The Resource The National Sexual Violence Resource Center Newsletter. Spring/Summer 2016. EVALUATION IS FOR EVERYONE (Cover graphic is a clipboard with the following list written on it) IN THIS ISSUE: MESA’s Culturally Rvant Evaluation Process West Virginia’s Online Training Academy Princeton’s Community Integrity Program How do you use social media to improve your work? PLUS: Connection between sexual violence and eating disorders Contact Us The National Sexual Violence Resource Center invites your comments: The Resource 123 North Enola Drive, Enola, PA 17025 Toll free: 877-739-3895 Fax: 717-909-0714 TTY: 717-909-0715 Email: resources@nsvrc.org Online: www.nsvrc.org COMMUNICATIONS DEPARTMENT LAURA PALUMBO, Communications Director MEGAN THOMAS, Communications Specialist, Editor of The Resource EMILY BIGGER, Graphic Design Specialist SUSAN SULLIVAN, Prevention Campaign Specialist LEADERSHIP DELILAH RUMBURG, CEO KAREN BAKER, NSVRC Director ADVISORY COUNCIL Pamela B. Brown, Atlanta, GA Susan Chasson, Provo, UT Maia Christopher, Beaverton, OR Nancy Hoffman, Fairmont, WV Keith L. Kaufman, Portland, OR Patrick Lemmon, Portland, OR Julie Lindahl, Huntsville, AL Grace S. Mattern, Northwood, NH Sarah McMahon, New Brunswick, NJ Strong Oak, Greenfield, MA Kelly Parsley, Helena, MT Holly Ramsey-Klawsnik, Canton, MA Jennifer Rauhouse, Phoenix, AZ Delilah Rumburg, Enola, PA Jonathan Yglesias, Richmond, VA Ellen Yin-Wycoff, Sacramento, CA Mira Yusef, Des Moines, IA This publication was supported by Cooperative Agreement #5UF2CE002359-03 from the Centers for Disease Control and Prevention. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the Centers for Disease Control and Prevention or NSVRC. About the Cover Evaluation is an important step in sexual violence prevention programs, and everyone can get involved. In this issue, Multicultural Efforts to end Sexual Assault (MESA) at Purdue University shares their culturally relevant evaluation process, from building a framework to implementing strategies in the community. READ MORE 6 DIRECTOR’S VIEWPOINT 7 A ‘SPOTLIGHT’ ON PREVENTION 8 MISSOULA: SHEDDING LIGHT ON THE TRUTH 18 SEXUAL TRAUMA AND EATING DISORDERS 32 MILESTONES: NATIONAL PARTNERSHIP AND VISIONARY VOICE AWARDS CONTENTS 10 EVALUATION IS FOR ALL MESA’s culturally relevant evaluation process works to engage and empower. 16 COMMUNITY VOICES We asked: How have you used social media to improve your anti-sexual violence work? 21 TECH ROUNDUP West Virginia’s Sexual Assault Services Training Academy fills a training gap for service providers. 24 COMMUNITY INTEGRITY PROGRAM Evidence-based practices are at work in Princeton’s secondary prevention program. (Image of a building on the campus of Princeton University.) 26 COALITION SPOTLIGHT Hawaii’s Community Action Teams mobilize communities to end sexual assault. 30 SNAPSHOTS Check out some photos from Sexual Assault Awareness Month. 34 FROM THE LIBRARY Read about four resources in NSVRC’s library that might interest you. Contributors Skye Ashton Brown is the LGBTQ+ Outreach Coordinator with Multicultural Efforts to end Sexual Assault (MESA) at Purdue University and leads a local transgender support group called Trans Lafayette. Skye has been involved as a community leader and organizer for seven years in Texas and Indiana, focusing on violence prevention, intervention, and anti-oppression work with LGBTQ+ communities. Paula Chun has served as the Executive Director of the Hawaii Coalition Against Sexual Assault since 2002. Her work in the sexual assault field has included planning, implementing, and enhancing sexual assault center treatment services in Hawaii. Ms. Chun has a Master’s degree in Social Work from Indiana University with a specialty in community organization. Joanne Higashi is a Program Specialist with the Hawaii State Department of Health’s Sexual Violence Prevention Program. She has managed the Rape Prevention and Education federal funds and the Domestic Violence/Sexual Assault State Special Funds to promote sexual violence primary prevention since 2014. Ms. Higashi has a Master’s in Social Work from the University of Hawaii and is a Licensed Clinical Social Worker. Nancy Hoffman, MA, LPC, CSW, is the State Coordinator for the West Virginia Foundation for Rape Information and Services. Her experience includes opening a regional sexual/domestic violence program in West Virginia. She serves on NSVRC’s Advisory Council, has presented at numerous conferences, and has written articles for several national publications. Helene Kaiwi is a Licensed Social Worker who supervises public health programs for the Hawaii State Department of Health’s Maternal and Child Health Branch. Programs include the prevention of sexual violence, domestic violence, and child abuse as well as neglect,home visiting, parenting and family support, and the Child Death Review. She has over 10 years of experience working with infants and toddlers with special needs and their families. Dr. Rachel Levine, MD, is the Physician General for the Commonwealth of Pennsylvania and professor of Pediatrics and Psychiatry at the Penn State College of Medicine. Dr. Levine graduated from Harvard College in 1979 and the Tulane University School of Medicine in 1983. She completed her training in Pediatrics at the Mt. Sinai Medical Center in New York City in 1987 and then did a Fellowship in Adolescent Medicine at Mt. Sinai from 1987-88. Shawn Maxam is the Prevention Coordinator for men’s initiatives at Princeton University’s Sexual Harassment/Assault Advising, Resources & Education office. In his role, he coordinates the Men’s Allied Voices for a Respectful & Inclusive Community (MAVRIC) Project, a healthy masculinity/engaging men initiative. Shawn is a graduate of Bryn Mawr College’s Graduate School of Social Work & Social Research with a Master of Social Service and Master of Law and Social Policy. Valerie Mariano is the Branch Chief of the Community and Crime Prevention Branch, Crime Prevention and Justice Assistance Division, Hawaii State Department of the Attorney General. Ms. Mariano has been educating and informing the community on crime prevention since 1987. She has facilitated and worked with community groups; federal, state, and county government a gencies; and private non-profit groups on topics of substance abuse and underage drinking prevention, sexual assault prevention, violence prevention, and more. Kimber J. Nicoletti, MSW, Director and founder of Multicultural Efforts to end Sexual Assault (MESA) at Purdue University, has been an advocate for farm worker, immigrant, and multicultural communities for over 20 years. Ms. Nicoletti works at the national, state, and local levels engaging communities and organizations in the use of culturally relevant models for promoting healing, healthy relationships, and prevention of sexual violence. Kimber created Mujeres del Movimiento, a national resource and support group for Latina women who work in violence prevention. Kelly Parsley has been a victim advocate for nineteen years and speaks nationally on violence prevention. She currently chairs the Health Sciences Department at Carroll College and has served on the Advisory Board of NSVRC for six years. In 2011, she was named the National Outstanding Prevention Professional of the Year by the national organization Everfi, and she was given the Visionary Voice Award in 2015. This past spring she was chosen to serve on the White House Think Tank to End Violence on Campuses. WRITE FOR THE RESOURCE Want to see your face here, among contributors of The Resource? Write for a future edition! Email your story idea to resources@nsvrc.org. Director’s Viewpoint Karen Baker, NSVRC Director We are excited to bring you this issue of The Resource. The passing year has been nothing short of incredible, and I can’t help but look back at the fascinating developments in our work and field. Two words sum it all up for me: culture change. This past year