Public Health Efforts Regarding Sexual Assault Among College Students:

A Critique Based on Social Ecological Theories – Meaghan McCusker

I.     Introduction

Sexual assault (SA), defined as any form of unwanted sexual contact obtained through violent or nonviolent means, is a critical public health concern within colleges and universities nationwide (1, 2, 3).  SA is the most common violent crime committed on college campuses today (4). Additionally, college women are at a higher risk of SA compared to peers who are not in college (1). One in five college women experience completed or attempted rape during their college experience (1, 5). More than half of college women experience some form of sexual victimization throughout their collegiate career (6). Victims of sexual assault are associated with various negative health outcomes, including increased substance use, depressive symptoms, health risk behaviors, and symptoms of posttraumatic stress disorder. Consequently, the described negative health outcomes have damaging repercussions on academic success (5, 7, 8).

In response to this widespread violence and severe implications, Congress enacted several laws requiring higher education institutions to notify students of sexual assault crime, publicize prevention methods, and ensure SA victims have access to basic legal rights. Despite federal legislation and widespread awareness of sexual violence, campus prevention programs have been slow to take hold. Less than two-thirds of US colleges offer sexual assault prevention programs, and only one-third offer campus wide safety programs (3, 9). Of college campuses that offer prevention programs, such methods include educating women on rates of SA, guidance on how to decrease risk of SA, as well as public health efforts in deterring men as SA perpetrators (10). While the implementation of sexual assault prevention programs has been seen as a positive trend, researchers have begun to question the effectiveness of widely used programs (11). Within this assessment, one will find a critique of three aspects of current SA prevention efforts, based on social ecological theories. Additionally, one will also find a proposed intervention that better addresses sexual assault on college campuses.

II.  First Critique: Use of Health Belief Model in Educating Women of SA Victimization

Many programs aimed at reducing sexual violence across college campuses rely on educating women about the existence of SA. Such educational campaigns include efforts publicizing rates of sexual violence. SA educational campaigns also strive to educate students by providing clear definitions of sexual assault, domestic violence, stalking, and rape (11). Additionally, some colleges also publicize the increased risk of women being SA victims with the use of alcohol and/or drugs (12, 13). Through these educational programs, women are taught to reduce their risk of victimization by avoiding risky situations, such as traveling alone or putting a drink down unattended at a party. Women are taught to travel in pairs, attend parties with friends, and are sometimes offered self-defense classes to physically protect themselves from a potential sexual violence attack.

While educational initiatives are widely used across college campuses that strive to address SA, studies have shown that increased knowledge of sexual violence and safety tips does not translate to a reduction in SA incidences (10). Failure to reduce sexual violence on campus, despite increased knowledge among college students, can be directly related to the over reliance and ineffective use of the Health Belief Model (HBM). The HBM is one of the most widely used behavioral theories in public health that centers around perceived susceptibility and severity of a public health concern, as well as perceived benefits and barriers in addressing a public health concern, that impacts a person’s intention and behavior (14). With this model, one would assume that if college women are educated about the existence of sexual violence, as well as provided safety tips and resources to reduce their risk of sexual violence, then rates of sexual violence would decrease, due to a change in women’s behavior. This assumption is incorrect, however, as the HBM is an individual level model that does not take into account social, environmental, or economics factors in determining behavior. The HBM also assumes rationality and equal access to campaign information (14, 15). As such, providing college campuses with SA information and safety tips do not lead to decreased incidences of sexual violence. Contemporary health prevention and promotion involves more than educating individuals about risks and benefits.

Additionally, educational programs that provide women with safety tips, such as traveling in pairs or avoiding dangerous neighborhoods, are more relevant to sexual assault cases committed by strangers. For example, if a victim were to be sexually attacked walking through an abandoned street, this may be prevented if a friend accompanied the potential victim. These safety recommendations are not typically helpful in preventing sexual assault where the perpetrator is an acquaintance, and when trust is already built between two individuals. As the majority of sexual assault cases within colleges are committed by acquaintances, this further contradicts the benefits of safety tips provided within SA prevention programs (9). Efforts should instead be made at a community level where public health practitioners strive to prevent sexual assault at more of a macro level, rather than though a micro level by educating individuals (16, 17).

