Evaluation of RISE: A Sexual Violence Prevention Program for Female College Students in India

Abstract

RISE, a sexual violence prevention program for female college students in India, covers topics on gender, healthy relationships, sexual violence, and bystander education, and focuses on the teaching of knowledge, the promotion of positive attitudes as well as the support of effective behaviors to prevent sexual violence against women in India. However, it is yet unclear what impact this program has in preventing sexual violence. In this evaluation study, a total of N = 245 female college students based in New Delhi and aged 17 to 22 years were assigned to a training (N = 128) or a waitlist control group (N = 117). The prevention program was conducted by two Indian professionals of a non-governmental organization (NGO) in New Delhi within five sessions. Results indicated that students in the training group showed significant increases in awareness of gender stereotypes, the importance of communication in relationships, bystander efficacy as well as intentions to intervene as a bystander in situations of violence when compared to students in the control group right after the program (posttest) and six months later (follow-up). Additionally, the training group displayed a significant increase of knowledge in all four program areas (gender, healthy relationships, sexual violence, and bystander education). Our findings implicate that future sexual violence prevention programs in India need to address women as well as men to effectively tackle sexual violence. In this context, bystander education seems to be one of the most promising approaches by targeting whole communities and creating new social norms regarding helping behavior and the prevention of sexual violence.

Keywords

sexual assault sexual harassment date rape cultural contexts prevention

Introduction

Sexual violence represents a serious health problem across the globe (Jina & Thomas, 2013), especially for women (Abrahams et al., 2014; Decker et al., 2014). Following the definition by Basile et al. (2014), we define sexual violence as nonconsensual sexual acts (e.g., rape), attempted nonconsensual sexual acts or abusive sexual contact (e.g., unwanted touching), and noncontact sexual abuse (e.g., verbal sexual harassment). Consequences of sexual victimization range from physical health issues (Bosch et al., 2017), mental health problems such as posttraumatic stress disorder (Kumar et al., 2013) up to suicide attempts (Devries et al., 2011). Despite the global presence of sexual violence, the situation appears to be particularly dramatic for women in India (Sharma et al., 2015) which, in turn, calls for effective prevention programs (Raj & McDougal, 2014). To address this issue, we have developed RISE, a culture-sensitive sexual violence prevention program for female college students in India, and, with this study, focus on evaluating the effectiveness of the program.

In India, public discussions about sexual violence against women intensified a few years ago after the brutal gang rape of a young student in New Delhi (Raj & McDougal, 2014). Despite recent efforts in India to end violence against women, sexual violence is still a major issue. In 2018, the Thomson Reuters Foundation published a study in which more than 500 experts rated India as the most dangerous country (among the 193 member states of the United Nations) for women worldwide because of the high risk of sexual violence (Goldsmith & Beresford, 2018). Considering data about the prevalence of sexual violence against women in India, around one in six women have fallen victim to sexual violence by an intimate partner or in a domestic setting (Babu & Kar, 2009; Kalokhe et al., 2017; Kimuna et al., 2013) and almost all women have faced public sexual harassment in their lives (Dhillon & Bakaya, 2014). An interview study with young women in Delhi documented how immensely sexual violence affected women’s daily lives. For instance, women reported being constantly concerned about their own safety and afraid of falling victim to sexual violence (Nieder et al., 2019).

To improve the current situation for women in India, effective prevention measures are needed (Lundgren & Amin, 2015; Vladutiu et al., 2011). Since it is particularly young women that are at a high risk of falling victim to sexual violence (Jewkes et al., 2002), many existing Western sexual violence prevention programs target college students (Carlyle et al., 2020; Peterson et al., 2018), in particular female college students (Foubert et al., 2010). However, we are not aware of any evidence-based sexual violence prevention programs specifically designed for Indian female college students. To fill this research gap, we developed the prevention program RISE. The development of a culturally sensitive program was a primary goal here. In a first step, we identified evidence-based concepts of Western sexual violence prevention programs, most importantly Safe Dates (Foshee et al., 2005), Dating Matters (Tharp et al., 2011), LoveU2 (Antle et al., 2011), Shifting Boundaries (Taylor et al., 2013), and Green Dot (Coker et al., 2011) as well as effective prevention principles more generally (Anderson & Whiston, 2005; Nation et al., 2003; Vladutiu et al., 2011). In a second step, Indian experts (working on sexual violence prevention) evaluated the importance and applicability of these concepts for the Indian context (Nieder, 2016), which led to the development of four modules (gender, healthy relationships and communication, sexual violence, and bystander). The specific design of each module was carried out by considering cultural characteristics of the Indian context as well as literature on sexual violence against women in India and by consulting again with Indian experts.

Sexual Violence Against Women in India

In India, key risk factors for falling victim to sexual violence are the acceptance of traditional gender roles, the taboo of sexuality in society as well as a lack of sex education (Nieder et al., 2019). Despite recent changes within the Indian society, for instance the growing empowerment of women (Simister & Mehta, 2010), the country is still widely dominated by patriarchal structures (Kimuna et al., 2013). This results in stereotypical gender roles, where women are seen as submissive and men are seen as dominant. Consequently, men are given the privilege to control and direct women’s lives (Babu & Kar, 2009), which in turn leads to the justification of sexual violence by men and the acceptance of violence by women (Kimuna et al., 2013).

Besides traditional gender roles, the taboo of sexuality, and, as a consequence, the lack of proper sex education are further risk factors. Especially in India, where sexuality is taboo (Dewey, 2009), it is difficult for young people to acquire sex-related knowledge. Thus, Das (2014) discovered that existing sex education programs in India such as the Adolescence Education Program (National Council of Educational Research and Training, 2012) use vague language, which further increases young people’s confusion about sex. Another study by O’Sullivan et al. (2019) also revealed a lack of support for truly comprehensive sex education among the majority of participants from India. Due to this lack of proper and comprehensive sex education, young adults are also likely to have a false or no understanding of consent (Muehlenhard et al., 2016), which, in turn, represents another risk factor for sexual violence (Jozkowski & Peterson, 2013). All these factors taken together constitute a problematic situation for women and illustrate the need for prevention measures.