has provided many examples where popular culture and prevention converge. From Lady Gaga heralding the voices of survivors on the stage of the Academy Awards to the White House, people are talking about culture change. The book Missoula topped bestseller lists and cataloged a community’s challenges in addressing campus sexual assault. Another powerful example is the film Spotlight, which won this year’s Best Picture at the Oscars for its depiction of the Boston Globe’s uncovering of child sexual abuse in the Catholic Church. Advocates and preventionists from the local, state, and national levels have tirelessly pointed out that sexual violence is a critical issue that must be addressed, and we are now joined by public figures and cultural icons who echo this message. Even President Barack Obama, in remarks on Sexual Assault Awareness Month said, “Together, we must stand up and speak out to change the culture.” This issue of The Resource catalogs many of the ways popular culture has intersected with our work. It also raises the theme of culture in a variety of ways that can inform and enhance our work to change lives, communities, and society. Culture is at the heart of MESA’s culturally relevant evaluation and programming. In this issue, you can learn how culture drives the organization’s mission and enhances their approach to prevention. This edition also features the many other ways change and innovation are happening in our work. The coalition in Hawaii shares how collaboration highlights the prevention expertise and strength embedded within each community. In West Virginia, advocates are using technology and developing local partnerships to extend the reach of their training and enhance the state’s overall capacity to address sexual assault. An article by the Pennsylvania Physician General raises the topic of culture change in another meaningful way by sharing how treatment and diagnostics workers can create a culture of care for trauma survivors struggling with eating disorders. The mission of changing the culture is at the core of a new partnership among PreventConnect/CALCASA, the National Alliance to End Sexual Violence, and NSVRC. Last fall at the National Sexual Assault Conference, we announced this endeavor, and in the following months, we’ve established a Washington, DC office, hired staff, and launched a national grant program. In this issue, we share more on this endeavor and invite you to stay tuned for more updates in the future. We look forward to seeing how the theme of culture change continues to shape our efforts to prevent sexual violence. We also know this theme will develop in different ways in every state, community, and region. How are you changing the culture? Share your successes and challenges with us. I hope to hear about that and to see all of you at the National Sexual Assault Conference in Washington, DC August 31- September 2. In Partnership, Karen Baker A ‘Spotlight’ on prevention: Film brings attention to sexual violence prevention BY NATIONAL SEXUAL VIOLENCE RESOURCE CENTER STAFF This past year, the film Spotlight won the Academy Awards for Best Picture and Best Original Screenplay — but more than that, it sparked a conversation and brought attention to sexual assault response and prevention. NSVRC applauds the makers of Spotlight for shining a bright light on the important role we all have in sexual violence prevention. We also commend The Boston Globe’s investigative journalism in uncovering widespread child sexual abuse within the Catholic Church — the basis of the film. As lawyer Mitchell Garabedian, played by Stanley Tucci, says in the film, “If it takes a village to raise a child, it takes a village to abuse one.” We all can and must help prevent sexual violence. It’s particularly important that large and influential institutions like the Catholic Church and the media serve as leaders by supporting survivors, investigating allegations, and holding those who harm others accountable and ensuring they get appropriate help. This shared responsibility isn’t about passing blame; it’s about empowering communities to look both internally and externally to change underlying systems that sustain silence and secrecy. Prevention of sexual violence is possible — and it’s happening within the military, on college campuses, and in faith communities. NSVRC is committed to driving positive change on this issue. Through research, resources, and collaboration, we’ll continue helping reporters inform the public with fact-based stories that place incidents in a broader context, as well as educating and training faith-based and other organizations on effective policies and programs. Are you talking about Spotlight in your community? The Washington Coalition of Sexual Assault Programs developed a discussion guide for the film at http://www.wcsap.org/media-discussion-guide-examining-film-spotlight (Photo: Still from the film Spotlight that shows several people looking at a computer screen) 'Missoula': Shedding light on the truth BY KELLY PARSLEY Health Sciences Department, Carroll College When Jon Krakauer authors a book, three things usually happen: 1) it becomes a best seller, 2) Hollywood makes a movie, and 3) it makes people angry. While Missoula: Rape and the Justice System in a College Town may or may not become a movie, one thing is for sure: This non-fiction account of several assaults (alleged and otherwise) that occurred in Missoula, Montana, and the adventures and misadventures of those dedicated to respond to such cases, has made people angry. Since its release, Missoula has provoked misguided rants, sparked thoughtful conversations about the state of women’s safety on America’s campuses, and most importantly, documented how far we have left to go to educate our friends and neighbors about the horrors of sexual violence. WHAT SOME MEN ARE SAYING Many young men who have read or simply heard about the book feel targeted, and it has galvanized their conviction that women “cry rape” just to get guys in trouble. During one of my prevention workshops, a college male lashed out, “Jordan Johnson’s accuser is a liar! How come she didn’t go to jail?!” This outburst meant that I had to take a 15-minute aside to share about how justice systems work: that just because one person is found not guilty, it doesn’t mean, by default, that the accuser is lying. Juries may simply feel that there was not enough evidence to confidently convict. WHAT SOME WOMEN ARE SAYING Some women (despite being victims themselves) who have read or simply heard about Missoula have determined that the female victims depicted in the book “asked for it.” Of course we should expect such things: Our culture does not shy away from victim-blaming (e.g., she shouldn’t have gone there, worn that, drank that), so why would we expect much of our female population to shy away from victim-blaming? But to hear well-educated women in a local book club spout victim-blaming rhetoric seems, said a friend who experienced this, like “an extra layer of betrayal.” The sexual assault is awful, but hearing victim-blaming from the mouths of people you thought were allies feels nearly as harmful as the crime itself. WHAT SOME SEXUAL ASSAULT ADVOCATES ARE SAYING Some who work in violence prevention are concerned Missoula didn’t go far enough: What about sexual violence against LGBTQ+ students? Male students? What about shining a light on the inadequate response of many schools instead of focusing primarily on the criminal justice system? WHAT OTHERS ARE SAYING Others are saying that it is about time we all learn more about the epidemic of violence against women on college campuses, and this book can help lead the way. Despite the rants, the good news is that we are talking. The book has become an opportunity to take the ugly truth of rape out of the dark alleys of ignorance and hold it up to the light of scrutiny, allowing many to explore their own biases and to see for the