III.         Second Critique: Failure to Follow Psychological Reactance Theory in Targeting Men as SA Perpetrators  

In recent years, public health practitioners striving to prevent sexual violence have shifted the responsibility of prevention by moving away from efforts in educating women about the existence of sexual violence and safety recommendations, and have moved towards efforts in changing men’s behavior. Through a movement aimed at taking away the responsibility of sexual assault from victims, practitioners have intended to decrease victim blaming (18). Such efforts have been supported by research showing the importance of men’s participation in educational programs and social marketing campaigns. A wide variety of programs and campaigns focus on telling men to stop perpetuating sexual violence against women. Common campaigns across college campuses include catch phrases such as “no means no” and “rape is rape”, when striving to deter men from sexually assaulting women (18, 19).

While campaigns aimed at deterring men from perpetuating sexual violence against women on college campuses have sincere intentions, these efforts go against Psychological Reactance Theory. Within this theory, psychologists conclude that when people are told what to do, they are more likely to do the opposite (20). This relates directly to the threat of freedom, an important core value among Americans, and more so among college students who may find their college experience a liberating time period within early adulthood. When applying Psychological Reactance Theory, one can determine that when such campaigns and programs advocate for men to stop perpetuating sexual violence, they may be more likely to conduct such violence. This can certainly be seen when perpetrators may justify sexually violent behavior as normal, especially when alcohol and/or drugs are involved.

In addition to the threat of freedom, SA prevention campaigns that focus on the victimization and perpetration continue stereotypical gender roles, as men are targeted as potential perpetrators and women are targeted as potential victims. There is a lack of research showing the benefits in attitude or behavioral changes in being more aware of stereotypical gender roles (10). This lack of empirical research can be related to both of failure of the HBM, as well as the failure in disregarding Psychological Reactance Theory. More specifically, informing college students about sexual violence, safety tips, stereotypical gender roles, and telling perpetrators what to do can have little impact in preventing incidents of sexual assault on college campuses.

IV.         Third Critique: Failure to Follow Social Expectations Theory in Accepting Sexual Assault as Social Norm

Within sexual violence prevention programs in college communities, public health practitioners have focused on both educating women in how to decrease their risk of victimization, as well as appealing to men to deter them from perpetration. By focusing on educating and changing the behavior of SA victims and perpetrators, there is a lack of effort in changing the social norm regarding the existence of sexual violence on college campuses (21). In other words, in striving to educate victims and change the behavior of perpetrators, it can be seen as socially accepted that sexual violence will exist on college campuses, and efforts are therefore made to reduce the rate of such violence. When efforts are being made to reduce the rate of sexual violence through victims and perpetrators, there is a lack of focus on changing the social acceptance, or the social norm, of sexual violence by all members of the community.

In promoting SA programs that perpetuate this type of violence as a social norm within college communities, public health practitioners are failing to follow the Social Expectations Theory. Within this theory, psychologists and sociologists reflect on the social nature of human beings. People live their lives in webs of complex social interactions and are more than individual organisms responding to stimuli (22). Subsequently, community members do not solely respond to information from public health programs and campaigns. Human behavior is better understood through the reflection of social norms, or general rules that are implied by all members of a group. Therefore, if public health campaigns do not strive to change the social norm of sexual violence on college campuses, then these campaigns may not be effective in changing behavior.

Theorists suggest that sexual violence will only be eliminated when broader social norms are addressed and a broader range of community members is reached (21, 23). Researchers have also noted the increased importance of peer norms, specifically related to the coercion and deterrence of sexual assault (23). Such research and theories call for more of a community level responsibility in changing the social norm of SA on college campuses. Consequently, the American College of Health Association (ACHA) and the Centers for Disease Control and Prevention (CDC) have recently called for the implementation of prevention programs that focus on changing the social norm of sexual violence within college communities (21).

