Program Profile: IMpower Program for American Indian Girls

This was a sexual assault prevention program adapted for American Indian girls that sought to reduce sexual assault victimization and to improve sexual assault resistance skills and self-defense knowledge. The program is rated Promising. Girls who received the intervention reported statistically significantly lower rates of sexual assault and sexual harassment, compared with girls in the comparison group. However, there was no impact on reported rates of physical dating violence.

A Promising rating implies that implementing the program may result in the intended outcome(s).

A Promising rating implies that implementing the program may result in the intended outcome(s).

Program Goals/Target Population

American Indian (also known as Native American) youths experience sexual assault at a disproportionately high rate (Edwards et al. 2021; Rutman et al. 2008; Warne et al. 2017). According to findings from a national survey, 16.4 percent of urban American Indian high school youths (compared with 6.6 percent of White youths) reported they were physically forced to have sex during the past year (Rutman et al. 2008). Because sexual assault is related to several adverse health and mental-health outcomes (such as depression, suicidal ideation, and binge drinking), tribal community partners sought to implement an intervention that would help reduce sexual assault, but also aligned with Lakota values (such as bravery and perseverance).

The IMpower program (also known as No Means No), which was originally implemented in Nairobi, Kenya, was a school-based sexual assault prevention program designed to increase resistance skills (i.e., mental, verbal and physical skills) and increase empowerment self-defense knowledge (i.e., the ability to recognize risk and respond using resistance strategies to prevent a sexual assault). The primary goal of the program was to reduce sexual assault victimization for American Indian girls. Secondary goals included reducing sexual harassment and physical dating violence.

Program Components

The IMpower program was a classroom-based curriculum delivered by trained instructors, with girls (aged 10-20) participating in six 2-hour sessions. During sessions, instructors taught girls how to recognize risk, use verbal and physical resistance strategies if faced with a potential sexual assault, and tell others if they are being hurt. Because empowerment self-defense was the primary focus of the intervention, each session, regardless of the topical focus, involved some skill-building related to self-defense (e.g., screaming “No,” running away).

During the initial session (Session 1—Introduction), low- and high-risk threat levels for sexual violence situations were discussed and the definition of self-defense and the five primary tools of defense were taught (spirit, mind, eyes, voice, and body). The remaining sessions were as follows:

• Session 2—Verbal Skills. This session discussed verbal resistance strategies that are taught through role playing, games, and other techniques. In particular, instructors taught use of verbal resistance strategies, such as how to say no effectively, setting boundaries, yelling, “No!,” assuming a strong stance, and enlisting others for help. Students were encouraged to disclose abuse during this session, and victims were provided referrals to service providers for support.
• Session 3—Physical Resistance. Physical resistance strategies were taught through demonstration from instructors in this session. Students were shown where to focus physical resistance efforts and practice escaping holds and grabs.
• Session 4—Physical Resistance. In this session, full-force fighting techniques meant to disable assailants quickly were demonstrated. Students engaged in full-force fighting techniques for the full session.
• Session 5—Extreme-Risk Strategies. During this session, the girls were shown various responses to high-risk scenarios—such as choking, weapon use, and multiple assailants—and practiced engaging in responses to high-risk situations.
• Session 6—Practice. This was a review session in which the instructors allowed students to practice what they had learned throughout the entire curriculum.

In addition to these sessions, girls engaged in chants and other activities to reinforce the messages and the importance of girls’ finding their voice and realizing that they are worth defending, as this relates to Lakota values of bravery and perseverance.

Additional information on how the IMpower curriculum was adapted for American Indian youth can be found under Implementation Information.

Study

Edwards and colleagues (2021) conducted a quasi-experimental design to evaluate the efficacy of the IMpower program on reducing sexual assault victimization among American Indian (also known as Native American) girls. Youth participants were American Indian middle and high school girls in grades 6–12, who were living either on an Indian reservation (in the Northern Great Plains region of the United States) or in a nearby city in the same state as the reservation. Specifically, girls on the reservation were recruited from one middle school and two high schools, while girls living in a nearby city in the same state were recruited from five middle schools and three high schools. Community and school partners felt it was an ethical concern to withhold intervention from some girls in the school. Because of this, and because of potential contamination effects, the intervention group comprised girls living on the reservation who participated in the 6-session, 2-hour classroom-delivered IMpower curriculum, and the comparison group comprised girls in a nearby city who did not receive any type of school-based sexual assault prevention programming.

