Sexual violence resistance education for women university students

About this review

This Intervention Review is primarily based on two systematic reviews and 16 primary studies, one of which was published across five documents.

The review draws on the best available impact evaluation evidence. The studies were selected against set selection criteria which is based on a rigorous and comprehensive search and screening process. This review includes impact evaluations of the intervention and therefore does not necessarily reflect all evidence on the intervention. Further materials on this intervention are listed under References and Further Reading.

See the Prevention Evidence and Gap Map to explore similar interventions. For details about the individual studies, see the Included Studies section. For further information about the methods informing this review, please see the Intervention Review Technical Report (forthcoming).

This Intervention Review is comprised of interventions with an educational and risk reduction focus, which often include verbal and physical tactics for resistance. It does not include sexual violence prevention programs that primarily focus on self-defence training without an educational component. Self-defence interventions will be the subject of a forthcoming Intervention Review.

Suggested citation: ANROWS. (2023). Sexual violence resistance education for women university students. Evidence Portal Intervention Review. ANROWS.

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Date Created: 18 January, 2024
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At a glance

Intervention

Risk reduction and resistance education delivered in tertiary education settings to educate women about how to reduce their risk of sexual violence and use resistance strategies

Key populations

Adult women who are university or college students

Outcomes studied

Gender-based violence; health; behaviours; knowledge, beliefs and attitudes; wellbeing and emotions; relationships

Impact of the intervention

Of the 18 studies, 9 outcomes received an effectiveness rating on our Effectiveness Estimate Tool

Australian Evidence

None of the studies presented findings from Australia

Risk of bias

Of the primary studies with available quantitative data, we rated 1 as moderate, 11 as moderate-high, 2 as high and 1 as very high risk of bias on the Risk of Bias tool The systematic reviews were rated as moderate and critically low confidence on the AMSTAR-2 tool

Intervention description

What are the key characteristics of the intervention?

Sexual violence resistance education programs seek to provide women university students with information about sexual violence, the associated risks, and practical self-protective strategies to avoid victimisation or increase personal safety. They also focus on ways to decrease self-blame for women who may have experienced sexual violence. Nearly all programs focused their content on risk reduction of sexual violence perpetrated by “acquaintances” or those known to participants such as classmates, friends and ex- or current intimate partners, rather than strangers.

The programs share common core elements, and generally involve:


Programs often include a component on verbal and physical resistance for sexual violence and feminist self-defence. They generally develop skills in awareness and body language, verbal, and physical techniques for forceful resistance.

Some interventions integrate multiple components of risk reduction from previously tested programs with additional content on emancipatory and positive sexual education that teaches participants about healthy sexual relationships, sex positivity and empowering women’s sexuality.

Some argue that the focus on educating women on strategies to prevent or reduce their own risk of sexual violence victimisation amounts to programs being inherently “victim-blaming”. Others argue that this intervention forms part of a comprehensive approach to prevention to empower women with the knowledge and skills to reduce their potential risk of victimisation.

There has been a shift over time in this thinking, with earlier programs mostly covering content on women’s own resistance to sexual violence. Meanwhile, more recent programs have evolved to include a stronger emphasis on placing the blame firmly with the perpetrator , not victims and survivors.


What does the intervention involve?

Where is the intervention set?

Tertiary education settings, including universities and colleges

How is the intervention delivered?

By a peer student facilitator or a professional (or both) who are women, in face-to-face groups of 15-30 participants. Often delivered via a presentation or video with interactive activities.

How frequently is the intervention delivered?

Varying frequency and duration, ranging from a single 1-hour session to multiple sessions (i.e., 3-4) up to 12 hours in length.

What resources and costs are involved?

None of the included studies commented on the costs associated with the intervention.

Theory of change

How is the intervention designed or theorised to work?

The programs in this Intervention Review are based on a number of psychological and behavioural theories, such as: social learning theory, the elaboration likelihood model, the health belief model social cognitive theory, and the theory of planned behaviour. Importantly, the theory of change behind these interventions is firmly grounded in feminist principles and has a strong focus on gender, power and control.