first time the systematic flaws that often provide injustice much more readily than justice. Because of Missoula, there is a much wider audience engaged in conversations about this crucial topic. And because the news has been delivered by a popular and well-liked author, many are hoping that it will help the movement discover new champions and encourage them to bravely step up to become allies in violence prevention. Interested in Missoula: Rape and the Justice System in a College Town? Check out our review on page 35 Sexual Violence in Pop Culture Television, books, movies, music, and social media can function as conversation-starters about sexual assault. The past few months have seen an explosion of conversations about sexual assault in the media and popular culture: Lady Gaga’s performance at the 2016 Oscars ceremony, alongside 50 other sexual assault survivors, put faces and names to those who have experienced sexual assault. The Oscar-winning film Spotlight drew attention to clergy abuse, giving some survivors courage to speak up and encouraging others to take action. Kesha’s civil case against her music producer elicited support from the public as well as other performers about sexual assault in the workplace. The sentencing of former police officer Daniel Holtzclaw gave the Black Lives Matter movement a platform to discuss racial injustice and sexual assault with social media hashtags like #StandWithHer. CULTURALLY RELEVANT EVALUATION ‘Designing an evaluation plan...requires an understanding of the community’s culture, language, and definition of sexual violence and prevention solutions.’ — KIMBER NICOLETTI, MESA founder (Photo: a diverse group of people. Photo: a young girl holding stuffed animals) Multicultural Efforts to end Sexual Assault (MESA) was founded in 2008. Based out of the College of Agriculture at Purdue University, this statewide program works on primary prevention strategies for underserved and marginalized communities, including Native American/Indigenous communities and migrant farm workers. ONLINE Find MESA on Twitter @MESAPurdue. Visit their website for more information at www.ydae.purdue.edu/mesa/ INTERACT How have you implemented culturally relevant evaluation in your anti-sexual violence work? Let us know by email at resources@nsvrc.org or on Twitter @NSVRC. At MESA, evaluation is for everyone BY KIMBER NICOLETTI AND SKYE ASHTON BROWN • Multicultural Efforts to end Sexual Assault (MESA) The acronym for Multicultural Efforts to end Sexual Assault is MESA. In Spanish, mesa means “table.” The idea behind the creation of MESA was to invite everyone to the table throughout the entire process of development, implementation, and evaluation of sexual violence prevention efforts. Evaluation should be fun. It should be user-friendly, by and for the people, and reflect the complexities of the communities we are working with, in an understandable way. Unfortunately, evaluation is often an afterthought in program development and may not accurately reflect the community efforts that are being evaluated. Programs and agencies that are already underfunded and overworked are often too taxed to learn ow to develop high-quality evaluation processes, especially those that consider the unique strengths, needs, and language of marginalized and underserved communities. Implementing evaluation is more effective and easier when evaluation has been incorporated into the project planning and when the community’s input, cultural perspective, and voice are the focus in the development of the plan. FRAMEWORK FOR EVALUATION In recent years, there has been an increase in literature available on program evaluation in sexual violence prevention. National Sexual Violence Resource Center (NSVRC), Pennsylvania Coalition Against Rape (PCAR), and other programs have written extensively on developing evaluation plans for the primary prevention of sexual violence. However there are limited data and resources available on the development and implementation of culturally responsive evaluation strategies with marginalized communities. MESA is a statewide sexual violence prevention program housed in the College of Agriculture on the Purdue University campus that focuses on reaching and engaging underserved communities in sexual violence and child sexual abuse prevention. MESA utilizes a social justice approach and a public health framework together to focus our evaluation strategies on anti-oppression and empowerment. Our program evaluation plans are informed by the community-identified strengths and needs, what resources the community has available, and the outcomes the community agrees are indicative of preventing sexual violence. This communication is important because we utilize evaluation not only to measure the effectiveness of our program methods, but also as a way to demonstrate effectiveness of the community leadership. For evaluation strategies to be effective and empowering, gaining community buy-in and input from community leaders is imperative and the first crucial step. MESA utilizes evidence-based strategies and the teachings and practices of Paulo Freire and critical pedagogy. For us, the methods by which we arrive at our outcomes are as important as the outcomes! BEFORE DESIGNING AN EVALUATION PLAN Designing an evaluation plan for a program or with a community action project requires an understanding of the community’s culture, language, and definition of sexual violence and prevention solutions. Additionally, knowledge of the community’s strengths and needs, communication style, and desired outcomes are the foundation to developing culturally relevant evaluation plans. Regardless of the specific wording of our program objectives, the goal is always to prevent sexual violence through community engagement, personal empowerment, and social change. To ensure that our evaluation plans are appropriate for the community setting, we spend time with community members — at informal gatherings, organized events, or through focus groups — before designing the evaluation plan. This is part of MESA’s process in becoming vested in the community and ensuring that the community’s voice is at the table. Many organizations attempt to collect data or engage the community in prevention work without having built a positive relationship with community leaders or understanding community norms, values, and accepted methods of communication. Evaluation plans that do not take into account the norms of the community may lead to low participation rates and poor outcomes, in addition to reifying the belief among some community members that preventionists are trying to “save” their communities from negative community “qualities.” Culturally responsive programs and evaluation enable violence prevention efforts to be more effective and more sustainable through the continued work of community leaders. (Photo: A handpainted banner showing the word Respeto hangs from the ceiling) MESA has a long history of sexual violence prevention work in migrant farm worker and low-wage immigrant worker communities. Over the years, we have conducted outreach, sexual violence prevention in engagement, and evaluation in Native American/Indigenous and other underserved communities. MESA’s method has always focused on a four-step process: 1. Seeking to understand (reviewing literature, making contacts, looking at existing programs) 2. Knowing (making connections, developing rapport, identifying leaders, and vesting in the community interest) 3. Engaging the community (community-based definitions and solutions for sexual violence prevention, community empowerment, and implementation) 4. Evaluating our efforts Two years ago, MESA had the opportunity to expand our program to develop sexual violence prevention in LGBTQ+ communities a nd hired an Outreach Coordinator. During the first 18 months, the Outreach Coordinator focused on developing rapport, providing technical assistance around