Self-Defense Training to Reduce Violence Against Women and Girls: An Integrative Review

BACKGROUND

Violence against women and girls (VAWG) is a serious threat to individual and public health with vast negative impacts, including numerous physical and mental health issues, as well as societal and economic consequences. Numerous women's self-defense interventions have been proposed to reduce the risk of victimization.

AIMS

The current integrative review, based on Whittemore and Knafl's framework, was completed to synthesize current evidence on women's self-defense training, the impact of such training on outcomes related to VAWG, and evaluate the strength of evidence for women's self-defense training interventions.

METHODS

A systematic literature search, guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement, was performed including a comprehensive computer-assisted database search, as well as citation searching and website searching for studies that included quantitative outcomes related to VAGW published between 2011 and 2023. Data were extracted and analyzed in accordance with Whittemore and Knafl's (2005) methodology, and the body of evidence was synthesized and best evidence recommendations developed based on the ©The Johns Hopkins Hospital/The Johns Hopkins University Evidence-Based Practice Model.

RESULTS

Ultimately, 19 publications met inclusion criteria and were included in this review. Key findings included strong evidence for women's self-defense training to reduce attempted rape, completed rape, and nonconsensual sexual contact, as well as emerging evidence for reduction in posttraumatic stress disorder (PTSD) symptoms, among other positive outcomes.

CONCLUSIONS

Further research is needed in more diverse populations at risk for violence and to identify key characteristics of effective interventions, including optimal content and dose.

Sexual Assault Among Young Adolescents in Informal Settlements in Nairobi, Kenya: Findings from the IMPower and SOS Cluster-Randomized Controlled Trial

Sexual assault is a global threat to adolescent health, but empowerment self-defense (ESD) interventions have shown promise for prevention. This study evaluated the joint implementation of a girls' ESD program and a concurrent boys' program, implemented via a cluster-randomized controlled trial in informal settlements of Nairobi, Kenya, from January 2016 to October 2018. Schools were randomized to the 12-h intervention or 2-h standard of care. Students were randomly sampled to complete surveys at baseline and again at 24 months post-intervention. A total of 3263 girls, ages 10-14, who completed both baseline and follow-up surveys were analyzed; weights were adjusted for dropout. At follow-up, 5.9% (n = 194/3263) of girls reported having been raped in the prior 12 months. Odds of reporting rape were not significantly different in the intervention versus SOC group (OR: 1.21; 95% CI (0.40, 5.21), p = 0.63). Secondary outcomes, social self-efficacy (OR: 1.08; 95% CI (0.95, 1.22), p = 0.22), emotional self-efficacy (OR 1.07; 95% CI (0.89, 1.29), p = 0.49), and academic self-efficacy (OR: 0.90; 95% CI (0.82, 1.00), p = 0.06) were not significantly different. Exploratory analyses of boys' victimization and perpetration are reported. This study improved on previous ESD studies in this setting with longitudinal follow-up of individuals and independent data collection. This study did not show an effect of the intervention on self-reported rape; findings should be interpreted cautiously due to limitations. Sexual assault rates are high in this young population, underscoring a dire need to implement and rigorously test sexual assault prevention interventions in this setting. The trial was registered with Clinical Trials.gov # NCT02771132. Version 3.1 registered on May 2017, first participant enrolled January 2017.

School-based interventions TO Prevent Dating and Relationship Violence and Gender-Based Violence: STOP-DRV-GBV systematic review

Background

Schools have a duty of care to prevent violence between students but a significant amount of dating and relationship violence and gender-based violence occurs in schools. These are important public health issues with important longitudinal consequences for young people.

Objectives

To understand functioning and effectiveness of school-based interventions for the prevention of dating and relationship violence and gender-based violence.

Review methods

We undertook a mixed-methods systematic review to synthesise different types of evidence relating to school-based interventions for the prevention of dating and relationship violence and gender-based violence to understand if, how and in what ways these interventions are effective. We searched 21 databases and 2 trial registers and undertook forwards and backwards citation chasing, author contact and other supplementary search methods. Searches identified all literature published to June 2021. All screening was undertaken in duplicate and independently, and we quality appraised all included studies.

