual Victimization Assessment Instruments for Use in Health Care Settings. Both compendiums represent the advancements and measurement that have been made since the passage of the Violence Against Women Act.

Many of these assessment tools are being used daily in health care settings to screen and assess for victimization and stalking, and researchers also routinely use them.

Historically, Mary Koss' Sexual Experiences Survey has been one of the most widely used measures. It, too, has evolved from what we have learned since the passage of the Violence Against Women Act. Koss and her dozen or so colleagues published a revised version of the SES in the late 2007. One primary change to the SES is the use of more behaviorally specific wording in the questions that provide descriptive cues with a scenario framework. As survey methodology research has shown, these types of questions make it more likely that the respondent will recall an event or understand that the event might be a victimization.

Two other changes also highlight the advances made in the measurement of sexual victimization since the passage of the Violence Against Women Act. First, researchers have well documented that not only are women at high risk of being revictimized as adults, if they were victims during childhood or adolescents, they have also shown that a substantial proportion of women will be repeatedly victimized during adulthood.

And Koss' newly revised SES has taken this into account because she also has questions that ask about repeat victimization.

I would also like to add that some of the research also shows that some of these screen questions, I want to say aren't enough, that we also need to take into account the value of incident reports, which provide us lots of information about what happened before, during and after a specific incident, so they can inform us about the process of a victimization.

Another example of an advancement in the measurement and categorization of rape is evident in two NIJ funded studies, one by Chris Krebs and Chris Lindquist of Research Triangle Institute and their research team, of which I was a member, and the second one led by Dean Kilpatrick and his colleagues at USC. These two studies build on the role that alcohol and/or drugs play in fostering sexual violence. They contribute to developing measures that can explicitly distinguish forcible rape, alcohol, drug induced rape and incapacitated rape. This is important because a growing number of researchers as well as prosecutors have begun to distinguish between different forms of rape, being able to measure different forms of rape, estimate their extent, identify their unique predictors as yet another avenue for researchers and practitioners to continue to pursue.

I'm just going to briefly go through the “so what” that Karen asked me to comment on. Why should measurement matter to both researchers and practitioners? A mathematics professor at Temple University summarized an answer to this question quite nicely in a New York Times Magazine article last month when he wrote, quote, “Unless we know how things are counted, we don't know if it is wise to count on those numbers,” end quote.

Continuing to improve upon the measurement of sexual victimization, its correlates and its impact should not be overlooked, especially in the age of evidence based programming, where translating research into practice and having practice inform research should continue to be among the goals of the Violence Against Women Act as we head into the next 15 years.

And I just want to in closing — I'm going to have to briefly summarize. Looking at what has been counted and what relationships have been estimated, I think there's some promising news. Looking at both the UCR and the NCVS rape rates over the last 15 years, both sources report that rape rates have decreased during this time.

Now, an important question to ask is can this drop and rape rates be attributed to violence against women funding. I would direct your attention to Rachel Boba and David Lilley's 2009 article that was published in Violence Against Women, and their finding seemed to suggest that there is evidence of a positive effect of Violence Against Women Act funding on reducing rape rates.

In terms of future directions, as you might expect, I think given the marathon that we're in — because I don't consider this a sprint that lies ahead; it's definitely a marathon — I think we need continuation of the researcher practitioner collaboration and the sharing and dissemination of sexual violence materials. I see an increase in sexual violence information, but, also, I'd like to see more jointly funded projects in order to do what I call the “big science.”

We know that we've had a lot of small scale projects that have been done, but I think the time now is to do some big science and to do some replication in terms of these smaller scale studies to see if we can see replication across time and places. And all we have to do is be reminded of the Minnesota Domestic Violence Experiment, and we well know that those results were not replicated. So I think the time is to do more jointly funded projects, so that we can do some more big science.

And last, let's also not forget that violence against women is not solely a U.S. issue. It is an international issue, and I want to just point your attention to the International Violence Against Women Act. It has bipartisan support. It's a bill that addresses, for the first time, violence against women and girls throughout all relevant U.S. foreign policy efforts, including international assistance programs.

So, once again, this legislation reminds us that violence against women is not just a U.S. issue or located in the United States. Violence against women and girls is a human rights violation occurring globally and one that we should be mindful as we move forward in our responses to violence against women in the United States and abroad.

Thank you.

[Applause.]