Prevention of Sexual Violence Against Women: State of the Art

Today, an explicit discussion of traditional gender roles and its consequences for the occurrence of sexual violence as well as the promotion of healthy relationship norms including communication and conflict management skills are covered in many positively evaluated sexual violence prevention programs (Antle et al., 2011; Foshee et al., 2005; Taylor et al., 2013; Tharp et al., 2011). For instance, the curriculum of the Safe Dates program focuses on changes of dating and gender role norms as well as an improvement of conflict management skills. Results of an evaluation study suggested a positive effect of the program on reducing sexual victimization mediated by a lower acceptance of negative dating norms and traditional gender roles (Foshee et al., 2005). The LoveU2 curriculum also addresses healthy and unhealthy relationship patterns as well as communication and conflict resolution skills. An evaluation study confirmed the program’s effectiveness regarding a significant increase of relationship knowledge, self-efficacy in terms of resolving conflicts, and a significantly positive change of attitudes toward violence in relationships (Antle et al., 2011).

Besides information about gender and healthy relationships, most sexual violence prevention programs also impart general information about sexual violence such as understanding consent, forms and consequences of sexual violence (Daigneault et al., 2015; Taylor et al., 2013) including a discussion of rape myths (Foubert et al., 2010). In an evaluation study of a sexual violence awareness program, Daigneault et al. (2015) found positive effects on knowledge and positive attitudes related to sexual violence. Similarly, Foubert et al. (2010) observed that female college students participating in The Women’s Program, a sexual violence awareness and risk-reduction program, showed significantly less acceptance of rape myths than control group participants.

Finally, bystander education (i.e., the engagement of participants as potential witnesses of sexual violence) has received most attention in the past years (Coker et al., 2011; McMahon, 2015; Peterson et al., 2018). In an evaluation of Green Dot, an active bystander intervention program to reduce sexual violence on college campuses, Coker et al. (2011) reported effects on rape myths acceptance and active bystander behavior. In another study by Peterson et al. (2018), a bystander education program showed greater effectiveness in terms of reducing rape myths acceptance and increasing bystander efficacy, intentions to intervene as well as actual bystander behavior compared to a traditional awareness education program.

Concerning effective principles more generally, sexual violence prevention programs have been more effective if they, first, include multiple settings and a variety of situations (de Koker et al., 2014; Lundgren & Amin, 2015; Nation et al., 2003), second, are longer (Anderson & Whiston, 2005; de Koker et al., 2014; Lundgren & Amin, 2015; Nation et al., 2003) and are offered at multiple times (Vladutiu et al., 2011), third, are conducted by professionals (Anderson & Whiston, 2005; Vladutiu et al., 2011), fourth, target a single-gender audience (Vladutiu et al., 2011) and, finally, are culturally sensitive (Anderson & Whiston, 2005; Nation et al., 2003). Considering these aspects, we have developed RISE, a sexual violence prevention program for female college students in Delhi.

RISE: A Sexual Violence Prevention Program for Female College Students in India

The development of RISE was based on evidence-based programs from Western contexts (Antle et al., 2011; Coker et al., 2011; Foshee et al., 2005; Taylor et al., 2013) and guided by interviews with six Indian experts regarding the importance and applicability of these concepts and their culture-specific design, which led to the development of the following four modules (Nieder, 2016): gender, healthy relationships and communication, sexual violence, and bystander. While specifying these modules, we considered the five principles for effective programs identified above and implemented a variety of teaching methods across all four modules (e.g., group discussions, case studies, practical exercises, and role plays) to promote a transfer of knowledge and skills in real-life situations (Nation et al., 2003). The program’s focus on women was based on results of meta-analyses suggesting positive effects of programs with single-gender audiences (Vladutiu et al., 2011) as well as cultural considerations (e.g., widespread gender segregation and taboo of sexuality in Indian society) that advised against mixed-gender audiences. Since previous research (Nieder, 2016, 2019) identified ideal features of a sexual violence prevention program for women, this served as a starting point to develop a program for female college students first.

Gender.

In this module, we focused on the change of gender-related norms, similarly to Foshee et al. (2005), by imparting knowledge and creating awareness on traditional gender roles and its consequences for the occurrence of sexual violence. To take particular account of the Indian context (i.e., deeply rooted gender stereotypes in society), this module started with a basic exercise on the difference between sex and gender followed by specific examples from the Indian context on how gender differences result in traditional gender roles and data on gender inequality in India from the Human Development Report (UNDP, 2016).

Healthy relationships and communication.

According to Indian experts, sex education is both an important and sensitive issue to address (Nieder, 2016). Consequently, we decided to focus on healthy relationships and communication skills, which both play a crucial role in preventing sexual violence (Antle et al., 2011; Foshee et al., 2005). Thus, the second module of RISE covered the concept of healthy relationships, different communication styles, and a nonviolent communication model (Rosenberg & Chopra, 2015). Since open discussions about sexuality are difficult in India (Dewey, 2009), so is being or admitting to be in a premarital relationship. Consequently, this module did not only focus on romantic relationships but those with friends and family as well to make sure that all participants were able to relate to the content of the module. Furthermore, each example referred to students’ everyday life and included an open discussion of cultural and social expectations from family members and partners in terms of healthy relationships.

Sexual violence.

Based on the feedback from Indian experts (Nieder, 2016) and promising effects of sexual assault awareness programs (Daigneault et al., 2015), the third module focused on knowledge about and awareness of sexual violence. Due to the lack of sex education in India, this module did not only deal with a definition and forms of sexual violence but a basic understanding of consent as well (Basile et al., 2014). Furthermore, the module covered information on the prevalence of sexual violence in India as well as key risk and protective factors for sexual violence (Jewkes et al., 2002). Additionally, we included a discussion about rape myths and victim blaming (Foubert et al., 2010) with a special focus on typical Indian rape myths (e.g., “If a woman goes out at night and then gets sexually assaulted, it is her fault”). Importantly, participants were made aware of the connection between rape myths and patriarchal values and traditional gender roles in Indian society as discussed in the first module on gender.

Bystander.