 If the elimination of sexual violence was a socially acceptable norm on college campuses, then researchers argue that this new trend would grow within the community and eventually the new social norm of living free from sexual assault on college campuses would take hold. This growth in trend can be related to Malcolm Gladwell’s Tipping Point, when there is one moment when everything can change all at once (24). This tipping point can be related to a change in social norm. If the social norm of SA is changed within a college community, then there is an opportunity where all community members’ acceptance of sexual assault as a social norm can also change. This key element in psychological theory reflects the critical importance of following Social Expectations Theory when creating and implementing public health prevention programs. While previous SA prevention campaigns have failed to follow social expectations theory, one can learn from this oversight when proposing a more effective intervention.

V.  Shift in Public Health Efforts: Community Level Intervention to Promote Bystander Activism

As the CDC and ACHA have called for prevention efforts that focus on changing the social norm of SA at a community level, the role of bystander prevention has become an integral method in doing so. The use of bystander prevention is a community based prevention method that specifically targets the responsibility of the entire community to decrease levels of sexual violence. The term bystander prevention relates to members of the community witnessing sexual violence among themselves and their responsibility in intervening to prevent the act of violence from initially occurring (9). This prevention method relates to a community-based program in publicizing the importance of a bystander and their role in preventing sexual assault within the community.

Bystander activism directly relates to the importance of changing the social norm. Shifting the prevention efforts to the community changes the social norm, in that community members will no longer see acts of SA as socially acceptable. Community-based bystander activism “help(s) all community members become more sensitive to issues of sexual violence and teach them skills to intervene with the intent to prevent assaults from occurring and provide support to survivors who may disclose” (25). The use of bystander prevention reaches a broader community range and promotes a culture free of sexual violence. As bystander activism is a critical method in addressing sexual assault on college campuses, the following section includes a proposed social media campaign to promote bystander activism.

VI.         Proposed Intervention: Know Your Power^TM Campaign

As previous public health interventions have disregarded important behavioral science theories, one can now better propose a SA prevention campaign that follows imperative social ecological theories through the promotion of bystander activism. Researchers at the University of New Hampshire have created, implemented, and analyzed a social media campaign that educates all members of the community to be active bystanders in preventing sexual violence. The social marketing campaign, known as Know Your Power^TM, includes various posters of student actors modeling community-oriented intervention behaviors. These posters were evaluated through focus groups, pilot studies, as well as pretests and posttests. Extensive analysis indicated that students who reported seeing the posters were more aware of bystander intervention behavior and were more willing to partake in bystander intervention to reduce sexual violence (9).

The posters portray typical campus scenarios and model preventive bystander behaviors. One of the posters displays a group of friends discussing how a friend, Joe, took another friend, Anna, into his room after heavily drinking.  The pictured group of friends determine that they should check on Anna, as she’s too drunk to consent. Another poster shows a young man chatting with his friend about how he met a guy online and plans to get that person drunk so they can hook up. The friend interjects and states: “That’s not okay. That’s rape”. A third poster displays a young woman yelling at her girlfriend for speaking to another friend, accusing the girlfriend of flirting with another woman. Bystanders nearby are pictured talking to each other, as they plan to step in and say something about their fear of an abusive relationship (26). Each poster includes the Know Your Power^TM logo and tagline: “Step In, Speak Up: You can Make a Difference”. Each poster provides specific advice about what to do in a situation similar to the one pictured (9). For example, the poster depicting friends intervening between Joe and Anna at the party had the advice of: “Friends watch out for one another…Especially when there is alcohol involved”.