community organizing and leadership, collaborated on community events that supported identity development and holistic health, and volunteered hours outside of their primary prevention work to assist with personal advocacy with community crisis intervention needs. Contributing to efforts like these were vital in allowing MESA to develop an understanding of the needs and strengths of the communities, what aspects of the local infrastructure and state infrastructure were supportive or unsupportive of LGBTQ+ communities, and what methods local communities were already utilizing to organize and contribute to prevention efforts — even if the language was not framed in this way. It wasn’t until these community relationships were developed that MESA could successfully engage community leaders in a seven-part LGBTQ+ leadership workshop series geared towards enhancing protective factors against sexual violence. THE LANGUAGE OF PREVENTION AND EVALUATION IN MARGINALIZED COMMUNITIES Many community leaders and organizations do not rely on public health as a framework for their organizing prevention efforts. Therefore, at MESA, we have realized that our role in many cases is to facilitate communication between public health language/models and community language and offer public health strategies when they are appropriate for the community. The LGBTQ+ Leadership workshop series is framed around “leadership development” and “healthy communities” to be more appealing and approachable to community members. However, in the workshops, participants are engaged in experiential learning to consider how community health impacts individual health, how individuals can contribute to community health, and how participants can contribute to sexual violence prevention across the socio-ecological model. Additionally, language and evaluation methods impact participation and buy-in. Should educational sessions be called “workshops,” “gatherings,” “meetings,” or “discussions?” Will asking for participants to write down their feedback be a barrier due to literacy or background? Who will be reached through digital vs. street advertising for events? Can the word “violence” be used in the project name or should more positive/different language be used? These are all questions MESA takes time to consider when planning a project and accompanying evaluation strategy. THE POWER OF OBSERVATIONAL EVALUATION AND ACTIVITY-BASED EVALUATION MESA relies heavily on both observational evaluation and activity-based evaluation. For example, at the beginning of every LGBTQ+ leadership workshop, participants are asked to introduce themselves and include why they decided to attend and what they hope to take away from the meeting. At the end of every workshop, participants are asked what they enjoyed most about the workshop and what aspects could be improved upon. These questions are left open-ended so participants can respond in any way and then MESA can incorporate these responses as data to improve our programs — both in event content and implementation methodology. Understanding what participants hope to gain and want to see done differently also gives us valuable information about community needs and strengths and the language that community members are most comfortable with. It also allows us to gather information about both process and outcome objectives. MESA also frequently collects data through participation in visual art activities, non-traditional theatre games, and group notes taken during discussion. Do individuals intervene if someone says something that contributes to a culture of victim-blaming? Can participants identify community norms within their identity groups or region that allow violence — especially sexual violence — to continue unchallenged? How do people think we can leverage this knowledge and the diverse skill-sets of those present to contribute to prevention at the community level? The challenge is that often these questions need to be asked in a less direct, culturally relevant way such as: “What are some of the things you’ve heard people say or seen them do that hurt others in the community?” or “How can we use what we’ve discussed today to change some of these problems?” Asking questions in these ways always leads to discussions about sexual violence because it is a huge problem in all communities. Community members know it, and they want to discuss it — but often feel that it is too taboo! MESA rarely uses written surveys because they create unnecessary challenges. Asking participants to fill out written feedback gives participants the feeling that the gathering is a space for educated, higher-class participants. Additionally, because it does not leave room for discussion or nuances in language, people may experience language barriers or feel ill equipped to respond, which detracts from MESA’s rapport-building efforts. Just like our work, all of our evaluation efforts are centered on relationship building. This allows evaluation to not only measure outcomes, but it results in evaluation development becoming part of the process as well! IMPLEMENTING COMMUNITY-LED EVALUATION STRATEGIES Communities already have the knowledge and experience to implement prevention and evaluate those efforts. However, sometimes it is challenging for mainstream organizations and preventionists to trust community members, and it seems easier to develop evaluation efforts without community input. This struggle is compounded by the fact that language used in public health spaces is often very different from language used in communities. It can be challenging to translate public health language into community language and community language into language that makes sense to funders — but it is a vital part of prevention work! MESA views the cultural and linguistic translation as part of the process. It is part of building the bridge between the community and public health paradigm. In farm worker and low-wage immigrant workers, the bridge is essential as success in sexual violence prevention strategies may be defined very differently. With increased focus on evaluation, there is a need for all programs to develop skills and capacity for culturally relevant evaluation methods for sexual violence prevention programs. Evaluation does not have to be intimidating and can be part of the building block in supporting the community mobilization efforts around sexual violence prevention if you are sure to include everyone’s voice at the table. (Photo: A diverse group of people sits around a table.) Community Voices For every edition, we ask our partners and community members a question related to sexual violence. Their answers are featured here. We asked: How have you used social media to improve your anti-sexual violence work? "We have daily themes so our followers can expect consistent communication from us: This Week at the Intersections (Monday), Take Action Tuesday, WCSAP Wednesday, This Week in Gender (Thursday), and Feel Good Friday." - Washington Coalition of Sexual Assault Programs, @WCSAP "Platforms like Twitter and Facebook have helped us communicate faster, and to a larger audience, than ever before. These tools are particularly useful for responding quickly to jokes about prisoner rape, which, depressingly, are still quite common in popular culture." - Just Detention International, @JustDetention "With so many conversations happening on social media, it provides the perfect platform to change the conversation around sexual assault and place real emphasis on ending victim-blaming behaviors. Identifying and calling out harmful attitudes through social media can help transform rape culture." - The Blue Bench, @TheBlueBenchDen "The tools available through social media allow for immediate response to timely issues – capturing the opportunity for impact that can be fleeting with new information flooding the news and other media daily." - Ann Emmerling, @blackburncenter "Connect with other