DESCRIPTIVE EPIDEOMIOLOGY PAPER

1

SEXUAL ASSUALT AMONG COLLEGE STUDENTS

Sexual Assault Among College Students Comment by Elizabeth Wachira: Good draft See comments on how to re-arrange parts 1-2 so that it all reads clearly and flows well. Data reporting – please update Grammatical/APA errors – watch for those.

Student’s Name: Kusum Syangbo, Kabita Budhathoki, Radhika Chhetri, Yesenia Binkley

Instructor: Dr. Elizabeth Wachira

Texas A &M University- Commerce

Course Name: HHPH 416

Date: 11/14/2021

Abstract

Sexual assault among college students is a common issue that usually goes unreported. It comprises any sexual activity that occurs without consent, from unsolicited touching to rape. Approximately 13% of college students in the United States encounter sexual assault through incapacitation, physical force, or violence. In addition, alcohol and substance use, delinquency, and early sexual initiation often play a role in sexual assault among college students. Sexual assault in colleges is common among females than males as 44.2% of females and 3.2% of males experience sexual assault. In addition, one in five college women experiences sexual assault, particularly women belonging to minority sexual groups. The purpose of this paper is to study the prevalence, incidence, implications, and interventions for sexual assault among college students in the United States. In addition, the paper identifies the public health strategies, including policy intervention and health education strategies suitable for preventing sexual assault cases in the United States colleges. Moreover, is important because it provides statistics that show that indeed the program is working in the reduction of sexual assault, with attempted and completed rapes noted to have reduced by 95% and 76%. Additionally, EAAA can be used by the administrator and staff responsible for the development of sexual assault and violence prevention policies and practices in the campuses. EAAA is formed to recognize the diversity of experiences of college students who is self-identify their prior sexual victimization history. Comment by Elizabeth Wachira: Which resource?

Keywords: sexual assault, prevention, implications, college students, intervention, violence, Incidence.

Part I. Overview of Sexual Assault among College Students

Sexual assault is any type of sexual contact or behavior which occurs without the explicit consent of the recipient (Reynolds-Tylus, Lukacena & Quick, 2019). This entails any sexual coercive contact or behavior which may include fondling, sexual intercourse, incest, or attempted rape. The central point is consent, which demands that the person must be able to recognize the situation, get to know what he or she desires, can communicate the desire, and be able to the identify consequences of the activity (Reynolds-Tylus, Lukacena & Quick, 2019). Therefore, when a person is coerced or threatened to engage in sexual activity, a situation where a person is not able to provide consent because he or she is under the influence of alcohol or drugs, situations when the person does not have the mental capacity to give consent, and in the instances where the person is legally minor, engaging in the sexual activity with a person in any of aforementioned situations amount to sexual assault (Reynolds-Tylus, Lukacena & Quick, 2019).

The prevalence rate of sexual assault among college students is at an alarming rate. Among the college students,, with one in five females and one in sixteen males reporting being are sexually assaulted (Reynolds-Tylus, Lukacena & Quick, 2019). Sexual victimization is a serious health concern among universities and college students, which requires a need for interventions to prevent or reduce the problem. Similarly, Katz and Moore (2013) report that approximately 20-25% of women experience sex during college, with 19% of women and 6% of men reporting to have experienced attempted or completed rape since starting college. Therefore, sexual assault is a big and consequential problem among college students. Comment by Elizabeth Wachira: ???

The consequences of the sexual assault are severe, with survivors exposed to multiple harmful physical, social, and mental outcomes. Unintended pregnancy elevated depression, sexually transmitted diseases such as HIV, and high risky behaviors in the aftermath of sexual assault such as drug abuse, bipolar conditions, disordered eating, and other extreme condition such as suicidal attempts (Reynolds-Tylus, Lukacena & Quick, 2019; Melkonian et al.., 2017). The sexual assaults tend to affect the preexisting relationship with friends, relatives, family members, and romantic partners, where college students that possibly could be dating one another might break up upon establishing their partner was sexually assaulted (Reynolds-Tylus, Lukacena & Quick, 2019). Therefore, in an endeavor to prevent college students from going through outlined harmful and shameful effects of sexual assault which compromises their physical and mental health, and social dignity and status, it is important to acknowledge it is serious problem that deserves immediate intervention.

