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Primary prevention of sexual violence in North Carolina: a public health approach.

N C Med J. November/December 2010, Volume 71, Number 6 In addition to supporting these individual-focused strategies, promising evidence supports an approach that targets sexual assault bystanders, which is an innovative intervention combining individualand community-level change strategies [8]. This approach leverages the fact that, although most people will be neither victim nor perpetrator of violence, nearly all people share a desire to live in communities that are violence free. Thus, the bystander approach teaches the majority of the population how to recognize and respond to situations that involve violence and how to— safely—intervene to prevent violence. Moreover, bystander interventions engage participants as supportive allies for violence survivors and teach participants to challenge social norms that support violence, such as how to diplomatically confront a coworker who tells jokes about rape or battered women. In summary, promising evidence exists for primary prevention interventions aimed at eradicating violence against women. Despite such promise, the small number of evidence-based preventions is worrisome, given the prevalence of partner violence and sexual assault. Secondary prevention. Secondary prevention interventions for partner violence and sexual assault aim to prevent survivors’ revictimization by reducing the perpetrators’ violence and by establishing the survivors’ safety. As with primary violence prevention, we have limited empirical evidence supporting the effectiveness of secondary-prevention interventions [9]. There are secondary prevention interventions for partner violence with promising—albeit limited— evidence. Nonetheless, these prevention interventions offer a starting place for building the state’s capacity for violence response. Secondary preventions with promising evidence include survivor advocacy (eg, legal advocacy services, such as helping survivors secure protection orders), shelter services (eg, emergency and transitional housing for survivors and children), and group-counseling interventions for violence perpetrators [9]. Primary Prevention of Sexual Violence in North Carolina: A Public Health Approach