Evaluating and strengthening Special Olympics' approach to sexual violence prevention

Seattle Children'S Hospital, Seattle WA

Investigators

Abstract

PROJECT SUMMARY Adults living with intellectual and developmental disabilities (IDD) are a population at elevated risk for sexual violence (SV). Living with IDD creates a unique set of risk factors (e.g., reliance on others for basic needs, inadequate support in existing systems) that can be exploited and strengthen coercive tactics by perpetrators. Creating protective environments is a key part of the public health prevention approach to SV, but there are few to no rigorous evaluations of the preventive practices or programs implemented by organizations serving individuals with IDD or those examining their effectiveness in reducing SV. Special Olympics is an organization that serves more than 500,000 athletes living with IDD in the United States, using sport as a vehicle for empowerment and positive development, and as an organizational structure for addressing health and social needs through a network of state programs. In response to athlete-expressed needs, Special Olympics has developed a curriculum for individuals with IDD about healthy relationships, consent, bodily autonomy, and pathways to help. Based on athlete-expressed preferences, this curriculum is meant to be delivered to teams or small groups of athletes by a local Special Olympics coach, who also functions as an ongoing point of contact for questions, disclosures of concerns, and connections with health- and community-based resources. We refer to this multi-level intervention that includes the athlete-facing curriculum as Healthy Relationships. Formative research conducted by Special Olympics finds that the athlete-facing curriculum is highly acceptable to athletes, however there is no data about whether the already-developed facilitator training is acceptable to coaches and effective in preparing them to deliver the curriculum and provide ongoing support to athletes. Because Healthy Relationships has not yet been systematically disseminated by Special Olympics to state programs, there is a timely opportunity for formative evaluation. In preparation for evaluation, there is also a critical need to ensure there are valid, inclusive measures and procedures for assessing sexual violence among individuals with IDD. Thus, we propose the following aims: Aim 1: Assess the acceptability and appropriateness of facilitator training for Healthy Relationships. If substantive changes are indicated and made to the training, we will repeat the formative evaluation procedures until predetermined thresholds of acceptability are met. Aim 2: Validate a measure of sexual violence victimization among individuals with IDD and establish inclusive procedures for question administration in preparation for a pilot evaluation of Healthy Relationships. Aim 3: Conduct a pilot evaluation of Healthy Relationships using a parallel arm cluster trial design with randomization at the local (community) program level. We will test the hypothesis that rates of SV among athletes in local programs randomized to the intervention condition will be lower than athletes in control condition programs. Achieving these aims will produce a strengthened organizational approach to SV prevention that can be readily implemented by Special Olympics and adapted to other organizations serving individuals with IDD. Pilot data about intervention effectiveness, as well as the validated measure of SV incidence, will provide the foundation for a subsequent large-scale effectiveness-implementation evaluation in continued partnership with Special Olympics.