Rebecca Campbell: OK. So I think Bonnie did an excellent job in helping us get a feel for what have been some of the measurement and definitional issues that have been key advancements in the past 15 years, and in my second half of my talk, I'm going to pick up the issue of what do we do about it in terms of the justice and community response and where we are at with the community response to rape, 15 years after VAWA.

In the research on the community response to rape, there's, generally speaking, two types of studies. One are what I would call “services as usual studies.” So, in the standard criminal justice system, standard advocacy, standard hospital emergency department, what are victims' experiences with these systems? Do they get the services that they need and want, and how are they treated?

And then the second main strain in this body of research are what I broadly call “intervention studies,” which are what are victims experiences with new community level programs that seek to change the status quo, the obvious implication there that the results from the services as usual studies suggested that there was probably a need for something different. So what I want to do is highlight for you what have been some of the key findings in each of these two areas of research 15 years after VAWA.

So what have we learned with respect to services as usual? What are victims' experiences in the community? Well, research funded by the NIJ sexual violence portfolio and others very consistently finds four major issues, four major findings. First off, most sexual assaults are not reported to the police. The rates of reporting to law enforcement vary tremendously across study. We could have interesting conversations about how and why and what the measurement issues are there, but I would challenge you to find a study that can top 40 percent. At best, I think about 40 percent of sexual assaults are reported to law enforcement, and that's a pretty high estimate.

Why don't they report? Because victims are very concerned about how they're going to be treated by law enforcement. They're concerned that they're not going to be believed. They're concerned that they're going to be treated in ways that revictimize them, and these issues are particularly of concern for African American women and other women of color, given institutionalized racism of the criminal justice system.

And, if women do report, most of the cases are not going to be prosecuted. Multiple studies continue to document that. Again, the rates vary depending upon how you do the math, but, in general, on average, 17, 20 percent of sexual assaults are going to end up in some type of guilty plea or conviction at trial.

What do victims need, what they want? They want comprehensive services. They want when they turn to their communities to be listened to, to be believed, to have the services that they need, to receive the medical care that they need, to receive the psychological support that they need, to have the legal system believe them, support them, and try to pursue their cases.

And that has led to the development of many new community level interventions to try to change services as usual. These programs began developing in the 1990s and developed very quickly and disseminated like wildfire, and the two most common types of interventions that are in practice now are Sexual Assault Nurse Examiner programs, or SANE programs, and Sexual Assault Response Teams, or SARTs. I want to say a few words about what these programs are.

The goal of these programs is to provide comprehensive patient care in a safe, supportive environment. The word “patient” there is very deliberate. SANE programs are nursing practice. They are not a tool of the criminal justice system. They were created by the nursing profession to respond to the health care needs of sexual assault survivors regarding injuries, sexually transmitted infections and the risk of pregnancy.

That said, because they're nurses, they also focus on the psychological health of their patients and try to provide crisis intervention and support after the trauma of the assault, but they're also forensic nurses, so they do collect the forensic evidence from the survivor's body. And, as a result of that, they do stand in an interesting position between the medical system and the legal system, but their focus is really on providing comprehensive medical care to their patients.

And, in addition, most SANE programs work in multidisciplinary collaborations. These are often the SART teams, where they bring together the advocacy community, law enforcement, prosecutors, other disciplines to try to coordinate their efforts, so that victims' cases don't fall through the system, so that they can look and see what do we need to happen for this case to be prosecuted, does the survivor want it to be prosecuted, how can we have a victim centered approach to care.

And many SANEs and SARTs try to address the gap that we have in law enforcement and in prosecution for consultation, training and resources. Many of the early research studies also found that police and prosecutors were very frustrated with the amount of training that they received as part of their basic education on sexual assault. So SANEs and SARTs are able to respond to that need by providing resources that law enforcement and prosecutors need and to be able to do their jobs more effectively.

So what have we learned about research on these kinds of new innovative community interventions? Well, the NIJ sexual violence portfolio has invested quite a bit of funding into the studies of the efficacy of community level interventions. When I showed you at the beginning those slides on forensic and investigative efforts, the bulk of those studies are studies of the efficacy of SANEs and SARTs.

And the results across these studies find that victim care is substantially better than services as usual. What victims experience in SANE programs and SARTs is a much more empowering, humane, respectful form of post assault care, and the results suggest that these SANE/SARTs' interventions can contribute to increased prosecution. So those abysmal rates regarding reporting and prosecution, maybe not so abysmal anymore in the face of these interventions.

