TDH Booklet4 - Texas Association Against Sexual Assault

A Strategic Plan 

To Prevent Violence 

Against Women 

2004 

in Texas

Eduardo J. Sanchez, M.D., M.P.H. 

Commissioner of Health 

1100 West 49th Street 

Austin, Texas 78756-3199 

http://www.tdh.state.tx.us 

1-888-963-7111 

Ben Delgado 

Chief Operating Officer 

Nicolas Curry, M.D., M.P.H. 

Executive Deputy Commissioner 

January 9, 2004 

The Texas Department of Health (TDH) is pleased to present “A Strategic Plan to Prevent Violence Against 

Women in Texas”, a strategic plan developed by the Violence Against Women Prevention Advisory 

Committee (VAWPAC). This plan is the result of extensive work over the last year by the VAWPAC, a diverse 

group of community-based, public, nonprofit, health care, and research professionals and individuals that 

examined how the problems of sexual assault, domestic violence and stalking could be addressed as a public 

health concern. The VAWPAC utilized Texas based research on prevalence and promising practices in 

prevention in order to develop recommendations about what can be done in Texas to prevent violence against 

women. They also used the results of a survey that looked at current primary prevention activities across the 

state. 

This strategic planning project was funded through a grant from the Centers for Disease Control and 

Prevention (CDC) to the Texas Department of Health, Bureau of Women’s Health. This project focused on 

primary prevention of violence against women because in Texas there are already two state level agencies, 

the Texas Association Against Sexual Assault (TAASA) and the Texas Council on Family Violence (TCFV), 

that plan for and provide intervention services. These organizations worked closely with TDH in this strategic 

planning process. 

We wish to thank the members of the VAWPAC for their efforts and commitment to this project. We would 

also like to especially thank the representatives of TAASA and TCFV for their time and partnership. 

Violence against women is a critical public health concern in Texas. It is an issue that requires a 

comprehensive approach to prevention that goes beyond the current system. These recommendations can 

guide efforts to partner with individuals, organizations and communities in Texas to protect, promote, and 

improve health by working to reduce and eliminate interpersonal violence. TDH cannot begin to implement 

these recommendations alone. Implementation will require commitment from and the mobilization of 

individuals, organizations and communities. We look forward to our continued involvement with other Texas 

partners and strongly encourage others to join with us in our collective efforts to end violence against 

women. Only by working together can we hope to see a day when women and children are spared the 

tragedy of interpersonal violence. 

Sincerely, 

Debra Wanser, R.N., M.P.Aff 

Associate Commissioner for Family Health 

An Equal Employment Opportunity Employer

Acknowledgements 

Violence Against Women Prevention Project Team Members 

Richard Casper, MPH 

Center for Health Training 

Annette Burrhus-Clay, MA 

Texas Association Against Sexual Assault 

Melissa Davis 

Texas Department of Health – Family Planning 

Division Center for Health Training 

Rose Hernandez, LMSW 

Texas Council on Family Violence 

Paula J. McDermott, MPAff, MA 


Division Center for Health Training 

Mary Chapman McIntosh, MEd 


Division 

Violence Against Women Prevention Advisory Committee (VAWPAC) Members 

Cesar Alvarado 

Migrant Clinicians Network 

Margaret Brackley, PhD, APRN, BC 

University of Texas – Health Science Center at San 

Antonio 

Judy Brow, MA, MSSW 

Texas Commission on Alcohol and Drug Abuse 

Cynthia Bunton, MS 

South Texas Family Planning and Health Corporation 

Noel Bridget Busch, PhD, LMSW, MPA 

University of Texas at Austin – Institute on Domestic 

Violence and Sexual Assault 

Swapna Chaudhuri 

Asians Against Domestic Abuse 

Alex A. Fisher, MEd 

Texas Department of Health – Male Involvement 

Projects 

Liz Cruz Garbutt 

Department of Human Services – Family Violence 

Program 

Susan Griffin 

Texas Medical Association 

Lesley Guthrie 

Governor’s Commission for Women 

Crystal Heinz 

Austin SafePlace, Expect Respect School-Based 

Services 

John Hellsten, PhD 

Texas Department of Health – Injury Epidemiology 

and Surveillance 

Jonathan Hook, PhD 

American Indian Resource Center 

Paula Kanter, RD 

Texas Department of Health – Special Supplemental 

Nutrition Program for Women, Infants and Children 

John Kim, LMSW 

Aid to Victims of Domestic Abuse 

Cheri Lee 

Texas Health Resources – Family Violence Prevention 

Initiative 

Lolly Lockhart, PhD 

Rural Health Initiative 

Cissy Lux, BSN, RNC, WHNP 

Health and Human Services Commission – Medicaid

Dena Miller 

Community Advocate – domestic violence 

William R. Moore, CAPT, USAF, LCSW 

Laughlin Air Force Base 

Jodi Park, LMSW-ACP, LPC 

Disability Policy Consortium 

Pam Rodgers 

Texas Office of Attorney General – Sexual Assault 

Prevention and Crisis Services Program 

Tammy Sajak, MPH 

Texas Department of Health – Injury Epidemiology 

and Surveillance 

Liliana Santoyo, MA 

Texas Department on Aging 

Cindi Shearer 

Community Advocate – domestic violence 

Sharon L. Walker, RN, MS, MPH, PhD 

Violence Intervention and Prevention Center – 

Parkland Hospital 

Violence Against Women Prevention Project Contributors 

Joe de la Cerda 

STARs – Students Taking Action for Respect 

TAASA Program 

Andrew Cooper 

STARs – Students Taking Action for Respect 

TAASA Program 

Emiliano Diaz de Leon 

Family Crisis Center – Men’s Nonviolence Advocate 

Travis Duke, MLIS 


Division 

Greta Hillin 


Victoria Hilton, MEd 


Brooke Hinojosa 

Texas Municipal Police Association 

Heather Kamper 

Austin SafePlace – A Safety Awareness Program 

Susan Kolliopoulos, LCSW 


Division 

Mary Ann Longenecker 

Texas Department on Aging 

David McLellan 

Texas Department of Health – Library Services 

Carolyn Medina 

Texas Department of Health – Library Services 

Ramdas Menon, PhD 

Texas Department of Health – Research and 

Public Health Assessment 

Cheryl Nicholson 


Division 

Marsha Robinson 

Community Advocate – Sexual Assault 

Bill Spears 

University of Texas – Health Science Center at 

San Antonio 

Pam Willhoite 


Kimberly Black Wisseman, LMSW 

Austin SafePlace – Disability Services 

Thandi ZiqubuPage, MPH, PhD 

Texas Department of Health – Research and 

Public Health Assessment

Table of Contents 

Executive Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .7 

Foreword - Call to Action . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13 

Introduction - Texas Violence Against Women Prevention Project . . . . . . . .21 

Background paper - Literature Review . . . . . . . . . . . . . . . . . . . . . . . . . . .27 

Plan for Action . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .37 

Glossary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .53 

Notes/Citations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .59 

Bibliography . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .73 

Appendices 

A- Plan Goals/Objectives . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .A-91 

B - Survey Analyses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .B-97 

C - Additional Acknowledgements . . . . . . . . . . . . . . . . . . . . . . . . . . .C-110 

D - Resource Guide . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .D-113 

E - VAW -Related Links . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . E-119

Executive Summary 







This Strategic Plan to Prevent Violence Against Women in 

Texas was developed as a tool to inform Texas stakeholders about 

recommendations and strategies to make primary prevention of 

sexual assault, domestic violence, and stalking a public health 

priority in the state. The report outlines results from a participatory 

strategic planning process led by the Bureau of Women’s Health at 

the Texas Department of Health (TDH), involving key actors 

interested in improving the well-being of Texans by preventing these 

serious health crises. Primarily funded by the Centers for Disease 

Control and Prevention, National Center for Injury Prevention and 

Control, this strategic plan serves as a blueprint for action in Texas. 

A Strategic Plan to 

Prevent Violence Against 

Women in Texas was 

developed as a tool to 

inform Texas stakeholders 

about recommendations 

and strategies to make 

primary prevention of 

sexual assault, domestic 

violence, and stalking a 

public health priority in 

the state. 

Texas is the second largest state in the nation in both 

population and land size. The state has a diverse population – U.S. 

Census Bureau data (2000) indicate that Latinos/Latinas comprise 

over 50 percent of the population in 33 Texas counties. This report 

publicizes significant findings about the current status of sexual 

assault, domestic violence and stalking in Texas, emphasizing the 

unique experiences of Latinas who experience these types of 

violence. The report summarizes primary prevention efforts 

underway in the state, prevention goals and objectives, and 

concrete suggestions for how to address related priority issues. This 

strategic plan clearly identifies violence against women as a public 

health crisis that can be prevented using a public health approach, 

an approach that has been successful in addressing other complex 

health problems. The plan serves as a resource, providing 

background information including a framework for understanding 

causes for the violence, points of intervention, risk and protective 

factors and what current research points to as promising 

components of effective prevention efforts. 

Findings 

Violence against women presents a complex and costly 

problem for the state of Texas. Recent statewide prevalence studies 

report nearly 2 million Texans have been sexually assaulted in their 

lifetimes and fully 47 percent of Texans experience domestic 

violence in their lifetimes. In addition, 113 females were murdered 

by intimate partners in Texas in 2001, resulting in a state homicide 

rate for this type of crime well above the national average. The 

costs are extremely high, particularly for the public health sector, 

and current resources cannot support those who suffer the many 

A STRATEGIC PLAN TO PREVENT VIOLENCE AGAINST WOMEN IN TEXAS 

8


consequences of violence against women. 

Prevention efforts designed to stop sexual assault, domestic 

violence and stalking before they occur are just beginning in the 

state. Over the past twenty years, Texas has emphasized 

intervening to assist and protect victims and their families once 

violence occurs. Likewise, this seems to be the situation nationally 

and internationally, with advocates and public health entities just 

beginning to focus attention on developing concerted prevention 

strategies. Accordingly, little evidence exists to document what 

prevention efforts work. 

Texas can adopt what the most current research shows to be 

promising in preventing violence against women and can contribute 

to the field by evaluating existing and new activities. A survey 

conducted as part of this planning project found that organizations 

and clinics across the state have initiated activities to help prevent 

sexual assault, domestic violence and stalking; however, few 

prevention efforts in the state include serious evaluation components 

either of programmatic design or outcomes. 

The priority issues, recommendations and strategies 

emphasized in this strategic plan incorporate what current research 

shows to be most promising in violence against women prevention. 

Primarily, this means applying a spectrum of interventions focused 

on addressing societal, community, individual and relationship 

factors as well as engaging communities and survivors in design, 

implementation and assessment of culturally appropriate prevention 

activities. Based on the best information available, participants in 

the planning process defined three key issue areas as the focus for 

making primary prevention of sexual assault, domestic violence and 

stalking a public health priority; 1) resources, research and data 2) 

communities, systems and infrastructure and 3) public awareness. 

Resources, Research, and Data 

Access to and effective use of resources, research and data 

will help Texas prevent violence against women. Recommendations 

include: securing new resources and using existing ones collaboratively 

and creatively, evaluating and publicizing effective prevention 

activities in the state, setting clear outcome markers and assessing 

progress in reaching goals, conducting studies to fill information 

gaps, utilizing relevant evidence specific to Texas to implement 

appropriate policies and sharing and linking non-identifying data 

across systems. State entities including advocacy and health 

networks, universities and government agencies will need to work 

9 A STRATEGIC PLAN TO PREVENT VIOLENCE AGAINST WOMEN IN TEXAS


closely with researchers, survivors and practitioners to address this 

issue area. 

Communities, Systems and Infrastructure 

Communities and systems must change infrastructure and 

practices to shift to a society that does not tolerate sexual assault, 

domestic violence, or stalking. The strategic plan emphasizes 

community-driven initiatives including collaborations with leaders, 

advocates, and nontraditional allies, facilitating social change 

organizing that leads to local sustainable action, supporting the 

development of innovative educational models and training based 

on the input of stakeholders and solid data. In addition, strategies 

involve the assessment, design and access to model administrative 

policies for sexual assault, domestic violence and stalking 

prevention across sectors. Public health related entities together with 

advocacy networks, community leaders, government systems and 

other state and local actors will need to facilitate implementation of 

these strategies. 

Public Awareness 

Multiple public awareness strategies designed with diverse 

input and applied in many different settings using various means of 

communication will help Texans understand sexual assault, domestic 

violence and stalking as public health crises. The strategic plan 

recommends involving men in message design and implementation, 

using community-informed public awareness campaigns, carefully 

educating and screening clients in health care settings and 

promoting effective anti-bullying efforts. All efforts should be 

carefully evaluated and adapted based on research. Again, many 

state and community leaders will have to work together, including 

stakeholders in youth education and health care, to appropriately 

inform the population at large and stimulate action. 

Action and Sustainability 

The plan for action summarized above condenses more 

specific goals and objectives created by the Violence Against 

Women Prevention Advisory Committee (VAWPAC), now called the 

Interpersonal Violence Prevention Collaborative (IVPC), representing 

wider input from their constituents. The more detailed document 

appears in an appendix of this report and serves as an additional 

resource in the emerging statewide initiative to focus on prevention 

of sexual assault, domestic violence and stalking as public health 


10


issues. This report contains an extensive bibliography of current 

related research, analyses of the state stakeholder survey of existing 

primary prevention efforts and needs, a record of stakeholders 

involved in the planning process, a resource guide of programs 

underway in the state and nationally and links to many internet 

sites with relevant information. 

Many stakeholders have already committed to working 

together to focus on making primary prevention of violence against 

women a public health priority by signing on to participate in the 

implementation of pieces of the plan for action presented here. In 

addition, many more will be invited to participate in the next phase 

of this initiative. This strategic plan was developed by building on 

the experience and knowledge of those committed to ending sexual 

assault, domestic violence and stalking in Texas. It will be 

implemented only through sustained commitment, creative use of 

resources and continued collaboration, respecting each Texan’s 

ability to help solve these serious health problems. 


FOREWARD - CALL TO ACTION 





FOREWARD - Call To Action 

WHY VIOLENCE AGAINST WOMEN? 

Texas currently faces health crises of enormous magnitude that 

stem from sexual assault, domestic violence 1 and stalking, often 

collectively referred to as violence against women (VAW). The sheer 

size of these problems, along with their associated costs, and the 

complexity of factors that interact to make them so pervasive 

requires immediate attention. The public health sector can lead 

concerted multi-disciplinary efforts to stop sexual assault, domestic 

violence, and stalking in Texas by applying primary prevention 

strategies. No individual, community, or sector in the state is 

immune to these preventable health crises, making every man, 

woman and child living in Texas a stakeholder in ending the 

violence. In addition, Texas faces particular challenges and 

opportunities in addressing VAW because of the rich diversity of its 

population. Texas shares its southern border with Mexico, and 

Latinos/Latinas and African Americans comprise a significant 

percentage of the state’s population. This cultural diversity calls for 

an in-depth understanding and consideration of cultural 

competency in addressing VAW in the state. 

Scope of the Problems 

In 2002, researchers conducted the first-ever representative 

surveys of sexual assault and domestic violence prevalence in 

Texas, providing critical state-level data that help define the 

problems. 2 The health survey focusing on sexual assault found that 

nearly 2 million Texans have been sexually assaulted in their 

lifetimes and that nearly one in ten Texan girls were assaulted 

before they reached age 14. 3 The domestic violence study reports 

the problem as an epidemic in Texas, with fully 47 percent of all 

Texans having been abused in their lifetimes. 4 Both studies confirm 

that these forms of violence go vastly underreported. 5 Moreover, 

findings correspond with international statistics that show that onethird 

of all women are physically or sexually abused in their 

lifetimes. 6 

Many who live with 

violence day in and day 

out assume that it is an 

intrinsic part of the 

human condition. But this 

is not so. Violence can be 

prevented. Violent 

cultures can be turned 

around. 

World Health Organization: 

World Report on Violence and Health 

The public health sector 

must lead concerted multidisciplinary 

efforts to stop 

sexual assault, demostic 

violence and stalking in 

Texas, employing a 

multitude of primary 

prevention strategies. 

The large number of rape, 

physical assault, and 

stalking victimizations 

committed against women 

each year…strongly 

suggest that violence 

against women is 

endemic. 

National Institute of Justice 

The most reliable national data of nonfatal rapes, physical 

assaults and stalking available in the United States come from the 

National Violence Against Women Survey (NVAWS) conducted 

from November 1995 to May 1996. 7 Results show that in this 

country perpetrators (overwhelmingly men) commit physical 

violence against nearly 52 percent of women, while rape or 

attempted rape is committed against 18 percent of women in their 

lifetimes and approximately 1 million women are stalked annually 

in the United States. 8 Women sustain injuries requiring medical 


14


Ninety percent of all rapes 

are planned and, in 87 

percent of the cases the 

assailant either carried a 

weapon or threatened the 

victim with death or bodily 

injury if she resisted. 


& Texas Office of the Attorney General 

At least 80 percent of 

stalkers are men who are 

primarily targeting 

women. These men are 

young to middle-aged, 

with above average 

intelligence. 

Because health care costs 

account for more than 

two-thirds of total cost 

estimates, clearly the 

public health sector must 

take action. 