Posters were displayed during the four weeks immediately following spring break, as studies have shown there is an increase in students drinking behavior during spring breaks and the following weeks. Increased drinking is in turn correlated with an increase in the incidence of sexual assault. Posters were hung throughout residence halls, academic buildings, campus recreation facilities, student centers, dining halls, Greek fraternity and sorority houses, as well as local businesses (9). Posters were also displayed on communal campus computers, as well as bus wraps that traveled around campus and surrounding towns. Additionally, Know Your Power^TM marketing material was distributed throughout campus, including key chains, buttons, water bottles, and bookmarks. Widely distributed posters ensure that member of the college community see these posters on a regular basis (9).

This social media campaign has been in effect for numerous years at the University of New Hampshire. Each year, evaluations are completed to improve current posters, as well as create new posters with varying scenarios that commonly occur within college. Posters are geared towards teaching college community members how to safely intervene when an incident of sexual violence may occur. Posters also provide a link to the campaign’s website, know-your-power.org, where students and community members can find information on bystander intervention and sexual violence resources. Within the following sections, one will find information about how the campaign better addresses sexual assault on college campuses based on three main social ecological theories.

VII.      First Defense: Use of Diffusion of Innovations Theory: Community Responsibility

Within this social media campaign, researchers use the Diffusion of Innovations Theory to prevent SA on a community level, rather than the use of the HBM on an individual level. The Diffusion of Innovations Theory reflects the importance of behavioral changes on a community level, where there are early adapters of behavior, followed by a tipping point where the intended behavior becomes a regular occurrence. Within this campaign, community members are exposed to posters teaching them the importance of bystander prevention, as well as specific ways to intervene to prevent sexual assault. Rather than relying on educating the public on the existence of sexual assault, this campaign specifically teaches students and other members of the community how to safely intervene during a potential sexual assault incident.

Know Your Power^TM is a community-level public health campaign that promotes the adoption of an effective behavior, which community members can mirror to uphold active bystander intervention. Importantly, this campaign is relative to all community members; it does not rely on educating and changing the behavior of SA victims or potential victims, as seen in previous public health efforts that use the HBM. This community level bystander prevention campaign shifts the focus from victim responsibility to community responsibility in preventing sexual assault. Within this campaign, it is more likely for the community to have a critical point where community members become active bystanders. This is because all members of the community are shown the importance and effectiveness of bystander intervention in creating an environment free of sexual violence. Rather than SA campaigns targeting a subset group of SA victims, this campaign reaches the whole community and uses the Diffusions of Innovations Theory in promoting bystander intervention.

VIII.    Second Defense: Use of Psychological Reactance Theory: Empowering Bystanders  

In addition to using the Diffusions of Innovations Theory, Know Your Power^TM also reflects the important findings from Psychological Reactance Theory. As this theory explains, when individuals are told what to do, they were more likely to do the opposite. Rather than tell perpetrators not to sexually assault victims, as previous campaigns have done, this campaign demonstrates the importance of bystander intervention and shows different scenarios in how community members can safely intervene. Within the campaign, all community members are empowered to prevent violence.

Through the use of the Know Your Power^TM campaign, community members receive an empowering message that provides useful and positive messages in how to safely prevent sexual violence, rather than more negative and dominant messages instructing potential perpetrators to not commit a crime. In addition to community level efforts, this campaign demonstrates to the public that there are safe and effective ways to intervene and prevent sexual assault. This campaign reflects the important findings of the Psychological Reactance Theory, and ultimately empowering bystanders within the community to: “Know Your Power^TM: Step In, Speak Up: You can Make a Difference”.

IX.         Third Defense: Use of Social Expectation Theory: Changing Social Norms

As this campaign successfully implements a community level intervention in empowering bystander intervention, the campaign ultimately promotes a critical change in social norm. Through this campaign, the historical social norm of sexual violence as a common occurrence on college campuses shifts to the norm of living free of sexual violence. The campaign follows the Social Expectation Theory in changing social norms to ultimately change behavior on a community level. First, the social norm is changed through the Know Your Power^TM media campaign, leading to a change in behavior in increasing bystander intervention. The powerful tool of bystander activism creates a new norm of intervention and prevention of sexual violence.