Results

We included 247 reports (68 outcome evaluations, 137 process evaluations). Synthesis of intervention components produced an intervention typology: single-component, curricular, multicomponent, and multilevel programmes. Synthesis of intervention theories suggested that interventions aiming to increase students' sense of school belonging and sense of safety in the school building could encourage increased learning of prosocial skills and increased prosocial peer norms, and so potentially reducing dating and relationship violence and gender-based violence. Synthesis of factors affecting delivery highlighted school organisation and leaders who believed in the importance of addressing dating and relationship violence/gender-based violence, along with time and resources to deliver the interventions. The ease with which the intervention could be delivered and modified was also important. Meta-analysis found stronger evidence for intervention effectiveness in reducing dating and relationship violence than for gender-based violence, with significant long-term impacts on dating and relationship violence victimisation and perpetration, and some evidence that interventions in high-income countries could be effective for reducing victimisation and perpetration of gender-based violence in the long-term. Impacts on knowledge and attitudes were primarily short-term. Network meta-analysis did not suggest superiority of any intervention type. Moderation evidence suggested interventions reduced dating and relationship violence perpetration in boys more than girls, but reduced gender-based violence perpetration more in girls. Metaregression by intervention component did not explain heterogeneity in effectiveness, but qualitative comparative analysis suggested that reducing perpetration was important to reducing victimisation, and that perpetration could be reduced via focus on interpersonal skills, guided practice and (for gender-based violence) implementation of social structural components.

Limitations

Despite an exhaustive search, trials may have been missed and risk of publication bias was high for several analyses.

Conclusions

This is the most comprehensive systematic review of school-based interventions for dating and relationship violence and gender-based violence to date. It is clear that the prevention of dating and relationship violence and gender-based violence in schools will require longer-term investment to show benefit.

Future work

Future research is needed to understand why intervention effectiveness appears stronger for dating and relationship violence than gender-based violence.

Study registration

The study is registered as PROSPERO CRD42020190463.

Funding

This award was funded by the National Institute for Health and Care Research (NIHR) Public Health Research programme (NIHR award ref: NIHR130144) and is published in full in Public Health Research; Vol. 12, No. 3. See the NIHR Funding and Awards website for further award information.

The Importance of Reflexivity in Program Development: A Case Study Involving Teaching Self-Defense to Middle School Girls in PE Class

This research used a self-defense program to explore how middle school girls could change their perspectives on the gendered roles of victim and protector within an empowered self-defense approach. Taking the dual role of researcher and self-defense instructor, I developed a program to influence changing information strips directed toward gender norms, behavior, and discourse. Reflexive thematic analysis was utilized due to its intersection of the researcher's experience, literature, and theory. The research consisted of 40 girls journaling and 23 girls completing a post-program survey. Findings suggested that reflexive body techniques through self-defense could potentially impact internalized gendered information strips.

Empowerment Through Feminist Self-Defense: The IMPACT Lasts

What do women learn in feminist self-defense that is empowering? This study examined the skills women used months and years after completing an IMPACT self-defense course. Ninety-seven survey participants described skills they had used and incorporated into their lives. The major themes that emerged through a classic grounded theory analysis were awareness, boundary setting, assertive body language, and managing adrenaline to prevent, interrupt, or stop uncomfortable, intrusive, or hostile behaviors. IMPACT-trained women did not engage in self-blaming or risky behavior and used their skills to prevent and interrupt aggressive behavior.

Implementation of empowerment self-defense programming in a university counseling center: An effective sexual violence prevention delivery model

Objective: Empowerment Self-Defense (ESD) is a sexual violence prevention approach backed by rigorous empirical research, yet its availability on college campuses is limited. This manuscript evaluates the feasibility and efficacy of an ESD program embedded within a university counseling center. Methods: Participants completed an 8-session ESD intervention and group counseling program. Results: Feasibility and acceptability of this program were demonstrated by excellent participant retention and supported by institutional buy-in and counselor involvement. Pre-post assessments demonstrated that participants reported significant reductions in posttraumatic stress symptoms, F (1, 56) = 22.46, p < .001 and improvements in both interpersonal self-efficacy, F (1, 56) = 88.81, p < .001, and self-defense self-efficacy, F (1, 56) = 100.20, p < .001. Conclusion: The findings support the use of ESD programming as part of college campus sexual violence efforts and provide a blueprint for administrators and college mental-health centers who wish to offer this effective program to the college students they serve.

Young People's Experiences With an Empowerment-Based Behavior Change Intervention to Prevent Sexual Violence in Nairobi Informal Settlements: A Qualitative Study

PURPOSE

Young people in sub-Saharan Africa face one of the world's highest burdens of sexual violence. Previous impact evaluations indicated that a 6-week empowerment-based behavioral intervention in Nairobi informal (slum) settlements can reduce sexual assault. This qualitative study investigated girls' and boys' experiences of the intervention to identify potential mechanisms of change.

METHODS

We conducted a qualitative study in Nairobi slums with students (aged 15-21 years) who had participated in 2 parallel school-based curriculums called IMPower (girls) and Your Moment of Truth (boys) at least 1 year ago. Data were collected via 10 focus group discussions (5 for boys, 5 for girls) with 6-11 participants in each and 21 individual in-depth interviews (11 boys, 10 girls) that explored participants' experiences of the intervention and their suggestions for improvement. Findings were analyzed using thematic network analysis guided by empowerment theory.