Many factors interact that 

contribute to the ongoing 

pervasive existence of 

these forms of violence, 

making it difficult to 

pinpoint where and how 

to end it. 

attention in a high percentage of both sexual and physical assaults 

and intimate partners are most likely to commit the violence. 9 

NVAWS report authors find violence against women endemic in the 

United States and a major public health concern with important 

policy implications. 10 

While most females who are assaulted survive the violence, 

men kill many women each year. According to 2001 reported data, 

intimate partners murdered nearly one woman per day in the 

United States. 11 In Texas, males took the lives of 113 females in 

2001 producing a state homicide rate well above the national 

average; 91 percent of the men knew the females they killed. 12 In 

2002 intimate partners killed more than two women every week in 

Texas. 13 While a system for estimating statewide costs of violence 

against women has not been developed, a recent national analysis 

of intimate partner violence (including homicides) yields evidence of 

the economic scope of the problem. 

Costs 

The Centers for Disease Control and Prevention released a 

report in March 2003 analyzing NVAWS data and estimating the 

costs of intimate partner violence, 14 including lifetime earnings for 

fatalities derived from FBI homicide data. 15 They found that costs of 

intimate partner rape, physical assault and stalking exceed $5.8 

billion per year, with nearly $4.1 billion going for direct medical 

and mental health care. 16 In addition, the report estimates nearly 

$0.9 billion in lost productivity from nonfatal domestic violence, and 

$0.9 billion in lost lifetime earnings by those women killed by 

intimate partner violence. 17 These costs reflect only those derived 

from reliable data sources. The actual costs are very likely much 

higher, including untold intangible costs. 18 Because health care costs 

account for more than two-thirds of total cost estimates, clearly the 

public health sector must take action. However, the complexity of 

the issues involved presents challenges that go beyond any specific 

sector. 

Complexity 

Violence against women, while increasingly treated as a 

singular phenomenon, really involves many layers. First, it is 

difficult to classify, sometimes encompassing forced pornography, 

prostitution, forms of slavery, trafficking and other exploitation not 

reflected in sexual assault, domestic violence and/or stalking 

definitions. 19 In addition, children, elders and people living with 

disabilities of both sexes are often times extremely vulnerable to the 

same abuses categorized as violence against women. Of course, 



men are also physically and sexually assaulted and sometimes 

denied quality assistance because services are designed for 

women. Moreover, many factors interact that contribute to the 

ongoing pervasive existence of these forms of violence, making it 

difficult to pinpoint where and how to end it. Violence affects all 

sectors of society, but it is not inevitable. 

WHY PUBLIC HEALTH? 

The health sector recognizes its special interest and key role in 

ending violence. Sexual assault, domestic violence and stalking 

lead to serious health consequences that cause significant economic 

and social burdens for the entire population. However, the health 

sector can build on its unique successes preventing other 

environmental and behavior-related health problems to focus on 

ending violence against women. 20 

Health Outcomes of VAW 

Where violence persists, 

health is seriously 

compromised. 



Physical, sexual and 

psychological abuse occur 

in every country on a daily 

basis, undermining the 

health and well-being of 

many millions of people, in 

addition to costing nations 

vast sums each year in 

health care, legal costs, 

absenteeism from work 

and lost productivity. 



Even though it is difficult to calculate actual costs, a growing 

body of evidence documents the many health outcomes of violence 

against women (see figure 1). 21 Violent acts result in death for 

females throughout the world every day, with homicide the most 

obvious cause of death, while suicide, maternal mortality, AIDSrelated 

and deaths attributed to “accidents” also contribute to fatal 

outcomes. 22 Studies show that pregnant women suffer high rates of 

abuse with profound consequences (including miscarriage) with 

homicide the leading cause of mortality for women in the pre- and 

post delivery time period of pregnancies. 23 However, more often 

females survive violence but experience a whole host of nonfatal, 

yet often devastating health outcomes, including reproductive health 

problems, chronic conditions and a multitude of physical, mental 

and behavioral consequences contributing to negative health. 24 

Accordingly, the international and national entities responsible for 

the well-being of the population have prioritized ending violence 

against women. 

Role of Health Sector 

In 2002 the World Health Organization (WHO) published the 

first world report on violence and health, declaring violence a 

worldwide public health problem. 25 The landmark report publicizes 

Resolution WHA49.25, passed by the 49 th World Health Assembly, 

making prevention of violence a public health priority. 26 Although 

the WHO report includes self-directed and collective violence in 

addition to interpersonal violence, it makes a good case for using 


16


Studies show that 

pregnant women suffer 

high rates of abuse with 

profound consequences 

(including miscarriage) 

with homicide the leading 

cause of mortality for 

women in the pre- and 

post delivery time period 

of pregnancies. 

the public health approach to address violence against women, 

emphasizing primary prevention and the intersections of different 

forms of violence. 

Similarly, the Centers for Disease Control and Prevention 

(CDC), the U.S. public health entity within the Department of Health 

and Human Services, continues to strengthen its commitment to 

ending violence against women through its National Center for 

Injury Prevention and Control. 27 The CDC, as the lead agency 

responsible for implementing the violence and abuse prevention 

related objectives outlined in Healthy People 2010, 28 prioritizes 

filling the gaps that impede the public health response to preventing 

sexual assault, domestic violence and stalking. 29 Accordingly, they 

fund efforts to collect reliable data and evaluate existing and 

potential intervention strategies in order to better define risk and 

protective factors and widely disseminate information about 

effective prevention efforts. The CDC stresses the public health 

approach to ending violence, emphasizing multidisciplinary, 

community-driven, comprehensive prevention efforts. 30 

Figure 1: Health Outcomes of Violence Against Women 

Partner Abuse 

Sexual Abuse 

Child Sexual Abuse 

Fatal 

Outcomes 

Nonfatal Outcomes 

• Homicide 

• Suicide 

• Maternal mortality 

• AIDS related 

Physical Health 

• Injury 

• Functional impairment 

• Physical symtoms 

• Poor subjective health 

• Permanent disabilty 

• Severe obesity 

Negative Health 

Behaviors 

• Smoking 

• Alcohol and drug abuse 

• Sexual risk-taking 

• Phyisical inactivity 

• Overeating 

Source: Center for Health and Gender Equity (CHAGE) Population Report 

Chronic Conditions 

• Chronic pain syndromes 

• Irritable bowel 

syndrome 

• Gastrointestinal 

disorders 

• Somatic complaints 

• Fibromyalgia 

Reproductive Health 

• Unwanted pregnancy 

• STD/HIV 

• Gynecological disorders 

• Unsafe abortion 

• Pregnancy 

complications 

• Miscarriage/low birth 

weight 

• Pelvic inflammatory 

disease 

Mental Health 

• Post-traumatic stress 

• Depression 

• Anxiety 

• Phobias/panic disorder 

• Eating disorders 

• Sexual dysfunction 

• Low self-esteem 

• Substance abuse 



Primary Prevention 

The Violence Against Women Prevention Project focuses on 

primary prevention of violence against women. Recognizing Texas’ 

leadership in providing intervention services and prevention efforts 

to reduce the reoccurrence of violence against women, 31 the project 

heeded the recommendations of major reports from the field that 

call for organized collaborative efforts to stop sexual assault, 

domestic violence and stalking before they occur – primary 

prevention. 32 In so doing, the state has the potential to build on 

existing infrastructure and knowledge of those experienced with 

mitigating violence to create new collaborations and galvanize 

efforts emphasizing primary prevention. Because serious efforts to 

end the complex problems associated with violence against women 

are only beginning, Texas also has the potential to serve as a 

leader nationally and internationally, providing critical data and 

documentation of primary prevention initiatives and outcomes. 

Due to the sheer size and 

complexity of the problems 

and their social and 

economic consequences, 

sexual assault, domestic 

violence and stalking 

affect the well-being of 

every sector, every 

community, every Texan. 

Focusing on primary prevention moves violence against 

women from being viewed as the problem of a specific group (i.e., 

women) or from the domain of a specialized sector, into the more 

realistic realm of the general public. By definition, primary 

prevention relies on a proactive, evidence-based collaborative 

approach to direct many different strategies toward a universal 

audience. 33 Due to the sheer size and complexity of the problems 

and their social and economic consequences, sexual assault, 

domestic violence and stalking affect the well-being of every sector, 

every community, every Texan. 


18

Introduction - Texas Violence 

Against Women Project 





Introduction - Texas Violence Against Women Prevention Project 

Introduction – Texas Violence 

Against Women Prevention Project 

Vision: The primary prevention of domestic violence, sexual 

assault and stalking is a public health priority in Texas. 

Mission: To implement a comprehensive plan for the primary 

prevention of domestic violence, sexual assault and stalking that is 

inclusive of all Texans and that includes strategies focusing on 

individuals and families, communities, state level organizations 

and government. 

This report pronounces 

the beginning of a 

determined initiative to 

implement a multitude of 

innovative strategies to 

make primary prevention 

of violence against women 

a public health priority in 

Texas. 

Principal Statements: Goals, objectives, and strategies aimed 

at the primary prevention of sexual assault, domestic violence and 

stalking will be appropriate for individuals and groups, taking into 

account attributes such as age, gender, culture, disabilities, sexual 

orientation, national origin, religious affiliation and socioeconomic 

status. 

The perspectives of those who have survived sexual assault, 

domestic violence and stalking will be integral to prevention efforts. 

This report marks the end of an intensive strategic planning 

period for a committed group of stakeholders concerned with 

ending sexual assault, domestic violence and stalking in Texas. At 

the same time it pronounces the beginning of a determined 

initiative to implement innovative strategies to make primary 

prevention of violence against women 34 a public health priority in 


In the fall of 2002, the Bureau of Women’s Health at the Texas 

Department of Health (TDH), with funding from the Centers for 

Disease Control and Prevention, began a statewide process to focus 

on prevention of violence against women (VAW) and the role of 

public health. A multidisciplinary project team quickly formed. The 

team was made up of representatives from Texas Association 

Against Sexual Assault (TAASA), Texas Council on Family Violence 

(TCFV), Center for Health Training (CHT) and the Epidemiology and 

Injury Prevention division of TDH. The organizing committee set out 

to facilitate a participatory process to create a prevention-oriented 

strategic plan that would lead to real action, represent the state’s 

unique characteristics and build on existing efforts. 


22


Because personal as well 

as professional experiences 

were relevant to the 

process, the advisory 

committee utilized a 

community-organizing 

model for social change in 

their strategic planning 

and made decisions by 

consensus. 

Survey respondents 

representing diverse 

sectors, advocacy efforts 

and governmental entities 

expressed enthusiasm and 

a willingness to 

collaborate on primary 

prevention of violence 

against women in Texas. 

The project team sought to determine the current state of 

affairs in Texas and nationally. They looked at what prevention 

efforts exist, what works and what would help a coalition of 

stakeholders understand and plan strategies to accomplish such an 

enormous task. Extensive research, the creation, implementation 

and analyses of a statewide survey and the dedication of a diverse 

group of advocates during ten months all contributed to this 

strategic plan to make primary prevention of sexual assault, 

domestic violence and stalking a public health priority in Texas. 

Process 

The project team convened the Violence Against Women 

Prevention Advisory Committee (VAWPAC), a diverse group of 

approximately 30 individuals representing survivors of VAW, 

community-based organizations, statewide advocacy networks, 

professional associations, research institutes, health settings, law 

enforcement and governmental entities. 35 The VAWPAC met initially 

for a two-day conference and then monthly for daylong work 

meetings from April to September 2003, participating in 

workgroups between meetings. 36 Because personal as well as 

professional experiences were relevant to the process, the advisory 

committee utilized a community-organizing model for social change 

in their strategic planning and made decisions by consensus. 37 

In order to include as many communities as possible in the 

large population of Texas, a multitude of stakeholders were invited 

to participate in the process through a virtual council. Utilizing this 

method, more than 50 additional representatives of various 

geographical regions, organizations and groups were able to 

provide feedback throughout the process, receiving regular updates 

via email and having access to the detailed project web pages 

(including findings from the literature, meeting summaries, current 

data and relevant links). 

Accomplishments 

The advisory committee disseminated a survey of Texas 

organizations and clinics entitled Primary Prevention of Violence 

Against Women that resulted in about 350 valid responses from 

throughout the state. 38 The questionnaire results illuminate the 

primary prevention activities in place in health settings as well as in 

various types of community and organizational settings, while 

providing excellent feedback on challenges and barriers to primary 

prevention. Generally, the survey found that prevention efforts are 



underway in Texas in all three areas: sexual assault, domestic 

violence and stalking. Reflecting national trends, very little 

evaluation is currently in place for these efforts, and virtually no 

rigorous scientific assessment of prevention efforts was reported. 

Nonetheless, respondents representing diverse sectors, advocacy 

efforts and governmental entities expressed enthusiasm and a 

willingness to collaborate on primary prevention of violence against 

women in Texas. 

Survey results and an extensive review of research relevant to 

violence against women prevention led to the development of A 

Plan for Action for Texas. 

Future Directions 

As a result of this planning process, a strong foundation now 

exists for a diverse coalition of stakeholders to facilitate primary 

prevention of sexual assault, domestic violence and stalking in 

Texas. The Texas Department of Health through this initiative has 

shown leadership in bringing violence against women into the 

public health purview and the stage is now set to sustain that 

momentum. 


24

Background Paper - Primary 

Prevention of Violence Against Women 





Background Paper - Primary Prevention of Violence Against Women 

Introduction 

Texans can work toward primary prevention of violence 

against women (VAW) as a public health priority by applying 

evidence of strategies that best address related problems to the 

unique characteristics of the state. To that end, this section gives a 

brief overview of current research findings using a public health 

approach to preventing VAW while emphasizing findings relevant to 

the state. 39 

Texas and VAW 

A statewide health survey initiated by the Texas Association 

Against Sexual Assault (TAASA) and the Office of the Attorney 

General (OAG) published in 2003, found that more than two million 

Texans experience sexual assault in their lifetimes. 40 The Texas 

Council on Family Violence (TCFV) reports domestic violence 

occurring in epidemic proportions in the state. 41 Every week, at 

least two abusive men kill their female intimate partners in Texas. 42 

Every week, at least two 

abusive men kill their 

female intimate partners 

in Texas. 

Two out of every five 

Latina Texas women 

experience severe abuse in 

their lifetimes and one of 

every five Latinas in the 

state is forced to have sex 

against her will. 

Texas, the second largest state in the nation in population and 

land size, contains three of the biggest cities in the United States as 

well as vast, sparsely populated regions. 43 In addition, Texas boasts 

a diverse population. U.S. Census Bureau data (2000) predict that 

the Latina/Latino population of the state will grow to 38 percent of 

Texas inhabitants by 2026, with ethnic minorities representing 62 

percent of metropolitan area populations. African-Americans makeup 

at least twice the state percentage (more than 23 percent) in 11 

Texas counties and Latinos comprise over half the population in 33 

counties. 44 Recent studies find that all ethnic groups in the state, 

both in rural and urban areas, suffer from VAW. 45 For example, two 

out of every five Latina Texas women experience severe abuse in 

their lifetimes and one of every five Latinas in the state is forced to 

have sex against her will. 46 Texas serves as a model in the nation, 

having developed a vast network of support services for residents 

despite the state’s geographic and size challenges. 47 Even so, access 

to services can be problematic. The Texas Department of Human 

Services found that support programs reached only about five 

percent of Texas women estimated to have been battered in 2001. 48 

In addition, 18 percent of Texans requesting shelter from domestic 

violence were turned away in 2002 due to lack of space. 49 

Current resources cannot provide support for the number of 

Texans victimized by sexual assault, domestic violence and stalking. 

Concerted primary prevention efforts can, however, effectively 

begin to address the public health crisis VAW presents in the state 

of Texas. 


28


Using the Public Health Approach to Prevent VAW 

As society recognizes VAW as a serious public health crisis, 

policymakers, health practitioners, researchers and anti-violence 

advocates are turning toward a public health approach to confront 

the complex problem of VAW. 5 

A public health approach to addressing a health problem 

(e.g., preventing premature death, disability and injury; reducing 

human suffering and medical costs; protecting a population) 

applies a systematic process to: 

1. Define the problem. 

2. Identify risk and protective factors. 

3. Develop and test prevention interventions. 

4. Implement and disseminate effective strategies. 51 

In addition, the public health approach is community-oriented, 

depending on collective action based on results from data and 

evidence. 52 

The science-based and interdisciplinary nature of the public 

health model, drawing from the fields of medicine, epidemiology, 

sociology, psychology, criminology, education and economics, 

make it particularly appropriate for the complex nature of VAW. A 

public health approach brings together the health, education, social 

services, justice and policy sectors to work in a collaborative effort 

for the prevention of VAW. 53 

Problem Definition 

Different types of interpersonal violence, such as abuse of 

children, elders, immigrants, gay men and lesbians, relate to each 

other in ways that may help inform those who develop efforts to 

end violence. Overwhelmingly, men commit violence against 

women. 54 Researchers and practitioners differ in defining VAW 

precisely, but generally, sexual assault, domestic violence and 

stalking make-up the major areas included in the scope of VAW 

research literature and the CDC has published references to help 

standardize definitions. 55 Nevertheless, current Texas research 

shows that public perception of each of these problems varies 

widely. 56 

The complex nature of sexual assault, domestic violence and 

stalking makes it difficult to understand the many factors that may 

contribute to the problems’ occurrence; likewise, a multitude of 

theories attempt to explain why VAW exists as it does. Researchers 



and practitioners in the field have successfully used a framework 

known as the ecological model to show how different theories 

about root causes of VAW coexist, and to examine the intersection 

of different risk and protective factors as well as potential key points 

where prevention efforts might prove effective. 57 The framework (see 

figure 2) shows the interplay between individual, relationship, 

community and societal factors that influence VAW while taking into 

account political, cultural and environmental causes. 58 

Risk and Protective Factors 

Violence against women crosses class, race, gender, and 

cultural constructs making it difficult to identify with certainty those 

things associated with a woman’s chance of being victimized (risk 

factors), or those that help keep women safe from VAW (protective 

factors). 59 Furthermore, advocates and researchers caution that 

some factors traditionally associated with a woman’s risk (e.g., 

isolation, mental illness, alcoholism) may actually result from the 

violence she experiences. Consequently, when exploring and 

reporting risk and protective factors it is important to take care not 

to contribute to public misperceptions that blame women for the 

abuse they experience. 60 

Increasingly, more attention has turned to identifying male risk 

factors for perpetrating violence. Negative peer relationships (i.e. 

peers who verbally encourage and support physical abuse of 

females) contribute significantly to the risk of male perpetration. 61 

Findings suggest that male abusers are more likely to be 

emotionally dependent, insecure, experience low self-esteem and 

are less likely to be able to control impulses. Male perpetrators are 

also likely to be depressed and exhibit signs of antisocial, 

aggressive and borderline personality disorders. 62 

When exploring and 

reporting risk and 

protective factors it is 

important to take care not 

to contribute to public 

misperceptions that blame 

women for the abuse they 

experience. 