Finally, Indian experts saw a need to include bystander education in a prevention program for women in India because of a lack of responsibility generally and a need for social norms to change (Nieder, 2016). Consequently, the fourth module of RISE dealt with bystander opportunities (McMahon, 2015), the five-step model of bystander behavior (Latané & Darley, 1970) and actual bystander intervention strategies. Due to traditional gender roles and resulting social expectations in India, young women might find it difficult to interfere in the affairs of strangers or to raise their voices publicly. Consequently, we put a special focus on predictors of bystander behavior (e.g., diffusion of responsibility), similarly to Coker et al. (2011), as well as how to overcome obstacles of bystander intervention. A typical Indian example of sexual harassment was used to discuss and practice bystander skills.

Evaluation Model and Hypotheses

To evaluate RISE, we used a pretest posttest follow-up (after six months) waitlist control group design and assessed outcomes at three levels, namely participants’ reaction, learning (including knowledge, attitudes, and skills), and behavior (Kirkpatrick & Kirkpatrick, 2006). The following specific hypotheses were tested.

Hypotheses module 1—Gender.

Participants in the training group will show an increase in (a) gender-related knowledge, (b) gender-equitable attitudes, and (c) gender awareness compared to participants in the control group. Effects will remain stable until the follow-up after six months.

Hypotheses module 2—Healthy relationships and communication.

Participants in the training group will show an increase in (a) knowledge regarding healthy relationships and communication as well as positive attitudes, namely regarding both the (b) importance of and (c) ability to communicate in relationships and an increase in (d) actual communication behavior (follow-up only) compared to participants in the control group. Effects will remain stable until the follow-up after six months.

Hypotheses module 3—Sexual violence.

Participants in the training group will show an increase in (a) sexual violence-related knowledge and (b) positive attitudes towards victims of sexual violence (i.e., less acceptance of rape myths) compared to participants in the control group. Effects will remain stable until the follow-up after six months. Furthermore, participants will show (c) a decrease of sexual victimization compared to participants in the control group from pretest to the follow-up after six months.

Hypotheses module 4—Bystander.

Participants in the training group will show an increase in (a) bystander-related knowledge, (b) bystander efficacy, (c) the intention to act as a bystander, and (d) actual bystander behavior (follow-up only) compared to participants in the control group. Effects will remain stable until the follow-up after six months.

Method

Design of the Study

For the current study, we used a pretest (T1)–posttest (T2) control group design, including a follow-up (T3) after six months. In total, 10 classes of students were assigned to either a training group (TG; N = 5 classes) or a waitlist control group (CG; N = 5 classes). Control groups received the training after the follow-up assessment. The training group consisted of 1st semester students (Political Science and Sociology), 3rd semester students (Political Science) and 5th semester students (Philosophy). The control group consisted of 1st semester students (Philosophy and Economics), 3rd semester students (Philosophy), and 5th semester students (Political Science and History). Class sizes varied between 16 and 35 students.

Participants

The sample of the present study consists of N = 245 (CG: N = 117; TG: N = 128) female college students between the ages of 17 and 22 years (M = 18.79, SD = 1.04; CG: M = 18.93, SD = 1.13; TG: M = 18.67, SD = 0.94). We excluded 91 students from the sample because they were not present at the time of posttest and/or follow-up data collection. All participants were students at a college in New Delhi and came from middle- and upper-middle class families. None of the participants were married, 27.8% of participants (CG: 32.8%; TG: 23.4%) indicated to be in a relationship and 71.8% of participants (CG: 67.2%; TG: 76.6%) declared to be single. Furthermore, 55.5% of participants (CG: 61.5%, TG: 54.8%) stated that they had been in a romantic relationship before. All 245 participants were Indian nationals and for the most part (83.1%) Hindu by religion (CG: 81.2%; TG: 84.9%). Most students (78.0%) mentioned Hindi as their native language. Since all students were following the English track at college, they were all fluent in English as well.

At the time of pretest (T1), the training and control group did not differ significantly regarding their relationship status, χ² = 2.63, p = .105, relationship experience, χ² = 1.08, p = .299, and religion, χ² = 9.19, p = .057. However, there was a significant age difference, F(1, 240) = 3.97, p = .048.

Pilot Study

Prior to the present study, two additional Indian experts evaluated the content of the prevention program and the evaluation instrument, which resulted in minor changes. After that, in a pilot phase, a total of N = 102 Indian female college students received a first version of the prevention program and evaluation instrument (pre and post). Results of the pilot study indicated an effect of the program in terms of increasing knowledge as well as changing attitudes (in the desired direction) in all four modules. Behavioral outcomes were not part of the pilot study. Furthermore, all participants received feedback forms after the pilot study and 10 students were interviewed and gave feedback on the program and the questionnaire. Based on these students’ responses, the final version of the program and the questionnaire were prepared: Since the questionnaire data of the pilot study and the interview data suggested an effectiveness of the program, we made minor changes in two of our four modules (i.e., including another group discussion and a behavioral exercise). Furthermore, the evaluation instrument was revised based on the questionnaire data of the pilot study. Further information on the pilot study can be requested from the first author.

Data Collection

The final version of the sexual violence prevention program consists of five sessions (a warmup session plus the four modules described above) each 120 minutes long and was conducted in English. Data were collected by two Indian professionals who were employees of a Delhi-based non-governmental organization (NGO) working on women’s rights and gender equality in India and who were involved in the pilot study. After giving written consent, participants in the training group received the prevention program on five different days over a period of up to six weeks. During the training, participants received an information sheet about helpline numbers, were informed about the counseling service on the college campus, and had the opportunity to seek help from the trainer in case of any stress during or after the program.

Outcome Measures

Based on the evaluation model by Kirkpatrick and Kirkpatrick (2006), outcomes were measured on three levels, namely participants’ reaction to the program (only for students in the training group), learning (including knowledge, attitudes, and skills), and behavior. Outcomes on knowledge were divided into two parts, namely objective (i.e., assessed by multiple choice items with one correct answer) and subjective knowledge (i.e., assessed by participants’ own evaluation of knowledge). All scales were coded in such a way that higher scores indicate more favorable outcomes (except for sexual victimization).

Reaction.