This campaign creates a change in social norms of sexual assault, and therefore promotes a change in behavior through bystander intervention. Through the shift in social norms, the campaign builds a broader sense of community. The bystander model provides each community member with an active role; each role can then be adopted to prevent sexual violence within that community, and eventually each community can reach a broader range of people with the increase of bystander activism.

The campaign is a community-level approach in preventing and ultimately terminating sexual assault on college campuses. Efforts through this group-level campaign to change this social norm relates directly to Malcolm Gladwell’s tipping point theory, where the change in social norm can lead to a relatively quick change in bystander intervention behavior. Through this intervention, resources can be used productively through shifting the social norm of preventing SA on college campuses. With the change in social norm and increase in bystander intervention behavior, each community member has an opportunity to become active bystanders, as well as build sense of trust and belonging with community members, specifically regarding the prevention of sexual assault.

X.  Conclusion

Sexual violence on college campuses is a critical public health concern (1, 2, 3). Various efforts have been implemented to educate the community about the existence and risk of sexual violence. While these programs may have increased awareness, sexual assault continues to be the most common violent crime committed on college campuses today (4). Recent efforts centered on changing the social norm and increasing bystander intervention has led to a new public health approach that prevents SA through the use of a group-level prevention methods. Such recent efforts should be implemented through various college campuses across the country to assess effectiveness in preventing SA. If effective across various campsues, the Know Your Power^TM should be widely used to prevent and ultimately eliminate sexual violence on college campuses.

XI.         Citation of References

1.    Young A., Grey M., Abbey A., Boyd C.J., & Esteban McCabe, S. (2008). Alcohol-Related Sexual Assault Victimization Among Adolescents: Prevalence, Characteristics, and Correlates. Journal of Studies on Alcohol and Drugs. Vol. 69, No. 1

2.   Shifting the Paradigm: Primary Prevention of Sexual Violence. (2008). American College Health Association

3.   Karjane, H. M., Fisher, B. S., Cullen, F. T. (2005). Sexual Assault on Campus: What Colleges and Universities Are Doing About It. U.S. Department of Justice: Research for Practice

4.   Fisher, B. S., Cullen, F. T., & Turner, M. G. (2000). The sexual victimization of college women: Findings from two national-level studies. Washington, DC: National Institute of Justice and Bureau of Justice Statistics.

5.    Crawford E., O'Dougherty Wright, M., & Birchmeier, Z. (2008). Drug-facilitated sexual assault: college women's risk perception and behavioral choices. Journal of American College Health. Vol. 57, No. 3

6.   Messman-Moore, T.L., Coates A.A., Gaffey K.J., & Johnson, C.F. (2008). Sexuality, Substance Use, and Susceptibility to Victimization: Risk for Rape and Sexual Coercion in a Prospective Study of College Women. Journal of Interpersonal Violence. Vol. 23, No. 12

7.   Banyard, V. L., Moynihan, M. M., & Crossman, M. T. (2009). Reducing Sexual Violence on Campus: The Role of Student Leaders as Empowered Bystanders. Journal of College Student Development, 50(4), Pg. 446

8.   Ullman, S.E. Starzynski, L.L., Long, S.M., Mason, G.E., & Long L.M. (2008). Exploring the Relationships of Women’s Sexual Assault Disclosure, Social Reactions, and Problem Drinking. Journal of International Violence. Vol. 23, No. 9

9.   Potter S. J., Moynihan, M. M., Stapleton, J.G., Banyard, V. L. (2009), Empowering Bystanders to Prevent Campus Violence Against Women: A Prelimiary Evaluation of a Poster Campaign. Violence Against Women. Vol. 15, No. 106

10.                  Sochting, I., Fairbrother N., Kock, W. (2004). Sexual Assault of Women: Prevention Efforts and Risk Factors. Violence Against Women. Vol. 10, No. 73

11.Breitenbecher K. H., Scarce M. (2001). An Evaluation of the Effectiveness of a Sexual Assault Education Program Focusing of Psychological Barriers to Resistance. Journal of Interpersonal Violence. Vol. 16, No. 387