1.Sexual Assault Causation

Sexual assault refers to any sexual activity, which happens without a person's consent (Muehlenhard et al., 2017). It can also include non-contact activities such as being forced to look at sexual images. In the United States, about 13% of all college students encounter sexual assault through incapacitation, violence, or physical force.

A. Risk Factors

i.Individual behavior

Alcohol use which tends to limit individual ability to make sound decisions is one of the individual behaviors that exposes one to the risk of sexual assault (CDC, 2021a). Delinquency behavior, where an individual engages in immoral acts which do not conform to the moral standards of society, is another risk individual behavior to sexual assault (CDC, 2021a). Difficulty in the identification and differentiation of one’s emotions is another individual behavior that predisposes to a high risk of sexual assault because of impaired detection of the risk of the sexual assault (Melkonian et al…, 2017). Early sexual initiation increases risk-taking behavior such as having multiple partners, which increases vulnerability to sexual assault (CDC, 2021a). Forceful sexual fantasies where the person rejects sexual advances and expresses discomfort in engaging in the sexual activity but with time, give up the fight and give in to the desire, a behavior that exposes one to sexual assault. The hostility that men have towards women, having no concern for others, and having a lower age where one is considered young and weak by others, are individual behaviors that are the risk factors for sexual assault (CDC, 2021a).

ii.Environmental factors

Exposure to sexually explicit media creates such as pornography increases the risk of colleges students becoming the victims of sexual violence, and other engages is rape to meet the sexual desire after watching pornographic materials (CDC, 2021a)). This shows consuming explicit sexual materials motivate college students to engage in sexual activities, and when they find no one to consent to sexual intercourse, rape might be the next course of action, which is a form of sexual assault. Children that have witnessed family violence are likely to be the victims of the sexual abuse, while others might develop antisocial behaviors such as males normalizing violence and abuse of the females when they grow in families where women are hit and disrespected (CDC, 2021a). This causes males to coerce, threaten and even rape women when they do not bow to their wishes, because they are opinion that violence can be used to obtain whatever they want from females, a trait learned family experiencing domestic violence. Lastly, late-night weekend parties characterized by heavy alcohol taking, addiction are vulnerable to sexual assault (Reynolds-Tylus, Lukacena & Quick, 2017). This is because the security of students cannot be guaranteed in these events, others tend to be under the influence of drugs and lured into sex without their knowledge while others are raped and forced into sex during late-night events. Comment by Elizabeth Wachira: Be careful… this reads as opinion especially if not supported by literature. Suggest deleting. Comment by Elizabeth Wachira: Sorority/fraternity, college athletes?? Any mention of that in the literature? Comment by Elizabeth Wachira: Huh? Re-read this. Comment by Elizabeth Wachira: Again…be careful with these “summary” statements…. Simply state what Reynolds said to explain why this is a risk factor

B. Determinants of sexual assault

I. Higher Education Institutions

In colleges and universities, a high prevalence rate of sexual assault has been reported, with 1 out 5 females and 1 out of 16 males reported to have experienced sexual assault among college students. Education is one of the parameters that is used to determine sexual assault. In the United States, it is reported that 300,000 cases of sexual assault are reported, from which young adults joining postsecondary institutions are at high risk of sexual victimization. In colleges and universities, a high prevalence rate of sexual assault has been reported, with 1 out 5 females and 1 out of 16 males reported to have experienced sexual assault among college students. Most of the studies that have been conducted to study the impact of the sexual assault, prevalence rate and the causative factors, have been on the campuses. For example, among 857 women involved in the study, who were first-year undergraduate students from 3 universities showed that 6.1% experienced completed rape while 5% experienced attempted rape (Senn et al…,2021). Therefore, education institutions provide appropriate ground for assessing the prevalence of sexual assault and answer the question about ways by which education determines or influences sexual assault.