The general premise of these interventions is that providing education about the risk of sexual violence posed to women in tertiary education settings and equipping them with resistance strategies (such as verbal and physical resistance) will reduce potential sexual violence as well as any subsequent self-blame from victimisation.

Most of the programs are based on a sexual assault resistance model called “Assess, Acknowledge, Act”, which encourages women to follow several steps to assess, acknowledge, and act in response to threatening sexual situations. It posits that perpetrators are responsible for sexual assault, but women can nonetheless reduce their risk and implement resistance strategies.

Interventions that include additional components like positive sexuality education or self-defence, focused on physical and verbal resistance tactics are underpinned by principles of empowerment.


Impact

This section speaks to the effectiveness of the studies.

The outcomes measured by the included studies include gender-based violence, health, behaviours, knowledge, beliefs and attitudes, wellbeing and emotions, and relationships.

Fifteen primary studies had available quantitative data and were assessed for risk of bias on the ANROWS-IRIS tool. Of these, one received a rating of moderate risk of bias, 11 received a rating of moderate-high, two received a rating of high, and one received a rating of very high.

This means only one study with moderate risk of bias and appropriate outcome data was used for the effectiveness estimate. This study examined the effectiveness of both an enhanced version of the Assess, Acknowledge, Act Sexual Assault Resistance program as well as a basic version of the same program. It conducted a 3-arm randomised controlled trial, comparing both the enhanced and basic programs to the same group of control participants. Results are reported for both versions of the program and across three time-points (immediately post-intervention, 3 months follow-up, and 6 months follow-up).

Although many of the critically appraised studies were randomised controlled trials or quasi-experimental studies, they tended to be rated as a high or moderate risk of bias on the ANROWS-IRIS domains of selection bias, withdrawals and drop-outs, confounders, and intervention fidelity.

In terms of selection bias, some studies included participants that self-selected into the intervention or were not likely to be representative of women university students broadly. Studies also tended not to assess equivalence between the intervention and control groups. Many studies provided no information about whether the students who dropped out of the intervention or control groups were different.

Some studies had cross-contamination, whereby some participants in an intervention group shared knowledge or skills gained via the program with participants in the control group, undermining the integrity of the intervention. Overall, these risks of bias hamper our ability to draw accurate conclusions about the effectiveness of interventions.

Two meta-analyses included in this intervention review were critically appraised on the AMSTAR 2 tool, of which one received a rating of moderate confidence, and one received a rating of critically low confidence.

The moderate rated meta-analysis examined educational programs for preventing violence among both adolescents and young adults in a range of settings (e.g., high schools, universities). It was not possible to include this meta-analysis in the Effectiveness Estimate Scale because the authors did not conduct subgroup analyses. That is, they did not analyse the impact of the intervention specifically by gender or setting to determine whether sexual violence resistance education programs designed for women university students specifically worked. While they intended to do these analyses, not enough studies presented results by gender for it to be possible.


Overall effectiveness of the intervention

The table below shows the effectiveness of the intervention.

✅ = Most systematic reviews and studies show effectiveness
🟢 = Most studies show effectiveness
🟨 = Most systematic reviews and studies show no effect
🟡 = Most studies show no effect
⛔ = Potentially harmful
🔵 = Mixed evidence
✖ = Insufficient causal evidence
🕓 = Not yet rated

Effectiveness rating
Outcome
Description



Fear of rape

There was no effect of both programs on participants’ fear of rape.

There was no significant effect between groups when comparing the enhanced Assess, Acknowledge, Act Sexual Assault Resistance program to the control group. This was true at all timepoints (post-test, 3 months and 6 months).

There was no significant effect between groups when comparing the basic Assess, Acknowledge, Act Sexual Assault Resistance program to the control group. This was true at all timepoints (post-test, 3 months and 6 months).


Perceived personal risk of sexual assault



The study showed decreased perceived risk of rape or sexual assault.

There was a positive significant effect of the enhanced Assess, Acknowledge, Act Sexual Assault Resistance program on perceived risk of rape compared to the control group. This was true at all timepoints (post-test, 3 months and 6 months).

There was a positive significant effect of the basic Assess, Acknowledge, Act Sexual Assault Resistance program on perceived risk of rape compared to the control group. This was true at all timepoints (post-test, 3 months and 6 months).