12.                  Adams-Curtis, L. E., & Forbes, G. B. (2004). College Women's Experiences of Sexual Coercion: A Review of Cultural, Perpetrator, Victim, and Situational Variables. Trauma, Violence, & Abuse, Vol. 5, No. 2

13.                  Sexual Violence and Alcohol and Other Drug Use of Campus. (2008). The Higher Education Center for Alcohol and Other Drug Abuse Violence Prevention. Infofacts Resources

14.                  Edberg, M. (2007). Chapter 4: Individual Health Behavior Theories. Essentials of Health Behavior: Social and Behavioral Theory in Public Health. Jones & Bartlett Publishers.

15.Thomas, L. W. (1995). A Critical Feminist Perspective of the Health Belief Model: Implications for Nursing Theory, Research, Practice, and Education. Journal of Professional Nursing. Vol. 11, No. 4

16.                  Marks, D.F. (1996). Health Psychology in Context. Journal of Health Psychology, Vol. 1, No. 1

17.                  Theory at a Glance: A Guide For Health Promotion (2005). National Cancer Institute

18.                  Berkowitz A. D. (2004). Working with Men to Prevent Violence Against Women: An Overview (Part One). National Electronic Network on Violence Against Women

19.                  Flood M. (2011). Involving Men in Efforts to End Violence Against Women. Men and Masculinities. Vol. 13, No. 3

20.                 Silvia P. J. (2005). Deflecting Reactance: The Role of Similarity in Increasing Compliance and Reducing Resistance. Basic and Applied Social Psychology. Vol. 27, No. 3

21.                  Potter, S. J., Moynihan, M. M., Stapleton, J. G. (2011). Using Social Self-Identification in Social Marketing Marterials Aimed at Reducing Violence Against Women on Campus. Journal of Interpersonal Violence. Vol. 26, No. 5

22.                 DeFlour, M. L., Ball-Rokeach S. J. (1989). Chapter 8: Socialization and Theories of Indirect Influence. Theories of Mass Communication. Longman Inc.

23.                 Banyard V. L., Moynihan M. M. (2011). Variation in Bystander Behavior Related to Sexual and Intimate Partner Violence Prevention: Correlated in a Sample of College Students. Psychology of Violence. Vol. 1, No. 4

24.                 Gladwell, M. (2000). The Tipping Point: How Little Things Can Make a Big Difference. Little, Brown and Company.

25.                  Banyard, V., Plante, E., and Moynihan, M. M. (2004). Bystander education: Bringing a broader community perspective to sexual violence prevention. Journal of Community Psychology. Vol. 32, No. 1

26.                 Know Your Power: About the Campaign. Prevention Innovations. University of New Hampshire. http://www.know-your-power.org/about.html

XII.      References

Journal Articles:

Adams-Curtis, L. E., & Forbes, G. B. (2004). College Women's Experiences of Sexual Coercion: A Review of Cultural, Perpetrator, Victim, and Situational Variables. Trauma, Violence, & Abuse, Vol. 5, No. 2

Banyard V. L., Moynihan M. M. (2011). Variation in Bystander Behavior Related to Sexual and Intimate Partner Violence Prevention: Correlated in a Sample of College Students. Psychology of Violence. Vol. 1, No. 4

Banyard, V. L., Moynihan, M. M., & Crossman, M. T. (2009). Reducing Sexual Violence on Campus: The Role of Student Leaders as Empowered Bystanders. Journal of College Student Development, 50(4), Pg. 446

Banyard, V., Plante, E., and Moynihan, M. M. (2004). Bystander education: Bringing a broader community perspective to sexual violence prevention. Journal of Community Psychology. Vol. 32, No. 1

Breitenbecher K. H., Scarce M. (2001). An Evaluation of the Effectiveness of a Sexual Assault Education Program Focusing of Psychological Barriers to Resistance. Journal of Interpersonal Violence. Vol. 16, No. 387

