The purpose of the study was to evaluate the Sexual Assault Nurse Program (SANE) through a developed practitioner-oriented evaluation Toolkit. The goal was to teach program staff how to evaluate whether prosecution rates increased in their communities after the implementation of their SANE programs. Additionally, researchers evaluated the training process itself by determining whether the resources provided to the sites for evaluating the program were in fact helpful.
This study selected six sites that had implemented the SANE program (two rural, two mid-sized, and two urban) and provided comprehensive technical assistance to help these programs work through the steps in the Toolkit so that they could evaluate whether the program was having a beneficial impact on prosecution rates. Site staff also worked with their prosecutor's office to be able to report official prosecutor outcomes for the cases being evaluated.
The technical assistance included: the Toolkit itself, group conference calls, webinars, individual consultation by phone and email, and in-person site visits. In addition, information was collected from multiple sources of process data (e.g., field notes, qualitative interviews, quantitative satisfaction surveys) to examine whether the resources provided to the sites were in fact helpful and increased their evaluation capacity.
A stratified, national random sample was used (based off of qualified applicants for the program) to identify six SANE programs (two rural, two mid-sized, two urban) that had organizational readiness to participate in program evaluation. Readiness was defined as those programs had the organizational resources to participate in evaluation learning activities without compromising program operations. These sites then used the criteria provided by the Toolkit to evaluate cases that the SANE program was used on. Some of the criteria required by the Toolkit in selecting eligible cases were only including cases where the victim was over the age of 18, a police report was made, victim has full name and date of birth, there was a medical exam performed, etc.
Longitudinal: Cohort / Event-based,
A stratified, national random sample of facilities that used SANE programs (two rural, two mid-sized, two urban).
SANE cases at the six sites.,
Six SANE sites.
Program Evaluation: Prosecution Results
Program Evaluation: Toolkit Screening Questions
Process Evaluation: Follow-Up Interview
Process Evaluation: On-Site Interview
Process Evaluation: Post-Implementation Interview
administrative records data,
The project includes one dataset with 30 variables and a case count of 1696. It contains variables on site identification, program implementation, case outcomes (such as not charged, plea bargained, trial with acquittal, trial with conviction, and withdrawn) and number of interactions with program sites.
Seventy three SANE sites applied, thirty completed the application in full and ten were deemed eligible. To be eligible, sites had to fulfill the following five requirements: (1) A full time SANE program coordinator; (2) Staffing levels appropriate for the number of patients served per year and geographic area served based off a rating system created from expert advice; (3) Access to the kinds of data needed for the pre/post evaluation design as indicated by affirmative answers to the case documentation questions in the application; (4) A mean score on the ROLE scale above the 25th percentile (i.e. programs scoring in the bottom quartile were disqualified due to concerns that they did not have sufficient organizational readiness and/or support for engaging in this type of evaluation); (5) a letter of support from the prosecutor's office with which the SANE program primarily works granting access to sexual assault prosecution case outcome data. Of the ten eligible sites, six sites were chosen to participate.
All six sites that were evaluated completed the Toolkit evaluation process. Three of the six sites conducted pre-post designs that compared prosecution rates before and after the implementation of their SANE program; the remaining three conducted post-only designs that examined trends in prosecution rates over multiple years in their communities. All six sites participated in process evaluation interviews.
The extent to which the sexual assault case progressed through the system comprised three ordered categories characterizing the ultimate disposition of each case: (1) 1465 cases were not referred/not charged (2) 71 cases were charged by the prosecutor but later withdrawn or acquitted, and (3) 160 cases resulted in a guilty plea or conviction. Cases spanned more than 14 years, from June, 1995 through September, 2009 resulting in a total of 1696 cases.