Sexual assertiveness



There was no effect of both programs on participants’ sexual assertiveness.

There was a significant effect between groups when comparing the enhanced Assess, Acknowledge, Act Sexual Assault Resistance program to the control group at the 3-month mark. However, this was not sustained at the 6-month mark, which had no effect between groups.

There was no significant effect between groups when comparing the basic Assess, Acknowledge, Act Sexual Assault Resistance program to the control group. This was true at all timepoints (3 months and 6 months).


Defence tactic: resistance



The study showed increased use of direct resistance as a defence tactic. This was measured post-intervention only, so longer term (e.g., 3- or 6-month change) cannot be established.

There was a positive significant effect of the enhanced Assess, Acknowledge, Act Sexual Assault Resistance program on use of direct resistance compared to the control group.

There was a positive significant effect of the basic Assess, Acknowledge, Act Sexual Assault Resistance program on use of direct resistance compared to the control group.


Defence tactic: forceful verbal tactics



The study showed increased use of forceful verbal defence tactics.

There was a positive significant effect of the enhanced Assess, Acknowledge, Act Sexual Assault Resistance program on use of verbal tactics compared to the control group.

There was a positive significant effect of the enhanced Assess, Acknowledge, Act Sexual Assault Resistance program on use of verbal tactics compared to the control group.


Defence tactic: forceful physical tactics



The study showed increased use of forceful physical defence tactics.

There was a positive significant effect of the enhanced Assess, Acknowledge, Act Sexual Assault Resistance program on use of physical tactics compared to the control group.

There was a positive significant effect of the enhanced Assess, Acknowledge, Act Sexual Assault Resistance program on use of physical tactics compared to the control group.


Self-defence efficacy



The study showed increased self-defence efficacy, measured by asking participants about their confidence to take action in various scenarios.

There was a positive significant effect of the enhanced Assess, Acknowledge, Act Sexual Assault Resistance program on self-defence efficacy compared to the control group. This was true at both 3-months and 6-months.

There was a positive significant effect of the basic Assess, Acknowledge, Act Sexual Assault Resistance program on self-defence efficacy compared to the control group at 3-months. There was no effect at 6-months.


Sexual assault risk detection in a hypothetical situation



There was no effect of both programs on participants’ sexual assault risk detection in a hypothetical situation.

There was no effect of either the enhanced or basic Assess, Acknowledge, Act Sexual Assault Resistance program on sexual assault risk detection in a hypothetical situation immediately post-intervention.


Avoidance of ‘close calls’ for sexual assault



The study showed increased avoidance of ‘close calls’ for sexual assault. This was not reported for the enhanced Assess, Acknowledge, Act Sexual Assault Resistance program.

For the basic Assess, Acknowledge, Act Sexual Assault Resistance program, there was a positive significant effect observed between groups at post-test, 3-months, and 6-months follow-up.

Key Populations

Has the impact of this intervention been tested with certain key populations?

This Intervention Review assessed the impact of sexual violence resistance education for women in tertiary education settings. Participants are cohorts of university or college students, mostly first-year students ranging in age from 18 to 21 years. Many participants were drawn from cohorts that were studying psychology courses. The interventions were not designed for any specific cultural or ethnic groups, or for people with physical or mental disabilities or health conditions. Many of the programs were delivered to students who were white, young and single.

The table below gives an overview of whether or not the intervention was examined with some key populations. The inclusion of these populations was guided by the National Plan to End Violence against Women and Children 2022-2032 and the Australian National Research Agenda to End Violence against Women and Children: 2023-2028.

🔴 = no studies
🟡 = at least 1 study mentions that population, but effectiveness wasn't tested with that population
🟢 = at least 1 study tests effectiveness with the population

Population What do we know about this group? Degree of knowledge
Aboriginal and Torres Strait Islander communities

0 studies examine the effectiveness of the intervention with Aboriginal and Torres Strait Islander communities. Therefore, we cannot confirm the applicability of this intervention to this population.

Sexuality and gender diverse / LGBTIQA+

0 studies examine the effectiveness of the intervention with sexuality and gender diverse/LGBTIQA+ communities. Therefore, we cannot confirm the applicability of this intervention to this population.

