A systematic review and meta-analysis of primary prevention strategies for sexual violence perpetration
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Description: Sexual violence is prevalent worldwide. For example, the World Health Organization (WHO) estimates that 1 in 3 women have experienced physical or sexual violence in their lifetime. Thus, sexual violence is considered a significant health problem affecting millions of people every day (WHO, 2013; CDC, 2016). To combat sexual violence, public health practitioners and scholars address three types of prevention strategies: 1. Primary prevention strategies that refer to “approaches that aim to prevent violence before it occurs” (WHO, 2010, p. 7), and may be targeted at both prevention of perpetration and victimization; 2. Secondary prevention strategies that refer to “approaches that focus on the more immediate responses to violence” (WHO, 2010, p. 7), and; 3. Tertiary prevention strategies that refer to “approaches that focus on long-term care in the wake of violence” (WHO, 2010, p. 7). While all three strategies have been recognized as important for combatting sexual violence, the public health approach to violence emphasizes the importance of primary prevention strategies. Moreover, the primary prevention approach shifts the focus of prevention from potential victims to potential perpetrators (Dahlberg & Krug, 2002; McMahon, 2000). However, the primary prevention approach has been much less studied systematically compared with secondary or tertiary approaches (Arango, Morton, Gennari, Kiplesund, Ellsberg, 2014; WHO, 2010). Accordingly, while a number of quantitative and qualitative reviews of primary prevention strategies were conducted in the past (e.g., Anderson & Whiston, 2005; DeGue, S., Valle, L. A., Holt, M. K., Massetti, M. G., Matjasko, J. L., & Tharp, A. T., 2014; Ellsberg et al., 2015; Kettrey & Marx, 2018; Vladutiu, Martin & Macy, 2011; ), a quantitative review that includes all subcategories of prevention efforts is still missing. Previous reviews have highlighted the fact that the majority of primary prevention evaluations focus on attitudinal rather than behavioral outcomes (Anderson & Whiston, 2005; Breitenbecher, 2000, DeGue et al., 2014; Schewe, P., & O'Donohue, 1993). In fact, recently DeGue and colleagues (2014) concluded that none of the primary prevention strategies to date have shown to be effective in reducing perpetration behavior in a rigorous evaluation design. Thus, this project will provide a first comprehensive review and meta-analysis of all studies that examined primary prevention strategies to reduce sexual violence targeting perpetration behaviors between 1985 (the year in which this literature begins, as demonstrated by other reviews; DeGue et al., 2014) and 2018. We will examine these studies with two questions in mind: 1) What intervention programs show causal effects on sexual violence perpetration over the short and long term? 2) what kinds of outcomes (i.e., attitudes vs. behavior) have been assessed to determine successful intervention over the short and long term?