A total of 984 girls were eligible for the study (intervention group = 599; comparison group = 385). Of these 984 girls, 255 consented and completed the 6-month follow-up survey (intervention group = 74; comparison group= 181) and were included in the study sample. Of the girls in the intervention group, 66.7 percent identified as heterosexual, and 33.3 percent identified as a sexual minority (i.e., identifying as bisexual, lesbian/gay, or another non-heterosexual identity). The average age of girls in the intervention group was 14 years. Of the girls in the comparison group, 80.1 percent of girls identified as heterosexual, and 19.9 percent identified as a sexual minority. The average age of girls in the comparison group was 13.7 years.

Propensity score weighting was used to minimize selection bias and aimed to statistically equate treatment groups. Using t-tests and chi-square analysis to establish covariates to use in the propensity score model (i.e., binge drinking, grades, experience of sexual harassment), propensity scores were calculated to use as weights in the causal analysis to correct for bias in the probability of being assigned to a treatment group. There were no statistically significant differences between girls in the intervention and comparison groups, based on baseline characteristics. Although not statistically significant, an attrition analysis found that girls in the intervention group who endorsed alcohol use at pretest (i.e., baseline) were less likely to participate in the posttest survey and girls in the comparison group who had higher grades and were older at pretest were less likely to participate in the posttest survey.

Survey data were collected at baseline and at the 6-month posttest. All survey items were responded to with a “yes” or “no” regarding whether the behavior had occurred during the past 6-months. Outcomes of interest included sexual assault, physical dating violence, and sexual harassment. Sexual assault was measured using four items, with three items taken from Cook–Craig and colleagues’ (2014) sexual violence instrument, which measured:

1. Sexual coercion (“Another student had sexual activities with you although you did not really want to because… the student threatened to end your friendship or romantic relationship if you didn’t”),
2. Physically forced sex (“Another student forced you to do sexual things that you did not want to do, such as kissing, touching, or being physically forced to have sexual intercourse?”), and
3. Incapacitated sex (“You had sexual activities when you did not want to because you were drunk or on drugs?”).

One-item from the Youth Risk Behavior Survey (Kann et al. 2014) was used to measure sexual dating violence (i.e., “Someone you were dating or going out with forced you to do sexual things that you did not want to do, including things such as kissing, touching, or being physically forced to have sexual intercourse?”). Physical dating violence was measured using one item from the Youth Risk Behavior Survey (i.e., “Someone you were dating or going out with physically hurt you on purpose, such as being hit, slammed into something, or injured with an object or weapon?”). Finally, sexual harassment was measured using two items from the American Association of University Women’s Survey on Sexual Harassment (Lipson 2001), with questions related to unwanted sexual comments (i.e., “Another student made sexual comments, jokes, gestures, or looks about you?”) and sexual rumors (i.e., “Another student spread sexual rumors about you?”).

Poisson regression and logistic regression models were used to estimate the intent-to-treat effect to determine differences between girls in the intervention and comparison groups, at the 6-month follow-up. The study authors did not conduct subgroup analyses.

The IMpower program (also known as No Means No) was first implemented in Nairobi, Kenya (Edwards et al. 2021). Thus, before implementing the IMpower curriculum, community members living on the Indian Reservation (i.e., Tribal Council members, Tribal Health Board members, school personal, parents, and youth) engaged in informal discussions regarding the intervention. During these discussions, school and community partners provided feedback on the self-defense programming, as several adaptations were made to ensure community relevance. Specifically, this included the adaption of local language into the curriculum and modifying scenarios to be relevant to the local context. Overall, Tribal community leaders felt the IMpower program aligned most with their values (i.e., bravery and perseverance) and would address their community needs.