RESULTS

Girls described how the intervention enabled them to recognize and resist sexual assault via verbal and physical strategies for self-protection, negotiate sexual consent, and exercise agency. Boys described increased ability to avoid risky behaviors and "bad" peer groups and to understand and respect consent. Girls also described how the intervention strengthened their self-confidence, and boys said that it boosted positive life values and gender-equal attitudes. Skilled facilitators and interactive and relevant content were highlighted as key to intervention success. Areas of improvement included expanding the curriculum to contain more content on sexual and reproductive health and rights and involving out-of-school youth, parents, teachers, and communities.

CONCLUSION

Findings indicate that a relatively short, behavioral school-based intervention can empower both girls and boys to prevent various forms of sexual violence in a low-income setting where it is endemic. Incorporating multilevel support structures, such as involving communities and families, could further enhance young people's long-term safety, health, and well-being.

Factors Influencing Safety Efficacy: Examining Past Experience, Mind-Set, and Emotion Management

Safety efficacy, or the perceived capability of preventing or deterring a personal safety threat, has emerged as a potentially important construct in personal safety outcomes. However, there has been limited research on factors that may facilitate or inhibit safety efficacy. The overall goal of this study was to examine indices of past history, mind-set, and emotion regulation associated with safety efficacy as informed by the self-efficacy literature. This study used a national sample of 821 women who completed a survey on personal safety concerns and responses. There were four main findings from this study: (a) although victimization experiences in this study were high, there were no differences in past or recent victimization experiences by safety efficacy group; (b) responding passively and feeling uncomfortable and nervous in interpersonal conflict situations were significantly associated with lower safety efficacy; (c) those with lower safety efficacy felt less confident in protecting themselves, were less likely to feel they could affect the outcome of external events, were less likely to seek information about their personal safety, and were more likely to feel personal characteristics increased their risk of victimization; and (d) discomfort when thinking about personal safety as well as emotion regulation problems were negatively associated with safety efficacy, yet have received limited research attention with regard to their role in personal safety outcomes. More research is needed to build on the success of various interventions that have shown evidence of increased safety efficacy and decreased revictimization as well as to reach women who may actively avoid prevention programs because they are not comfortable thinking about their safety.

"They destroyed my life because I do not feel like a man anymore": An Interpretative Phenomenological Analysis of Men's lived experiences of rape victimization

Over the past three decades, rape victimization has been regarded as a women-only issue, with men regarded as the only offenders. This has resulted in a narrow-focused approach in addressing this scourge where men who could be primary victims are marginalized. This marginalization has also occurred in research, resulting in the paucity of literature on men's experiences of rape victimization in South Africa and globally. The main aim of the study was to explore, analyze and interpret men's lived experiences of rape victimization and the meaning they attached to such experiences. An Interpretative Phenomenological Analysis research design was used to collect and analyze data from a purposive sample of 11 participants, using semi-structured face-to-face interviews. The findings of the study revealed eight superordinate themes and related subordinate themes as follows: unexpected overpowering experience, forceful sexual violations, rape as torture, intense emotions attached to being raped, rape as a permanent emotional scar, negative perceptions of self, rape as something being taken away, and rape as divine punishment. The findings highlight the experiences and meanings which men attach to being raped, thus demonstrating the need to develop men-specific post-rape care management guidelines to support and care for men who are rape victims.

Everyday self-defence: Hollaback narratives, habitus and resisting street harassment

Street harassment is recognized as an 'everyday' form of violence against women. Influenced by contemporary sociologies of everyday life, this article examines women responses to street harassment, drawing on over 500 first person narratives submitted to the website of Hollaback London. The narrative structure highlights women's actions, which (like street harassment) have generally been considered inconsequential. Quantitative content analysis reveals the extent and variety of strategies employed by women, including speaking back, calling on others for help, physically fighting back, walking away and an array of 'small', everyday actions and gestures that aim to resist harassment. I argue that these responses comprise everyday self-defence practice. Furthermore, the notion of narrative habitus is employed to argue that Hollaback narratives do not just describe harassment, but that reading narratives can generate dispositions for self-defence. Narrative analysis reveals the way that satire is employed to make space for women's successful self-defence. I argue that Hollaback narratives do not just offer storylines or scripts for resisting street harassment but foster a style for doing so. Analysis considers the limits to narratively motivated self-defence. This research demonstrates that, in order to 'see' women's resistance, we need to pay close attention to the everyday as the site of both oppression and moments of liberation.

A protocol for a cluster-randomized controlled trial testing an empowerment intervention to prevent sexual assault in upper primary school adolescents in the informal settlements of Nairobi, Kenya

Background

Sexual violence against adolescents is prevalent worldwide and results in significant physical and mental injuries as well as loss of economic and personal potential. Urban informal settlements such as those around Nairobi, Kenya have been shown to have especially high incidences of violence. Research has shown that empowerment interventions for female adolescents can reduce sexual assault. However, these interventions have had limited testing in urban informal settlements, with young adolescents, or in coordination with complementary programs for male adolescents.