To measure students’ reaction to the program, we used two items (“I am satisfied with the program,” and “The program was helpful”).

Gender.

Gender Objective Knowledge was assessed with three multiple-choice items with four options each (e.g., “The main sources of the development of gender roles are (a) biological characteristics that define people as female or male, (b) specific beliefs, expectations and attitudes, (c) peoples’ personality, and (d) none of them”). Gender Subjective Knowledge was assessed by three items (e.g., “I know exactly what makes sex and gender different”) on a 6-point Likert-type scale ranging from 1 (“not agree at all”) to 6 (“strongly agree”). Cronbach’s alpha was α_pretest = .72, α_posttest = .88, and α_follow-up = .91. The subscale Gender Attitudes was adapted from the Sex-Role Egalitarianism Scale (Beere et al., 1984) and the Gender-Equitable Men Scale (Pulerwitz & Barker, 2008). Students rated 10 statements about gender stereotypes (e.g., “The husband should be the head of the family”) on a 6-point Likert-type scale ranging from 1 (“not agree at all”) to 6 (“strongly agree”). Cronbach’s alpha was α_pretest = .68, α_posttest = .73, and α_follow-up = .71. Gender Awareness was assessed by three items (e.g., “I recognize when other people use gender stereotypes”) on a 6-point Likert-type scale ranging from 1 (“not agree at all”) to 6 (“strongly agree”). Cronbach’s was α_pretest = .70, α_posttest = .81, and α_follow-up = .82.

Healthy relationships and communication.

Two multiple-choice items with four options each assessed students’ knowledge concerning healthy relationships and communication (Relationships Objective Knowledge). Furthermore, three items (e.g., “I can clearly define what a healthy relationship is for me”) measured students’ subjective improvement of knowledge (Relationships Subjective Knowledge) on a 6-point Likert-type scale ranging from 1 (“not agree at all”) to 6 (“strongly agree”). Cronbach’s alpha was α_pretest = .59, α_posttest = .81, and α_follow-up = .72. Relationships Importance was assessed by six items regarding the importance of communicating needs and feelings (e.g., “It is important to me to tell my partner when something bothers me about his/her behavior”) on a 6-point Likert-type scale ranging from 1 (“not agree at all”) to 6 (“strongly agree”). Cronbach’s alpha was α_pretest = .70, α_posttest = .86, and α_follow-up = .87. Similarly, six items on Relationships Ability assessed students’ ability to communicate personal needs and feelings in relationships (e.g., “I feel able to tell my partner when something bothers me about his/her behavior”). Cronbach’s alpha was α_pretest = .83, α_posttest = .88, and α_follow-up = .89. Finally, students’ actual communication of needs and feelings (Relationships Behavior) was assessed by six items (e.g., “In the past three months, I told my partner when something bothered me about his/her behavior”) on a 5-point scale (0 = “not once,” 1 = “1 to 5 times,” 2 = “6 to 10 times,” 3 = “more than 10 times,” 4 = “not applicable”). Since behavioral outcomes are indicated for a three months’ period, this scale was used at pretest and follow-up only. Cronbach’s alpha was α_pretest = .80 and α_follow-up = .81.

Sexual violence.

Sexual Violence Objective Knowledge was assessed by five multiple-choice items with four options each (e.g., “Victim blaming: (a) does not lead to self-blame of the victim, (b) is emphasized through rape myths, (c) does not happen in court, and (d) is in some situations a correct response”). Sexual Violence Subjective Knowledge was assessed by three items (e.g., “I know strategies how to deal with victim blaming”) on a 6-point Likert-type scale ranging from 1 (“not agree at all”) to 6 (“strongly agree”). Cronbach’s alpha was α_pretest = .81, α_posttest = .91, and α_follow-up = .91. The subscale Sexual Violence Attitudes was adapted from the Attitudes Toward Rape Victims Scale (Ward, 1988). Students rated 10 statements about attitudes towards rape victims (e.g., “A raped person is usually an innocent victim”) on a 6-point Likert-type scale ranging from 1 (“not agree at all”) to 6 (“strongly agree”). Cronbach’s alpha was α_pretest = .68, α_posttest = .68, and α_follow-up = .71. Finally, students rated how often they fell victim to four different forms of sexual violence, namely rape, unwanted kissing, unwanted touching and sexual harassment in the past three months (Sexual Violence Victimization) on a 4-point scale (0 = “not once,” 1 = “once,” 2 = “twice,” 3 = “more than twice”). We calculated weighted sum scores (rape x 3, unwanted kissing and unwanted touching x 2, sexual harassment x 1) so that a maximum score of 24 could be achieved. Lower scores indicate less sexual victimization. Cronbach’s alpha was α_pretest = .50 and α_follow-up = .59.

Bystander.

Bystander Objective Knowledge was measured by four multiple-choice items with four options each (e.g., “As a bystander: (a) one cannot do anything when the situation is over, (b) one cannot make the situation worse, (c) one should not address the perpetrator directly, and (d) one has the power to help prior, during or after the situation of violence”). Bystander Subjective Knowledge was measured by four items (e.g., “I know strategies for how to behave as a bystander in situations of sexual violence”) on a 6-point Likert-type scale ranging from 1 (“not agree at all”) to 6 (“strongly agree”). Cronbach’s alpha was α_pretest = .86, α_posttest = .94, and α_follow-up = .92. The subscale Bystander Attitudes was adapted from the Slaby Bystander Efficacy Scale (Slaby et al., 1994) and the Mentors in Violence Program Efficacy Scale (Cissner, 2009). Students rated 10 statements about attitudes towards bystander efficacy (e.g., “I can learn to do or say the kinds of things that help prevent violence in my community”) on a 6-point Likert-type scale ranging from 1 (“not agree at all”) to 6 (“strongly agree”). Cronbach’s alpha was α_pretest = .80, α_posttest = .85, and α_follow-up = .83. Students’ intention to intervene as a bystander (Bystander Intention) was assessed by four items (e.g., “I want to step in if somebody is being harassed”) on a 6-point Likert-type scale ranging from 1 (“not agree at all”) to 6 (“strongly agree”). Cronbach’s alpha was α_pretest = .83, α_posttest = .90, and α_follow-up = .90. Finally, students were asked to indicate if they witnessed four different situations of sexual violence (e.g., someone forced a girl/woman to have sex). Afterwards, if they were present in one of the four situations, they rated how they reacted on a 5-point scale (Bystander Behavior: 1 = “I did nothing,” 2 = “I wanted to help, but I didn’t,” 3 = “I talked to the victim afterwards,” 4 = “I intervened but it didn’t stop the violence,” 5 = “I intervened and it did stop the violence”). Cronbach’s alpha was α_pretest = .87 and α_follow-up = .77. Because of the design of this scale (i.e., requirement of being present in a situation of sexual violence), we only received valid scores (pretest and follow-up) from a small portion of the sample (N = 70).