Specific age groups (including older people, children and young people)

All studies examined the effectiveness of the intervention with young women aged up to 25 years.

Culturally and racially marginalised (CARM) groups

0 studies examine the effectiveness of the intervention with CARM groups. Therefore, we cannot confirm the applicability of this intervention to this population.

Migrants and refugees

0 studies examine the effectiveness of the intervention with migrant and refugee communities. Therefore, we cannot confirm the applicability of this intervention to this population.

People with disability

0 studies examine the effectiveness of the intervention with people with disability. Therefore, we cannot confirm the applicability of this intervention to this population.

Key considerations

This section summarises factors that may contribute to study results, factors that may be considered to facilitate better outcomes, and the transferability of the intervention to an Australian context.


What do we know about the intervention in Australia?



What should Australian stakeholders consider?


Available evidence considerations:

Implementation considerations

Included studies

Characteristics of primary studies included in the Intervention Review
Study and location Design Intervention Sample Outcome categories
Anderson & Whiston (2005) Systematic review
Type of analysis:Meta-analysis
Search period:Not reported, studies published from 1978 to 2002
Sexual assault education programs
N Included studies:69
Included research design:Randomised controlled trials and quasi-experimental studies with a control group
Countries:United States only
N=18,172
College students, 48.7% women, mean age 20.3 years
Gender-based violence; knowledge, beliefs and attitudes
Breitenbecher & Gidycz (1998) United States Randomised controlled trial
Comparison: No treatment
Qualitative data: No
Sexual assault risk reduction program with education on the prevalence of sexual violence, discussion of risk factors and information on risk reduction strategies
Duration and format: A single 90-minute group session delivered face-to-face, facilitator details not reported
Setting: Tertiary education
Cost:Not reported
N=406
Nexp=211, N=comp=194,
Adult women university students enrolled in psychology courses, 73% aged 18-19 years, 95% White
Behaviours; relationships
Breitenbecher & Scarce (1999) United States Randomised controlled trial
Comparison: No treatment
Qualitative data: No
Sexual assault risk-reduction program for women based on the prevalence of sexual violence, existence of rape myths, vignettes, developing a redefinition or rape and response strategies to reduce risk based on lecture and facilitated discussion
Duration and format: A single 1-hour group session delivered face-to-face by a graduate student
Setting:Tertiary education
Cost:Not reported
N=275
Nexp=132, N=comp=143
Adult women university students, 72% aged 18-21 years
Gender-based violence; knowledge, beliefs and attitudes
Breitenbecher & Scarce (2001) United States Randomised controlled trial
Comparison: No treatment
Qualitative data: No
Sexual assault risk-reduction program for women based on the prevalence of sexual violence, existence of rape myths, vignettes, developing a redefinition or rape and response strategies to reduce risk based on lecture and facilitated discussion
Duration and format: A single 90-minute group session delivered face-to-face, facilitator details not reported
Setting:Tertiary education
Cost:Not reported
N=117
Nexp=67, N=comp=50
Adult women university students, 72% aged 18-21 years, 81% White
Gender-based violence; knowledge, beliefs and attitudes; relationships
Crann et al. (2022) Canada Qualitative study Enhanced Assess, Acknowledge, Act, an educational sexual assault resistance program, teaches women how to identify risk for sexual assault, overcome emotional barriers to resistance, verbal and physical self-defence techniques, and emancipatory sexuality education, all featuring a series of lectures, discussions, games and activities
Duration and format: Total of 12 hours, based on four units of 3-hour groups delivered face-to-face by a pair of trained female graduate student facilitators
Setting:Tertiary education
Cost:Not reported
N=445
Adult women university students, 72.8% White
Behaviours; knowledge, beliefs and attitudes
Fellmeth et al. (2013) Systematic review
Type of analysis:Meta-analysis
Search period:Start date not reported, end date 2012
Sexual assault and intimate partner violence prevention educational and skills-based interventions
N Included studies:38