So what I want to do now is take a few moments to try to glue together the results across all of the different SANE/SART studies and show you in a visual way what it looks like right now regarding SANE/SARTs' effectiveness.

So the $6 million question there says, “What will increase prosecution rates?” It's just a box at the bottom says “increase prosecution.” I know many of you in the back can't see it.

OK. So, if you look at these studies as a set, what it appears is that, OK, the reason why we see increased prosecution from these types of interventions is that the medical forensic evidence now being collected by SANEs is just flat out better quality. The evidence is better quality. The documentation is better quality. What law enforcement and prosecutors have to work with in terms of the evidence, the medical evidence of the assault is far superior to what they had before the advent of SANE programs and SART programs, and that in and of itself is a key contributing factor to why we see increased prosecution rates in communities after they've implemented these kinds of interventions.

But it's not just the evidence itself. It also has to do with the collaborations. The medical forensic evidence collected by SANEs helps save time for police. When victims had emergency room hospital exams, the police often had to wait with them. Rape is very rarely an emergent health threat, so it wasn't uncommon victims would have to wait for six to eight hours in a hospital emergency room to have an exam. Police would often have to wait with them. That's six to eight hours. That's, you know, very difficult for the survivor, and it's a complete waste of time for law enforcement. They can't do anything. They're stuck there.

By having the survivors be examined at the same programs, the police officers just got six to eight hours freed back to them to put into the investigation, and they do. In these communities, we find that they do turn around and use that time to look at crime scene evidence, track down the suspect and the like, and that helps them put more investigational effort, and they get more evidence out of the case.

And then, finally, these SANE and SART programs, as I said, provide training and ongoing consultation. So it addresses the need and the real interest that law enforcement and prosecutors often have to know more about how to prosecute these cases. So SANE and SARTs can provide training and provide them with information and resources, so they know what it is medical forensic evidence can do for them in trying to move forward with a case. And, again, that helps contribute to increased prosecution.

So these studies suggest that when you take all of these different factors about the evidence, the training, the collaboration, those factors work in concert to increased prosecution rates, and when we come at it from the other direction, the better victim care, the better patient care survivors receive in SANE programs means they're less traumatized. And when survivors are less traumatized, they're in a better position to make a decision about involvement with the criminal justice system, and when they enter into the system, they're in a much better place to contribute and to share information with the legal system. So it works in both directions. Why we do we see increased prosecution? It provides incredible and important resources to the legal system, and the survivors are in a very different place of engagement.

So that's what we know from the compendium and other funding about community resources for sexual assault survivors. What are the key gaps? The most salient one in my opinion is that there's far more SANE/SART programs in practice than have been rigorously evaluated. When I said these grew like wildfire, I wasn't kidding. A conservative estimate is there's now about 400 SANE/SART programs in the United States. How many have been rigorously evaluated? About four. OK. So saying that these interventions can necessarily increase prosecution rates would be a vast overstatement. So there's a real pressing need to evaluate more SANE programs, and these aren't the only community level interventions out there. There's growing interest in restorative justice and other types of collaborative programs to seek redress for survivors. We need evaluations of those programs as well.

And in any type of community intervention, it's important to understand how these interventions work with survivors from marginalized populations. Most of the studies to date of SANE/SART programs have had predominantly Caucasian samples. That is a huge limitation in this literature, and it's important for us to understand how these interventions work for women of diverse races, ethnicities, and social classes, as well as those living in tribal communities.

So where do we go from here? I think that this research really emphasizes the importance of researcher practitioner collaborations. It's very hard to study community interventions without actively involving the community. You're going to miss a lot. And I think this emphasizes the importance of developing what I call “organic collaborations,” meaning there's been a long term relationship between researchers and practitioners that naturally flows into a research study, but we also need to find ways to support “opportunity collaborations,” I call them, the response to the RFP, where you don't necessarily know each other, but you need to start knowing each other.

And the NIJ has recently started funding research on researcher practitioner collaborations to figure out how do we support organic collaborations that develop over time, and when the timing is right and the money is available, how do we get together quickly to respond to a unique opportunity.

And as we move forward, I think it's important for us to share, then, the substantive findings of these studies as well as the narratives regarding the collaborative process. How do we work together? If SANEs and SARTs can figure out how to bring together vast, arguing, bitterly divided practitioners to work together, I am quite sure that researchers and practitioners will have no trouble working together in ways that will benefit survivors.