Statistical Analyses

For statistical analyses, we used SPSS Version 24. Preliminary data analyses covered descriptive statistical analyses as well as pretest differences between groups. To test for differences between the training group and control group over the three points of data collection, we performed mixed ANOVAs with time as a within-subjects factor (pretest, posttest and follow-up) and group (training group and control group) as a between-subjects factor. For post hoc tests, we used a series of t-tests. A Bonferroni-adjusted significance value of p < .017 was utilized to control for multiple comparisons.

Results

Preliminary Analyses

Preliminary analyses revealed no differences at T1 between the training and the control group, except for Gender Awareness, t(242) = –2.80, p = .006, and Bystander Objective Knowledge, t(243) = –3.43, p = .001. In both cases, students in the training condition had higher values than students in the control condition (see Table 1 for details). As described above, women in the training group were on average three months younger than women in the control group. Since there are no conceptual reasons to assume that this age difference affected the effectiveness of the training in any way, we decided to drop age as a covariate in the final analyses to report the mixed ANOVAs. In fact, considering age as a covariate in the mixed ANOVAs did not affect the overall pattern of results. Finally, analyses of missing values revealed a percentage of less than 4.9% for all scales at all three points of data collection, except for Bystander Behavior (because of the above-presented design features of this scale).

Reaction

Participants in the training group showed a mean satisfaction score of M = 5.43 (SD = 0.42), indicating a high satisfaction with the program (see Table 1).

Gender Module

Regarding the module about gender, we considered four different aspects, namely knowledge (objective as well as subjective), attitudes, and awareness. There were significant main effects for Group and Time for all four scales, namely Gender Objective Knowledge, Gender Subjective Knowledge, Gender Attitudes, and Gender Awareness (see Tables 1 and 2 and Figure 1 for details). Furthermore, there were significant Group × Time interaction effects for Gender Objective Knowledge (small effect, see Table 2 for η²s), Gender Subjective Knowledge (medium effect) and Gender Awareness (small effect), but not for Gender Attitudes.

Figure 1.

Note. Post hoc tests with Bonferroni-adjusted significance values. *p < .017. **p < .003. ***p < .001.

Regarding Gender Objective Knowledge, post hoc t-tests showed significantly higher scores in the training group compared to the control group at T2 (p < .001) and T3 (p < .001). Additionally, there were significant increases in the training group from T1 to T2 (p < .001) and T1 to T3 (p < .001), but not in the control group (T1 to T2, p = .408; T1 to T3, p = .631). For Gender Subjective Knowledge, post hoc t-tests indicated significantly higher scores in the training group compared to the control group at T2 (p < .001) and T3 (p < .001). Additionally, we found significant increases in the training group from T1 to T2 (p < .001) and T1 to T3 (p < .001) and, unexpectedly, in the control group from T1 to T3 (p = .009), but not in the control group from T1 to T2 (p = .626). Concerning Gender Awareness, post hoc t-tests revealed significantly higher scores in the training group compared to the control group at T2 (p <.001) and T3 (p < .001). Additionally, there were significant increases in the training group from T1 to T2 (p < .001) and T1 to T3 (p < .001), but not in the control group (T1 to T2, p = .467; T1 to T3, p = .068).

Healthy Relationships and Communication Module

Regarding the module about relationships, we considered five different aspects, namely knowledge (objective as well as subjective), importance, ability, and behavior. There were significant main effects for Group and Time for three scales, namely Relationship Objective Knowledge, Relationship Subjective Knowledge, and Relationship Ability, a significant main effect of Group for Relationship Importance and a significant main effect of Time for Relationship Behavior (see Tables 1 and 2 and Figure 1 for details). No significant main effect of Time for Relationship Importance and no significant main effect of Group for Relationship Behavior were found. Furthermore, there were significant Group × Time interaction effects for Relationship Objective Knowledge (small effect, see Table 2 for η²s), Relationship Subjective Knowledge (medium effect) and Relationship Importance (small effect), but not for Relationship Ability and Relationship Behavior.

Table 1.

Means and Standard Deviations for Outcome Variables.