2.Sociodemographic factors

a. Poor social status

Students from poor families are more exposed more to sexual assault than those from well-off families. For example, in one of the studies, it was established that women that had difficulties paying necessities had increased odds of sexual assault, with the same trend appearing to male students even though did not reach statistical significance (Mellins et al…,2017). Narrowing down, both males and females that exhibited difficulties in paying necessities had an increased risk of penetrative assault compared to those who had no had difficulties (Mellins et al…,2017). This shows that poor social status increases sexual assault. Comment by Elizabeth Wachira: Is this what the literature says?? And is it only determined by difficulty paying bills?

b. Racial discrimination

Racial discrimination is another social determinant of sexual assault. African women are the odds of the experiencing sexual assault than whites’ women, exacerbated by the nature of dignity and respect accorded based on the race, and prevailing skewed justice administration that is favorable to the whites. In American history, adverse sexual health was experienced by the African Americans through Black Codes, and in some states enacted laws that protected whites against rape, while many African American women endured gang rapes (Prather et al…, 2018). Systemic racial discrimination has continued to prevail in the United States and with sexual assault likely to be reported or experienced by people of color more than whites.

c. Lack of social support

Social support and identification with a group enhance the likelihood of one being influenced by the in-group behavior. The positive effect of the group identity in the interaction, and the individual perceive the prevalence of the behavior among the referent group widespread and see themselves like the members of the referent group, they are likely to engage in the behavior themselves (Reynolds-Tylus, Lukacena & Quick, 2019). The students in the college might engage with the gang and other groups that engage in criminal activities because they can find solace, empathy and support from them in the instances where they lack social support from families and relatives, which exposes them to engage in sexual assault. Therefore, when social fabric, support and interaction systems are not working in the favor of the students, it might be a factor that predisposes them to sexual assault. Comment by Elizabeth Wachira: Not sure about this section…. You only have one citation to support and link this.. be careful

2.Sexual Assault Diagnosis

## give an introduction sentence for this section before discussing how S.A is diagnosed. Emotional identification is one of the strategies that is adopted to identify victims of the sexual assault and bystanders that are potentially are likely to engage in the sexual assault (Melkonian et al…, 2017). Emotion identification requires an individual to appropriately differentiate the emotions of others and establish those related to the risk of sexual assault. Victimization history is another approach that can be used in the diagnosis of sexual assault because sexual victimization is associated with subsequent victimization (Melkonian et al…, 2017). Forensic investigation entails conducting the DNA based on specimens collected on the crime scene such as sperms, hair, or any other DNA testable material, which are used to identify the victims of sexual assault such as rape. The investigation by questioning and cross-examining the suspects is another approach that can be used to identify the victims of the sexual assault as well as the perpetrators of the sexual assault (Melkonian et al…, 2017). Therefore, any of the methods can be used in the sexual assault diagnosis based on the available data, situation, and complexity of the case.

Why Is Sexual Assault A Problem? Allocation Graphs and Data to Show the Variation in Rates. Comment by Elizabeth Wachira: Reconsider a different title for here… and why is this needed?? It is simply a restatement of what has been said above… We are reporting data in #3…

Sexual assault is a health problem concern in the undergraduates, with the rate of sexual assault for those enrolled ranging between 19% to 35% for the women, 43% experience sexual victimization in their lifetime, and 5-15% for men with 23% of men likely to experience sexual victimization in the lifetime (Melkonian et al…, 2017). In the United States, data show that about 300,000 people are sexually assaulted every year, a number that has remained high consistently. Consequences of sexual assault include such as depression, sexually transmitted diseases, unwanted pregnancies, alcohol use, trauma, suicide, and victim-blaming from peers (Melkonian et al…, 2017). This shows that indeed sexual assault is a problem that needs to be mitigated considering its high rates and harmful physical, mental, and social consequences. Comment by Elizabeth Wachira: Delete from here. This was in the lit review section.

Figure 1 those affected by sexual assault in U.S. Source: RAINN, 2021.

Figure 2 Number of people victimized each year: Source: RAINN, 2021.

Figure 3 Location where sexual assault occurs: Source: RAINN, 2021.

