Rationale for this Study: Sexual assault and harassment is a widespread and growing problem that impacts readiness. In 2018, 6.2% of active duty women and 0.7% of active duty men were sexually assaulted; across their military careers, about 20% of female Service members are sexually assaulted. The military Services have been fighting this “invisible war,” via prevention and response efforts, for a decade and a half, and yet rates are not decreasing; they are increasing. Clearly, a change in approach is needed. This Funding Opportunity Announcement makes an ambitious and audacious request: conduct a bottom-to-top study to provide policymakers with evidence-based guidance about how to improve prevention.

This request comes at a good time. The last several decades have seen unprecedented developments in the prevention of complex behavior problems. Thirty years ago, we knew very little about how to prevent problems such as sexual assault, child abuse, drug use, and suicide. Today, our understanding of (a) risk factors and social ecology for the target problems and (b) the science of behavior change has made designing high-quality programs “the easy part” (relatively speaking).

The hard part is that the development of efficacious interventions does not necessarily lead to effective, sustained use. Put another way, even if you build a better mousetrap and even if you can convince some people to beat a path to your door, many will stop using it even if it works, and others will modify it to the point where it no longer works. This conundrum has spawned the field of implementation science.

Thus, the Funding Opportunity Announcement demands, and this proposed research will deliver, a study of the factors that may impede or support evidence-based prevention interventions for sexual assault and harassment. In other words, the Department of Defense (DoD) wants the Services to implement interventions that have evidence of working, but knows that, just because a program worked in trials, doesn’t mean it will work in a Service; and just because it is successfully transplanted to a Service, doesn’t mean it will continue to work. What policymakers need is science-based intelligence to implement and sustain effective prevention programming through evidence of what elements are critical and which seem critical, but are not, to implementing and sustaining effective practices.

Objectives:

1. This study will examine the properties of policies that foster the sustainment of evidence-based prevention interventions and the properties of interventions themselves that foster efficacious sustainment. This Funding Opportunity Announcement presciently requested a single research proposal that provides a comprehensive understanding of the multiple influences across the many levels that make up the military: end-users (Service members) to Service agencies to installation up to the DoD itself. The aim is to identify gaps in existing theories of the prevention at all levels and propose a military-specific model of factors that impede and support prevention implementation and sustainment.

2. Because almost all implementation science studies investigate a particular program in a particular setting (even if it’s across sites), the literature is in many ways an impressive collection of case studies that allude to multiple levels of influence but cannot test them. We will establish a new state of the science by testing hypothesized impediments and supports of implementation and sustainment across all levels.

Short-Term and Long-Term Outcomes of the Proposed Research: In the short term, this study will apply and test existing implementation science research in a military setting. In the long term, this intelligence will allow policymakers to focus on the program and policy elements that matter and reduce energy expended on the less important ones.

How the Proposed Research Will Address Prevention Efforts to Reduce the Occurrence of Sexual Assault and/or Harassment for Service Members and the Public At Large: This study will not be the tactic that drives down sexual assault and harassment; it will provide military planners with an evidence-guided strategy (that does not now exist) for how to develop and implement any selected program to drive down sexual assault. The results of this study will provide the evidence-based foundation from which military policymakers can (a) select and tailor evidence-based prevention interventions and (b) develop guidelines and systems for their implementation and sustainment. For once, military planners can have an end-user-to-DoD, evidence-based strategy for sexual assault and harassment prevention. This would be a critical discovery for (a) sexual assault prevention specifically and (b) prevention more generally, as it would be the only study to incorporate the entire ecology in a single investigation.