Crawford E., O'Dougherty Wright, M., & Birchmeier, Z. (2008). Drug-facilitated sexual assault: college women's risk perception and behavioral choices. Journal of American College Health. Vol. 57, No. 3

Flood M. (2011). Involving Men in Efforts to End Violence Against Women. Men and Masculinities. Vol. 13, No. 3

Marks, D.F. (1996). Health Psychology in Context. Journal of Health Psychology, Vol. 1, No. 1

Messman-Moore, T.L., Coates A.A., Gaffey K.J., & Johnson, C.F. (2008). Sexuality, Substance Use, and Susceptibility to Victimization: Risk for Rape and Sexual Coercion in a Prospective Study of College Women. Journal of Interpersonal Violence. Vol. 23, No. 12

Potter, S. J., Moynihan, M. M., Stapleton, J. G. (2011). Using Social Self-Identification in Social Marketing Marterials Aimed at Reducing Violence Against Women on Campus. Journal of Interpersonal Violence. Vol. 26, No. 5

Potter S. J., Moynihan, M. M., Stapleton, J.G., Banyard, V. L. (2009), Empowering Bystanders to Prevent Campus Violence Against Women: A Prelimiary Evaluation of a Poster Campaign. Violence Against Women. Vol. 15, No. 106

Silvia P. J. (2005). Deflecting Reactance: The Role of Similarity in Increasing Compliance and Reducing Resistance. Basic and Applied Social Psychology. Vol. 27, No. 3

Sochting, I., Fairbrother N., Kock, W. (2004). Sexual Assault of Women: Prevention Efforts and Risk Factors. Violence Against Women. Vol. 10, No. 73

Thomas, L. W. (1995). A Critical Feminist Perspective of the Health Belief Model: Implications for Nursing Theory, Research, Practice, and Education. Journal of Professional Nursing. Vol. 11, No. 4

Ullman, S.E. Starzynski, L.L., Long, S.M., Mason, G.E., & Long L.M. (2008). Exploring the Relationships of Women’s Sexual Assault Disclosure, Social Reactions, and Problem Drinking. Journal of International Violence. Vol. 23, No. 9

Young A., Grey M., Abbey A., Boyd C.J., & Esteban McCabe, S. (2008). Alcohol-Related Sexual Assault Victimization Among Adolescents: Prevalence, Characteristics, and Correlates. Journal of Studies on Alcohol and Drugs. Vol. 69, No. 1

Book:
Gladwell, M. (2000). The Tipping Point: How Little Things Can Make a Big Difference. Little, Brown and Company.
Book Chapters or Articles:

DeFlour, M. L., Ball-Rokeach S. J. (1989). Chapter 8: Socialization and Theories of Indirect Influence. Theories of Mass Communication. Longman Inc.

Edberg, M. (2007). Chapter 4: Individual Health Behavior Theories. Essentials of Health Behavior: Social and Behavioral Theory in Public Health. Jones & Bartlett Publishers.

Reports or Other Documents:

Berkowitz A. D. (2004). Working with Men to Prevent Violence Against Women: An Overview (Part One). National Electronic Network on Violence Against Women

Fisher, B. S., Cullen, F. T., & Turner, M. G. (2000). The sexual victimization of college women: Findings from two national-level studies. Washington, DC: National Institute of Justice and Bureau of Justice Statistics.

Karjane, H. M., Fisher, B. S., Cullen, F. T. (2005). Sexual Assault on Campus: What Colleges and Universities Are Doing About It. U.S. Department of Justice: Research for Practice

Sexual Violence and Alcohol and Other Drug Use of Campus. (2008). The Higher Education Center for Alcohol and Other Drug Abuse Violence Prevention. Infofacts Resources

Shifting the Paradigm: Primary Prevention of Sexual Violence. (2008). American College Health Association

Theory at a Glance: A Guide For Health Promotion (2005). National Cancer Institute

Website:
Know Your Power: About the Campaign. Prevention Innovations. University of New Hampshire. http://www.know-your-power.org/about.html