Methods/design

This study was a two-arm, parallel, cluster-randomized trial testing a combination of a previously-tested girls’ intervention, IMPower, and a newly revised boys’ intervention, Source of Strength. Clusters were defined as schools within the informal settlements; participants were adolescent girls and boys in class 6, generally between the ages of 10–14 at baseline. Data collection began in January 2016 and continued through December 2018. The primary outcome was the change in incidence of self-reported sexual assault among girls from baseline, compared to a life skills standard of care intervention. Secondary outcomes included experiences of physical and emotional violence, as well as determining the effects of the intervention on self-efficacy, self-esteem, and gender attitudes and beliefs, and how those effects led to changes in experience of sexual assault. For the primary outcome and several of the secondary outcomes, we used an intention to treat estimand.

Discussion

This was the first randomized controlled trial with longitudinal follow-up of an empowerment self-defense approach to violence prevention for adolescents in informal settlements. The large size and rigorous design supported analysis to understand multiple subgroup experiences in the hypothesized reduction in sexual assault. The study was also unique in its focus on young (10–14 years of age) adolescents and in engaging both boys and girls in separate but coordinated curriculums. The focus on a highly vulnerable and understudied population will make it a significant contribution to the literature on violence prevention.

Trial registration

Clinical Trials.gov #NCT02771132. Version 3.1 registered May 2017, first participant enrolled January 2017. Retrospectively registered.

Does sex education before college protect students from sexual assault in college?

PURPOSE

College-bound young people experience sexual assault, both before and after they enter college. This study examines historical risk factors (experiences and exposures that occurred prior to college) for penetrative sexual assault (PSA) victimization since entering college.

METHODS

A cross-sectional study, including an online population-based quantitiative survey with undergraduate students was conducted in spring 2016. Bivariate analyses and multivariable regressions examined risk and protective factors associated with ever experiencing PSA since entering college. Concurrently-collected in-depth ethnographic interviews with 151 students were reviewed for information related to factors identified in the survey.

RESULTS

In bivariate analyses, multiple historical factors were significantly associated with PSA in college including adverse childhood experiences and having experienced unwanted sexual contact before college (for women) and initiation of alcohol, marijuana, and sexual behaviors before age 18. Significant independent risk factors for college PSA included female gender, experiencing unwanted sexual contact before college, first oral sex before age 18, and "hooking up" (e.g., causual sex or sex outside a committed partnership) in high school. Receipt of school-based sex education promoting refusal skills before age 18 was an independent protective factor; abstinence-only instruction was not. In the ethnographic interviews, students reported variable experiences with sex education before college; many reported it was awkward and poorly delivered.

CONCLUSIONS

Multiple experiences and exposures prior to college influenced the risk of penetrative sexual assault in college. Pre-college comprehensive sexuality education, including skills-based training in refusing unwanted sex, may be an effective strategy for preventing sexual assault in college. Sexual assault prevention needs to begin earlier; successful prevention before college should complement prevention efforts once students enter college.

Human Listeners Can Accurately Judge Strength and Height Relative to Self from Aggressive Roars and Speech

Although animal vocalizations and human speech are known to communicate physical formidability, no previous study has examined whether human listeners can assess the strength or body size of vocalizers relative to their own, either from speech or from nonverbal vocalizations. Here, although men tended to underestimate women's formidability, and women to overestimate men's, listeners judged relative strength and height from aggressive roars and aggressive speech accurately. For example, when judging roars, male listeners accurately identified vocalizers who were substantially stronger than themselves in 88% of trials, and never as weaker. For male vocalizers only, roars functioned to exaggerate the expression of threat compared to aggressive speech, as men were rated as relatively stronger when producing roars. These results indicate that, like other mammals, the acoustic structure of human aggressive vocal signals (and in particular roars) may have been selected to communicate functional information relevant to listeners' survival.

"Get Out of My Home and Don't Come Back!" Empowering Women Through Self-Defense

Can self-defense courses empower those already victimized? This article explores the potential for self-defense courses to have specific efficacy in the prevention of intimate partner violence (IPV). It draws on interview ( n = 36) and pre- and postevaluation ( n = 44) data from two studies: (a) evaluation of a pilot study of a feminist empowerment self-defense course designed specifically for women's refuge/shelter clients (Violence Prevention Project [VPP]) and (b) evaluation of women's self-defense courses collected as part of a larger evaluation study (Skills for Safety). The overwhelmingly positive findings from both studies suggest greater consideration be offered to providing further collaborative refuge/self-defense courses for women victimized by IPV.