I. Prevalence rates

Figure 4 Prevalence rate for sexual assault: source: CDC, 2021b.

According to figure 4 above, it is evident that the prevalence rate of sexual assault is highest in Dallas County, followed by Texas and least at the national level. Therefore, Dallas County is dangerous when comes to sexual assault which demands an investigation to establish the most attractive features that cause it to register such a higher prevalence level of sexual assault. Comment by Elizabeth Wachira: This should come BEFORE the graph. And simply report the data, don’t give a “so what conclusion” … Be sure you define the rate, what year is being reported and then give a summary. Also put a label for each rate so can see what these rates are. See example “Prevalence rates measure the number of new and old cases of sexual health. Figure 4 provides rates at the national to local level with county level rates for Dallas county being higher than the other levels (cite your source)”

II. Incidence rates

Figure 5 Sexual Incident Rates: source, CDC, 2021b.

According to figure 5, Dallas County reports the highest sexual incident rate than the Texas States which also reports a higher sexual incident rate than the United States. It seems that determinants and risk factors that favor sexual assault are conducive in Dallas County than the Texas States, and the same applies at the national level. This creates a need to institute preventive measures that would reduce sexual in Dallas County and equally the Texas States and the United States. Comment by Elizabeth Wachira: See my comment on how to write this and emulate…

III. Morbidity and Mortality rates

Figure 6 Sexual assault mortality rate: Source, CDC, 2021C.

High death due to sexual assault is higher in Dallas than in Texas, with Texas also reporting higher rates than the United States. This corresponds to the observed prevalence incidence and prevalence rates as illustrated in Figures 4 and 5 respectively. This means when higher incident and prevalence rates are reported, morbidity and mortality rates are also expected to be high. Comment by Elizabeth Wachira:

Sexual Assault Distribution

I. Demographic variation Comment by Elizabeth Wachira: Give me a chart for gender only and age only.. don’t mix them.

i. Age and Gender

Figure 7 age female sex victimization

Figure 8 age female sex victimization: Source, CDC, and 2021C.

According to Figures 7 and 8, sexual assault is higher in females than males. This shows that women are vulnerable to sexual assault than males, which could be attributed to the weak nature of women and having the males that take advantage of the women. Similarly, sexual assault is higher among younger age or the children both in the males and females. This happens because children are easily lured and cheated to engage in sexual activities and others are raped unlike the adults. Therefore, interventions are needed that would target the prevention of sexual assault among children and college students that are less than 18 years. Comment by Elizabeth Wachira: Avoid this.. how do you know this? Comment by Elizabeth Wachira: Again avoid this…!

ii. Race/ethnicity

Figure 9 sexual assault based on ethnicity: Source: CDC, 2021C.

Sexual assault is unevenly distributed across the race, with people of color experiencing higher sexual assault than whites.

iii. . Socioeconomic status

Figure 10 Sexual assault based on the socioeconomic status: source, CDC, 2021C.

The poor individuals, who lack the potential to meet basic needs are vulnerable to sexual assault than well-off and economically stable individuals. Those that are economically unstable, in the process of looking for ways to meet their needs, may end in unsecure places, and even interact with people that take advantage of them hence having them exposed to sexual assault. Comment by Elizabeth Wachira: Avoid explaining…..

Part II: Intervention Opportunities

Literature Review Comment by Elizabeth Wachira: Be sure ALL parts as outlined are covered. This read too brief to be thorough.

A. Sexual assault is a Public Health Issue

Sexual assault is a public health concern with that has consistently been high among college students. It has been revealed that Aapproximately 300,000 people are sexually assaulted every year in the United States, with college students in the colleges being ahaving higher prevalence rates. portion of this population that are at high risk of sexual assault (Reynolds-Tylus, Lukacena & Quick, 2019). The study by Melkonian et al. (2017) reveals that even though there are sexual prevention inteventions that are implemented in colleges, sexual assaults remain the main health issue with sexual assaults remaining considerably highan issue. Elevated depression, sexually transmitted diseases, alcohol use disorders, anxiety, unintended pregnancy, trauma, bipolar conditions, ruined social relations are some of the harmful physical, social, and mental consequences of sexual assault ( Reynolds-Tylus, Lukacena & Quick, 2019; Melkonian et al…,2017). Therefore, it is evident that sexual assault is public health issue considering its harmful effects on physical and mental health.