survivors on #socialmedia. write about it for @feministing. spread awareness & educate." - @corinnekai_ "Connecting w/ other survivor activists, sharing resources, improving institutional transparency through external scrutiny." - @a_learoth "FORGE uses social media as not only an educational tool for transgender and gender non-binary (GNB) survivors of sexual violence, but also as a way to advertise all of our resources and technical assistance to service providers who want to provide better services to their trans and GNB clients." - FORGE, @FORGEforward BE A FEATURED VOICE! We want to hear your response to our next Community Voices question: How did you get started in working to end sexual violence? Tweet your answer to @NSVRC or email resources@nsvrc.org using the subject line “Community Voices.” SEXUAL TRAUMA & EATING DISORDERS For some patients, there is a correlation between sexual trauma and disordered eating BY DR. RACHEL LEVINE, MD Pennsylvania Physician General (Photo: An empty plate sits on a table between a knife and fork) Prior to becoming Physician General for the Commonwealth of Pennsylvania in January 2015, I served as Chief of the Division of Adolescent Medicine and Eating Disorders at Penn State Hershey Children’s Hospital-Milton S. Hershey Medical Center. In this capacity, observed first-hand what a growing body of medical research is confirming: For some patients, there is a correlation between sexual trauma and the development of an eating disorder. Here is a typical case study: A 19-year-old woman sought medical care for a specific eating disorder, bulimia nervosa. Her recurrent bingeing a nd purging symptoms led to esophageal inflammation, internal bleeding, and involuntary vomiting. She also suffered from depression, self-harm behaviors, substance abuse, and, at that point in her treatment, undiagnosed post-traumatic stress disorder (PTSD). It wasn’t until well into her therapy that she disclosed she had been sexually abused as a young adolescent. Today, after years of medical care and eating disorder and trauma therapy, she has recovered. Eating disorders are serious mental health illnesses that can cause significant medical complications, and even death. Not every patient who has experienced trauma develops an eating disorder, just as not every patient with disordered eating has a history of sexual abuse. That said, patients benefit when therapists treating sexual abuse survivors and physicians treating patients with eating disorders are aware of the potential connection. The three most common eating disorders are: • Anorexia Nervosa, in which patients restrict food (sometimes to the point of starvation) and have an intense fear of gaining weight or becoming fat, even if they are already underweight. Anorexia Nervosa has two peak points: young adolescents, and older adolescents and adults. • Bulimia Nervosa, in which patients have recurrent episodes of eating large amounts of food with a sense of a lack of control over their eating during the episode. Patients then purge to compensate for overeating. Bulimia Nervosa is most commonly seen in older adolescents and adults. • Binge Eating Disorder, in which patients eat large amounts of food and experience a feeling that the overeating cannot be controlled. Binge Eating Disorders are most commonly seen in older adolescents and adults. Eating disorders are caused by factors that converge — almost like a perfect storm. Emotionally, many people are negatively impacted by today’s cultural obsession with thinness, which is exacerbated by the media and sets an unrealistic picture of health in a person’s mind. People with disordered eating experience psychological issues as well — whether related to body image, personal challenges, or family or social issues. There is also a genetic component. A person with disordered eating has a chemical imbalance of neurotransmitters in the brain that can be impacted by environmental influences. Research and clinical experience support the observation that patients with Anorexia Nervosa demonstrate a low self esteem and a pervasive sense of ineffectiveness. They are often depressed, anxious, obsessive, perfectionistic. Patients with Bulimia Nervosa or Binge Eating Disorder are more likely to be impulsive with more risk-taking behavior. Eating disorders require early and aggressive treatment because, untreated, they can lead to serious medical conditions and can affect every organ in the body. Some conditions are reversible, but others can cause long-term, irreversible complications. There is a four percent mortality rate associated with anorexia, which can cause severe electrolyte disturbances and heart arrhythmias. Recovery from an eating disorder is possible. Treatment requires a multidisciplinary approach that addresses medical stabilization, nutritional rehabilitation, control of abnormal eating behavior, psychological treatment, and prevention of relapse. Treatment options differ, depending on the type of eating disorder and also the patient’s medical and psychological history. Medical stabilization and some nutritional rehabilitation must occur before significant psychological progress can be made. When an individual with a serious eating disorder discloses sexual trauma, the medical team must deal with the eating disorder symptomatically before the person can begin serious work on the trauma. For example, neither a patient with Anorexia Nervosa whose heart has been affected or a patient with bulimia with a serious gastrointestinal condition would be physically capable of making significant progress in trauma therapy until the medical symptoms are under control. Research studies indicate that trauma contributes to the development of an eating disorder for some people because it leads to psychological conditions such as PTSD or depressive symptoms, which, in turn, are related to the development of an eating disorder. As mentioned previously, much depends on the individual’s genetic disposition and environmental influences. We live in a culture preoccupied with thinness, which places a tremendous burden on people in our society, particularly adolescent females and women. In a vulnerable person, these pressures can interact with other biological, psychological, and familial factors to lead to an eating disorder. Professionals working with a trauma patient can enhance patient care by being aware of this potential pathway, by discussing specific concerns if disordered eating is suspected, and by sending the patient to the appropriate medical specialist or clinic. Likewise, sexual assault prevention specialists across the country can enhance their messaging by including information about eating disorders in presentations and written materials. Similar to sexual assault, eating disorders often are misunderstood and their effects are underestimated. By bringing this information to light, we have the potential to improve the care for and lives of sexual assault survivors. Exploring the Links: Eating Disorders & Sexual Violence Interested in learning more about the links between sexual violence and eating disorders? NSVRC has an online resource collection that explores the following information: • Eating Disorders & Sexual Violence Overview • Understanding Oppression: Eating Disorders & Sexual Violence • Prevention of Eating Disorders & Sexual Violence • General Information on Eating Disorders Visit http://www.nsvrc.org/publications/exploring-links-eating-disorders-sexualviolence to view this collection. (Photo: One pair of hands comforting another.) TECH ROUNDUP West Virginia’s online academy provides needed resources BY NANCY HOFFMAN West Virginia Foundation for Rape Information and Services (Photo: A computer keyboard, notepad, and pen sit on a table.) Learning about activities and products created by organizations with deep pockets and seemingly unlimited resources can simultaneously create envy, awe, and frustration. Hearing of their successful ability to ‘think outside the box’ does not necessarily create motivation, but instead, at times, — for those of us in rural areas — just highlights our reality that we may not even have a box ‘to think outside of.’ For years, our sexual assault coalition, the West Virginia Foundation for Rape Information and Services (FRIS), has had an unofficial bucket list of needs to be addressed to improve services to victims of sexual violence. Meeting the training needs of an increasing number of stakeholders (e.g., advocates, campus staff, nurses, correctional facilities, disability service providers, etc.) has occupied a large portion of the list and an increasing amount of the coalition staff’s time. Identifying the problem — while simultaneously recognizing that the coalition singularly did not have the capacity to fix it — provided the motiva­tion to develop a broader vision that focused on training infrastructure and sustainability. THE CREATION OF SASTA (Photo: Four sets of training materials are shown.) Through the Office on Violence Against Women’s Disability Grant Program, FRIS collaborated to create a toolkit of 27 cross-training modules addressing four key areas: sexual violence 101, disabilities 101, collaboration 101, and tools to increase access to services. Phase I of our bucket list vision of developing accessible training was to convert the toolkit into online training modules that collectively provide the core of the Sexual Assault Services Training Academy, or SASTA. Having an E-Learning training site that can be accessed by advocates, rape crisis center volunteers, law enforcement officers, and allied professionals and that provides continuing education credits for key disciplines filled a huge training gap. This enabled the rape crisis centers to begin creating standards for sexual assault advocates, resulting in additional topical modules to be added to SASTA to address the identified standards. SASTA provides a venue to create discipline-specific courses. One currently is being finalized for law enforcement, and discussions are underway for adding a course for correctional facilities for PREA training requirements as well as one for ollege faculty and staff for Campus SaVE Act compliance. Although ideally all E-Learning will be supplemented with face-to-face training components, SASTA has exponentially increased the coalition’s capacity to insure that the initial training content for many of West Virginia’s first responders includes basic, updated content. It also has resolved 10+ years of minimally successful efforts in launching SANE programs in the state due to training challenges. SASTA was developed through a partnership with two state universities. Marshall University Forensic Science Center initially created and continues to host FRIS’s website. West Virginia University’s Instructional Design and Technology Department designed SASTA and continues to work with FRIS to add new modules and courses. WEST VIRGINIA GOES SANE One of the major training challenges in West Virginia has been centered around the collection of medical forensic evidence. An active statewide SANE Advisory Board, created by FRIS in 2000, has worked tirelessly and creatively with no resources to try to resolve the issue. With no in-state SANE trainer, the cost of providing SANE trainings severely limited the frequency of the trainings — adding additional barriers to developing SANE programs. The creation of a SANE mobile project did not address the training problem, nor did the creation of SAKiTA — a sexual assault kit tracking application designed to provide feedback to the individual forensic examiners regarding the evidence-collection process. But the development of SASTA created the infrastructure to provide part of the SANE course online (24 of the 40 hours required). West Virginia is indebted to the Illinois Attorney General’s Office for sharing their core online SANE course content and to the Claude Worthington Benedum Foundation for investing funds to enable FRIS to adapt the 24-hour SANE course into SASTA as well as to create a 16-hour SANE classroom component that can be provided regionally in a cost-efficient, significantly more flexible method utilizing a newly trained in-state SANE faculty. THE IMPORTANCE OF VISION SASTA has been at the center of a training wheel comprised of many spokes. It has taken nearly a decade for all of the separate projects/spokes to begin reaching fruition and merge into SASTA. Several coalition staff and numerous collaborators have simultaneously been working to develop their specific projects: a board workgroup creating advocacy standards, rape crisis center staff creating module content, a statewide college council identifying campus training needs, etc. The cross-training potential is vast, and FRIS has gently encouraged collaborators to utilize SASTA for their training needs. For example, if the state wants to require all STOP-funded victim service providers/teams to complete a module on confidentiality, that module can be created and accessed through SASTA. All vendors with the state’s correctional facilities have to complete a training on PREA; that could be created and accessed through SASTA with a certificate of completion provided. Grassroots rape crisis centers that have historically resisted any standardization of advocate training not only want to convert to a hybrid training format (part online/mentoring/face-to-face) but actually initiated the standards conversation because of the ease of training and content quality that SASTA provides. By offering SASTA as a free training opportunity to our partners, we are also ensuring collaboration for many years to come. It opens the door for the coalition’s input into the training content, ensuring that updated information will be disseminated. Although the development has been a long process, SASTA creates a long-term solution and offers endless possibilities to address the training needs of all sexual violence service providers in West Virginia. ONLINE Find the West Virginia Foundation for Rape Information and Services (FRIS) online at www.fris.org. Learn more about SASTA at http://www.fris.org/onlinetraining/sasta.html COMMUNITY INTEGRITY Community Integrity Program uses evidence-based practices BY SHAWN MAXAM Princeton University’s Sexual Harassment/Assault Advising, Resources & Education (SHARE) The goal of primary prevention is to prevent sexual violence from happening while supporting norms that foster a healthy and safe community. Unlike primary prevention, in secondary prevention, an assault has already occurred; however, the coordinated efforts that hold perpetrators accountable can reduce the likelihood that another act of violence will take place. Holding individuals accountable can be difficult within a university setting. Amidst comprehensive legislation at the state and federal level, universities experience a great deal of pressure to effectively balance the needs of all their constituents (e.g., victims, perpetrators, and community members), at times in conflict with one another. This pressure compels universities to understand and address the complex social, cultural, and legal factors as they relate to sexual violence. Thus, many institutions are currently grappling with how to integrate the aforementioned factors along with the principles of an accountability model into their institutional disciplinary process while also meeting their prevention goals. One example of an integrated accountability model within a disciplinary process is the educational sanction used at Princeton University. When students are found responsible for violating the institution’s Sex Discrimination and Sexual Misconduct Policy, they are given a variety of punitive sanctions (e.g., probation, suspension, expulsion, withheld degree). In addition, these students are mandated to an educational sanction, the Community Integrity Program (CIP). In situations