A history of violence in the family of origin reportedly 

constitutes the most significant risk factor for both victimization and 

perpetration. The vast majority of perpetrators and victims report 

experiencing violence as children – either being beaten themselves 

or by witnessing abuse between parents. Poverty and associated 

stress, economic inequality within poverty settings (when one 

partner works/contributes more than the other), isolation and lack 

of social support (especially for women) and alcohol use by both 

men and women are other major risk factors on which many 

researchers agree. 63 New Texas research shows, however, that drug 

and alcohol use may not be a noteworthy risk factor for sexual 

assault victimization, but may be significant for perpetration. 64 This 


30


does not take into account the possibility of increased risk of 

victimization due to drugs such as GBH, the “date rape drug,” or 

other drugs consumed without consent. 

Judith McFarlane, a Texas-based researcher in the public 

health field, has been involved with recent studies that assess risk 

factors for escalated abuse and those that lead to a woman’s 

chance of being killed by her abuser, femicide. 65 Findings support 

previous research showing a woman’s risk of being killed increases 

if the man abusing her has access to a firearm, 66 while other risk 

factors for femicide include estrangement, stalking, forced sex and 

abuse during pregnancy. 67 

VAW occurs at all socioeconomic levels, however, financial 

independence can protect women in some situations, while an 

arrangement where a woman works and her partner does not can 

constitute a risk factor. Education can be protective for both women 

and men, however some researchers assert that education levels 

need to be high before education becomes protective. Residing in 

communities with access to sanctuary (shelters or family support) 

and community norms against VAW (legal or moral pressure) has 

been found to be strong protective factors. 68 

Residing in communities 

with access to sanctuary 

(shelters or family 

support) and community 

norms against VAW (legal 

or moral pressure) has 

been found to be strong 

protective factors. 

Risk and protective factors continue to be explored in their 

complexities. Findings influence efforts to prevent and minimize 

VAW and should be applied carefully with an eye to cultural, 

gender and class biases. 

Developing and Testing Prevention Efforts 

Primary prevention refers to the public health strategy of 

working with the general population to stop a public health 

problem before it occurs. Traditional and current efforts to prevent 

VAW emphasize secondary and tertiary prevention efforts to 

reduce victims’ risks and minimize exposure to violence. 69 

Researchers and practitioners in the field of VAW and injury 

prevention have, however, begun shifting their focus to primary 

prevention in order to transform community beliefs and norms 

about VAW, with a vision to go beyond managing the violence, 

toward anticipating an end to men’s coercive and violent conduct 

toward women. 70 

The field of primary prevention to end sexual assault, domestic 

violence and stalking is still in a formative phase and has not been 

submitted to rigorous evaluation. In fact, the dearth of good 



evaluation information poses a major obstacle for primary 

prevention of VAW. 71 Few programs have undergone long-term, 

comprehensive evaluations to determine what works in terms of 

prevention. The very nature of primary prevention presents a 

challenge to researchers because of the difficulty of measuring 

violence that does not occur. 72 

Researchers recommend longitudinal studies that measure 

behavior change (an actual decrease in the prevalence of VAW as 

opposed to simply heightened awareness) and a true collaborative 

relationship between the research team and community 

participants. 73 Some researchers and practitioners recommend that 

evaluation efforts come from an explicit theory used in developing 

the prevention activity itself. 74 Research on VAW prevention efforts 

emphasizes the importance of collaboration and focusing efforts on 

both males and females. 75 

Adoption and Dissemination of Effective Strategies 

Although a significant gap in long-term evaluations of 

primary prevention of VAW exists, research shows some promising 

trends. A growing body of research addresses program-specific 

evaluation activities, particularly sexual assault prevention 

programs. 76 Much of this literature focuses on outcome evaluation 

– measuring whether a program or effort has reached its goals and 

objectives. Many researchers point to the need for case studies of 

model programs or best practices, to which efforts can be 

compared. 77 However, in order to arrive at such “best practices,” 

long-term evaluation must be conducted with a variety of primary 

prevention efforts. Until that time, we cannot say for certain “what 

works” in the field of VAW prevention, but we can indicate with 

some confidence, “what seems to work” about prevention efforts. 

The very nature of 

primary prevention 

presents a challenge to 

researchers because of the 

difficulty of measuring 

violence that does not 

occur. 

Due to the devastating nature of VAW, stakeholders must work 

with the best information currently available (despite gaps) to 

develop and implement primary prevention efforts. Including and 

carefully reporting evaluation and outcome measures in all 

prevention efforts will contribute needed information about characteristics 

of effective strategies. 

Promising Practices in VAW Prevention 

The following summarizes promising trends and key 

components of VAW primary prevention efforts that will help Texas 

implement priority recommendations. 


32


Cultural Competency 

Success in ending sexual 

assault, domestic violence, 

and stalking in the state 

depends on cultural 

competency during all 

stages of planning, 

implementation, and 

evaluation of prevention 

efforts. 

Given the diverse make-up of Texas, success in ending sexual 

assault, domestic violence and stalking in the state depends on 

cultural competency during all stages of planning, implementation, 

and evaluation of prevention efforts. Cultural competency goes 

beyond providing linguistically appropriate materials or services, as 

emphasized in an award-winning essay of a University of Texas 

medical student that states: 

Competence encompasses an appreciation for the ways in 

which culture shapes a patient’s values, beliefs, and health 

behaviors; an understanding of how these…intersect with the 

health care system; and most importantly it involves action to 

devise interventions that meet the culturally unique needs of 

patients…to institutionalize cultural knowledge. 78 

Competency involves education and training but also policies 

and programs that involve people from different cultures in 

leadership roles. 

The Texas Council on Family Violence recently completed an 

extensive three-year assessment and planning process involving 

data collection, community audits, interviews with service providers 

and 34 focus groups with underserved populations. 79 They found 

that many groups face cultural barriers leaving critical needs 

unmet. Their plan includes specific recommendations to better serve 

people with disabilities, people who are elderly, people with mental 

illness, people with substance abuse problems, people who are 

immigrants, people of color and people who are lesbian, gay, 

bisexual or transgender (LGBT). Prevention efforts can build on 

Texas-specific findings related to different cultures and VAW. 

Traditional intervention and prevention activities often derive 

from a mainstream, white, middle class model. Research on cultural 

competence in VAW prevention activities suggests that those 

mainstream efforts are often ineffective with marginalized and 

disenfranchised populations. 80 Effective prevention efforts consider 

elements such as language, social mores, and access to 

information. Program content can be adapted appropriately to the 

needs of specific groups and can address the particular challenges 

and barriers they face. 81 



Engaging Survivors 

Thirty-odd years after the anti-violence movement coalesced in 

the 1970s, advocates and researchers acknowledge that aspects of 

the movement have strayed from its grassroots, woman-positive 

origins. Statistics on prevalence of VAW have not decreased 

significantly, and studies show that existing intervention services do 

not adequately meet the needs of many victims. Advocates worry 

that in overlooking the voices of survivors, intervention and 

prevention services may not have relevance for the general public. 

In response, the movement has begun to re-emphasize the essential 

perspectives of those who have survived sexual assault, domestic 

violence and/or stalking. TCFV and other coalitions have started 

“listening projects” where advocates ask survivors broad questions 

about their experiences in order to garner a more complete 

understanding of the nature of VAW and what can be done to 

prevent it from occurring. 82 Survivors increasingly participate in 

focus groups and take leadership on councils, boards and informal 

community groups that influence VAW prevention and intervention 

efforts. 83 

Advocates worry that in 

overlooking the voices of 

survivors, intervention and 

prevention services may 

not have relevance for the 

general public. 

Community Organizing 

Effective prevention efforts create networks of community 

groups, churches, public sector agencies, and educational settings 

in order to strengthen the movement. 84 Increasingly, practitioners, 

researchers and advocates acknowledge the need to stimulate 

citizen participation in collaborative social change movements to 

end VAW. The anti-violence movement generally now recognizes 

that those most affected by VAW – individuals, families and 

communities – are often left out of efforts to prevent violence. 

Traditionally, “experts” develop and implement solutions in a 

hierarchical manner, imposing programs and activities on target 

populations. Acknowledging that community members are the 

ultimate experts on VAW increases effectiveness of prevention 

efforts. Long ignored community residents and community-based 

organizations can provide critical guidance in developing, testing, 

and building public support for prevention programs that consider 

the complexity of diverse communities. 85 Citizen participation in 

formulating solutions to VAW ensures that prevention activities 

address overlapping problems (i.e. poverty and VAW, racism and 

VAW, etc.) and are relevant to community members. 86 Successful 

community organizing builds collective power to impact policies, 

bring about institutional change and eventually change social 

Citizen participation in 

formulating solutions to 

VAW ensures that 

prevention activities 

address overlapping 

problems (i.e. poverty and 

VAW, racism and VAW, 

etc.) and are relevant to 

community members. 


34


norms. 87 

Spectrum of Strategies and Actors 

Research on successful prevention of injuries and other health 

problems emphasizes the need to apply a spectrum of strategies 

involving many actors, including non-traditional allies in the 

development, implementation, and evaluation of efforts. 88 In 

addition to undertaking public awareness efforts and education to 

change individual behaviors, effective prevention efforts focus on 

systems and comprehensive solutions that also influence policy and 

legislation. 

Eventually these efforts 

will lead to a society that 

will no longer tolerate 

violence. 

For VAW prevention in Texas this means applying evidence of 

the influence health care professionals can have in helping people 

who suffer from VAW. Many people access the health care system 

who do not seek support from services specific to VAW, so health 

care professionals have the opportunity to educate and influence 

both men and women. In addition, advocates of VAW prevention 

promote involving men, including former perpetrators, in the 

dialog. 89 Effective prevention efforts focus on including men as 

essential allies in ending VAW. 90 

Conclusion 

Emphasizing primary prevention of VAW as a public health 

priority holds great promise for the state of Texas and beyond. 

Viewing the issues of sexual assault, domestic violence and stalking 

through the lens of the public health model helps clarify the great 

need to focus resources and concerted efforts on stopping the 

violence before it occurs. 

Clearly defining these issues and the factors that contribute to 

their existence requires culturally competent action using a 

comprehensive approach. The problems occur at such high rates 

that they have become part of what is considered normal by many 

Texans. Trying to understand and stop VAW can seem 

overwhelming due to its complex nature. But the research shows 

that other complex health problems have been successfully 

addressed using a multidisciplinary, evidence-based, communitycentered 

public health approach. It is time to apply such a strategy 

to stop the violence and its devastating consequences in Texas. 

As stakeholders across the state implement the plan outlined in 

this document, Texans and others interested in stopping VAW will 

be able learn from the principles emphasized here. When survivors 

of VAW, community leaders and advocates from many affected and 

influential groups come together to plan, put into action, evaluate, 

and share prevention efforts and outcomes, the potential for change 

is significant. Eventually these efforts will lead to a society that will 


Plan for Action 







The many stakeholders who contributed to A Strategic Plan to 

Prevent Violence Against Women in Texas created this Plan for 

Action in an effort to ensure the timely implementation of steps to 

end sexual assault, domestic violence and stalking in Texas. Based 

on the best information available, the Violence Against Women 

Prevention Advisory Committee (VAWPAC) has defined priority 

issue areas, recommendations and strategies that form the Plan for 

Action. In addition to the general information on VAW prevention, 

the public health model and promising practices presented in the 

Background Paper, relevant research that contributes to the plan 

precedes the recommendations and strategies for each issue area: 

1) Resources, Research, and Data, 2) Communities, Systems, and 

Infrastructure, and 3) Public Awareness. In order to be successful, 

action partners will strive to incorporate culturally competent, 

data-driven information and the perspectives of those who have 

survived domestic violence, sexual assault and stalking into 

prevention efforts. 

To arrive at this initial Plan for Action the VAWPAC developed 

numerous specific goals and objectives detailed in Appendix A. 

Workgroups then proposed recommendations based on criteria, 

such as: importance, do-ability, community-driven, connection to 

public health, timing (foundation for further action), filling gaps, 

involvement of non-traditional allies/community leaders and 

primary prevention (not early intervention). The VAWPAC then 

discussed, amended, and came to consensus on this initial plan for 

action, intending to ultimately work for the implementation of all 

goals and objectives included in Appendix A. 

The partners listed under each recommendation are those that 

have already committed to some level of involvement in working to 

implement related strategies. More actors will be invited to 

participate on workgroups and in advisory roles. Estimated 

timelines for completion of related objectives can also be found in 

Appendix A. 


38



RESOURCES, RESEARCH, and DATA 

Texans must have access to and utilize effectively, a multitude 

of resources, research and data in order to stop sexual assault, 

domestic violence and stalking. 

Significance: 

A public health approach to prevention applies strategies that 

demonstrate cost effective benefits for the most people possible in 

the community at large. Designing, implementing and evaluating 

prevention efforts based on the best information available cannot 

be overemphasized in trying to end violence against women in 

Texas. Every step of the public health prevention model defining the 

problem, identifying risk and protective factors, developing and 

testing prevention efforts, adopting and disseminating effective 

strategies rely on data and evidence. Only then can resources be 

used most effectively. 

Current Status: 

In Texas as elsewhere, big gaps in rigorous research, 

evaluation, and data collection make effective prevention efforts 

difficult to define or implement. Although many stakeholders 

engage in primary prevention efforts, few activities in the state 

currently emphasize culturally appropriate research and data 

collection. A survey of Texas organizations and clinics conducted as 

part of this strategic planning process found the majority of the 

almost 350 respondents do not engage in research or data 

collection. 91 Nonetheless, momentum seems to be gaining in 

recognizing the importance of directing resources toward these 

activities. 92 

Researchers recently conducted the first statewide evidencebased 

prevalence and awareness studies in Texas for both sexual 

assault and domestic violence with important implications for 

defining and ending these complex problems. 93 Notably, both 

surveys included important information about specific ethnic and 

age groups in the state, making them a good starting point for 

future research. 

Within Texas, well-respected university researchers and 

institutes contribute significantly to current information regarding 

risk and protective factors for potential victimization and 

perpetration, as well as the potential for health care professionals 



to help prevent VAW. For example, Judith McFarlane at Texas 

Woman’s University in Houston, together with colleagues, has 

contributed significantly to research assessing risk factors for 

femicide, health care professionals’ ability to prevent VAW, 

implications of intimate partner stalking, gun availability, abuse 

among Latina pregnant women and effects of VAW on children. 94 

Much of this research takes place in Texas among the state’s diverse 

population and involves high levels of collaboration. Likewise, state 

agencies are increasingly working together and with service 

providers, research institutes and advocates to create shared 

methods of tracking important data. 

Future Directions: 

Texas stakeholders want to know what works to end sexual 

assault, domestic violence and stalking in their communities so that 

they may utilize limited resources effectively and garner support for 

funding successful strategies. They plan to collect culturally 

appropriate data through research that includes community 

engagement, longitudinal studies and assessment of clearly defined 

outcome markers, in order to understand, design, implement and 

evaluate prevention efforts. In so doing, Texas will demonstrate 

leadership in contributing to national and international efforts to 

better understand the complexities of violence against women, while 

providing badly needed evidence of strategies that show promise in 

ending sexual assault, domestic violence and stalking. 


40



RESOURCES, RESEARCH, and DATA 

Texans must have access to, and utilize effectively, a multitude 

of resources, research and data in order to stop sexual assault, 


Recommendation: 

Identify and secure necessary resources to implement the 

strategic plan. 

Strategies: 

1. Identify potential funding sources, write grant proposals, 

and publicize plan and successes. 

2. Use existing resources creatively. 

Partners: 

Texas Department of Health – Family Planning Division, Texas 

Association Against Sexual Assault, Department of Human 

Services – Family Violence Prevention Program, Texas Council 

on Family Violence, South Texas Family Planning Health 

Corporation, Migrant Clinicians Network 


Evaluate and report benefits of prevention activities for sexual 

assault, domestic violence and stalking in Texas. 

Strategies: 

1. Create workgroup of academic and state entities involved 

with relevant research/studies to develop Texas-specific 

cost estimates of sexual assault, domestic violence and 

stalking. 

2. Conduct an empirically based evaluation of existing 

prevention efforts in order to conduct a cost/benefit 

analysis. 