B. Prevention and Management of Sexual assault Comment by Elizabeth Wachira: This reads as targeted interventions… LR from article 3 Where is the discussion on LR from article 2 (“prevention and management review”?

Various methods have been proposed for the prevention and management of sexual assault. Bystander intervention is one of the methods that have been proposed for the prevention of sexual assault, which empowers the community as bystanders thatto actively stand up to prevent sexual assault and seek to change cultural values and norms that seem to promote the prevalence of sexual assault (Reynolds-Tylus, Lukacena & Quick, 2019; Melkonian et al…,2017; Katz and Moore, 2013). Another approach that has been implemented to reduce sexual assault is The Enhanced Assess, Acknowledge, Act (EAAA) program which has been known to improve risk detection for sexual assault in the social interactions, decrease obstacles for risk detection and improve on the effectiveness of the deployment of the self-defense (Senn et al…, 2021).

Instances in which individuals are threatened are incapable to make sound decisions because they are influenced by the alcohol, are minors and or when individuals are mentally incapacitated because of the illness are regarded as the situations that do not meet the threshold of consent (Reynolds-Tylus, Lukacena & Quick, 2019). Additionally, silence does not amount to consent, and rolling programs that de not only incorporate women but also men as part of the solution, are interventions that would promote end or reduction of the sexual assault. Training on the identification of the emotions of others and non-verbal cues is another intervention that can help prevent sexual assault (Melkonian et al…, 2017). The interventions are core in preventing sexual assault. Consequently, discreet screening which incorporates forensic examination to identify perpetrators of the sexual assault to enhance legal action take the due course is another strategy that can be deployed to prevent sexual assault.

Public Health Practice (Strategies)

At the national level, a bystander intervention program is the policy intervention that can be deployed in reducing sexual assault. This is because bystander intervention programs empower the community to actively participate in reducing sexual assault and modifying cultural practices such as normalization of men beating and oppressing women, values and norms that could promote sexual assault. At the local level, EAAA intervention would be most suitable it has proven effective in reducing sexual assault such as attempted and completed rape, and other forms of sexual assault by 50% (Senn et al…, 2021). Therefore, because sexual assault was identified to be higher at the local level than the national level, EAAA would effectively address this menace. Comment by Elizabeth Wachira: This is an educational program…… What is the policy interventions that were discussed in #5???

Strategies adopted should target young adults such as thein college. Study reveals that sexual assault is considerably high among college students, with 20-25% of women reported to experience sexual assault during college, 19% of women and 6% of men reported to have experienced completed or attempted rape since started college (Katz and Moore, 2013). Additionally, high sexual incidence rates are reported among young adults, some which have fallen on the traps of peer pressure, others in the late-night campus events which are vulnerable to sexual assault. Therefore, to ensure sanity in the colleges and young adults grow into mature and responsible adults, tailoring sexual assault prevention programs around them is necessary.

Part III: Implications

Implications  

It has been identified that sexual assault is the main problem in colleges. In the school, public health players can set up systems that promote quick response to sexual assault cases such as conducting the DNA analysis to establish perpetrators and create awareness among the students on the situations that qualify to consent, and which do not. Additionally, creating awareness among the students on the health dangers associated with sexual assault.

Student’s groups can be trained on the EAAA which equips them with the necessary skills for identifying risks of sexual assault, developing confidence to counter obstacles for sexual risk detection, and developing effective self-defense which cumulatively promotes the reduction of sexual assault. Additionally, bystander intervention can be implemented among the student groups to ignite collective responsibility phenomenal in preventing sexual assault and modifying existing culture that could be promoting sexual assault. Teaching EAAA equips female students with knowledge of effective resistance strategies in acquaintances situations and sexual assault cues in men’s behavior enhancing significant reduction in the sexual assault on the campuses.

Conclusion and Implications    Comment by Elizabeth Wachira: 4 paragraphs total….