So thank you, and I'm going to turn it over now to Delilah.

Delilah Rumburg: I do want to respond first, though, to — the second reauthorization of the Violence Against Women Act, actually has created a dot dot dot and “sexual assault,” because they created the National Sexual Violence Resource Center opportunity, and PCAR was successful in getting — winning that cooperative agreement with CDC to create the National Sexual Violence Resource Center, the first VAWA had the Domestic Violence Resource Center, but it wasn't until five years later that we got the National Sexual Violence Resource Center.

And so I want to talk a little bit about what we've been doing through the NSVRC to build a capacity of the anti sexual violence movement understanding and utilization of this research. We've developed a national collaborative of researchers and practitioners, and the goals of that collaborative are, number one, to facilitate networking between different experts, synthesize the information on sexual violence and its prevention, disseminate seminal literature to a wider audience, and explore what is known and unknown about sexual violence and its prevention and to determine where research needs to be directed.

You also need to know that our funding is under the rape prevention education line item, so most of what we do really is focusing on the prevention of sexual violence through the creation of our resource center.

We also maintain several other mechanisms that inform the development of research priorities. We do an annual survey with state, territory and tribal sexual assault coalitions. We maintain a detailed call center database that tracks requests for information and research that we receive and that we can analyze that on a monthly basis and begin to track trends. We also conduct regular focus groups on emerging issues in the field.

So, in addition to that, we continue to synthesize and disseminate those research findings through partnerships with researchers, research institutions and funders of research, and we maintain a comprehensive research collection in our library. So most of you are probably familiar with that. If you've been doing this work at all at the www.nsvrc.org, you'd have access to that really comprehensive library, and I think we have over 20,000 items cataloged. I think the first five years of our — we said we'd have 10,000. We have more than doubled that in the last five years.

But one of the things as I prepare — oh, before I go into that, I wanted to talk about — we did identify priorities. So those of you that are researchers that are looking for areas to get funded, let me tell you what has been identified by the field as what they see as priorities, and this was by our studies in 2009.

Number one, we want to know the effectiveness and the outcome and the impact of advocacy services for sexual assault victims and their families and friends and partners.

Secondly, we need to know what the cost of sexual violence is. What is a comprehensive study that talks about it across the life span? I think the domestic violence folks are really good at talking about that, and we don't have enough analysis. There's been some but no really good research that allows us to talk about that.

We also need to talk about the cost effectiveness of our programs, including the SANEs and the SARTs. Those are the kinds of things we need to know when we're trying to market our programs and get funding to continue to do this work.

We also would like to see updated data on the public perception about sexual violence. We think that has changed since the Violence Against Women Act was passed. We also want data on reporting investigation and prosecution of adult sexual assault.

Additionally, we need to know about the effectiveness of the culturally specific outreach programs and the response to systems to those traditionally underserved populations.

We also know there's the data regarding the gap between sexual assault laws and the enforcement of those laws.

We'd also like to know what social marketing campaigns have the greatest impact to change public behavior within specific groups such as young men in rural communities.

And lastly we'd like to see the further examination of the rates of false versus unfounded reports of rape and sexual assault. When I was working with the Department of Defense, there was this huge misunderstanding. If they said a rape was unfounded, everybody just assumed it was a false report. We need to have more data to help us be able to explain that, particularly, you know, to our local communities and our jury pools.

So, again, as I looked at this, preparing, I decided to look at what has really changed in the last 15 years in the field of services, and, certainly, this probably isn't that complete list but certainly the money. I started doing work in a domestic violence shelter in the '80s, and compared to where people were then after the passage of the Violence Against Women Act, the money just increased, quadrupled, more than quadrupled. But what's happening now, we're starting to see that erode. So we had this huge peak and all these services started to balloon, and, actually, now we're starting to see the loss and many of the things we started over the first 15 years of the Violence Against Women Act, and that really is causing me great concern.

I had one local director say, “I wish we had never had all that money because we started promising everybody we could do all these wonderful things, and now we have to keep saying we're sorry, we can't do that anymore, there's not enough funding to allow us to do that.”

Secondly, what has changed is certainly the body of knowledge. None of this was — we didn't have access to it. It just wasn't there 15 years ago. I think that it was happening, what you were doing. I know you were doing it many years ago, but we didn't know about it for sure.