The IMpower curriculum was developed by IMpower United and is implemented by No Means No Worldwide, a nonprofit organization that has implemented child sexual abuse and sexual assault prevention programming in East Africa since 2012 (Edwards et al. 2020). All program instructors are trained and certified to deliver the curriculum. For additional training information, visit the IMpower United and No Means No Worldwide websites.

These sources were used in the development of the program profile:

These sources were used in the development of the program profile:

Cook–Craig, Patricia G., Ann L. Coker, Emily R. Clear, Lisandra S. Garcia, Heather M. Bush, Candace J. Brancato, Corrine M. Williams, and Bonnie S. Fisher. 2014. “Challenge and Opportunity in Evaluating a Diffusion-Based Active Bystanding Prevention Program: Green Dot in High Schools.” Violence Against Women 20(10):1179–1202.

Edwards, Katie M., Laura Siller, Leon Leader Charge, Simone Bordeaux, Damon P. Leader Charge, and Ramon Herrington. 2020. “Efficacy of a Sexual Abuse Prevention Program With Children on an Indian Reservation.” Journal of Child Sexual Abuse 29(8):900–10.

Gidycz, Christine A., Amy Van Wynsberghe, and Katie M. Edwards. 2008. “Prediction of Women’s Utilization of Resistance Strategies in a Sexual Assault Situation: A Prospective Study.” Journal of Interpersonal Violence 23(5):571–88.

Kann, Laura, Steve Kinchen, Shari L. Shanklin, Katherine H. Flint, Joseph Hawkins, William A. Harris, Richard Lowry, Emily O’Malley Olsen, Tim McManus, David Chyen, Lisa Whittle, Eboni Taylor, Zewditu Demissie, Nancy Brener, Jemekia Thornton, John Moore, and Stephanie Zaza. 2014. “Youth Risk Behavior Surveillance—United States, 2013.” Surveillance Summaries 63(4):1–168.

Lipson, Jodi (ed). 2001. Hostile Hallways: Bullying, Teasing, and Sexual Harassment in School. Washington. D.C.: American Association of University Women.

Orchowski, Lindsay M., Katie M. Edwards, Jocelyn A. Hollander, Victoria L. Banyard, Charlene Y. Senn, and Christine A. Gidycz. 2018. “Integrating Sexual Assault Resistance, Bystander, and Men’s Social Norms Strategies to Prevent Sexual Violence on College Campuses: A Call to Action.” Trauma, Violence, and Abuse 21(4):811–27.

Rutman, Shira, Alice Park, Mei Castor, Maile Taualii, and Ralph Forquera. 2008. “Urban American Indian and Alaska Native Youth: Youth Risk Behavior Survey 1997–2003.” Maternal and Child Health Journal 12(1):76–81.

Warne, Donald, Kristen Dulacki, Margaret Spurlock, Thomas Meath, Melinda M. Davis, Bill Wright, and K. John McConnell. 2017. “Adverse Childhood Experiences (ACE) Among American Indians in South Dakota and Associations With Mental Health Conditions, Alcohol Use, and Smoking.” Journal of Health Care for the Poor and Underserved 28(4):1559–77.

Following are CrimeSolutions-rated programs that are related to this practice:

Programs to Reduce Dating and Sexual Violence for Youth and Young Adults

This practice involves a range of prevention and intervention programs that are designed to address problems associated with dating violence for youth and young adults. The practice is rated Effective for reducing the perpetration of dating violence and improving dating violence knowledge and attitudes. The practice is rated Ineffective for reducing dating and sexual violence victimization, reducing sexual violence perpetration, and for improving bystander behaviors.

Evidence Ratings for Outcomes

	Attitudes & Beliefs - Dating violence knowledge
	Attitudes & Beliefs - Dating violence attitudes
	Crime & Delinquency - Violent offenses
	Victimization - Bystander behavior and intentions
	Crime & Delinquency - Sex-related offenses
	Victimization - Sexual abuse/exploitation
	Victimization - Domestic/intimate partner/family violence

Why might a practice's outcome ratings differ from the ratings of specific programs encompassed by that practice?