3. Build on current research to examine the relationship 

between social indicators and sexual assault, domestic 

violence and stalking. 

Partners: 


Association Against Sexual Assault, University of Texas – 

Institute on Domestic Violence and Sexual Assault, Texas 

Department of Human Services – Family Violence Prevention 

Program, Texas Council on Family Violence, Texas Office of 

Attorney General – Sexual Assault Prevention and Crisis 

Services Program, South Texas Family Planning Health 





Evaluate progress in making prevention of sexual assault, 

domestic violence and stalking public health priorities in 


Strategy: 

1. Create interdisciplinary workgroup to designate and assess 

outcome markers. 

Partners: 


Association Against Sexual Assault, Texas Department of 

Human Services – Family Violence Prevention Program, Texas 

Council on Family Violence, South Texas Family Planning 

Health Corporation, Migrant Clinicians Network 


Utilize Texas-specific research to implement policy that will aid 

in the prevention of sexual assault, domestic violence and 

stalking. 

Strategies: 

1. Form workgroup to prioritize policy initiatives (at the 

legislative, organizational and other levels) based on 

stakeholder input and existing research. 

2. Facilitate the effective use of existing research in advocating 

for the implementation of policy initiatives. 

Partners: 


Association Against Sexual Assault, Texas Council on Family 

Violence, Migrant Clinicians Network 


Share and link non-identifying data among systems in Texas 

to support the prevention of sexual assault, domestic violence 

and stalking. 

Strategies: 

1. Create workgroup of diverse entities that collect and utilize 

data to identify available and missing data. Ensure that 

advocates aware of client confidentiality issues are part of 

decision-making process. 

2. Establish infrastructure for the ongoing exchange of 

appropriate prevention-oriented information. 

Partners: 

Texas Department of Health – Family Planning Division, 

Department of Texas Human Services – Family Violence 

Prevention Program, South Texas Family Planning Health 



42



COMMUNITIES, SYSTEMS AND INFRASTRUCTURE 

Texans must work to change infrastructure and norms in their 

own communities and systems (social, economic, political) that 

allow sexual assault, domestic violence and stalking to occur, 

creating an environment that does not tolerate violence. 

Significance: 

Studies and literature concerned with ending violence against 

women emphasize the importance of directing prevention efforts 

toward multiple levels, working in many sectors of society 

simultaneously. Community engagement that stimulates collective 

action is critical to solving the complex problems of sexual assault, 

domestic violence and stalking. The people who form part of each 

community have the greatest potential to understand and influence 

the many variables, including infrastructure and system conditions 

that currently give rise to violence and those that will stop it. 


Reviews of sexual assault, domestic violence and stalking 

prevention efforts show that most programs and activities focus on 

influencing individual or relationship factors, with few efforts 

directed toward the community or societal levels. 95 At the same time 

the literature and practitioners emphasize collaboration and 

community-based organizing, pointing to the need for integrating 

primary prevention into governmental systems and public policies. 96 

Researchers highlight programs that: center on locally planned and 

directed actions, build on current successes, incorporate what 

resonates with the community, keep messages simple and 

emphasize diversity and collaboration with social systems (e.g. the 

workplace, faith-based organizations, neighborhoods, families and 

informal networks). 97 

Texas efforts seem to reflect these findings. The VAW primary 

prevention survey found that current efforts center on changing 

individual knowledge and behavior with about half the respondents 

organizing community-based efforts (mostly teaching or training) to 

prevent sexual assault and domestic violence. Higher percentages 

of stakeholders report collaborating with other groups, local 

leaders, and advocates. Few respondents emphasize high-visibility 

community-led prevention efforts, though anecdotally much 

enthusiasm stems from these types of activities in Texas. In addition, 

although over half of respondents report administrative policies that 



address sexual assault and domestic violence, only a third of 

stakeholders know of stalking-related organizational policies. 

Stakeholders do little to influence legislative and public policies, 

according to survey results. 98 


Texas recognizes the integral role of communities and systems 

in creating the conditions that either allow or prevent sexual 

assault, domestic violence and stalking. Stakeholders plan to 

engage local community leaders, administrators and advocates in 

order to change policies, infrastructure and norms to stop violence 

against women before it occurs. 


44



COMMUNITIES, SYSTEMS AND INFRASTRUCTURE 

Texans must work to change infrastructure and norms in their 

own communities and systems (social, economic, political) that 

allow sexual assault, domestic violence and stalking to occur, 

creating an environment that does not tolerate violence. 


Facilitate community-based collaborations to address the 

prevention of sexual assault, domestic violence and stalking. 

Strategies: 

1. Convene groups of traditional and nontraditional 

stakeholders including representatives of government and 

community-based organizations. 

2. Utilize the Popular Education for Social Change Model to 

facilitate community input and committed partnerships. 

Partners: 


Office of Attorney General – Sexual Assault Prevention and 

Crisis Services Program, Texas Association Against Sexual 

Assault, Texas Council on Family Violence, Texas Commission 

on Alcohol and Drug Abuse, South Texas Family Planning 

Health Corporation, Migrant Clinicians Network 


Include prevention of sexual assault, domestic violence and 

stalking in administrative policies of the for-profit, not-forprofit 

and governmental sectors. 

Strategies: 

1. Encourage state and local institutions to conduct internal 

reviews and assessments of existing policies related to 

sexual assault, domestic violence and stalking. 

2. Identify, develop and provide access to model policies via 

web-based and other communication means. 

Partners: 


Department of Health – Women Infants & Children, Texas 

Association Against Sexual Assault, Texas Council on Family 

Violence, South Texas Family Planning Health Corporation, 





Train personnel of local and state institutions about sexual 

assault, domestic violence and stalking and its prevention. 

Strategies: 

1. Provide web-based and other access to relevant training 

curricula for use by state and local institutions 

2. Emphasize training within health care settings, educational 

institutions, and nontraditional locations. 

Partners: 





Assault, South Texas Family Planning Health Corporation, 



Provide educational materials for local and state institutions 

and their constituencies about sexual assault, domestic 


Strategies: 

1. Identify and develop high quality and community-driven 

educational materials. 

2. Provide web-based and other access to educational 

materials. 

3. Emphasize health care settings, educational institutions and 

non-traditional organizations for distribution of materials. 

Partners: 



Association Against Sexual Assault, South Texas Family 

Planning Health Corporation, Migrant Clinicians Network, 

Texas Office of Attorney General – Sexual Assault Prevention 

and Crisis Services Program 


46



PUBLIC AWARENESS 

Texans must understand sexual assault, domestic violence, and 

stalking as public health crises and emphasize primary prevention 

interventions that create nonviolent norms and behavior in the 

population at large. 

Significance: 

In order for the population to engage in collective action to 

end public health crises, the community at large must understand 

the problems (their roots, definitions and prevalence) as well as 

each person’s role in contributing to the existence or ending of the 

crisis. A spectrum of interventions that goes beyond educational 

materials are required in order to raise public awareness of 

complex issues like sexual assault, domestic violence and stalking. 99 


Recent statewide studies examining Texans’ perceptions of 

sexual assault and domestic violence found many differing levels of 

understanding of the problems. 100 Not only do Texans diverge 

dramatically in the way they define abuse, but they also vary in 

their interpretation of risk and protective factors for both 

perpetrators and victims. Nonetheless, survey respondents 

overwhelmingly expressed great concern about both issues and do 

not believe the state of Texas is doing enough to address sexual 

assault or domestic violence. 

Generally, public awareness efforts strive to promote 

individual action and change social norms that deem violence 

against women acceptable. 101 Campaigns aim to create social 

expectations for non-violent behavior, change attitudes about risk 

and consequences of taking action and promote through 

demonstration the expectation that people can make changes. 102 

Activities that expose the population repeatedly to related messages 

have culminated in changed attitudes and beliefs. 103 Recent 

grassroots efforts where men take the lead in visibly standing up 

against abuse of women have been very effective, as have efforts 

to change related policy through associate media coverage and 

education. 104 

Screening clients in health care settings, particularly for 

victimization has become a standard practice in many states and 

proponents believe it helps many survivors of abuse access help 



they may not otherwise seek. 105 Recent research shows that even 

brief discussions about VAW in health care settings can improve 

women’s safety and prevent abuse. 106 Additionally, universal 

screening of all males and females may serve as an excellent way 

to raise awareness about sexual assault, domestic violence and 

stalking especially because the public generally respects health care 

professionals. 107 However, many dilemmas accompany the issue of 

universal screening and there are those who oppose screening 

believing it may actually introduce risks for clients. 108 Very little 

literature exists on screening men or women for perpetration, 

though this may also be a useful prevention tool. 109 

In Texas, it seems the majority of prevention efforts focused on 

raising public awareness center on providing educational materials 

and training. 110 Although some excellent media campaigns have 

been introduced to raise awareness in Texas about sexual assault 

and domestic violence, 111 a small percentage of stakeholders report 

engaging in these types of activities or other high-visibility 

community directed efforts. 


Stakeholders must have access to a spectrum of appropriate 

public awareness interventions in Texas. Engaging communities to 

help design, evaluate, and improve strategies to end sexual assault, 

domestic violence and stalking will increase understanding of the 

problems and solutions among the people living in the state. 

Diverse state entities and local stakeholders will need to work with 

advocates to address this critical issue area. 


48



PUBLIC AWARENESS 

Texans must understand sexual assault, domestic violence, and 

stalking as public health crises and emphasize primary prevention 

interventions that create nonviolent norms and behavior in the 

population at large. 


Create positive prevention messages/campaigns for men and 

by men. 

Strategies: 

1. Involve men in all stages of development of public 

awareness campaigns through focus groups and other 

participatory methods. 

2. Utilize a wide spectrum of means and opportunities to 

engage men in stopping sexual assault, domestic violence 

and stalking. 

Partners: 




Assault, Texas Commission on Alcohol and Drug Abuse, South 

Texas Family Planning Health Corporation, Migrant Clinicians 

Network 


Use media campaigns to prevent sexual assault, domestic 


Strategies: 

1. Employ community-driven research methods (e.g., Popular 

Education Model) to create effective and targeted 

messages. 

2. Develop campaigns directed toward multiple intervention 

levels (e.g., individual, relationship, community, society) 

with the goal of changing social norms and promoting 

individual action. 

Partners: 


Association Against Sexual Assault, South Texas Family 

Planning Health Corporation, Migrant Clinicians Network, 

Texas Office of Attorney General – Sexual Assault Prevention 

and Crisis Services Program 




Promote appropriate education and screening of clients in 

health care settings regarding sexual assault, domestic 


Strategies: 

1. Identify evaluations of current screening efforts underway in 

Texas and the United States to determine appropriate 

health screening models. 

2. Provide access to evidence-based information on suitable 

screening tools for use by health care providers. 

Partners: 


Department of Health – Women, Infants & Children, South 

Texas Family Planning Health Corporation, Migrant Clinicians 

Network 


Promote anti-bullying efforts to prevent sexual assault, 


Strategies: 

1. Identify and develop evidence-based and age appropriate 

tools for incorporating anti-bullying messages into school 

curricula and extra-curricular activities. 

2. Involve and respect children and youth in the development 

of anti-bullying curricula. 

Partners: 

Texas Department of Health – Family Planning Division, Austin 

Safe Place School-Based Services, Texas Commission on 

Alcohol and Drug Abuse, South Texas Family Planning Health 



50

Plan for Action

Glossary 





Glossary 

Glossary 

Batterers Intervention and Prevention Programs 

(BIPPs) – Programs targeting batterers and former batterers 

designed to intervene in patterns of violence and prevent future acts 

of violence toward intimate partners. Participants may be court 

ordered or self-referred to the programs. 

Community Based Organization – Formal or informal 

network or organization formed to further a specific mission in the 

community. 

Ecological Framework – An approach to social problems 

suggesting that causal factors are embedded in several levels of 

causality including the individual level, the relationship level, the 

community level and the societal level. 

Faith Based Organization – A formal or informal 

organization or network formed to support communities of people 

subscribing to a particular religion or genre of religion. 

Domestic Violence - Violence between intimates (e.g. spouses, 

domestic partners, boyfriends and/or girlfriends). Domestic 

violence usually involves a pattern of coercive behaviors including 

physical, sexual and psychological attacks used by one person to 

gain control and dominance over another person. Such behaviors 

can include degrading remarks, cruel jokes, economic exploitation, 

punches, kicks, false imprisonment, sexual abuse, suffocating 

actions, maiming assaults, stalking and homicide. 

Interpersonal Violence – violence inflicted by another 

individual or by a small group of individuals where there is no 

clearly defined political motive. The World Health Organization’s 

World Report on Violence and Health divides interpersonal violence 

into two categories: 

• Family and intimate partner violence - that is, violence 

largely between family members and intimate partners, 

usually, though not exclusively, taking place within the 

home. 

• Community violence - violence between individuals who 

are unrelated and who may or may not know each 

another, generally taking place outside the home. 


54

Glossary 

Popular Education - A tool to raise people’s critical awareness 

about the world around them, based on their personal experience. 

Primary Prevention – Targeting the general population to stop 

a public health problem before it occurs in society. 

Priority Issue – An issue identified to be important because it is 

a prerequisite for other actions, it can be realistically accomplished 

and/or it addresses a glaring gap in existing efforts. 

Public Health – An effort organized by society to protect, 

promote and restore the people’s health through the application of 

science, practical skills and collective actions. 

Public Health Model – A systematic process to 1) define a 

public health problem; 2) identify risk and protective factors; 3) 

develop and test prevention interventions and strategies (including 

evaluation); and 4) implement and disseminate effective strategies. 

Secondary Prevention – Approaches that focus on the more 

immediate responses to violence, such as pre-hospital care, 

emergency services or treatment for sexually transmitted diseases 

following a rape. 

Sexual Assault – The act of forcing any type of sexual activity 

onto a person against her/his will or engaging in sexual activity 

with someone who is unable to consent (e.g. a child, someone who 

has a disability or someone under the influence of alcohol or other 

drugs). 

Social Norm – A pattern or trait, attitude or belief taken to be 

typical in the behavior of a social group. 

Stalking - Repeated behaviors directed at a specific person which 

cause fear, involving visual or physical proximity; nonconsensual 

communication; verbal, written, implied threats or some 

combination. 

Strategic Plan – Goals, objectives, strategies and 

recommendations that create a framework for approaching a 

specified vision and mission. 

Tertiary Prevention – Approaches that focus on long-term care 

in the wake of violence such as revictimization, rehabilitation and 


Glossary 

reintegration, and attempts to lessen trauma or reduce the longterm 

disability associated with a public health problem. 

Violence Against Women – Gender-based violence 

encompassing sexual assault, domestic violence and stalking 

directed toward females that demeans, injures or disempowers 

individuals or groups of women and/or girls. 


56

Glossary

Notes/Citations 






1 This report uses the term domestic violence, recognizing that 

intimate partner violence and even family violence are terms used 

widely to represent the same, or similar, problems. 

2 Noel Bridget Busch et al., A Health Survey of Texans: A Focus on 

Sexual Assault, Final Report (Austin, Texas: Institute on Domestic 

Violence & Sexual Assault, August 2003); and Saurage 

Research, Perceptions, and Awareness of Domestic Violence As 

Reported by Residents in the State of Texas: A Quantitative Study 

(Austin, Texas: Texas Council on Family Violence, August 2002). 

3 Busch et al., A Health Survey of Texans, p.iii. In 2001, Texas 

reported 8,169 forcible rapes in the FBI’s Uniform Crime 

Reporting Program. See Crime in the United States – 2001. 

Available online: http://www.fbi.gov/ucr/01cius.htm. Accessed: 

September 25, 2003. 

4 Saurage Research, Prevalence, Perceptions, and Awareness of 

Domestic Violence in Texas, Executive Summary (Austin, Texas: 

Texas Council on Family Violence, February 11, 2003), p. 5. 

5 Busch et al., A Health Survey of Texans, p. iv; and Saurage 

Research, Executive Summary. 

6 Population Reports: Ending Violence Against Women, Center for 

Health and Gender Equity & Population Information Program 

(Baltimore: Johns Hopkins University School of Public Health, 

1999). Available Online: 

http://www.jhuccp.org/pr/l11/violence.pdf. 

7 Patricia Tjaden and Nancy Thoennes, Extent, Nature and 

Consequences of Intimate Partner Violence: Findings from the 

National Violence Against Women Survey (Washington D.C.: US 

Dept. of Justice, Office of Justice Programs; 2000), publication 

NCJ 181867. Eight thousand women and 8,000 men, 18 years 

and older, were surveyed (the women’s survey also contacted 

4,829 ineligible households, 4,608 eligible households that 

refused to participate, and 351 interviews that terminated before 

completion yielding a 71 percent response rate, p. 7). 

8 Tjaden et al., Extent, Nature and Consequences. 

9 Ibid., pp. iii-v. 

10 Ibid., p. v. 

11 The Violence Policy Center analyzes the Supplementary 

Homicide Report (SHR) data submitted to the FBI’s Uniform 

Crime Reporting (UCR) Program each year to compare female 

murders by males in single victim/single offender incidents. See 

When Men Murder Women: An Analysis of 2001 Homicide 

Data (Violence Policy Center: Washington DC, September 

2003). 


60


12 Ibid., Appendix Two – Texas. Texas consistently ranks among the 

15 states with the highest rates of male murders of females in 

single victim/single offender homicides (see 

www.vpc.org/studies for past analyses). 