Sexual assault has been identified to be a major health issue and is rampant in colleges. Depression, sexually transmitted disease, anxiety, alcohol use disorder, suicidal attempts, trauma, unintended pregnancy, and ruined social interactions, are some of the harmful physical, social, and mental consequences of sexual assaults. Alcohol use, early sex initiation, delinquency, sexually explicit media, family violence and late-night weekend parties have been highlighted risk factors for sexual assault. Education, poor social status, experiencing racial discrimination, and lack of social support have been identified as determinants of sexual assault with incidence and prevalence observed to be higher at Dallas County than Texas and national levels.

Finally, bystander intervention and EAAA are two main prevention and management approaches that have been identified, with EAAA recommended for the local level and EAAA for the national level. Adopting proposed interventions would promote the reduction of sexual assault by equipping the youths and students with the knowledge to enhance detection of the risk of sexual assault, overcome obstacles for risk detection, develop effective self-defense, encourage the participation of bystanders in the sexual prevention, and change cultural practices that encourage sexual assault. Training by healthcare professionals on the health effects of sexual assault, proper implementation of EAAA and bystander intervention in the colleges, are essential steps in commitment to prevention and reduction of sexual assault.

Part Contribution

Kusum Syangbo contributed to Risk factor, determinants

Kabita Budhathoki contributed to Part II: Intervention Opportunities

Radhika Chhetri contributed to Part III: Implications

Yesenia Binkley contributed to Why Is Sexual Assault A Problem? Allocation Graphs and Data to Show the Variation in Rates.

References

Bhochhibhoya, S., Maness, S. B., Cheney, M., & Larson, D. (2019). Risk Factors for Sexual Violence Among College Students in Dating Relationships: An Ecological Approach. Journal of Interpersonal Violence, 36(15–16), 7722–7746. https://doi.org/10.1177/0886260519835875

Cascardi, M., Krauss, A., O’Leary, K. D., Loatman, K. L., Sargent, K., Grych, J., & Jouriles, E. N. (2018). The Bystander Behavior (For Friends) Scale: Factor Structure and Correlation With Prior Victimization. Journal of Interpersonal Violence, 36(9–10), NP4850–NP4873. https://doi.org/10.1177/0886260518794011

CDC. (2021a, February 21). Risk and Protective Factors. Retrieved from https://www.cdc.gov/violenceprevention/sexualviolence/riskprotectivefactors.html

CDC. (2021b). The National Intimate Partner and Sexual Violence Survey (NISVS). Retrieved from https://www.cdc.gov/violenceprevention/datasources/nisvs/index.html

CDC.(2021C, July 19). Reports and Publications. Retrieved from https://www.cdc.gov/violenceprevention/datasources/nisvs/summaryreports.html

Katz, J., and Moore, J. (2013). Bystander education training for campus sexual assault prevention: An initial meta-analysis. Violence and victims, 28(6), 1054-1067.

Melkonian, A. J., Ham, L. S., Bridges, A. J., & Fugitt, J. L. (2017). Facial emotion identification and sexual assault risk detection among college student sexual assault victims and nonvictims. Journal of American college health, 65(7), 466-473.

Prather, C., Fuller, T. R., Jeffries IV, W. L., Marshall, K. J., Howell, A. V., Belyue-Umole, A., & King, W. (2018). Racism, African American women, and their sexual and reproductive health: a review of historical and contemporary evidence and implications for health equity. Health equity, 2(1), 249-259.

RAINN (2021). Scope of the Problem: Statistics. Retrieved from https://www.rainn.org/statistics/scope-problem

Reynolds-Tylus, T., Lukacena, K. M., & Quick, B. L. (2019). An application of the theory of normative social behavior to bystander intervention for sexual assault. Journal of American college health, 67(6), 551-559

Senn, C. Y., Eliasziw, M., Hobden, K. L., Barata, P. C., Radtke, H. L., Thurston, W. E., & Newby-Clark, I. R. (2021). Testing a model of how a sexual assault resistance education program for women reduces sexual assaults. Psychology of Women Quarterly, 45(1), 20-36.