Included research design:Randomised controlled trials and quasi-experimental studies with a control group
Countries:Any country
N=15,903
Adolescents aged 12 to 18 years, all genders
Gender-based violence; health; knowledge, beliefs and attitudes
Gidycz et al. (2001) United States Randomised controlled trial
Comparison: No treatment
Qualitative data: No
Ohio University's Sexual Assault Risk Reduction Project,, a didactic and interactive program including a presentation, two videos, role plays, discussion of definitions and statistics of sexual assault, risk factors, psychological barriers to resistance, post-assault reactions and a feminist self-defence workshop focused on physical and verbal resistance tactics
Duration and format: A single 3-hour face-to-face group session peer-led by two trained female graduate students
Setting:Tertiary education
Cost:Not reported
N=762
Nexp=395, N=comp=357
Adult women university students, studying psychology, aged 18-21 years, 93.7% White
Gender-based violence; wellbeing and emotions; behaviours; relationships
Gidycz et al. (2006) United States Randomised controlled trial
Comparison: Waitlist
Qualitative data: No
Ohio University's Sexual Assault Risk Reduction Project,, a modified version of Gidycz et al. (2001), including an additional self-defence component and booster session
Duration and format: A 7-hour face-to-face group program peer-led by two trained female graduate students
Setting:Tertiary education
Cost:Not reported
N=500
Nexp=234, Ncomp=266
Adult women university students, studying psychology, 88% aged 18-19 years, 93% White
Gender-based violence; wellbeing and emotions; behaviours; relationships
Gidycz et al. (2015) United States Randomised controlled trial
Comparison: Waitlist
Qualitative data: No
Ohio University's Sexual Assault Risk Reduction Project,, (updated since piloted by Gidycz et al., 2001; 2006), a 3-part intervention consisting of (1) a didactic and interactive program including presentation, videos, role play and discussion of definitions and statistics of sexual assault, risk factors, psychological barriers to resistance, post-sexual assault reactions; (2) feminist self-defence workshop focused on physical and verbal resistance tactics; and (3) a booster revision course
Duration and format: A 7-hour program delivered in three face-to-face group sessions peer-led by two female graduate students trained for 20-25 hours
Setting:Tertiary education
Cost:Not reported
N=650
Adult women university first-year students, 98.5% aged 18-19 years, 91.8% White
Gender-based violence; behaviours
Holtzman & Menning (2019) United States Quasi-experimental study
Comparison: No treatment
Qualitative data: No
Elemental,, sexual assault prevention and risk reduction program involving sexual communication and verbal and physical self-protection techniques that uses videos, simulations and discussions
Duration and format: A single 6-hour group face-to-face seminar delivered by a facilitator trained for 25 hours, also open to male students
Setting: Tertiary education
Cost: Not reported
N=539
Nexp=255, Ncomp=284
Adult women university students, 80% White
Gender-based violence; behaviours
McManus (2015) United States Randomised controlled trial
Comparison: Another active intervention, Sexual Assault Prevention Psychoeducation
Qualitative data: No
Sexual Assertiveness Skills Training, an interactive training session including behavioural rehearsal of resistance and refusal strategies to sexual assault using vignettes and role play
Duration and format: Two 90-minute individual training sessions, peer-led by a student and delivered face-to-face
Setting:Tertiary education
Cost:Not reported
N=136
Nexp=70, Ncomp=66
Adult women university students, mean age 19.57 years, 71% White
Gender-based violence; knowledge; beliefs and attitudes; behaviours
Menning & Holtzman (2015) United States Quasi-experimental study
Comparison: No treatment
Qualitative data: No
Elemental,, see Holtzman & Menning (2019)
Duration and format: A single 6-hour group face-to-face seminar delivered by a trained facilitator, also open to male students
Setting: Tertiary education
Cost: Not reported
N=331
Nexp=166, Ncomp=165
Adult women university students
Gender-based violence; behaviours
Newins & White (2021) United States Randomised controlled trial
Comparison: Passive intervention, an 18-minute video on time management followed by discussion
Qualitative data: Yes
A sexual violence risk reduction program, including a video called I Thought It Could Never Happen to Me, providing women with information about and risk factors of sexual assault, and discussion about resistance techniques