13 Saurage Research, Executive Summary. Texas Council on Family 

Violence (TCFV) has compiled the names and stories of more 

than 100 women killed in Texas in 2002 by intimate partners 

(see http://www.tcfv.org/info_silenced.html or call 1-800-525- 

1978). 

14 No comparable report exists that includes costs for violence 

committed by individuals not considered intimate partners. 

15 National Center for Injury Prevention and Control (NCIPC), 

Costs of Intimate Partner Violence Against Women in the United 

States, Atlanta, GA: Centers for Disease Control and Prevention, 

2003. Available online: www.cdc.gov/ncipc/pubres/ipv_cost/ipv.htm. 

16 Ibid. 

17 Ibid. 

18 Ibid. 

19 The Texas Violence Against Women Prevention Advisory 

Committee (VAWPAC) will focus their efforts on ending sexual 

assault, domestic violence, and stalking for all Texans, 

recognizing that positive effects of prevention efforts will 

address other forms of violence like child abuse, violence 

against elders, and suicide. 

20 The health sector has successfully reduced the spread of sexually 

transmitted diseases, tuberculosis, and even tobacco use (all 

considered health crises) through application of a public health 

approach that focuses on prevention. See Healthy People 

2010, objectives 15.32 – 15.37. Available online: 

http://www.healthypeople.gov/document. Accessed: September 

15, 2003; Krug et al., World Report on Violence and Health, p. 

3; Linda Saltzman et al., “Violence Against Women as a Public 

Health Issue: Comments from the CDC,” American Journal of 

Preventive Medicine, Vol. 19, No. 4 (2000), p. 325. 

21 See for example, Population Reports: Ending Violence Against 

Women; NCIPC, Costs of Intimate Partner Violence; and 

Jacquelyn Campbell et al., “Reproductive Health Consequences 

of Intimate Partner Violence: A Nursing Research Review,” 

Clinical Nursing Research, Vol. 9, No. 3 (August 2000), pp. 

217-237. 



22 See Population Reports: Ending Violence Against Women; and 

Etienne G. Krug et al., World Report on Violence and Health 

(Geneva: World Health Organization, 2002). 

23 Krug et al., World Report on Violence and Health, pp. 101- 

102. 

24 Ibid., pp. 100-102; and Population Reports: Ending Violence 

Against Women. 

25 Krug et al., World Report on Violence and Health. 

26 Ibid., pp xix-xxi. 

27 See NCIPC, CDC Injury Research Agenda. Atlanta, GA: Centers 

for Disease Control and Prevention, 2002; and Saltzman et al., 

“Violence Against Women as a Public Health Issue,” pp. 325- 

329. 

28 See specifically Healthy People 2010, objectives 15.32 – 15.37. 

29 Ibid., p. 15-5. 

30 NCIPC. CDC Injury Research Agenda. 

31 See Office of the Governor, Criminal Justice Division, Violence 

Against Women Act: Statewide Implementation Plan 2001-2005 

(April 22, 2002); and Texas Council on Family Violence (TCFV), 

Access to Safety, Justice and Opportunity: A Blueprint for 

Domestic Violence Interventions in Texas (2002). 

32 See for example Krug et al., World Report on Violence and 

Health; NCIPC, Costs of Intimate Partner Violence; and Tjaden 

et al., Extent, Nature and Consequences. 


34 Violence against women will be used throughout this strategic 

plan; however, the Texas Violence Against Women Prevention 

Advisory Committee (VAWPAC) will address sexual assault, 

domestic violence, and stalking whenever possible, recognizing 

that males and children also experience these types of violence. 

35 See the Acknowledgements section of this report as well as 

Appendix C for a list of participants. 

36 VAWPAC members demonstrated incredible commitment to the 

process, communicating frequently with workgroups and project 

staff between meetings, as well as serving as a conduit for the 

constituencies each was part of. When unable to attend 

meetings, members usually sent substitutes, yielding high 

attendance rates at meetings. 

37 The VAWPAC applied a popular education model for social 

change (outlined in the background paper section of this report) 

to strategic planning when possible and utilized organized 


62


consensus decision-making techniques described on the project 

website and available upon request. 

38 See Appendix B for survey analyses. 

39 For a more extensive literature review, please contact the Office 

of Special Projects in the Family Planning Division at the Bureau 

of Women’s Health, Texas Department of Health. 

40 Busch et al., A Health Survey of Texans, p. iii. 

41 TCFV, Access to Safety, Justice and Opportunity, p. 2. 

42 TCFV, Know the Facts: Texas Silent Witness Project. Online. 

Available: http://www.tcfv.org/killed_in_texas.htm. Accessed: 

November 4, 2003. 

43 U.S. Census Bureau, 2000. 

44 Ibid. 

45 Busch et al., A Health Survey of Texans, p. 1; and Saurage 

Research, Perceptions and Awareness of Domestic Violence, p. 

3. 

46 TCFV, Know the Facts: Abuse in Texas, p. 2. Online. Available: 

http://www.tcfv.org/killed_in_texas.htm. Accessed: November 

4, 2003. 

47 See TCFV, Access to Safety, for a thorough overview of domestic 

violence intervention services available throughout the 254 

counties in Texas. See Texas Association Against Sexual Assault 

(TAASA). Online. Available: http://www.taasa.org for updated 

information about sexual assault services in the state. 

48 TCFV, Access to Safety, p. 2. 

49 Saurage Research, Executive Summary, p. 5. 

50 Jeffrey L. Edleson, “Primary Prevention and Adult Domestic 

Violence,” (paper presented at the meeting of the Collaborative 

Violence Prevention Initiative, San Francisco, CA – Feburary 17- 

18, 2000). Online. Available: 

http://endabuse.org/programs/children/files/prevention/Prim 

aryPrevention.pdf. Accessed: June 15, 2003; Krug et al.,World 

Report on Violence and Health. 

51 NCIPC, CDC Research Agenda, p. 1; Krug et al., World Report 

on Violence and Health, p. 4. 


53 Barbara J. Hart.,Coordinated Community Approaches to 

Domestic Violence. Paper presented at the Strategic Planning 

Workshop on Violence Against Women, National Institute of 

Justice, Washington D.C.: March 31, 1995. Online. Available: 

www.mincava.umn.edu/hart/nij.htm. Accessed: April 24, 

2003. 



54 Tjaden et al., Extent, Nature, and Consequences, pp iii-v; 

Family Violence Prevention Fund (FVPF), The National 

Consensus Guidelines on Identifying and Responding to 

Domestic Violence Victimization in Health Care Settings (San 

Francisco: Family Violence Prevention Fund, 2002), p. 17. 

Online. Available: www.endabuse.org/programs. Accessed 

March 3, 2003. 

55 Kathleen C. Basile et al, Sexual Violence Surveillance: Uniform 

Definitions and Recommended Data Elements (Atlanta GA: 

Centers for Disease Control and Prevention, 2002); Linda E. 

Saltzman et al., Intimate Partner Violence Surveillance: Uniform 

Definitions and Recommended Data Elements. (Atlanta GA: 

Centers for Disease Control and Prevention, 2002). 

56 Busch et al., A Health Survey of Texans; TCFV, Access to Safety; 

and Saurage Research, Perceptions and Awareness of Domestic 

Violence. 

57 Krug et al., World Report on Violence and Health; Population 

Reports: Ending Violence Against Women; Lori L. Heise, 

“Violence Against Women: An Integrated, Ecological 

Framework” Violence Against Women, Vol. 4, No. 3 (June 

1998), pp. 262-290. 

58 The extended Background Paper: Primary Prevention of Violence 

Against Women for this project explains the ecological 

framework as it is applied to VAW (available via the Office of 

Special Projects in the Family Planning Division at the Bureau of 

Women’s Health, TDH). 

59 Rachel Jewke, “Intimate Partner Violence: Causes and 

Prevention,” The Lancet. Vol. 359. (April 20, 2002), p. 1423. 

60 TCFV reports that “…a majority of Texans demonstrate a 

willingness to blame victims for being abused …” (TCFV, Know 

the Facts: Abuse in Texas, p. 3 - online). 

61 Deborah Reitzel Jaffe and David A. Wolfe, “Predictors of 

Relationship Abuse Among Young Men,” Journal of 

Interpersonal Violence, Vol. 16, No. 2 (February 2001), p. 110. 

62 Krug et al., World Report on Violence and Health, p. 99. 

63 For an overview of risk factors for victimization and 

perpetration of VAW see: Jaffe et al.,“Predictors of Relationship 

Abuse Among Young Men,” p. 109; Jewke,“Intimate Partner 

Violence: Causes and Prevention,” pp. 1424-5; and Krug et al., 

World Report on Violence and Health, p. 99. 

64 Busch et al., A Health Survey of Texans, pp. 30-32. 


64


65 Jacquelyn C. Campbell et al., “Risk Factors for Femicide in 

Abusive Relationships: Results from a Multisite Case Control 

Study,” American Journal of Public Health, Vol. 93, No. 7 (July 

2003), pp. 1089-97; and Judith McFarlane, et al., “Severity of 

Abuse to Pregnant Women and Associated Gun Access of the 

Perpetrator,” Public Health Nursing, Vol. 15, No. 3 (June 1998), 

pp. 201-206. 

66 Violence Policy Center, When Men Murder Women: An 

Analysis of 2001 Homicide Data, September 2003. Online. 

Available: http://www.vpc.org. Accessed: September 29, 

2003. 

67 Campbell et al., “Risk Factors for Femicide,” p. 1089. 

68 For an overview of protective factors for women’s victimization 

see: Jewke, “Intimate Partner Violence: Causes and Prevention,” 

p. 1424-5; and Krug et al., World Report on Violence and 

Health, p. 99. 

69 NCIPC, CDC Injury Research Agenda, p. 51. 

70 Hart, Coordinated Community Approaches to Domestic Violence 

(online), p. 3-4. 

71 David Wolfe and Peter Jaffe,“Prevention of Domestic Violence 

and Sexual Assault,” National Electronic Network on Violence 

Against Women (January 2003). 

72 Edleson, “Primary Prevention and Adult Domestic Violence;” 

and Wolfe and Jaffe, “Prevention of Domestic Violence and 

Sexual Assault,” p.1. 

73 For an overview of promising trends in evaluation of VAW 

prevention efforts see: Paul A. Schewe and Larry W. Bennet, 

“Evaluating Prevention Programs: Challenges and Benefits of 

Measuring Outcomes,” in Preventing Violence in Relationships: 

Interventions Across the Life Span, ed. Paul A. Schewe 

(Washington, D.C.: American Psychological Association, 2002) 

pp.247-265; Deborah L. Shapiro and Alicia Rinaldi, “Achieving 

Successful Collaboration in the Evaluation of Sexual Assault 

Prevention Programs,” Violence Against Women, Vol. 7, No. 10 

(October 2001); Elizabeth A. Yeater and William O’Donohue, 

“Sexual Assault Prevention Programs: Current Issues, Future 

Directions, and the Potential Efficacy of Interventions With 

Women,” Clinical Psychology Review, Vol. 19, No. 7 (1999), 

pp. 739-771; Nancy A. Crowell and Ann W. Burgess, eds., 

Understanding Violence Against Women. (Washington, D.C.: 

National Academy Press, 1996), p. 137; and U.S. Department 



of Justice, National Institute of Justice. Special Report, Batterer 

Intervention Programs: Where do we go from here? (June 

2003), pp. 1-2. 

74 Crowell et al., Understanding Violence Against Women 

(Washington, D.C.: National Academy Press, 1996), p. 137; 

and Interview with Maggy McGiffert and Jennifer Margulies, 

Education Department, Texas Council on Family Violence, 

Austin, Texas, July 23, 2003. 

75 Yeater et al., “Sexual Assault Prevention Programs,” pp. 739- 

771. 

76 Kimberly Hanson Breitenbecher, “Sexual Assault on College 

Campuses: Is an ounce of prevention enough?” Applied and 

Preventive Psychology, Vol. 9 (2000), pp. 23-52; and Mary J. 

Heppner et al., “Examining Immediate and Long-Term Efficacy 

of Rape Prevention Programming with Racially Diverse College 

Men,” Journal of Counseling Psychology, Vol. 46, No. 1 (1999), 

pp. 16-26. 

77 Edward Gondolf et.al., “A Multi-Site Evaluation of Batterer 

Intervention Systems,” Abstracts on Research Design, Indiana 

University of Pennsylvania Mid-Atlantic Addiction Training 

Institute. Online. Available: 

www.iup.edu/maati/publications/designabstracts.shtm. 

Accessed: August 4, 2003; Ethel Klein et al., Ending Domestic 

Violence: Changing Public Perceptions/Halting the Epidemic 

(Thousand Oaks, CA: Sage Publications, 1997), p.104. 

78 Email from Eduardo Sanchez, Health Commissioner, Texas 

Department of Health (TDH), to TDH employees, September 23, 

2003. 

79 TCFV, Access to Safety. 

80 Meredith Minkler, ed., Community Organizing and Community 

Building for Health (New Jersey: Rutgers University Press, 

1997), p. 213. 

81 For information on primary prevention and cultural competence 

see: FVPF, The National Consensus Guidelines (online); Cathy 

Schechter, Qualitative Research on Outreach and Public 

Education. Report to the Texas Council on Family Violence 

(Austin, TX, 1997); David Wolfe et al., “Prevention of Domestic 

Violence and Sexual Assault,” National Electronic Network on 

Violence Against Women (January 2003). 

82 TCFV started a listening project in 2002. Advocates travel 

around the state interviewing survivors in domestic violence 

shelters and service centers. (McGifford and Margulies 

interview.) 


66


83 Information on including survivors can be found in: Catlin P. 

Fullwood, Family Violence Prevention Fund, “Preventing Family 

Violence: Community Engagement Makes the Difference.” 

Online. Available: 

http://endabuse.org/programs/children/files/Preventing.pdf. 

Accessed: September 25, 2003; Schechter, Qualitative Research 

on Outreach and Public Education; McGiffert and Margulies 

interview. 

84 For more on collaboration see: Fullwood, “Preventing Family 

Violence” (online); NCIPC, CDC Research Agenda, p. 55. 

85 For information on the importance of community organizing to 

prevent VAW see: Fullwood, “Preventing Family Violence” 

(online); Hart, Coordinated Community Approaches to Domestic 

Violence (online); Schecter, “Expanding Solutions for Domestic 

Violence and Poverty” (online). 

86 Janet Carter et al., “Domestic Violence and Poverty: Organizing 

an Advocacy Voice,” NFG Reports, Vol. 7, Issue 3 (Fall 2000). 


http://www.nfg.org/reports/73domestic.htm. Accessed: 

September 25, 2003; Schecter, “Expanding Solutions for 

Domestic Violence and Poverty” (online). 

87 For more on community organizing for prevention see: Minkler, 

Community Organizing; Larry Cohen et al., “The Spectrum of 

Prevention: Developing a Comprehensive Approach to Injury 

Prevention,” in Injury Prevention (of BMJ Publishing Group), Vol. 

5 (1999), pp. 203-207. See also the Prevention Institute 

(www.preventioninstitute.org). 

88 Cohen and Swift, The Spectrum of Prevention. 

89 Advocates caution that this practice should be undertaken with 

care and consideration for survivors’ safety, and should not 

undermine the experiences of former victims of VAW. 

90 Schecter, Susan, “Expanding Solutions for Domestic Violence 

and Poverty: What Battered Women with Abused Children 

Need from Their Advocates” in Building Comprehensive 

Solutions to Domestic Violence: Publication #13, A Vision Paper. 


www.vaw.umn.edu/documents/expandin/expandin.html. 

Accessed: April 28, 2003. See also: Gloucester Men Against 

Domestic Abuse (GMADA) (www.strongmendontbully.com); Men 

Stopping Violence (MSV) (www.menstoppingviolence.org); 

Men’s Resource Center of Western Mass (www.mensresoucecenter.org); 

and White Ribbon Campaign 

(www.whiteribbon.ca/wrchrome.htm). 



91 See Appendix B for the analyses of the Texas Talks: Primary 

Prevention of Violence Against Women survey. 

92 For more information on public health evaluation methods for 

prevention activities see: Centers for Disease Control and 

Prevention, Evaluation Working Group, “Framework for 

Program Evaluation in Public Health.” Online. Available: 

http://www.cdc.gov/eval/framework.htm. Accessed: October 

10, 2001; Center for Substance Abuse Prevention, “Building a 

Successful Prevention Program: Step 7 – Evaluation.” Online. 

Available: 

http://www.unr.edu/westcapt/bestpractices/eval.htm. 

Accessed: October 10, 2003; Lana Muraskin. Understanding 

Evaluation: the Way to Better Prevention Programs. Westat, 

Inc., U.S. Department of Education. Online. Available: 

http://www.ed.gov/PDFDocs/handbook.pdf. Accessed: 

October 10, 2003. 

93 Busch et al., A Health Survey of Texans; and Saurage Research, 

Perceptions, and Awareness of Domestic Violence. 

94 See for example Judith McFarlane et al., “Intimate Partner 

Stalking and Femicide: Urgent Implications for Women’s Safety,” 

Behavioral Sciences and the Law, Vol. 20 (2002), pp. 51-68; 

Judith McFarlane et al., “Severity of Abuse to Pregnant Women 

and Associated Gun Access of Perpetrator,” Public Health 

Nursing, Vol. 15, No. 3 (June 1998), pp. 201-206; and 

William Wiist and Judith McFarlane, “The Effectiveness of an 

Abuse Assessment Protocol in Public Health Prenatal Clinics,” 

American Journal of Public Health, Vol. 89, No. 8 (August 

1999), pp. 1217-1221. 