	Training (n = 128)			Control (n = 117)
	T1	T2	T3	T1	T2	T3
	M (SD)	M (SD)	M (SD)	M (SD)	M (SD)	M (SD)
Reaction	–	5.43 (0.42)	–	–	–	–
Gender
Attitudes	5.51 (.58)	5.62 (0.43)	5.67 (0.46)	5.47 (.45)	5.46 (0.63)	5.52 (0.51)
Awareness	4.71 (1.11)	5.33 (0.82)	5.35 (0.94)	4.29 (1.23)	4.21 (1.27)	4.50 (1.13)
Knowledge (objective)	0.51 (.26)	0.67 (0.25)	0.62 (0.30)	0.50 (0.24)	0.52 (0.25)	0.49 (0.27)
Knowledge (subjective)	4.24 (1.19)	5.59 (0.71)	5.44 (0.86)	4.02 (1.16)	4.08 (1.15)	4.33 (1.13)
Relationships
Importance	5.56 (0.60)	5.72 (0.56)	5.74 (0.59)	5.41 (0.59)	5.35 (0.73)	5.36 (0.77)
Ability	5.25 (0.85)	5.48 (0.66)	5.57 (0.69)	5.01 (1.05)	5.06 (1.00)	5.07 (1.02)
Knowledge (objective)	0.65 (0.35)	0.84 (0.27)	0.84 (0.27)	0.65 (0.35)	0.69 (0.35)	0.73 (0.34)
Knowledge (subjective)	4.60 (1.12)	5.67 (0.52)	5.32 (0.84)	4.59 (0.97)	4.61 (1.10)	4.64 (0.94)
Behavior	1.14 (0.73)	–	1.28 (0.69)	1.17 (0.69)	–	1.27 (0.80)
Sexual violence
Attitudes	4.57 (0.81)	4.78 (0.85)	4.72 (0.85)	4.41 (0.86)	4.47 (0.78)	4.45 (0.86)
Knowledge (objective)	0.32 (0.25)	0.68 (0.26)	0.53 (0.27)	0.28 (0.22)	0.34 (0.23)	0.41 (0.24)
Knowledge (subjective)	3.80 (1.14)	5.61 (0.60)	5.25 (0.92)	3.63 (1.07)	3.91 (1.09)	3.76 (1.04)
Victimization	2.13 (2.95)	–	2.56 (3.72)	2.16 (3.38)	–	2.09 (3.40)
Bystander
Attitudes	4.67 (0.83)	5.24 (0.61)	5.04 (0.75)	4.46 (0.89)	4.38 (0.92)	4.34 (0.88)
Knowledge (objective)	0.59 (0.24)	0.65 0(.22)	0.59 (0.25)	0.48 (0.24)	0.52 (0.26)	0.51 (0.25)
Knowledge (subjective)	3.75 (1.23)	5.72 (0.46)	5.45 (0.74)	3.79 (1.20)	3.84 (1.24)	4.01 (1.16)
Intention	5.30 (0.76)	5.77 (0.44)	5.58 (0.73)	5.09 (0.98)	5.17 (0.96)	5.09 (0.97)
Behavior	2.78 (1.27)	–	3.39 (1.24)	3.06 (1.33)	–	3.02 (1.36)

Note. T1 = pretest, T2 = posttest, T3 = follow-up. Scores range from 1 to 6. Exceptions: All knowledge (objective) scores range from 0 to 1, relationship behavior scores range from 0 to 3, sexual violence victimization scores range from 0 to 24, and bystander behavior scores range from 1 to 5.

Table 2.

Mixed ANOVA Results for Outcome Variables.

	Time				Group				Time × Group
	F	df	p	η²	F	df	p	η²	F	df	p	η²
Gender
Attitudes	4.35	486	.013	.018	4.63	243	.032	.019	1.08	486	.341	.004
Awareness	15.97	484	<.001	.062	53.35	242	<.001	.181	10.74	484	<.001	.043
Knowledge(objective)	11.69	486	<.001	.046	14.26	243	<.001	.055	8.35	486	<.001	.033
Knowledge (subjective)	64.25	482	<.001	.210	84.41	241	<.001	.259	38.94	482	<.001	.139
Relationships
Importance	.89	482	.402	.004	23.22	241	<.001	.088	3.90	482	.024	.016
Ability	5.65	480	.005	.023	17.50	240	<.001	.068	2.82	480	.064	.012
Knowledge (objective)	21.16	484	<.001	.080	7.21	242	.008	.029	6.52	484	.002	.026
Knowledge (subjective)	37.43	482	<.001	.134	38.95	241	<.001	.139	33.24	482	<.001	.121
Behavior	4.34	221	.038	.019	.01	221	.940	<.001	.10	221	.751	<.001
Sexual violence
Attitudes	4.48	478	.013	.018	6.93	239	.009	.028	1.51	478	.223	.006
Knowledge (objective)	106.79	484	<.001	.306	38.93	242	<.001	.139	53.79	484	<.001	.182
Knowledge (subjective)	123.63	476	<.001	.342	126.18	238	<.001	.346	71.53	476	<.001	.231
Victimization	.62	234	.432	.003	.33	234	.564	.001	1.21	234	.272	.005
Bystander
Attitudes	12.17	484	<.001	.048	46.31	242	<.001	.161	23.33	484	<.001	.088
Knowledge (objective)	2.66	484	.071	.011	22.03	242	<.001	.083	.96	484	.384	.004
Knowledge (subjective)	104.13	474	<.001	.305	122.11	237	<.001	.340	80.32	474	<.001	.253
Intention	13.31	474	<.001	.053	24.32	237	<.001	.093	7.27	474	.001	.030
Behavior	2.40	70	.126	.033	.03	70	.854	<.001	3.30	70	.074	.045

Regarding Relationship Objective Knowledge, post hoc t-tests showed significantly higher scores in the training group compared to the control group at T2 (p < .001) and T3 (p = .004). Additionally, there were significant increases in the training group from T1 to T2 (p < .001) and T1 to T3 (p < .001), but not in the control group (T1 to T2, p = .200; T1 to T3, p = .040). For Relationship Subjective Knowledge, post hoc t-tests indicated significantly higher scores in the training group compared to the control group at T2 (p < .001) and T3 (p < .001). Additionally, we found significant increases in the training group from T1 to T2 (p < .001) and T1 to T3 (p < .001), but not in the control group (T1 to T2, p = .761; T1 to T3, p = .549). Concerning Relationship Importance, post hoc t-tests revealed significantly higher scores in the training group compared to the control group at T2 (p < .001) and T3 (p < .001). Additionally, there were significant increases in the training group from T1 to T2 (p < .001) and T1 to T3 (p = .009), but not in the control group (T1 to T2, p = .347; T1 to T3, p = .460).

Sexual Violence Module

Regarding the module about sexual violence, we considered four different aspects, namely knowledge (objective as well as subjective), attitudes and victimization. There were significant main effects for Group and Time for three scales, namely Sexual Violence Objective Knowledge, Sexual Violence Subjective Knowledge, and Sexual Violence Attitudes (see Tables 1 and 2 and Figure 1 for details). No significant main effects for Sexual Victimization were found. Furthermore, there were significant Group × Time interaction effects for Sexual Violence Objective Knowledge (large effect, see Table 2 for η²s) and Sexual Violence Subjective Knowledge (large effect), but not for Sexual Violence Attitudes and Sexual Victimization.

