Abby Kelly-Smith, Chair Sexual Violence Primary Prevention Council Indiana State Department of Health

 Physical Health ◦ Injuries ◦ Disability ◦ Unwanted/unplanned pregnancy ◦ Sexually transmitted diseases ◦ Increased risk for onset of chronic disease and early death (Adverse Childhood Experiences Study)  Mental Health ◦ Increased risk for substance abuse (tobacco, alcohol, drugs) ◦ Increased risk of depression, anxiety, post- traumatic stress disorder, and suicide

Public HealthClinical Health PopulationIndividual HealthDisease Prevention & Health Promotion Diagnosis & Treatment

 Primary Prevention: Approaches or activities that take place before sexual violence has occurred to prevent initial perpetration or violence/victimization; (universal and selected interventions)  Prevention is: A systematic process that promotes healthy environments and behaviors and reduces the likelihood or frequency of violence against women. Source: Centers for Disease Control and Prevention, The Prevent Institute

 “Violence can be prevented and its impact reduced, in the same way that public health efforts have prevented and reduced pregnancy-related complications, workplace injuries, infectious diseases, and illnesses resulting from contaminated food/water in many parts of the world. The factors that contribute to sexual violence…can be changed”. ◦ Dahlberg and Krug, 2002

Define the Problem Develop & Test Prevention Strategies Assure Widespread Adoption Identify Risk & Protective Factors Step 1 Step 2 Step 3 Step 4

A Social Ecological Approach Societal CommunityRelationshipIndividual

 “It is unreasonable to expect that people will change their behavior easily when so many forces in the social, cultural, and physical environment conspire against such change.” - Institute of Medicine

Risk Factors for Perpetration Societal CommunityRelationshipIndividual -Alcohol & Drug Use -History of physical and/or sexual abuse -Hostility towards women -Hyper-masculinity -Sexually aggressive peers -Strongly patriarchal family -Observing family violence -Poverty -Lack of economic opportunities -Weak community sanctions -General tolerance of sexual violence in the justice system - Social and cultural norms supportive of sexual violence, such as male superiority/sexual entitlement

Protective Factors Against Perpetration Societal CommunityRelationshipIndividual -Strong sense of respect for others -Connectedness to school -No history of physical or sexual abuse -Relationships with peers who exhibit respectful behaviors to others -Observing equality, respect, and non- violence in the family -Educational and extracurricular/social opportunities -Collective efficacy of the community -Low tolerance of SV in the community justice system - Social norms supporting gender equity -Strong policies against sexual violence -Low tolerance for violent crime

Potential Interventions Societal CommunityRelationshipIndividual -Interventions targeting social, cognitive skills and behavior -Educational Sessions -Bystander intervention and healthy relationship skill development in various settings -Parenting classes -Policy development & implementation for no tolerance of SV in workplaces, schools, the justice system, etc. -Positive youth development opportunities -Engagement of multiple partners to change laws and social norms related to violence and gender inequity -Social marketing