96 Asian and Pacific Islander Institute on Domestic Violence, 

“Ending Intra-Familial Violence: Community Organizing.” 


www.apiahf.org/apidvinstitute/Gender%20Violence/community 

/htm. Accessed: July 2, 2003; Fullwood, “Preventing Family 

Violence” (online); Linda Gunderson. “Intimate Partner 

Violence: The Need for Primary Prevention in the Community,” 

Annals of Internal Medicine, Vol. 136, No. 8 (April 16, 2002), 

p. 639; Schecter, “Expanding Solutions for Domestic Violence 

and Poverty” (online); Interview with Krista DelGallo, Policy 

Department, Texas Council on Family Violence (TCFV), Austin, 

Texas, July 23, 2003. 

97 Edleson, “Primary Prevention and Adult Domestic Violence” 

(online), p. 13; Fullwood, “Preventing Family Violence” (online), 

p. 2. 


68


98 See Appendix B for full analyses. 

99 Cohen and Swift, “The Spectrum of Prevention” (online), pp. 

203-207; 

100 Saurage Research, Perceptions, and Awareness of Domestic 

Violence; and TAASA, Findings From a Statewide Survey: 

Strategic Summary. 


(online), p. 10; Marissa Ghez, “Getting the Message Out: 

Using the Media to Change Social Norms on Abuse,” in 

Sourcebook on Violence Against Women, ed. Claire M. 

Renzetti, Jeffrey L. Edleson and Raquel Kennedy Bergen 

(Thousand Oaks, CA: SAGE Publications, 2001), p. 418; and 

Klein et al., Ending Domestic Violence,” p. 101. 

102 Ghez, “Getting the Message Out,” pp. 420-423. 

103 Ibid., p. 429. 

104 See the resource guide in Appendix D and links in Appendix E 

for excellent examples. 

105 FVPF, The National Consensus Guidelines (online), p. 7; and 

Lynn M Short., et.al. “Recommended Components of Health 

Care Provider Training Programs on Intimate Partner 

Violence,” American Journal of Preventative Medicine, Vol. 14, 

No. 4 (1998), p. 284. 

106 Phyllis Sharps et al., “Health Care Providers’ Missed 

Opportunities for Preventing Femicide,” Preventive Medicine, 

vol. 33 (2001), p. 377; Wiist and McFarlane, “The 

Effectiveness of an Abuse Assessment Protocol,” p. 1219; Pam 

Wilson et al., “Primary Healthcare Provider’s Lost Opportunity 

to Help Abused Women,” Journal of the American Academy 

of Nurse Practitioners, vol. 13, no. 12 (December 2001), p. 

566-7. 


(online), p. 9; FVPF, The National Consensus Guidelines, p. 6;, 

Vaughn, I. Rickert, Roger D. Vaughan, Dr PH, and Constance 

M. Wiemann, “Violence Against Young Women: Implications 

for clinicians,” Contemporary Ob/Gyn, Vol. 2, p. 9; and Evan 

Stark, “Health Intervention with Battered Women: From Crisis 

Intervention to Complex Social Prevention,” Sourcebook on 

Violence Against Women, ed. Claire M. Renzetti, Jeffrey L. 

Edleson and Raquel Kennedy Bergen ( Thousand Oaks, CA: 

SAGE Publications, 2001) pp. 362-363. 



108 FVPF, The National Consensus Guidelines, Appendix C: 

Dilemmas when screening all patients for victimization; Jean 

Ramsay et al., “Should health professionals screen women for 

domestic violence? Systematic review,” BMJ, Vol. 325 (2002). 

Online. Available: www.bmj.com. Accessed: July 24, 2003. 

109 Kathleen A. Oriel and Michael F. Fleming, “Screening Men for 

Partner Violence in a Primary Care Setting: a new strategy for 

detecting domestic violence,” Journal of Family Practice, Vol. 

46, No. 6 (June 1998), pp. 493-499. 

110 See the survey analyses in Appendix B. School-based efforts 

such as anti-bullying programs are also popular in Texas and 

help to raise public awareness of non-violence and related 

issues. 

111 See the resource guide in Appendix D for good examples. 


70

Bibliography 





Bibliography 

Bibliography – 

Primary Prevention of Violence Against Women (VAW) 

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Background 

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Appendices 





Appendicies - A Plan Goals/Objectives 

APPENDIX A 

Goals and Objectives: 

Texas Strategic Plan to Prevent Violence Against Women 

Vision: The primary prevention of sexual assault, domestic violence and stalking is a public 

health priority in Texas. 

Mission: To implement a comprehensive plan for the primary prevention of sexual assault, 

domestic violence and stalking that is inclusive of all Texans and that includes strategies focusing on 

individuals and families, communities, state level organizations and government. 

Principal Statements: Goals, objectives, and strategies aimed at the primary prevention of 

sexual assault, domestic violence, and stalking will be appropriate for individuals and groups, 

taking into account attributes such as age, gender, culture, disabilities, sexual orientation, national 

origin, religious affiliation and socioeconomic status. The perspectives of those who have survived 

sexual assault, domestic violence, and stalking will be integral to prevention efforts. 

The Texas Violence Against Women Advisory Committee (VAWPAC) identified the following goals 

and objectives for ending violence against women in Texas. Actors are not specified for each 

objective because implementation of this plan is a work in progress in collaboration with 

stakeholders who participated in the planning process and other entities who will be invited to 

participate. Potential actors will include state entities such as: Department of Human Services 

Family Violence Prevention Program, Governor’s Commission for Women, Office of Attorney 

General, TX Association Against Sexual Assault, TX Council on Alcohol and Drug Abuse, TX 

Council on Family Violence and TX Department of Health. 1 Actors will also include academic 

entities such as: the UT Health Science Center at San Antonio and the UT Center for Social Work 

Research - Institute on Domestic Violence and Sexual Assault. Other actors will include communitybased, 

advocacy and faith-based organizations such as: Migrant Clinicians Network, Austin 

SafePlace, and Batterers Intervention and Prevention Programs. 2 A-92 

1 

2 

Other state level entities that will be invited to participate include: State Licensing Boards for Health Professions, TX Association of Business and 

Chambers of Commerce, TX Education Association, TX Hospital Association, TX Medical Association, Texas Municipal Police Association, TX Nurses 

Association, Military entities, Woman’s Chamber of Commerce, TCLEOSE - Continuing Education for Law Enforcement, TX Department of Mental 

Health and Mental Retardation, TX 

Other community efforts to be invited include: Austin Commission for Women, Center for Health Training, Children’s Advocacy Centers of TX, 

Domestic Violence Initiative, Faith Based Organizations, Greater Dallas Crime Commission, Media entities, Texas Health Resources, Woman’s 

Advocacy Project. 

A STRATEGIC PLAN TO PREVENT VIOLENCE AGAINST WOMEN IN TEXAS


PRIORITY: RESOURCES, RESEARCH AND DATA 

Goal 1: Identify and secure necessary resources to implement the strategic plan 

Objective 1: Identify potential funding sources and in-kind contributions for 

implementation of the statewide strategic plan by December 2003 and on a 

continuing basis. 

Objective 2: Identify funding feasibility and timelines by November 2003. 

Objective 3: Submit at least three additional grant proposals to fund the implementation 

of the statewide strategic plan by December 2004. 

Objective 4: Coordinate a state-level effort to seek funding directed at preventing sexual 

assault, domestic violence and stalking by September 2005. 

Objective 5: Support local-level efforts to seek funding directed at preventing sexual 

assault, domestic violence and stalking in Texas by September 2006. 

Goal 2: Support Texas-specific research on sexual assault, domestic violence, 

and stalking. 

Objective 1: Estimate indirect and direct costs for sexual assault, domestic violence and 

stalking in Texas by September 2005. 

Objective 2: Conduct an empirically based evaluation of existing prevention efforts for 

sexual assault, domestic violence and stalking in Texas by September 2006. 

Objective 3: Analyze and examine the relationship between social indicators and VAW 

by January 2006. 

Objective 4: Conduct a cost/benefit analysis of prevention efforts by September 2007. 

Goal 3: Share and link non-identifying data among systems to aid in the 

prevention of sexual assault, domestic violence, and stalking. 

Objective 1: Identify available and missing non-identifying data sources to assist in the 

development of efforts to end sexual assault, domestic violence and stalking 

in Texas by September 2005. 

Objective 2: Establish an infrastructure to support the ongoing appropriate exchange of 

prevention-oriented information relevant to sexual assault, domestic violence 

and stalking by March 2005. 

A-93 A STRATEGIC PLAN TO PREVENT VIOLENCE AGAINST WOMEN IN TEXAS


PRIORITY: COMMUNITIES, SYSTEMS, INFRASTRUCTURE 

Goal 1: To integrate primary prevention of sexual assault, domestic violence, 

and stalking into Texas state, county and city entities, state legislation, 

judicial and service systems, the military and resource allocation. 

Objective 1: Make available training curricula addressing the prevention of sexual 

assault, domestic violence and stalking to governmental entities via webbased 

and other mediums by January 2005. 

Objective 2: Make available appropriate training curricula addressing the prevention of 

sexual assault, domestic violence and stalking to Texas law enforcement via 

web-based and other mediums by January 2005. 

Objective 3: Identify potential legislative allies, and make available educational materials 

regarding sexual assault, domestic violence and stalking to Texas legislators 

in preparation for the 2005 session of the Texas legislature by January 

2005. 

Objective 4: Make available information on the primary prevention of sexual assault, 

domestic violence and stalking to personnel at Texas military installations by 

September 2006. 

Objective 5: Contact state agencies requesting that they conduct an internal review and 

assessment of their existing policies addressing sexual assault, domestic 

violence and stalking by September 2005. 

Objective 6: Make available research-based “best practices” in institutional policies 

addressing the primary prevention of sexual assault, domestic violence and 

stalking to state agencies by September 2005. 

Objective 7: Complete a review of state laws concerning sexual assault, domestic 

violence and stalking and develop a document delineating these laws by 

October 2004. 

Goal 2: To integrate primary prevention of sexual assault, domestic violence, 

and stalking into formal and informal community-based organizations, 

networks, and corporate sector systems. 

Objective 1: Contact community and faith-based organizations, businesses and other 

formal networks requesting that they conduct an internal review and 

assessment of their existing company or organizational policies addressing 

sexual assault, domestic violence and stalking by September 2005 and on 

a continuing basis. 


A-94


Objective 2: Make available “best practices” for organizational and company policies 

addressing sexual assault, domestic violence and stalking to community and 

faith-based organizations, businesses and other formal networks via webbased 

and other mediums by September 2005. 

Objective 3: Encourage Executive Directors, CEOs, and leaders within Texas communities 

to strengthen their existing networks of communication to prevent sexual 

assault, domestic violence and stalking in their communities by June 2006 

and on a continuing basis. 

Objective 4: Utilize the Centers for Disease Control and Prevention (CDC) VAW 

Community Planning Guide and the Popular Education for Social Change 

Model for planning and organizing primary prevention efforts, and make 

those resources available to Texas communities by September 2004. 

Goal 3: To integrate primary prevention of domestic violence, sexual assault 

and stalking into public and private educational systems at the state, 

school district and local levels. 

Objective 1: Involve youth in the development of an action plan that prevents and 

challenges the issues of sexual assault, domestic violence and stalking in 

school systems by September 2005. 

Objective 2: Make available appropriate literature detailing the prevalence and costs of 

sexual and dating violence among children and youth to district superintendents 

and high school principals in Texas via web-based and other 

mediums by June 2007. 

Objective 3: Make available research-based, age-appropriate tools, including evaluation 

methods, for incorporating primary prevention of sexual assault, domestic 

violence and stalking into existing educational curricula via web-based and 

other mediums by December 2005. 

Objective 4: Encourage local sexual assault and domestic violence coalitions and 

organizations to solicit a professional representative from public school 

districts, colleges and/or universities to serve on their boards or councils by 

January 2005. 

Goal 4: To integrate primary prevention of domestic violence, sexual assault, 

and stalking into public and private health care delivery systems. 

Objective 1: Contact medical, dental, nursing and other health care training schools 

requesting that they conduct an internal review and assessment of their 



existing organizational policies on sexual assault, domestic violence and 

stalking by September 2006 and on a continuing basis. 

Objective 2: Make available research-based tools, including evaluation methods, for 

incorporating training on sexual assault, domestic violence and stalking into 

existing curricula to medical, dental, nursing and other health care training 

schools via web-based and other mediums by December 2005. 

Objective 3: Encourage professional organizations and licensing boards to require 

health care professionals to take continuing education courses addressing 

the primary prevention of sexual assault, domestic violence and stalking by 

September 2006 and on a continuing basis. 

Objective 4: Make available research-based information on best practices, including 

evaluation tools, for pre-screening and universal screening for sexual 

assault, domestic violence and stalking to Texas health care providers via 

web-based and other mediums by September 2005. 

PRIORITY: PUBLIC AWARENESS 

Goal 1: Promote awareness that domestic violence, sexual assault, and 

stalking are public health issues. 

Objective 1: Implement appropriate sexual assault, domestic violence, and stalking 

screening activities (including evaluation of process) in a proportion of 

family planning and maternal child health programs of Texas public health 

settings based on “promising practices” in the field, by January 2006 and 

on a continuing basis. 

Objective 2: Make available educational materials with the prevention message that 

sexual assault, domestic violence and stalking are unacceptable via webbased 

and other mediums to public health agencies, encouraging those 

entities to make these resources available to clients by January 2007. 

Goal 2: Develop and implement strategies for social change resulting in the 

prevention of sexual assault, domestic violence, and stalking. 

Objective 1: Use the Popular Education Model for Social Change and involve 

communities to train health professionals on issues related to sexual assault, 

domestic violence and stalking as an avenue of social change by January 

2005 and on a continuing basis. 


A-96


Objective 2: Facilitate the formation of two organized groups of men 3 to work toward the 

prevention of sexual assault, domestic violence and stalking and to serve as 

models for other men by January 2006. 

Objective 3: Involve community members, including survivors and former perpetrators of 

violence against women in planning and implementation of efforts to prevent 

sexual assault, domestic violence and stalking by January 2006 and on a 

continuing basis. 

Objective 4: Facilitate collaboration between Batterers Intervention and Prevention 

Programs, Council on Sex Offender Treatment programs, and former 

perpetrators of violence against women in Texas to prevent sexual assault, 

domestic violence and stalking through raising awareness and modeling for 

other men by January 2007 and on a continuing basis. 

Objective 5: Make available speakers and other resources to make the connection 

between substance abuse and sexual assault, domestic violence and stalking 

to organizational and state conferences on violence against women and/or 

substance abuse, by January 2008. 

Objective 6: Implement a statewide public awareness campaign about the connection 

between child abuse and sexual assault, domestic violence and stalking by 

December 2005. 

Objective 7: Make available research-based school-wide bullying prevention models, 

including evaluation tools to Texas School District personnel by September 

2007. 

Goal 3: Assist consumers in taking responsibility for the way sexual assault, 

domestic violence and stalking are portrayed in the media. 

Objective 1: Involve youth and parents in a community-based approach to implement a 

statewide campaign about the effects of violence in the media and its 

connection to sexual assault, domestic violence and stalking in Texas by 

January 2010. 

1 Other state level entities that will be invited to participate include: State Licensing Boards for Health Professions, TX Association of 

Business and Chambers of Commerce, TX Education Association, TX Hospital Association, TX Medical Association, Texas Municipal Police Association, TX 

Nurses Association, Military entities, Woman’s Chamber of Commerce, TCLEOSE – Continuing Education for Law Enforcement, TX Department of Mental 

Health and Mental Retardation, TX Department of Protective and Regulatory Services 

2 Other community efforts to be invited include: Austin Commission for Women, Center for Health Training, Children’s Advocacy Centers of TX, 

Domestic Violence Initiative, Faith Based Organizations, Greater Dallas Crime Commission, Media entities, Texas Health Resources, Woman’s Advocacy 

Project. 

3 These groups should be formed in at least two of the following Texas cities/regions: Dallas, Ft. Worth, San Antonio, Houston, Austin and/or the Rio 

Grande Valley. 


Appendicies - B Survey Analyses 

APPENDIX B 

Background 

A goal of the project was to learn more about the types of violence against women (VAW) primary 

prevention services that were being provided in Texas. A survey of stakeholders was conducted as 

part of this project. The goals of this survey included identifying service providers in this arena, 

determining where primary prevention efforts were targeted, whether efforts in Texas were being 

evaluated as well as obtaining some baseline information on primary prevention activities in the 

state. Differences in responses by type of service provider (health care setting versus other) were 

also examined. 

The survey was designed by staff working with the VAW prevention project and administered 

between June and August 2003 to organizations or clinics thought to offer VAW prevention 

services. 1 In this report, the terms “stakeholders” or “respondents” are used interchangeably to 

refer to those organizations or clinics that responded to the survey. A snowball sampling frame 

was used to identify a sample of targeted organizations or clinics. In this type of convenience 

sampling, a small group of organization or clinic representatives working with the VAW prevention 

project were asked to identify additional stakeholders to be included in the sample. One key 

drawback of the snowball sampling technique is that generalizations should be made with caution 

because the sample was not selected randomly. The location (by zip codes) of survey respondents 

is available in Map 1. 

1 

Copies of the questionnaire are available from the Office of Special Projects in the Family Planning Division at the 

Bureau of Women’s Health, TDH. The following resource was used to design and implement the survey: Dillman, 

Don, Mail and Internet Surveys: The Tailored Design Method.(New York: J. Wiley, 2000). 