Concerning Sexual Violence Objective Knowledge, post hoc t-tests revealed a significantly higher scores in the training group compared to the control group at T2 (p <.001) and T3 (p < .001). Additionally, there were significant increases in the training group from T1 to T2 (p < .001) and T1 to T3 (p < .001), and, unexpectedly, in the control group from T1 to T2 (p = .003) and T1 to T3 (p < .001). For Sexual Violence Subjective Knowledge, post hoc t-tests indicated significantly higher scores in the training group compared to the control group at T2 (p < .001) and T3 (p < .001). Additionally, we found significant increases in the training group from T1 to T2 (p < .001) and T1 to T3 (p < .001), and, unexpectedly, in the control group from T1 to T2 (p = .003), but not from T1 to T3 (p = .147).

Bystander Module

Regarding the module about bystander education, we considered five different aspects, namely attitudes, knowledge (objective as well as subjective), intention, and behavior. There were significant main effects for Group and Time for three scales, namely Bystander Subjective Knowledge, Bystander Attitudes and Bystander Intention, and a significant main effect for Group for Bystander Objective Knowledge (see Tables 1 and 2 and Figure 1 for details). No significant main effects for Bystander Behavior were found. Furthermore, there were significant Group × Time interaction effects for Bystander Subjective Knowledge (large effect, see Table 2 for η²s), Bystander Attitudes (medium effect), and Bystander Intention (small effect), but not for Bystander Objective Knowledge. However, there was a marginally significant Group × Time interaction effect for Bystander Behavior (which is only mentioned here due to the small sample size N = 70 for this subscale).

Regarding Bystander Subjective Knowledge, post hoc t-tests showed significantly higher scores in the training group compared to the control group at T2 (p < .001) and T3 (p < .001). Additionally, there were significant increases in the training group from T1 to T2 (p < .001) and T1 to T3 (p < .001), but not in the control group (T1 to T2, p = .632; T1 to T3, p = .086). Concerning Bystander Attitudes, post hoc t-tests revealed significantly higher scores in the training group compared to the control group at T2 (p <.001) and T3 (p < .001). Additionally, there were significant increases in the training group from T1 to T2 (p < .001) and T1 to T3 (p < .001), but not in the control group (T1 to T2, p = .225; T1 to T3, p = .067). For Bystander Intention, post hoc t-tests indicated significantly higher scores in the training group compared to the control group at T2 (p < .001) and T3 (p < .001). Additionally, we found significant increases in the training group from T1 to T2 (p < .001) and T1 to T3 (p < .001), but not in the control group (T1 to T2, p = .272; T1 to T3, p = .950).

Discussion

In the present study, we evaluated the short- and long-term effects of the sexual violence prevention program RISE. As expected, participants in the training group showed a high satisfaction with the program. Furthermore, we found a significant effect of the program in terms of increasing knowledge in all four modules, namely gender, healthy relationships and communication, sexual violence, and bystander. Thus, participants in the training group showed a significant increase of objectively assessed knowledge (except for bystander) and rated their knowledge regarding all four modules significantly higher than participants in the control group, both at posttest and six months later. This supports seven of our eight hypotheses regarding an increase of knowledge and is in line with previous evaluation studies (Antle et al., 2011; Daigneault et al., 2015). The program further showed effectiveness in terms of changing participants’ attitudes. Thus, participants in the training group showed significantly higher scores on awareness of gender stereotypes, the importance of communicating needs and feelings in relationships, bystander efficacy and intentions to intervene, both at posttest and six months later. This supports four of our seven hypotheses on a positive change of attitudes and corresponds to the results of previous evaluation studies (Antle et al., 2011; Coker et al., 2011; Foshee et al., 2005). However, different from other programs in the USA (Antle et al., 2011; Foshee et al., 2005; Foubert et al., 2010), we did not find an effectiveness of the program in terms of changing participants’ attitudes towards gender stereotypes, their ability to communicate needs and feelings in relationships, or a decrease of rape myths acceptance. Unlike other studies (Coker et al., 2011; Foshee et al., 2005), we found no significant effects of the program on behavioral outcomes, namely an actual change of communication in relationships, a decrease of sexual victimization or an increase of bystander behavior.

An explanation for the nonsignificant results on gender attitudes might be the ceiling effect. Thus, participants in the training and control groups already showed very high scores on gender-equitable attitudes at the time of pretest, which left little room for further improvement. The nonsignificant findings regarding communication in relationships might be related to the nonsignificant findings on attitudes (Relationships Ability). Thus, according to the theory of planned behavior (Ajzen, 1991), attitudes towards behavior can predict its actual performance. Since we found no significant improvement of student’s ability to communicate needs and feelings, a change of actual communication behavior was unlikely as well. The fact that there were no changes in attitudes and actual behavior concerning the communication of needs and feelings might be related to the fact that this is a relatively new concept that is based on the cultural concept of individual agency. Nevertheless, students in the training group showed an increase in the importance given to communication in relationships, which suggests that participants are sensitized for the topic but may need more time for the practice and actual implementation of new communication patterns. According to the transtheoretical model of behavior change (e.g., Prochaska & DiClemente, 1983), which was successfully utilized in the context of sexual violence prevention before (Banyard et al., 2010), the acquisition of knowledge and an increase in awareness is a necessary foundation and important precondition for future behavior change. The nonsignificant findings regarding a decrease of rape myths acceptance and sexual victimization could have to do with the length of the program (that was too short after all) and the unchanged environment (that students face after participation in the program). Thus, even if participants have changed after the program, victimization rates might only decrease if the program targets the whole community, including men. Finally, there was no significant effect on bystander behavior despite a significant increase of bystander efficacy and intentions to intervene. To be able to measure students’ intervention behavior, they had to witness situations of violence. Since some of the presented examples were quite severe (e.g., rape), only a small number of students was able to answer the relevant items (N = 70 students). In this light, one might want to consider that there was a marginally significant effect in the training group regarding an increase of actual bystander behavior. To be able to make a reliable statement, one would need a larger sample.