Also, we've always had a really good crisis response, but we really started focusing on primary prevention in the last 15 years. Prior to the Violence Against Women Act, there was very little focus in the field on the prevention of sexual violence.

Certainly, technology is huge, a huge impact on what that means to services. Not only do people have — readily have access to the information, but it's also making us look at how we provide services. You provide services to a 14 year old very differently through technology and what they want through technology versus what those that are my age may have expected. You know, we pick up the phone and call the hotline. The younger generation, they're not going to do that. So those things are changing every day, and we're having actually a very difficult time trying to stay on top of that. So that would be another area of research that I didn't list, how can technology, how can we use technology to respond to the future generations when it comes to services.

The other thing is the sex offender treatment. Involvement of advocates have become more involved in the treatment of sex offenders. Men are more involved and engaged than they were 15 years ago, and, certainly, we're now doing evaluation locally. That is just starting, and particularly with services in Pennsylvania, we're just going to start requiring evaluation of services and outcome measurements starting July 1. And we've been working on this. I know when I met you 15 years ago, it was like, ah, we have to do it, that it's coming, and it's taken us 15 years to get a tool ready that we can really begin to evaluate quantitatively — or not quantitative — qualitatively. Do these services work and which ones work better, what can we do about that? That's a huge step forward. I think to many of us, it's a little frightening, but we're excited about the fact that we're really, really beginning to say we're going to evaluate the effectiveness of our direct services.

Of course, then we're going to be challenged. Our next step is how do we evaluate and determine the outcomes of our prevention. That's a huge leap forward, and, certainly, we're going to need a lot of research.

How do we measure these programs? We talk about the data saying that rapes are going down. I'm not sure that we know that. It may that media has caused more rape victims even more to come forward. We really don't know that. So I think how can we really measure all these new prevention programs we're putting in place now, do they work? Because we're — we've got to figure that out.

And, certainly, our field has become more professional. I think a lot of people don't like that, but what does that mean? So how do we maintain that grass roots activism and become more professional, but that is certainly evolving, and most of our programs are becoming more professional, so to speak.

And, certainly, the SANEs and SARTs, before this, you know, there was less than six in Pennsylvania, and those numbers in Pennsylvania quadrupled. As she said, they have just grown by leaps and ground — by leaps — what do you say? Leaps and bounds.

[Laughter.]

Rumburg: That didn't come out right.

But what hasn't changed, obviously, is the grass roots. It is still there. As I said, we've become more professional, but that grass roots commitment has not changed providing those basic services.

Certainly, we continue to do efforts in the community about education and awareness, but we still aren't doing skills building when we're out there doing these programs. We still haven't changed that.

The number of programs has remained, where crisis centers have not changed, and PCAR is one of the oldest coalitions in the country, and the number of rape crisis centers has changed very little, but now with funding becoming so difficult, we're starting to see a decrease in the number of those centers. And if they don't completely go away, then they merge with the domestic violence programs.

So, as I was preparing for this trying to figure out what kinds of questions to ask and I looked at the compendium and I saw this research and certainly noted that most of it's for domestic violence — and I realized after — and particularly in Pennsylvania, we're a rural state. We have 51 centers that cover 67 countries. We're mostly rural. And that information, even though we have the national resource center in our back yard, that body of knowledge is not making it down to Small Town, USA. I think we've learned a little bit.

As I said, we've become more professional in our services. We certainly changed our community education programs. As I said, we're focusing on primary prevention, but even in Pennsylvania, we continue to fund all these different projects. You know, every year we do — put out special initiative grants and continue to fund just these status [inaudible]. We keep making it up as we go. So we've got all these great things out there, but we've not pulled it together. There's great research. There's great prevention programs. We know some of those are working. We're beginning to have some of these studies that say this really looks like it's a promising practice.

So what I want to know — and I'm going to ask my friends here — how can we put that together? That's what I want to do now, take what we know about what are the best services, whether the cognitive therapy, how can we take that and use it in our local programs, what kinds of prevention programs are working. What I want to do is to identify some model programs, and I can tell you there are probably five or six in Pennsylvania that, if I had an overlay of the best of what we know in research, if I could take all that, services and prevention, and put it in half a dozen communities and really then partner with our researcher friends, let's figure out what works and what doesn't work, we haven't done that.

So I'd like for you all to think about how can we take that. We keep talking about that gap between research and practice. How can we do that now? That should be our next step. Let's take what we know, let's apply it locally.