B-98


MAP 1: Location of Survey Respondents by Zip Code 

B-99 A STRATEGIC PLAN TO PREVENT VIOLENCE AGAINST WOMEN IN TEXAS


Stakeholders and Respondents 

A total of 345 questionnaires were received. Data from approximately 330 respondents 

were included in the analyses because fifteen (about 5%) of the organizations or clinics surveyed 

were not involved in primary VAW prevention efforts. In the data analyses, descriptive statistics 

were used extensively. 

The type of organizations or clinics that responded to this survey and were involved in the 

primary prevention of violence against women varied widely. Fifty-one percent (n=162) of the total 

responses were received from health care settings, which included community health centers (CHC), 

family planning clinics, women, infants and children’s (WIC) clinics. Additionally, clinics offering 

maternal and child health services (MCH), and substance abuse and mental health centers were 

also among organizations or clinics in health care settings (see Figure 1). Some cross-tabulations 

and chi-square tests of significance were also done to identify some key differences in response 

patterns by type of service provider, i.e., between respondents in health care settings and others 

located in non-health care settings. 

Forty-nine percent (n=155) of the organizations or clinics responding were in non-health care 

settings. These stakeholders included nonprofit groups, local and state government agencies, law 

enforcement groups, VAW service providers, and universities (see Figure 2). 2 B-100 

A STRATEGIC PLAN TO PREVENT VIOLENCE AGAINST WOMEN IN TEXAS


FIGURE 1: Description of Survey Respondents: Types of Health Care Settings (n = 162) 

Other 16% Comm Health Ctr 12% Women, Infant & Child 17% 

Family Planning Clinic 18% MCH Services Substance Abuse/Mental Health 8% 

Hospitals 11% University Health Ctr 7% 

Substance 

Abuse/Mental 

Health 

8% 

Hospitals 

11% 

University 

Health Center 

7% 

Other 

16% 

Comm Health Ctr 

12% 

MCH Services 

11% 

Family Planning Clinic 

18% 

Women, Infant 

& Child 

17% 

FIGURE 2: Description of Survey Respondents: Types of Non-Health Care Settings (n=155) 

Government 16% Law Enforcement 18% Non-profits 27% 

Universities 10% VAW Service . Providers 18% Other 10% 

Other 

10% 

Government 

16% 

VAW Service 

Providers 

18% 

Law Enforcement 

18% 

Universities 

10% 

Non-profits 

27% 



Results 

The VAW prevention services offered by organizations or clinics were grouped into three 

areas of emphasis: sexual assault, domestic violence, and stalking. Results from the survey 

indicated that more primary prevention emphasis was being placed on sexual assault and 

domestic violence than on stalking. Among respondents, 90 percent emphasized some level of 

primary prevention (a little, some or a lot of emphases) in the area of domestic violence, 98 

percent emphasized sexual assault and 67 percent focused on stalking. As shown in Figure 3, over 

70 percent of the organizations placed “some” or “a lot” of emphasis on domestic violence and 

sexual assault while 41percent did the same for stalking. 

The differences in prevention services being offered by type of provider were also examined. 

The only statistically significant (p


FIGURE 4: Adoption of Policy Regarding VAW (N=306) 

70 

60 

Percentage effort 

50 

40 

30 

20 

Yes 

No 

Do Not 

Know 

10 

0 

Sexual Assault Domestic Violence Stalking 

Categories of VAW 


A series of questions were posed on how the organization or clinic raised public awareness. 3 

The most popular method reported for increasing public awareness was the distribution of 

educational materials, followed by raising community awareness of VAW through parades and 

fairs. The emphasis on public awareness was found to be more on domestic violence (75%) and 

sexual assault (71 percent) than on stalking activities (37 percent). From Table 1, it is clear that the 

majority of the organizations or clinics did not rely on newsletters/email, media campaigns and 

community activities to raise public awareness of VAW. Surprisingly, very little public awareness is 

reported beyond distribution of educational materials. The percentage of respondents who 

promoted public awareness of primary prevention by sending out newsletters or informational email 

messages ranged from 19 percent (sexual assault), to 23 percent (domestic violence) but only 14 

percent did the same for stalking. Only 18 percent (sexual assault), 23 percent (domestic violence) 

and 11 percent (stalking) of those surveyed used media campaigns such as radio/tv spots, signs on 

buses and press conferences. Similarly, only 29 percent, 33 percent and 15 percent of 

organizations or clinics used high visibility community activities such as parades and fairs for sexual 

assault, domestic violence, and stalking respectively. Other means of raising public awareness 

included tear strips, concealable information cards in waiting rooms and restrooms, as well as peerled 

theatrical presentations. 

TABLE 1: How Public Awareness of VAW Issues was Raised 

Percentage using these strategies 

Sexual 

Assault 

Domestic 

Violence 

Stalking 

Distribute educational material n = 326 Yes 71 75 37 

Send out related newsletter or informatin email messages n = 328 Yes 19 23 14 

Media Campaigns (radio/tv spots/buses ads etc.) Yes 18 23 11 

High Visibillity Community Activities such as parades & fairs Yes 29 33 15 

n = 329 



School-Based Efforts 

The survey asked questions about primary prevention efforts in schools, such as anti-bullying, 

good touch/bad touch issues, gender respect, dating and other programs. The majority of those 

responding did not conduct primary prevention in schools. Twelve percent of the respondents 

directed school-based efforts to elementary school children for Stalking, 25 percent for Domestic 

Violence and 26 percent for Sexual Assault. Thirty-five percent of the respondents targeted junior 

and high school students with regard to Sexual Assault and 34 percent for Domestic Violence but 

about 20 percent offer Stalking prevention services to this group (see Table 2). Between 19 

percent and 29 percent of these respondents targeted college level students: 29 percent (Domestic 

Violence) of the organizations or clinics focused on college-level students, and smaller percentages 

were involved with Sexual Assault (26 percent) and Stalking (19 percent) efforts. 

Based on open-ended comments, other respondents indicated that they targeted beauty 

schools and salons or trained paramedics and medical students to be sensitive and recognize signs 

of sexual assault and/or domestic violence when treating trauma cases. 

TABLE 2: Primary Prevention Efforts in Schools 




Domestic 

Violence 

Stalking 

Programs for elementary children (< 12 years) n = 313 Yes 26 25 12 

Programs for junior & high school students n = 316 Yes 34 35 20 

Programs for college-level students n = 315 Yes 26 29 19 

Community-Based Efforts 

Regarding efforts made by some organizations or clinics in preventing and stopping VAW 

before it happens, some respondents were engaged in community-based efforts through 

presentations, teaching classes, organizing discussion forums, conferences, and training. 

Approximately 50 percent of the responding organizations or clinics taught classes or organized 

training, conferences or discussions related to Sexual Assault, Assault and Domestic Violence, while 

29 percent did the same for Stalking (see Table 3). Organizations and clinics were also involved in 

working with other community groups, local leaders, or advocates on primary prevention efforts. 

Here also more emphasis was placed on Sexual Assault (68 percent), and Domestic vViolence (71 

percent), than on Stalking (42 percent). Open-ended responses indicated that community 

partnerships and coalitions were another strategy used to prevent or stop VAW. 


B-104


TABLE 3: Strategies for Community-Based Prevention Efforts 




Domestic 

Violence 

Stalking 

Make presentations, teach classes or organize training, Yes 49 51 29 

conferences or discussion forums n = 324 

Work with other groups, local leaders or advocates on primary Yes 68 71 42 

prevention of VAW n = 324 

Research and Data Collection 

A series of survey questions focused on research and data collection activities. The most 

commonly reported research and data collection activity was related to keeping track of information 

(e.g., hotline calls, shelter visits etc) – 46 percent for Sexual Assault and Domestic Violence and 32 

percent for Stalking. Other data collection, research, and evaluation activities were reported by the 

survey respondents (see Table 4). Whereas 30 percent, 36 percent and 21 percent were involved in 

researching effective programs (best practices) for Sexual Assault, Domestic Violence and Stalking 

respectively, only 20 percent of the respondents were involved in researching evaluation techniques for 

Sexual Assault, 22 percent for Domestic Violence and 12 percent for Stalking. Surprisingly, a number 

of organizations or clinics researched factors influencing a person or a group’s risk for acting violently 

towards women (i.e., the likelihood of perpetrating violence). Thirty percent (Sexual Assault), 31 

percent (Domestic Violence) and 19 percent (Stalking) screened for violent tendencies. Other 

respondents researched factors that help protect people from victimization: 38 percent for Sexual 

Assault, 39 percent for Domestic Violence and 27 percent for Stalking. The majority (60 percent) of 

the organizations or clinics did not conduct research activities. Survey respondents were also asked 

why they conducted research and/or collected data. 

Responses to this question were: 

• 27 percent did so to fulfill grant or program requirements, 

• 35 percent to promote outreach and advocacy, 

• 31 percent to evaluate the effectiveness of their programs, and 

• 6 percent with the purpose of writing academic reports. 

Open-ended comments also indicated that reporting requirements from government agencies 

were a reason for the collection of VAW data. 

TABLE 4: Efforts in Research & Data Collection 




Domestic 

Violence 

Stalking 

Research effective programs (best practices) for VAW n = 321 Yes 31 36 21 

Collect or keep track of info related to VAW prevention n = 322 Yes 46 46 32 

Research factors influencing person/group’s risk for acting Yes 30 31 19 

violently (perpetrating violence) n = 317 

Research factors that help protect person(s) from Yes 38 39 27 

victimization n = 317 

Research Evaluation Techniques n = 315 Yes 20 22 12 



Evaluation 

Survey questions also focused on efforts by the respondents to evaluate their primary 

prevention programs. The majority (70 percent) of the participating organizations or clinics did not 

conduct evaluations. Of the 92 (30 percent) respondents that conducted evaluations, a significantly 

(p


Assessment 

The targeted groups for Sexual Assault, Domestic Violence, and Stalking primary prevention 

assessment activities varied among respondents. Survey respondents were asked about the groups 

or target population they screened with regard to the three categories of VAW. About 75 percent of 

the responding organizations or clinics reported that they screened people or groups to find out 

whether they might be potential victims of violence, for Sexual Assault and Domestic Violence, but 

only 45 percent screened for Stalking (see Table 6). About 70 percent of the respondents reported 

that they screened women 18 yrs and older, 60 percent screened teen girls aged 13-17, while 

about 40 percent screened men (18 years and older), teen boys (13-17 years) and children (12 

and under) for potential victimization. 

TABLE 6: Respondent percentages grouped by type of VAW service 

and screening services 




Domestic 

Violence 

Stalking 

Screen people to determine victims of VAW n = 319 Yes 76 76 45 

Screen people to determine if people might act violently/ Yes 34 37 25 

perpetrate VAW n = 317 

The survey also addressed which type of respondent was likely to do the screenings to 

determine possible victimization. Further analyses indicated that respondents from health care 

settings, as compared to respondents from non-health care settings, were significantly (p


Training Personnel 

The majority of the organizations or clinics surveyed provided staff training through periodic 

training sessions. Brochures, handouts, policy/protocol were often printed for training purposes 

(Table 7). A much smaller percentage of respondents were involved in training for Stalking in 

comparison to Sexual Assault and Domestic Violence. Open-ended comments indicated that 

seminars, conferences and workshops were also used for purposes of training personnel by 

organizations or clinics. 

Goals of VAW Organizations or Clinics 

Organizations and clinics were asked to list the goals of their VAW primary prevention 

efforts. Three main goals were provided in the questionnaire and open-ended comments were 

solicited. Seventy-nine percent (n=262) of the respondents picked at least one goal. Fifty percent 

of the 262 respondents selected risk reduction for potential victimization of VAW as their most 

important goal, with another 32% selected changes in attitudes and behavior about VAW as the 

most important goal. Eleven percent selected changing societal power structures as their most 

important goal. 

Respondents also ranked these goals with a score of 1 being the highest priority and 4 

indicating lowest priority. Average rankings for the goals outlined in the questionnaire were: 

• Reducing risk factors for potential victims – Average 1.74 (Highest priority) 

• Changing attitudes/beliefs (social norms) about acceptability of VAW – Average 2.27 

(Next highest priority) 

• Changing societal power structures that allow for VAW – Average 3.31 (Lowest priority) 

Obstacles and challenges 

The survey respondents were also asked about the obstacles and challenges they encountered 

in their primary prevention efforts. Open-ended responses (n = 201) were analyzed, and some 

respondents provided multiple responses. The majority (54 percent) of the responses cited lack of 

funding as the main challenge they faced in the implementation of primary prevention programs. 

Twelve percent of the respondents indicated that other resources were overextended and priorities 

were set according to available funding. For example, among the 29 WIC clinics that responded, 

many had other priorities to cover during client contacts, and VAW related issues competed with 

many other health/social issues. All these issues had to be addressed at the same client interview 

with limited time and staff resources. 

Other obstacles/challenges the respondents faced included inadequate training or education 

of law enforcement personnel (5 percent), and lack of staff resources to deal with VAW cases (10.5 

percent). Lack of community awareness and general attitude of the public towards VAW was a 

challenge and an obstacle for 13 percent of the survey respondents. Sixteen percent cited societal 

norms and the stigma attached to VAW reporting as a major obstacle. A lack of culturally 

appropriate educational materials was also cited as obstacles by 12 percent of the survey 

respondents. 


B-108


Resource Needs 

When the respondents were asked what would be most helpful in their effort to prevent VAW 

before it happens, funding, staffing, time, lack of resources (posters, brochures and educational 

material) as well as ways and means of increasing community awareness were cited as the most 

needed resources. Other suggestions included stricter protective laws, greater accountability and 

coalitions working together. 

Figure 5: Services Directed to Rural Population 

9% Unsure 54% Do Offer 37% Do Not 

Offer 

37% 

9% 

54% 

Targeting Services 

One question ascertained whether the organizations or clinics directed services to rural 

populations. The majority (54 percent) of the respondents indicated that they did offer such services, 

while 37 percent did not. The remainder were unsure (see Figure 5). 

Summary 

Survey findings indicated that: 

• Primary prevention activities were reported by organizations or clinics in a variety of settings 

and in diverse sectors. 

• Although efforts to prevent stalking were much lower than those to prevent sexual assault and 

domestic violence, they were higher than many might have predicted. 

• Very little few public awareness efforts were conducted other than the dissemination of 

educational material. 



• Only a minority of organizations or clinics targeted youth in schools and colleges. 

• The main research activity that was conducted involved collection of data useful for 

tracking purposes (shelter visits, hotline calls etc). The majority of respondents did not 

conduct evaluations. 

• Policy efforts were primarily concentrated in efforts to promote the understanding and 

use of laws and regulations. 

• Both organizations or clinics in health settings and others are conducting screening or 

assessment of Texans for potential victimization or perpetration of violence. Screening is 

being done on both males and females and across the age spectrum, which relates well 

to primary prevention. Respondents also researched factors that influence the risk for 

acting violently towards women. 

• The general tone of respondents on open-ended questions was one of support for 

primary prevention of VAW and willingness to learn and collaborate. 

• Some of the obstacles and challenges respondents defined can be addressed via 

collaboration and sharing of human and educational resources and other cost-effective 

strategies. 