Overall the findings presented demonstrate that the RISE program was effective in increasing participants’ knowledge (gender, healthy relationships, and sexual violence), positively changing their attitudes and awareness (gender, healthy relationships, and bystander) and increasing their intention to change behavior (bystander). Even though there was no significant change in behavior, the program represents a promising starting point for sexual violence prevention in India, especially against the background of lacking evaluation studies in this cultural context and the significant effects on knowledge and awareness that represent an essential foundation for future behavior change (Banyard et al., 2010).

Study Strengths and Limitations

A key strength of the program is its careful development as a culture-sensitive program to prevent sexual violence in Indian college students. Furthermore, the program considered other effective prevention principles (Anderson & Whiston, 2005; Nation et al., 2003) such as comprehensiveness (e.g., our program covered four different topics with regard to three different levels), length (e.g., our program comprised five sessions at 120 minutes each), the facilitators (e.g., our program was conducted by two Indian professionals), and the audience (e.g., our program targeted a single-gender audience). Through the engagement of Indian professionals and support structures at the college campus, we also made sure that students were in a safe environment during the duration of the study. A further major strength of our study is the rigorous evaluation design that considered short-term as well as long-term effects on several evaluation levels (knowledge, attitudes, and behavior).

However, there are limitations of the present study as well. Since the program was specifically designed for Indian female college students, results might not generalize to other Indian subsamples. Thus, we do not know whether the program would be effective if it was used for women from other socioeconomic backgrounds or rural areas. Furthermore, there is a huge diversity within the Indian subcontinent itself, meaning that results might not generalize to female college students in other parts of the country. Since we only targeted a single-gender audience (i.e., women), this might have played a role in the results we found on the gender module. Furthermore, we decided to forgo the topic of sex education. Although we had several reasons to leave the topic out of the program, it seems necessary to include it as a basis of discussions on sexual violence. Further limitations of the present study concern scales applied to evaluate the program’s effectiveness. Developing culture-sensitive programs always comes with the challenge to develop culture-appropriate measures of approved reliability and validity. In the current study, we have taken two important first steps in that direction: Concerning reliability, we developed scales of approved reliability in terms of internal consistency (which applies to 10 out of 13 scales). However, the low Cronbach’s alpha of three subscales—namely Gender Attitudes (i.e., αs = .68 at pretest), Relationship Subjective Knowledge (i.e., αs = .59 at pretest), and Sexual Violence Attitudes (i.e., αs = .68 at pre and posttest) that was adapted from the validated Attitudes Toward Rape Victims Scale (Ward, 1988)—are of concern and results should be interpreted with caution. The subscale Sexual Victimization also had a poor Cronbach’s alpha, but is a special case, since it assesses the experience of very different forms of sexual violence, and not a homogeneous construct. We assume that regarding the subscale Relationship Subjective Knowledge, the meaning of healthy and unhealthy relationships was not clear at pretest. In terms of the other two subscales, one item concerning Gender Attitudes (“A man needs other women, even if things with his wife are fine”) and one item concerning Sexual Violence Attitudes (“Good girls are as likely to be raped as bad girls”) seemed confusing for students. Moreover, we conclude that some of the presented gender role stereotypes and rape myths are less appropriate for the Indian context since they represent typical examples of the Western context. Concerning validity, there were no other established scales that could be used to evaluate criterion validity. Therefore, we assured content and face validity based on expert ratings and interviews with students of the pilot study, which is essential for the development of culture-appropriate evaluation instruments. Interestingly, most significant findings were based on measures that were developed with Indian experts, which might be a first indication of their appropriateness and validity. If there are more reliable and valid instruments available for the Indian context, it will be critical to also test criterion validity of the scales used for evaluating the effectiveness of this prevention program.

Implications for Future Research

Our study highlights the importance of developing culture-sensitive prevention programs. Since cultural factors (e.g., societal structures and norms) influence the occurrence of sexual violence, effective prevention programs need to take these aspects into account. This study represents a starting point, but it also points out the need for the creation and validation of further culturally sensitive measures to evaluate such programs. In reference to the findings of the current study—namely effects on knowledge and attitudes, but not behavior—this study illustrates the vital necessity to work with whole communities (i.e., including men and women). A change of behavior might be best achieved through an increased focus on a change of attitudes in all target groups as well as practical behavioral exercises. Future research should also consider that the practice of relatively new concepts (e.g., the communication of needs and feelings in relationships that are based on a cultural ideal of individual agency) needs more time. Given the phenomenon, it seems particularly important to focus on sexual violence prevention programs with men. Even though one can bring about change within female participants, it is the whole community that must change to make long-lasting strides in the prevention of sexual violence against women. In this context, bystander education seems to be one of the most promising strategies, especially against the background of new social norms being created within the community. In summary, future research should focus on the development of culturally sensitive prevention programs for men as well as women (from all socioeconomic backgrounds) and put a special emphasis on bystander education.

Footnotes

Acknowledgments

The authors would like to thank Dr Swati Pal, Vandana Madan, Gayatri Sharma, and Parul Sethi for supporting the collection of data. We further wish to thank all students who participated in the study and Dr Celeste Brennecka for proofreading the manuscript.

Declaration of Conflicting Interests

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The authors received no financial support for the research, authorship, and/or publication of this article.

ORCID iD

Christina Nieder

Author Biographies

Christina Nieder is a PhD scholar and research assistant in the Developmental Psychology Lab at the University of Muenster, Germany. Her main research interests include the prevention of sexual violence against women in India and the development of culturally sensitive counselling concepts for refugees in Germany.

Johannes Florenz Bosch received his master’s degree in Psychology from the University of Muenster, Germany, and works as an educational psychologist at the Regional School Counselling Center in Herford, Germany.

Anna Panaiota Nockemann received her master’s degree in Psychology from the University of Muenster, Germany, and works as a family counsellor at the Association for Psychological Counselling and Assistance in Iserlohn, Germany.

Joscha Kärtner received his PhD from the Department of Culture and Development at the University of Osnabrueck, Germany, and is head of the Developmental Psychology Lab and the Counselling Lab at the University of Muenster, Germany. His main research interests include cultural influences on early social, socio-cognitive and socio-emotional development. Besides basic research in these fields, a second emphasis is on developing culturally informed programs and policies for applied developmental science.

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