when a community member is temporarily separated from the institution by one- or two-year suspensions, oftentimes for acts of nonconsensual penetration, they participate in the CIP upon their return to the community. For offenses that don’t rise to the level of separation (e.g., offensive verbal behavior), community members engage in CIP immediately upon the conclusion of a disciplinary investigation. The CIP, as well as other accountability models, acknowledges and emphasizes that, although there can be many contributing factors to someone perpetrating harm, the individual is still responsible for his/her/their behavior. In the CIP, participants learn to: 1. Recognize the internal and external motivators influencing their problematic behavior(s) that contributed to the resulting disciplinary sanction 2. Identify possible “triggering” events (past and future) and augment their awareness of how emotions are experienced in the body 3. Distinguish unique persons, places, and things that should be avoided 4. Identify members of a reliable support team 5. Generate relevant interventions to prevent future incidences of problematic behavior(s) (Photo: An image of a building on Princeton University's campus.) For some participants, the skills developed in CIP will serve as a protective factor in preventing the perpetration of further harm, although this is not an expected outcome given the research on serial offenders. For others, community-based treatment is recommended. The CIP utilizes a collaborative approach based upon the evidence-based practice of Motivational Interviewing. Facilitators use CIP’s psychoeducational curriculum, supplemented with approaches adapted from Cognitive Behavioral Therapy (CBT) and the Good Lives Model (GLM), to guide their work with participants. Although the CIP is relatively new to Princeton University, it is being evaluated to determine its effectiveness and for continuous quality improvement purposes. ONLINE Learn more about SHARE online at https://share.princeton.edu or connect on Twitter @PrincetonSHARE COALITION SPOTLIGHT Laulima: Many hands working together to prevent sexual violence BY HELENE KAIWI, JOANNE HIGASHI, VALERIE MARIANO, AND PAULA CHUN Hawaii Coalition Against Sexual Assault Hawaii’s Sexual Violence Primary Prevention (SVPP) Plan, Preventing Sexual Violence in Hawaii, A State-Wide Plan, was approved by the Centers for Disease Control and Prevention (CDC) in 2010. The vision of this plan is “a Hawaii where people are free from sexual violence and where sexual respect and healthy relationships flourish.” To implement this statewide plan, the Department of Health (DOH) began utilizing a community mobilization approach in 2011, supported by Community Action Teams (CATs) who self-formed by either a geographic community or community of practice (e.g., military, higher education). To start this process, the DOH, in partnership with the State Department of the Attorney General and the Hawaii Coalition Against Sexual Assault, planned and implemented a statewide training on issues related to sexual violence including what to consider when working with special communities/populations and how to sustain community prevention efforts. It is understood CATs are experts in the communities they represent. To begin this community mobilization process, a facilitated approach was used at the initial training to guide teams in developing their action plans for primary prevention based on the goals and strategies outlined in the DOH’s SVPP Plan. From the beginning of this process, the DOH has communicated openly about the inability to fund CAT efforts, but offered technical assistance to guide teams in the implementation of their action plans. The DOH continues to provide annual Sexual Violence Prevention (SVP) training for all current CAT members, as well as newly formed CATs. Trainings typically include 90-100 participants and provide information on local and national trends, topics, and issues specific to sexual violence prevention. These annual trainings provide CATs time and technical a ssistance support to refine and update their action plans based on newly acquired information. The following are examples of community mobilization efforts completed through CAT action plans. The Military CAT is made up of members from various branches of the armed forces, including the Hawaii National Guard. The U.S. Air Force provided First Responder Training, which examined how “consent” is used in non-stranger sexual assault cases, offender behavior(s), and how alcohol and drugs affect the question of “consent.” To increase knowledge of military culture and of the training topic, the Military CAT invited members of the DOH’s Rape Prevention and Education Steering Committee to attend this training. The Military CAT continues to foster relationships beyond their immediate community and offers Sexual Assault Prevention & Response (SAPR) 101 workshop trainings to civilian agencies that provide support services to military families. SAPR 101 education and training workshops were developed to increase knowledge of sexual assault and provide resource information to service providers about the military community. The Safer Bars CAT is made up of representatives from The Sex Abuse . Treatment Center and Honolulu Police Department’s Sex Crimes Detail. With a high prevalence of sexual assault occurring around the use of alcohol, the Safer Bars CAT has begun mobilizing local bars in the Honolulu area to provide awareness and education on sexual violence prevention. The Safer Bars CAT plans to expand efforts through continued partnerships with community businesses and the Higher Education and Lesbian, Gay, Bisexual, Transgender, and Queer/Questioning CATs. Safer Bars collaboration discussions have also begun with the Hawaii Partnership to Prevent Underage Drinking CAT to address underage drinking and sexual violence. The Hilo CAT developed a healthy relationships video and radio public service announcement media campaign for youth on the island of Hawaii, which included partnerships with the Department of Education Hilo High School’s Performing Arts Center, the Hawaii Youth Business Center, and Na Leo O Hawaii (Public Access Television Station). Students from Hilo High School provided a youth perspective to increase knowledge and understanding to prevent sexual violence by creating scenarios and scripts and doing their own acting in the video. Partnership with Na Leo O Hawaii assisted with the broadcasting of the video through their public access television at no charge. The Hilo CAT developed a youth discussion guide and informational resource brochure to accompany the video to increase educational opportunities on healthy relationships for middle and high schools on Hawaii Island and throughout the state. Statewide SVP trainings will continue to be offered to CAT members to strengthen Hawaii’s community mobilization efforts with the support of the CDC’s Rape Prevention and Education grant, national partners at California Coalition Against Sexual Assault (CALCASA) and The Prevention Institute, local government agencies, and community-based organizations. PREVENTION IS POSSIBLE This year’s Sexual Assault Awareness Month campaign focused on the actions that individuals, communities, and the private sector can take to promote safety, equality, and respect. President Obama’s Sexual Assault Awareness Month Proclamation kicked off the month with an emphasis on changing the culture around sexual violence. Obama stated, “Together, we must stand up and speak out to change the culture that questions the actions of victims, rather than those of their attackers.” There were many ways for everyone to get involved in learning their part in preventing sexual violence. This year’s promo video reached over one million people on Facebook, more than 14,000 people changed their Facebook profile pictures in support of survivors, individuals and organizations