Duration and format: A single 1-hour session consisting of an 18.5-minute video followed by a group face-to-face discussion
Setting:Tertiary education
Cost:Not reported
N=300
Nexp=157, N=comp=143
Adult women university students, 91.7% aged 18-19 years, 96% White
Gender-based violence; behaviours; relationships; knowledge; beliefs and attitudes
Orchowski et al. (2008) United States Randomised controlled trial
Comparison: Passive intervention, a peer-based vaccine preventable disease education and awareness program
Qualitative data: : No
Ohio University's Sexual Assault Risk Reduction Project, see Gidycz et al. (2015)
Duration and format: A 7-hour program delivered in three face-to-face group sessions peer-led by two female graduate students trained for 20-25 hours
Setting:Tertiary education
Cost:Not reported
N=300
Nexp=157, N=comp=143
Adult women university students, 91.7% aged 18-19 years, 96% White
Gender-based violence; behaviours; relationships; knowledge; beliefs and attitudes
Senn et al. (2011) Canada Randomised controlled trial
Comparison: No treatment
Qualitative data: No
Intervention 1: Assess, Acknowledge, Act Program, a sexual assault resistance program featuring a series of lectures, discussions, games and activities based on risk assessment, problem-solving, sexual communication and resistance
Duration and format: Total of 9 hours, based on three units of 3-hour groups delivered face-to-face by a trained female graduate student facilitator
Setting:Tertiary education
Cost:Not reported
Intervention 2: Enhanced Assess, Acknowledge, Act Program, an enhanced version of the sexual assault resistance described above with an additional 3-hour unit focused on sexuality and relationships
Duration and format: Total of 12 hours, based on four units of 3-hour groups delivered face-to-face by a trained female graduate student facilitator
Setting:Tertiary education
Cost:Not reported
N=224
Nexp1=50, Nexp2=67, N=comp=127
Adult women university students, mean age 18.89 years, 81% White
Gender-based violence, knowledge; beliefs and attitudes; behaviours; wellbeing and emotions
Senn et al. (2013; 2015; 2017; 2021; 2022) Canada Randomised controlled trial
Comparison: Passive intervention; brochures related to sexual assault and legal and medical advice for victims/ survivors (considered treatment-as-usual for women students on campus)
Qualitative data: : No
Enhanced Assess, Acknowledge, Act Program, an educational sexual assault resistance program, teaches women how to identify risk for sexual assault, overcome emotional barriers to resistance, verbal and physical self-defence techniques, and emancipatory sexuality education, all featuring a series of lectures, discussions, games and activities
Duration and format: Total of 12 hours, based on four units of 3-hour groups delivered face-to-face by a pair of trained female graduate student facilitators
Setting:Tertiary education
Cost:Not reported
N=893
Nexp=451, Ncomp=442
Adult women first-year university students, mean age 18.5 years, 73% White
Gender-based violence; behaviours; knowledge; beliefs and attitudes; wellbeing and emotions
Raymond (2019) United States Quasi-experimental study
Comparison: No treatment
Qualitative data: No
Relationships, Sexuality, and Violence Prevention (RSVP), didactic education, videos, and collaborative discussion of rape myths, positive sexuality, sexual agency and female desire, and rehearsal of verbal assertiveness in various self-defence scenarios
Duration and format: A total of 12 hours, based on four 3-hour modules delivered to face-to-face in groups led by two trained female graduate student co-facilitators
Setting:Tertiary education
Cost:Not reported
N=173
Nexp=90, Ncomp=83
Adult women university students; mean age 20.8 years; 92.5% White
Knowledge; beliefs and attitudes; behaviours; relationships
Raymond & Hutchison (2019) United States Quasi-experimental study
Comparison: Waitlist
Qualitative data: Yes
Relationships, Sexuality, and Violence Prevention (RSVP), see Raymond (2019)
Duration and format: A total of 12 hours, based on four 3-hour modules delivered to face-to-face in groups by a trained female graduate students facilitators
Setting:Tertiary education
Cost:Not reported
N=63
Nexp=34, Ncomp=29
Adult women university students; mean age 22.98 years; 87.3% White
Gender-based violence; wellbeing and emotions; behaviours; relationships

References and further reading

Included Studies


Primary studies

Systematic reviews


Additional evidence on the intervention

This list contains other evidence that was not eligible for the Intervention Review based on our selection criteria but may provide further information regarding the intervention.