The purpose of the study was to explore the impact of interventions by Sexual Assault Nurse Examiners/Sexual Assault Response Teams (SANE/SART) on the judicial process. The goal of this study was to test the efficacy of SANE/SART programs as a tool in the criminal justice system. The American Prosecutors Research Institute and Boston College tested the hypotheses that SANE/SART exams increase arrest and prosecution rates. In testing this hypothesis, the project team sought to answer five primary research questions: (1) Is the arrest rate higher in cases where a SANE/SART exam is performed as compared with cases in which no exam is performed?, (2) Is the indictment/charging rate higher in such cases?, (3) Are guilty pleas more likely to be entered in such cases, and are pleas likely to be to the existing charge or to a lesser charge?, (4) Is the conviction rate higher in such cases?, and (5) Is the sentence more severe in such cases?
In addition, the project team examined the participation of victims in the criminal justice process and the types of services that were offered them. As a large portion of SANE/SART programs focus on understanding victims' reactions to sexual assault and ensuring proper treatment to minimize the chance of further trauma, a central hypothesis to be tested was that improved case outcomes may be a result of increased participation by the victim in the identification, apprehension, and prosecution of the perpetrator. Moreover, the level of services offered and provided to victims, particularly those related to prosecution would likely affect case outcomes as well. Both the victim's participation in the criminal justice system and specifics of SANE/SART services, including evidence collection, were considered in determining the true impact of SANE/SART interventions on case outcomes.
The researchers chose a quasi-experimental design for the study as the performance of a Sexual Assault Nurse Examiners/Sexual Assault Response Teams (SANE/SART) exam could not be randomly assigned, thus making an experimental design impossible. The research study focused on differences in case outcomes in selected prosecutorial districts between cases in which a SANE exam was performed or there was a SART response and cases in which a SANE or SART intervention was not performed. SANE/SART and non-SANE/SART cases between 1997 and 2001 from Sedgwick County (Wichita), Kansas, Suffolk County (Boston), Massachusetts, and Monmouth County (Freehold), New Jersey were drawn randomly from police incident reports and the data were then matched to records in the SANE/SART programs and/or the prosecutor's office. In all sites, the project team also made distinctions between cases involving only a SANE exam and cases in which a SART responded as well.
Data to address the primary questions of the study were gathered on-site by the SANE/SART program staff and members of the project team. A five-day site visit was required as project team members physically reviewed each case file to extract the data. To facilitate the site visit, the cases were selected in advance and assigned unique identifiers to ensure confidentiality.
The research team developed three standardized records abstraction forms to collect data: (1) the incident form collected data from police reports and the prosecution files about the actual sexual assault, (2) the case abstraction form collected prosecution data and case outcome data drawn from the prosecutors' case files, and (3) the SANE/SART data collection form abstracted information about the SANE/SART intervention from the SANE/SART files. Staff members in the SANE/SART programs and members of the project team were responsible for extracting the data from the various reports and files in each of the prosecutorial districts. In total, data were collected on 530 cases (108 SANE cases, 151 SANE/SART, and 271 non-SANE cases).
Originally, when the study was first conceptualized, researchers proposed five study sites. However, due to some challenges, the study team reduced the proposed number of study sites to three. The final sites were determined based on availability of data and likelihood of obtaining a sufficient non-SANE sample. Therefore, the study team selected sites where the SANE program was implemented in the late 1990's, thus making it possible to collect a sufficient number of non-SANE cases. As a result, the three study sites selected for the study were Sedgwick County (Wichita), Kansas, Suffolk County (Boston), Massachusetts, and Monmouth County (Freehold), New Jersey. Cases that were opened and closed between 1997 and 2001 were randomly selected from police incident reports in New Jersey and Kansas and the state crime lab in Massachusetts, as all sexual assault reports were automatically sent to the crime lab. From those data sources, the project team obtained a list of adult female sexual assault reports during that time period. Data collected from the police incident forms were from the largest police departments in the participating jurisdictions. Staff from the SANE/SART program in each jurisdiction reviewed the list and identified all cases in which a SANE/SART exam was performed. The project team then split the list into two groups (non-SANE/SART cases and SANE/SART cases) and then randomly selected up to 125 cases in each category. In total, data were collected on 530 cases (108 SANE cases, 151 SANE/SART, and 271 non-SANE cases).
Although every attempt was made to follow the random selection and matching protocol, the sampling strategy was not able to be implemented in one site because the prosecutor's office tracked cases by victim and defendant name, not by a police report or incident number. Working with the police department and the state crime lab, a list of adult female sexual assault victims was identified. The police department and a SANE nurse culled the list into a SANE and a non-SANE sample and provided the list of victim names to the prosecutor's office so files could be matched. Once the match occurred, a unique case identifier was assigned to the file to maintain victim anonymity and confidentiality.
This study focused on the impact of SANE/SART interventions on the formal criminal justice response, not the victim's decision or likelihood to report the assault to the police or to obtain services. As such, the cases examined were only those in which a report had been made to law enforcement. The victims may or may not have had a SANE/SART intervention, which served as the theoretically relevant independent variable in the study. The research team collected data that allowed the team to control for any selection bias that may have arisen from cases not processed through the SANE/SART system.
The major impact of using only three sites is on the ability to generalize to a larger population. Because of contextual differences and the smaller sample size, comparisons of differences between SANE only, SANE/SART, and non-SANE/SART cases across all sites is recommended rather than within-site and cross-site comparisons.
SANE/SART cases that were opened and closed between 1997 and 2001 in Sedgwick County (Wichita), Kansas, Suffolk County (Boston), Massachusetts, and Monmouth County (Freehold), New Jersey.
An incident form was designed to collect data from police reports and the prosecution files about the actual sexual assault.
A SANE/SART data collection form collected information about the SANE/SART intervention from the SANE/SART files.
A case abstraction form was designed to collect prosecution data and case outcome data from the prosecutors' case files. Most case files contained a case summary and disposition sheet that served as the primary source of data.
Administrative records data
The incident form collected details about the incident including the time between incident and report, use of force, the nature of the victim/offender relationship, types of evidence collected, types of services offered to the victim, previous suspect arrests and convictions, and other demographic information about the victim and the perpetrator. The case abstraction form was used to extract information such as whether charges were filed, the specific charge(s) filed, whether there was a guilty plea and to what charge, whether a trial was held and the outcome, whether there was an appeal and the outcome of the appeal, what the sentence was, and participation of the victim in the prosecution. With regard to the latter, the team extracted information regarding the victims' cooperation with the prosecutor, whether the victim appeared at Grand Jury proceedings or testified at trial, and whether the victim gave a victim impact statement (where applicable). The SANE/SART data collection form collected information about the evidence collected during the victim's exam, the nature of the assault, the evidence/forensic kits collected, the victim's demeanor, the weapon(s) used, the number of assailants, and the victim/offender relationship.