|Evaluating Sexual Assault Nurse Examiner Programs|
|By Beth Pearsall, managing editor of the NIJ Journal|
New tool helps programs understand how they affect the prosecution of sexual assault cases in their communities.
Victims of sexual assault may suffer physical, emotional and psychological trauma as a result of their victimization. Providing them with sensitive health care in the aftermath of their assault is paramount.
Unfortunately, all too often, victims must wait long hours in busy emergency departments. They are not allowed to eat, drink or even go to the bathroom while they wait for a medical exam. And frequently, the physicians or nurses who perform the exams lack training and proficiency in medical evidence collection procedures.
To help improve post-assault care for victims, communities around the country have implemented Sexual Assault Nurse Examiner (SANE) programs, which offer a multidisciplinary, victim-centered response. Through these programs, specially trained nurses provide crisis intervention and emotional support, health care, injury detection and treatment, and forensic medical evidence collection in hospital emergency departments or community-based clinics. More than 600 SANE programs now exist throughout the United States and Canada.
SANE programs not only provide sensitive care and support to victims — research suggests that these programs also may have a positive impact on prosecution rates in their communities. For example, two NIJ-funded studies found that communities' prosecution rates increased significantly after the communities implemented SANE programs.
As promising as these findings may be, they should be interpreted with caution, because only a handful of the 600 SANE programs have been rigorously evaluated. We know little about the majority of SANE programs and their impact on local criminal justice systems. There is a pressing need for ongoing evaluation to determine if and under what circumstances SANE programs can positively affect criminal justice case outcomes.
To fill this need, Rebecca Campbell and her colleagues at Michigan State University received a competitive grant from NIJ to develop a toolkit that SANE program staff can use to evaluate how their program affects the prosecution of sexual assault cases in their community. The user-friendly toolkit walks practitioners through a six-step evaluative process. It also offers ideas for using the findings to improve practice and enhance a program's positive impact on the reporting, investigation and prosecution of sexual assault cases.
"Programs might be hesitant to take on an evaluation because they're worried it will be too hard, too complicated, too much time away from patients," Campbell said. "The toolkit streamlines the steps of evaluation into an easy-to-follow process. We designed it specifically for busy practitioners."
She added, "Evaluating the work of SANE programs — or any innovative program for victims of crime — is so important because it helps front-line practitioners know what's really happening in their communities. What's going well? What are our areas for improvement? What resources do we need to be successful? Evaluation is critical for funders and policymakers, too, as it identifies promising new programs and practices that merit further study and investment." Inside the Toolkit: Choosing an Evaluation Design
When planning an evaluation, a SANE program must make several important decisions, including what information to collect and from whom, how many times, and when and how to collect it.
The program also must decide what its overall evaluation will look like. The toolkit presents three evaluation designs:
Figure 1: The Six Basic Steps of Evaluation.
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Six-Step Evaluation Roadmap
Once a program chooses a design, it is ready to get started. The toolkit provides a detailed how-to for the six basic steps of evaluating criminal justice outcomes for each of the three design.
Getting to the results is not the final goal of an evaluation — it is the first step in better understanding a program and its relation to prosecutor outcomes. Programs will need to think about how to use these results.
The toolkit helps programs frame their thinking with three questions:
"The whole point of evaluation is utilization — using the findings to create change, improve the program and help plan new initiatives," Campbell noted.
She added, "Six SANE programs worked with us in the toolkit project, and they all used their findings to create positive changes in their communities. Some were able to leverage new funding; some established a new sexual assault response team. The evaluation helped them set goals and create concrete action plans for improvement."
Reprinted - NIJ Journal No. 272
Access the toolkit (pdf, 227 pages).
NIJ Journal No. 272, posted May 2013
About the AuthorBeth Pearsall is managing editor of the NIJ Journal.
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