The art and science of measuring prevention
This week I am attending the California Coalition Against Sexual Assault’s series of trainings on Measuring Prevention where California’s rape crisis centers and domestic violence programs are exploring how to evaluate their prevention programs and examine ways to collect and analyze data. Given the small budgets to implement and evaluate the programs, we are exploring creative ways to do this.
The article Commentary on Foubert, Godin, & Tatum (2010): The Evolution of Sexual Violence Prevention and the Urgency for Effectiveness recently ePublished for the Journal of Interpersonal Violence prompted me to think hard about how we measure sexual violence prevention efforts.
Since sexual violence recognized as a serious problem, there is a growing consensus that both intervention and prevention are necessary. But creating change that will actually reduce the rates of sexual violence is quite complex. There are no easy answers, no magic solution nor one key behavior that will absolutely lead to prevention, Even with a complex issue such as HIV prevention, we know that regular consistent use of condoms will reduce incidence of HIV infection. But there is no simple equivalent behavior for rape prevention. (Part of me wants to say there is – just don’t force someone to have sex. While this sentiment is understandable and true, unfortunately this message alone is not really a good strategy to actually ending rape.)
Evaluation is a tool that will assist us in determining how we can prevent rape. I think of the process of developing, implementing and evaluating prevention efforts as a combination of art and science. Science provides essential tools to for our work (such as epidemiology to understand the problem, and rigorous evaluation of prevention program effectiveness), but the art is the creativity and innovation that goes beyond what we have done in the past to create new approaches. While science is grounded in testable knowledge, I do not want to lose the art of finding ways to connect with communities and fostering change to shift cultural norms. Some of the greatest movements in our history to create change relied heavily on the art more than the science to foster change. The civil rights movement did not rely of randomized clinical trials to take action to change policies. I want to learn from both the art and science of prevention.
Commentary on Foubert, Godin, & Tatum (2010): The Evolution of Sexual Violence Prevention and the Urgency for Effectiveness looks at the science of evaluation of sexual violence prevention. The authors describe “experimental and rigorous quasi-experimental designs with well-matched control groups that have been replicated by investigators other than the developers as the designs that provide the strongest evidence.” What I found especially useful in this article is the notion that evaluation is part of a process. The authors suggest that “[r]efining a program through less rigorous evaluation methods is often cost effective and may result in a more cohesive and well-developed program that can then be subjected to more rigorous evaluation.” That process is what I described above as the art.
In this article, the authors critique the published evaluations of John Foubert and his colleagues about The Men’s Program. I too have written previously about some of my concerns about this program. I agree that the one-hour presentation of the Men’s Program is inconsistent with generally accepted prevention principles. I find it hard to image actual behavior change comes from such a short presentation alone.
However, I do like the methodology of interviewing participants seven months after the presentation as Fobert, Godin and Tautm had done in their evaluation. That is a good early effort for prevention to inform the development and determine whether the practice has promise. The authors of the commentary suggest that over time the rigor of evaluation should increase.
What does this mean for the prevention practitioner? At this time there is so little research on sexual violence prevention programs that demonstrate effectiveness at reducing rape rates. As we read the research that is released, I agree we need to look at the rigor of the evaluation method. Unfortunately the cost and time commitment for quality effectiveness research is high. In our prevention efforts we must use systematic evaluation efforts such as process evaluation and measures of potential indicators of change to inform the program’s development and implementation – that is the art of creating and conducting a prevention program.
However, that is not enough. Over time we will need to conduct more rigorous research to determine the impact of our work – find a way to use science as tool to understand what our prevention efforts can do. In the meantime, we must continue to innovate – that is engage in the practice of art to create new approaches to creating change.
How are you using both art and science to improve your prevention efforts?
Here is the full abstract and references to the article:
Commentary on Foubert, Godin, & Tatum (2010): The Evolution of Sexual Violence Prevention and the Urgency for Effectiveness
Andra L. Teten Tharp, Sarah DeGue, Karen Lang, Linda Anne Valle, Greta Massetti, Melissa Holt and Jennifer Matjasko, Journal of Interpersonal Violence, 2011, ePublished February 28, 2011
Click here for a link to the abstract on the journal’s web site.
Foubert, Godin, and Tatum describe qualitative effects among college men of The Men’s Program, a one-session sexual violence prevention program. This article and the program it describes are representative of many sexual violence prevention programs that are in practice and provide an opportunity for a brief discussion of the development and evaluation of sexual violence prevention approaches. In this commentary, we will focus on two considerations for an evolving field: the adherence to the principles of prevention and the use of rigorous evaluation methods to demonstrate effectiveness. We argue that the problem of sexual violence has created urgency for effective prevention programs and that scientific and prevention standards provide the best foundation to meet this need.
Photo by Addison Berry. Use permitted by Creative Commons.