submitted thousands of images for the #30DaysofSAAM Instagram contest, and the Huffington Post published a blog series about sexual assault prevention. Pictured are some of the contest entries that highlight how individuals, communities, and the private sector worked together this April to share the message that Prevention is Possible. (Photo: Four coloring pages on a table) @mycaremylife (Photo: Three young women hold a large poster that says Prevention is Possible) @team_traumarecovery (Photo: A young woman holds up a sign that says I will always believe you) @buildsafelives (Photo: Four people are holding teal ribbons in their palms) @raperesponse (Photo: Image of a teal fountain) @familiesincrisis (Photo: A hand-drawn image of an anchor with the words Prevention is Possible and Hope) @curlyhairnails (Photo: A large Prevention is Possible poster hangs in a stairwell) @ywcawcmi MILESTONES Members of the national partnership National partnership meets in Washington, DC BY NATIONAL SEXUAL VIOLENCE RESOURCE CENTER STAFF The National Partnership, comprised of NSVRC, the National Alliance to End Sexual Violence (NAESV), and PreventConnect/CALCASA, received initial funding from the National Football League (NFL) to bolster prevention strategies, strengthen the response to victims of sexual assault, and improve access to treatment for those who commit sexual offenses. Activities will also include coordinating policy, prevention, and messaging initiatives, as well as awarding grants that advance these goals. The partners and staff met together in person for the first time in the new office to discuss goals, roles, and deliverables. (Photo: Group shot of the national partners) Visionary Voice Awards honor 35 recipients BY NATIONAL SEXUAL VIOLENCE RESOURCE CENTER STAFF Each year, NSVRC presents the Visionary Voice Awards in conjunction with Sexual Assault Awareness Month. The award is presented to a wide range of public servants and industry professionals who have been nominated by state, territory, and tribal coalitions. This multidisciplinary group of honorees is selected for their outstanding work toward ending sexual violence.This year, 35 recipients from across the country were honored. These honorees have achieved various accomplishments in the anti-sexual violence field, including: • Ending statutes of limitations • Advocating for underserved communities • Ensuring that victims are supported • Influencing policies and practices • Working to end human trafficking • Providing services for marginalized communities • And overall, working to educate communities and prevent sexual violence “Sexual violence is a serious and widespread problem, but prevention is possible and it’s happening,” said NSVRC Director Karen Baker. “We are pleased to honor our Visionary Voice Award recipients for their important work in helping individuals, communities, and the private sector understand how they can take action to promote safety, respect, and equality to stop sexual assault before it happens.” For a complete list of this year’s Visionary Voice Award recipients, visit www.nsvrc.org/saam/award. (Photo: Image of the clock trophy presented to Visionary Voice Award recipients. It has a ribbon and the words NSVRC Visionary Voice Awards 2016 etched on it.) FROM THE LIBRARY 4 resources worth checking out The National Sexual Violence Resource Center library is overflowing with great materials, with more than 37,000 unique titles and growing every day. NSVRC staff members share four of the collection’s resources you might want to grab for your own library. Looking for research materials? Search the database at www.nsvrclibrary.org. 1. In American Girls: Social Media and the Secret Lives of Teenagers, Nancy Jo Sales candidly interviews over 200 girls aged 13-19 throughout the United States about sexuality and social media. Their revealing conversations provide shockingly necessary insight into the world of today’s teenagers. The resulting dependence surrounding virtual reality results in traumatic effects such as extreme cyberbullying on anonymous platforms, provocative poses that result in body image and self-esteem issues, and the influence on the behaviors and expectations of girls as well as boys. Sales’ honest narrative is paralyzing at times, but the unflinching repetition she provides with these young women’s recounting brings attention to how c ommon their feelings and experiences are in their secret cyber lives. -Emily Immel American girls: social media and the secret lives of teenagers by Nancy Jo Sales. (Alfred A. Knopf, 2016) 404 p. 2. Yoga Therapy: Theory and Practice serves as a guidebook for medical and mental health professionals looking to incorporate yoga, mind, and body healing into their practice. With contributions from multiple practitioners, each chapter offers historical context of yoga and its relation to healing, instructional tips and techniques for integrating yoga into practice, and resources. The reader has the opportunity to not only follow along with the instructions, but is also encouraged to practice while reading along with questions and prompts for self-reflection rounding out each chapter, making this a tangible resource for many professionals. -Taylor Teichman Yoga therapy: theory and practice edited by Ellen G. Horovitz and Staffan Elgelid. (Routledge, 2015) 215 p. 3. The Beginning and End of Rape: Confronting Sexual Violence in Native America is a collection of essays that expands the powerful writings in which Deer has advocated for cultural and legal reforms to protect Native women from endemic sexual violence and abuse. These essays provide a clear historical overview of rape and sex trafficking in North America, paying particular attention to how federal law has accommodated rape by destroying tribal legal systems. Deer draws on her extensive experiences in advocacy and activism to present specific, practical recommendations. Her work bridges the gap between Native law and feminist thinking by explaining approaches that are vital to addressing the rape of Native women. -Karen Litterer The beginning and end of rape: confronting sexual violence in Native America by Sarah Deer. (University of Minnesota Press, 2015) 207 p. 4. In Missoula: Rape and the Justice System in a College Town Journalist Jon Krakauer, channeling his obvious anger, dives into the acquaintance rape scandal that enveloped the University of Montana Grizzlies football team, combined with the ineptitude of university administrators when confronted with accusations of rape among their students, and the inability or refusal of local prosecutors to convict accused rapists. The raped women, their friends, family, and defenders faced ostracism, threats, and the accusation that they were somehow making things up in order to harm the football program. The result of Krakauer’s rigorous, disciplined reporting is an exposé that looks underneath the he-said-she-said to get at the sexist assumptions that cover up and enable these crimes. -Karen Litterer Missoula: rape and the justice system in a college town by Jon Krakauer (Doubleday, 2015) 367 p. RECOMMEND A RESOURCE Read something interesting? Let us know! We could add it to our library and feature it here. Tweet suggestions to @NSVRC, share them on NSVRC’s Facebook page, or email resources@nsvrc.org using the subject line “From the Library.” [Advertisement: NSVRC has culturally relevant resources available, including: Key findings from studies on sexual violence victimization in communities of African American women and Hispanic women For these resources and more, visit www.nsvrc.org or email resources@nsvrc.org] [Advertisement: The National Sexual Assault Conference August 31 - September 2, 2016 Washington, DC Hopeful future, honored past Register at nsvrc.org/nsac #NSAC2016] [Advertisement: xCHANGE forum summer series Explore new research with the online forum summer series http://www.nsvrc.org/xchange-forum]