Any thoughts on how we can begin to do that?

[Laughter.]

Rumburg: That's a big question, I know.

[Simultaneous speaking.]

Karen J. Bachar: Use the microphone.

Bonnie S. Fisher: I'm not shocked. I actually pick up the phone and call people or I go visit people and I introduce myself, and I say, “Here's what I'm interested in. Can we collaborate? Is there anything, you know, I can help you with?” So I'm a very outreach person, but I have found that that helps, as you were suggesting with the organic ness of it [inaudible], so that there is a partnership, so that we can talk to each other and work with each other in sort of a very natural way, but sometimes it just takes that one person, you know, either the researcher or practitioner, just to outreach, to knock on doors, to pick up the phone.

I mean, that's always worked for me, and it might not be the way — the only way.

Rebecca Campbell: I agree with what Bonnie said, and to that, I would add I think there's another opportunity for bringing research and practice together, and that's in the way that practitioners are being trained, the way advocates are being trained.

In a midwestern state that I live in that shall remain nameless, I had the opportunity to do an in depth analysis of the training of service providers in that state. I don't think it's anything particularly surprising or unique, but I was shocked, the extent to which rape crisis advocates, law enforcement and prosecutors were being trained on really dated information.

And particularly with your comments about technology, there's been quite a bit of emphasis in developing online training for practitioners. Ending Violence Against Women International has developed some really nice online training resources for advocates, for law enforcement through prosecutors. We're actually going to do a test in our state to phasing in online training for all practitioners of the sort of idea of like let's just start over and let's try to bring evidence-based training into practitioners as a way of bringing the research into the training itself, so that when they're being trained from the get go, part of that training is a synthesis, and it is a summary of what we found in our research today. So I think that it works both ways, of bringing the research into the training of practitioners and for researchers to do, as Bonnie is suggesting, which is to get out and make the contacts ourselves.

Fisher: And another way I do that, in my victimology class, all the students know that they're going to have to go out and talk with service providers with respect to what types of services are available locally to address different types of victimization. That's always going to be a requirement of my class. So I always make sure that the students, if you will, are ambassadors of knowledge, that they take what they learned in the classroom, because one of their assignments is they have to go talk to service providers and basically incorporate in their discussion what they've learned in the class to see how it's being applied outside the classroom and then bringing that service provider information back into the classroom, so we can look to see what's being provided outside the classroom in conjunction with what we know in terms of research.

So we spent a whole quarter doing that. So that way, service providers in the community also know that there are interested students, and a lot of times, that turns into internships, which is very nice for the students as well.

Bachar: Last question.

Rumburg: Oh. Well, I only had like three main questions.

It didn't still quite get to how do we do that, take what we know and really replicate it and understanding that we do have the training, but you know how it costs hundreds of thousands of dollars to develop that online training. And I know in Pennsylvania we're trying to do that.

And we also — there are a couple of things that we're concerned about — is that you have to have so much face to face time when you're training advocates. So we're trying to find that balance of how much face to face time can you have and how much can be online. So that's one of the reasons I think you're not seeing more of that, but I know in Pennsylvania, we're really — we're getting ready to invest a bunch of money and doing that to really develop that, and, certainly, it would be available for people to replicate.

I guess the other thing, then — and I think I'll mention this — how can we better serve, then? What do we know about research? When I was looking at the compendium, there's so many different ones, African American communities, Latino communities, communities of disabilities. So how do we take that body of information and understand what's working well and what's not and apply it locally? I know many of us are still struggling with how do we do more effective outreach in those communities, what do our services look like. So how can I take what you all know about that or what NIJ has funded and apply that locally as well?

Bachar: In 25 words or less.

Campbell: Twenty five words or less. Well, I think part of the problem is that what makes it difficult to get that kind of information down to the local level to practitioners is that we don't have much of it to begin with. The research on the experiences of women of color and other marginalized groups remains a major gap in the compendium. I think is also reflects the under representation of people of color in the academy and those who receive funding.

That said, I think it also is a challenge to all of us with white skin to move beyond that and to do research with communities of color. There's been some excellent examples. There's a recent study funded by NIJ and Historically Black Colleges and Universities that involved many predominantly — the researching was predominantly Caucasian. They did a fabulous job of understanding the prevalence of sexual assault in that and really worked with their community partners to assess that particular issue in that particular population. So I think it's a challenge on both fronts.