B-110

Appendicies - C Additional Acknowledgements 

APPENDIX C 

Additional Acknowledgements 

Violence Against Women Prevention Project Virtual Council Members 

Wendie Abramson 

Austin Safe Place – Disability Services 

A Safety Awareness Program (ASAP) 

Ann Bayliss 

Katy Christian Ministries 

Domestic Abuse Center 

Laury Bosley 

Brazos Valley Rape Crisis Center 

Diane Bomash 

Domestic Violence Awareness Committee of 

Greater Dallas 

Margaret Brackley 

University of Texas Health Sciences Center at 

San Antonio 

Al Brown 

Red River Drug and Alcohol Treatment Center 

Ann Burgardt, MD 

University of Texas Health Sciences Center at 

San Antonio 

Hector J. Campos 

HCJ & Associates 

Jessie Cleveland 

Planned Parenthood of Texas Capital Region 

Cynthia Colbert 

Catholic Health Association of Texas 

Pamela Cook 

University of Texas at Austin 

Voices Against Violence Project 

Roger Curme 

Texas Legal Services Center 

Richard Davidson 

JOVEN 


Family Crisis Center 

Men’s Nonviolence Advocate in the Valley 

Martha Duffer 

Austin Latino/a Lesbian Gay Bisexual 

Transgender Organization 

Tony Dunn, MD 

American College of Obstetricians and 

Gynecologists 

Texas Section and Texas Association 

Randall Ellis 

Lesbian/Gay Rights Lobby of Texas 

Joslyn Weiner Fisher, MD 

Ben Taub General Hospital 

Harris County Public Hospital 

Melanie Gantt 

Mental Health Association of Texas 

Fernando Guerra 

San Antonio Metropolitan Health District 

Judy Harden 

Permian Basin WIC Program 

Texas Tech University 

Brenda Heredia 

Harlingen Family Crisis Center 

Carla Holeva 

Planned Parenthood of West Texas 

Betty Chern-Hughes 

US DHHS Region VI 

Office of Family Planning 

C-111 A STRATEGIC PLAN TO PREVENT VIOLENCE AGAINST WOMEN IN TEXAS


Heather Kamper 

Austin Safe Place Disability Services 

A Safety Awareness Program (ASAP) 

Tracy A. Levins, PhD 

Texas Youth Commission 

Catherine Lewis 

Central Texas Doula Association 

Patricia R. Lykos 

Governor’s Council on Sex Offender Treatment 

Alice Mann 

San Antonio Independent Living Services 

Barbara Marek 

Jackson County Sheriff’s Office 

Sexual Abuse Awareness Training Programs 

Lt. Richard Maxey 

Houston Police Department 

Family Violence Unit 

Angie McCown 

Texas Department of Safety 

Victim Services 

Jesus Ortega 

Out Youth Austin 

Wanda Paige 

Disabled Crime Victims Assistance 

Art Resa 

League of United Latin American Citizens 

Health Education Committee 

Ann J. Robison, PhD 

Montrose Counseling Center 

Jose Sanchez 

Aid to Victims of Domestic Abuse 

Batterers Intervention and Prevention Program 

Jean Spence 

Austin/Travis County – Health and Human 

Services Department 

Communicable Disease Unit 

Martha Stowe 

Injury Prevention Center of Greater Dallas 

Amanda Stukenberg 

Planned Parenthood of South Texas 

Tony Switzer 


Men’s Nonviolence Project 

Wendell Teltow 

Prevent Child Abuse Texas 

Marcy Thomas 

Red River Drug and Alcohol Treatment Center 

Karen Thompson-O’Briant 

American College of Obstetricians and 

Gynecologists 

Texas Section and Texas Association 

Debby Tucker 

National Center on Domestic and Sexual 

Violence 

Nikki Van Hightower 

Program for the Prevention of Rural Family 

Violence - Texas A&M University 

Juliet Walters 

National Center on Domestic and Sexual 

Violence 

Shannon Walton 


Division 


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Family Planning on the Inside 

Project 

Lydia Gonzalez Welch 

League of United Latin American Citizens 

Deputy Director for Women 

Janis Willis 

Planned Parenthood of Central Texas 

Amy Wright 

Women’s Advocacy Project 

Lori Yarbrough 

Rape Crisis Center, Brazos Valley 

Kelly Young 

Houston Area Women’s Center 

Laura Zarate 

Arte Sana 

Martha Zuniga, MPA 

South Texas Family Planning and Health 

Corporation 

C-113 A STRATEGIC PLAN TO PREVENT VIOLENCE AGAINST WOMEN IN TEXAS

Appendicies - D Resource Guide 

APPENDIX D 

National Resource Guide 

Efforts in the Primary Prevention of Violence Against Women (VAW) 

The following programs from around the United States are highlighted for employing promising 

practices in the prevention of VAW. 

Communities Against Rape and Abuse (CARA) Seattle, Washington 

Works with marginalized groups such as minorities, LGTB communities, youth, and people with 

disabilities. Prevention activities focus on peer-based education, community organizing, and 

promoting cultural competence. 

www.cara-seattle.org 

Cut It Out (program of Salons Against Domestic Abuse) National (U.S.) 

Program encouraging beauty salons to raise awareness about domestic abuse among their 

clientele and their staff using posters and brochures, and training personnel to recognize signs of 

domestic violence in their clients. http://www.cutitout.org/ 

Deana’s Fund – “The Yellow Dress” and “Remote Control” National (U.S.) 

Dating violence prevention through innovative, age-appropriate youth theater. 

www.deanasfund.com 

Family Violence Prevention Fund (FVPF) San Francisco, California 

Resources, activism, and policy work to prevent family violence on the national level. Recently 

released a publication entitled, The National Consensus Guidelines on Identifying and Responding 

to Domestic Violence Victimization in Health Care Settings. 


Gloucester Men Against Domestic Abuse (GMADA) Gloucester, Massachusets 

Community driven effort involving men in changing social norms that see VAW as acceptable. 

Prevention activities focus on public awareness. 

www.strongmendontbully.com 

Initiative for Violence-Free Families (program of Family and Children’s Service) 

Minneapolis, Minnesota 

Seeks to change underlying attitudes toward VAW. Prevention activities focus on public awareness 

and education.www.famchildserv.org 

Men Stopping Violence (MSV) Atlanta, Georgia 

Training, educational outreach, counseling, and community partnerships targeting men. Prevention 

activities focus on public awareness and community collaborations. 

www.menstoppingviolence.org 


D-114


Men’s Resource Center of Western Mass Amherst, Massachusetts 

Men’s Center promoting men’s nonviolence and challenging traditional male stereotypes. 

Prevention activities focus on public awareness and community collaborations. 

www.mensresoucecenter.org 

Mentors in Violence Prevention (MVP) Northeastern University (Massachusetts) 

Violence prevention program engaging student and professional athletes as role models. Prevention 

activities target youth, focusing on public awareness and social norm change. 

www.sportinsociety.org 

Missouri Care Health Plan Health Screening Program State of Missouri 

Medicaid health plan providing screening for VAW in healthcare settings. Prevention activities 

focus on public awareness and systems change. 

www.chcs.org/spotlight/2003February 

Physicians for a Violence-Free Society San Francisco, California 

Addresses all kinds of violence, including VAW, by defining physicians’ role in preventing violence. 

www.pvs.org 

Silent Witness National Initiative National (U.S.) 

Public awareness prevention effort using life-size silhouettes representing women who have died as 

a result of domestic violence. The silhouettes are used in marches, vigils and other awareness 

events in Washington, D.C., and the Initiative provides support for all 50 states to develop their own 

Silent Witness programs. 

www.silentwitness.net 

White Ribbon Campaign Canada 

Newsletter, media campaigns, and educational materials dedicated to encouraging men to 

participate in ending VAW. Prevention activities focus on public awareness. 

www.whiteribbon.ca/wrchrome.htm 

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Texas Resource Guide 

Efforts in the Primary Prevention of Violence Against Women (VAW) 

The following prevention efforts in Texas seem to employ promising practices for the prevention of 

VAW. 

Resource Description 

Arte Sana (Art Heals) Austin, Texas 

Culturally and linguistically appropriate community education, 

training, and technical assistance for VAW programs. 

Prevention activities focus on community organizing and 

promoting cultural competence. Website: www.arte-sana.com 

Contact Information 

Laura Zarate 

Email: lazarate@yahoo.com) 

ASAP (A Safety Awareness Program) Austin Texas Wendi Abramson 

Domestic violence and sexual assault services for individuals with Phone: (512) 267-7233) 

disabilities operated through Austin Safe Place (domestic violence and Email: wabramson@austin-safeplace.org 

rape crisis center). Prevention activities focus on education and promotion 

of cultural competence. 

Website: http://www.austin-safeplace.org/programs/disability/default.htm 

Center for Violence Prevention 

UT Health Sciences) San Antonio, Texas 

Promotes violence prevention related research, training and practice. 

Website: http://nursing.uthscsa.edu/CVP/cvp.shtml 

Margaret Brackley, R.N, Ph.D. 

Email: brackley@uthscsa.edu 

Coaching Boys Into Men Amarillo, Texas 

Susan Ginn 

Public awareness campaign involving local coaches and other male Phone: (806) 372-3202 x3082 

role models in educating boys and men about domestic violence. Email: susan@fss-ama.org 

Encouraging men to be positive role models for boys and communicate Family Support Services 

about violence against women. 

1001 S. Polk 

Susan Ginn phone: (806) 372-3202 x3082; (email: susan@fss-ama.org) Amarillo, TX 79101 

Expect Respect Austin, Texas 

Barri Rosenbluth 

School-based program focusing on the prevention of dating violence Phone: (512) 356-1628 

and sexual assault operated through Austin Safe Place (domestic violence Email: brosenbluth@austin-safeplace.org 

and rape crisis center), providing counseling, support groups, 

presentations, and training. Website: www.austin-safeplace.org/programs/school 

Injury Prevention Center of Greater Dallas Diane Bomash 

Dallas, Texas Phone: (214) 590-4457 

Coalitions on Domestic Violence Awareness, Child Abuse Prevention, Email: dbomas@parknet.pmh.org 

Elder Abuse Prevention and Family Violence Prevention create and Website: www.ipcdallas.pmh.org 

prevention projects, programs, and interventions. The coalitions are made 

execute up of representatives of various agencies, institutions, and 

groups in the community. 


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Institute on Domestic Violence and 

Noel Busch, Ph.D. 

Sexual Assault UT Center for Social Work Research Phone: (512) 471-3198 

University institute supporting research on domestic violence and Email: nbusch@mail.utexas.edu 

Austin, Texassexual assault, training, technical assistance, and 

dissemination. Prevention activities focus on research and data 

information collection to inform policymakers and practitioners. 

Website: http://www.utexas.edu/research/cswr/idvsa/ 

JOVEN San Antonio, Texas 

Richard Davidson 

Community-based organization targeting at-risk youth and their Phone: (210) 924-0330 

families with intervention and prevention programming. 

Email: joven@stic.net 

Prevention activities focus on education. 

Website: www.joven-sa.org 

Men’s Nonviolence Project 

TX Council on Family Violence 

(TX Council on Family Violence) Austin, TX Phone: 1-800-525-1978 

Public awareness prevention campaign directed at men, including 

posters and palmcards, and radio, television, outdoor, and 

print PSAs providing information on what constitutes abuse 

and urging men to speak to their peers about violence 

against women. Website: http://www.tcfv.org/programs_for_batterers.html 

Men’s Resource Center of South Texas 


Harlingen, Texas 

Email: ecddl@yahoo.com 

Men’s organization providing support groups to promote men’s 

nonviolence. Prevention activities focus on group and peer-based education. 

Migrant Clinicians Network Austin, Texas 

Cesar Alvarado 

Violence prevention within migrant worker families. Prevention Phone: (512) 327-2017 

activities focus on public awareness and health care screening for Email: calverado@migrantclinician.org 

domestic violence. Website: www.migrantclinician.org 

MOSAIC Family Services Dallas, Texas 

MOSAIC staff 

Provides shelter and services to domestic violence, as well as services Phone: (214) 821-5393 

to victims of trafficking, refugees, immigrants, and Hispanic communities 

as part of the East Dallas Counseling Center. Prevention activities focus 

on raising public awareness, community collaboration, and promoting 

cultural competence. Website: http://www.edcctexas.org/mission.html 

P.E.A.C.E. (Putting an End to Abuse through Patricia Castillo 

Community Efforts) Initiative – San Antonio, Texas Phone: (210) 533-2729 

Coalition of 52 institutions, organizations, and individuals working to Email: patpeace@texas.net 

end family violence through community organizing, collaboration, and 

promotion of cultural competence. 

Website: http://www.salsa.net/peace/initiative/index.html 





Poder de la Mujer y las Americas El Paso, Texas Poder de la Mujer y las Americas 

Community directed peer-based empowerment program for immigrant Phone: (915) 544-5126 

women focusing on domestic violence. Prevention activities focused 106 East Yandell 

on public awareness and community organizing. El Paso, Texas 79902 

Program for the Reduction of Rural 

Nikki Van Hightower, Ph.D. 

Family Violence College Station, Texas Phone: (979) 847-8924 

Collaborative advocacy program targeting rural communities to 

Email: nikki@polisci.tamu.edu 

overcome obstacles to obtaining domestic violence services such as 

geographic isolation, weak economies, and lack of transportation. 

Prevention activities focus on public awareness and community organizing. 

Website: http://ruralfamilyviolence.tamu.edu 

Silent Witness Program 

TX Council on Family Violence 

(TX Council on Family Violence)Austin, TX (and statewide) Phone: 800-525-1978 

Public awareness effort using life-size silhouettes representing women 

who have died as a result of domestic violence. Silent witnesses were 

initially used in a march on the TX State Capitol, and now shelters 

and service providers around the state use the exhibit in local awareness events. 

Website: http://www.tcfv.org/silent_witness.html 

South Texas Family Planning and 

Cynthia Bunton 

Health Corporation Corpus Christi, Texas Phone: (361) 855-7333 

Screens for VAW in a healthcare setting, as well as provides prevention Email: cynthiabunton@stfphc.org 

and intervention services for victims. Prevention activities focus on public 

awareness and education. 

“Speak Up Speak Out” Campaign Against Chris Lippincott 

Sexual Assault Austin, Texas Phone: (512) 474-7190 ext. 7777 

Research-based public awareness media campaign conducted 

Email: clippincott@taasa.org 

by the Texas Association Against Sexual Assault (TAASA) promoting 

the prevention of sexual assault. 

Website: http://www.taasa.org/media/default.php 

Students Taking Action for Respect (STARs) Byron Thompson 

Austin, Texas Phone: (512) 474-7190 x 7014 

Involves youth in educating and empowering fellow students in a Email: bthompson@taasa.org 

peer-led program focusing on ending dating violence and sexual assault. Website: www.taasa.org/star 

Un Nuevo Amanecer/A New Dawn Weslaco, Texas Alicia Vasquez 

Peer-based promotora program in collaboration with Planned Phone: (956) 969-8185 

Parenthood and Mujeres Unidas/Women United shelter to promote Email: welsacomujeres@juno.com 

education and public awareness about domestic violence, sexual assault, 301 W. Bus. Hwy. 83 

and child abuse. Prevention activities focus on public awareness. Weslaco, TX 78569 


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APPENDIX E 

Violence Against Women (VAW) Related Links 

A list of websites and online resources to inform those developing efforts to end domestic violence 

(DV), sexual assault (SA), and stalking. 

VAW Policy and Government Agencies/Programs 

American Bar Association Commission on Domestic Violence 

Broad range of information on DV, has link to extensive VAW statistics. 

www.abanet.org/domviol or www.abnet.org/domviol/stats.html (statistics) 

Bureau of Justice Statistics, U.S. Department of Justice 

Current statistics on VAW and other related topics www.ojp.usdoj.gov/bjs/ 

Center for Women Policy Studies 

Multiethnic and multicultural feminist research, policy analysis and advocacy. Several VAW-related 

research programs. www.centerwomenpolicy.org 

Family Violence Department, National Council of Juvenile and Family Court 

Judges 

Information on improving the response of courts and law enforcement to VAW issues. 

www.ncjfcj.org/dept/fvd/ 

Office of Victims of Crime (OVC) 

Resources and information about all types of crime, including victims of VAW. 

www.ojp.usdoj.gov/ovc 

Violence Against Women Office at U.S. Department of Justice 

VAW funding information, statistics, and federal laws and regulations addressing VAW. Also has 

link to “best” or model practices in the area of VAW. www.ojp.usdoj.gov/vawo 

Violence Policy Center 

Research on all kinds of violence in America, advocates development of violence-reduction policies. 

Focus on firearms. www.vpc.org/index2.htm#women 


Appendicies - E Related Links 

General Information and Resources on VAW 

National Resources 

American College of Obstetricians and Gynecologists (ACOG) 

VAW issues section. www.acog.org/goto/noviolence 

Community United Against Violence Network (CAVNET) 

Research site featuring articles and resources on DV, SA, and stalking. www.cavnet.org 

Corporate Alliance to End Partner Violence 

Coalition of business leaders committed to raising awareness about VAW. Funding resources. 

www.caepv.org 

Family Violence Prevention Fund 

Resources on the prevention of family violence. News updates on VAW in the media, and some 

research articles on prevention of VAW. http://www.endabuse.org 

Family Violence and Sexual Assault Institute 

– Research on VAW, bulletin on VAW issues, training and educational materials. www.fvsai.org 

MediaEd 

Resources on documentaries and videos addressing VAW prevention training and public 

awareness. www.mediaed.org 

Minnesota Center Against Violence and Abuse Electronic Clearinghouse 

(MINCAVA) 

Includes many useful links to VAW related topics and resources.http://www.mincava.umn.edu/ 

National Center for Human Rights Education 

Focus on VAW as a human rights issue, connecting VAW with related social change efforts. 

Information on community organizing. 

http://www.nchre.org/ 

National Center for Injury Prevention and Control (NCIPC) 

A CDC web page with links to different types of family violence as well as general injury issues. 

http://www.cdc.gov/ncipc/ 

National Coalition Against Domestic Violence 

National advocacy organization focusing on governmental policies addressing domestic violence. 

www.ncdv.org 

National Domestic Violence Hotline 

Extensive resources on DV. www.ndvh.org 


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National Network to End Domestic Violence 

Focuses mainly on legislation and funding for VAW.www.nnedv.org 

National Organization for Men Against Sexism (NOMAS) 

nformation on pro-feminist men’s movement and men’s involvement in VAW prevention. 

www.nomas.org 

National Organization for Women (NOW) 

Organization of feminist activists working to eliminate discrimination and end VAW, among other 

feminist causes. www.now.org 

National Sexual Violence Resource Center 

Clearinghouse for resources and research on sexual violence. www.nsvrc.org 

National Violence Against Women Prevention Research Center 

– Sponsored by the CDC. Targeting scientists, practitioners, advocates, grassroots organizations, 

anyone interested in topics related to VAW and its prevention. 

http://www.vawprevention.org/main3.shtml 

Rape Abuse and Incest National Network (RAINN) 

Operates the National Sexual Assault Hotline and organizes prevention and intervention programs. 

www.rainn.org 

ROAR (Reducing Our Assault Risk) 

Information on Interpersonal Violence. http://www.fmarion.edu/~roar/violence.htm 

Stalking Resource Center 

Definitions and statistics on stalking. www.ncvc.org/src/statistics/nvawsurvey.html. 

VAWnet Library 

Research site for VAW related issues. www.vawnet.org 

Texas Resources 

Austin SafePlace 

Domestic violence and sexual assault prevention and intervention center. www.austin-safeplace.org 


Coalition of DV organizations, networks and individuals working to end family violence. 

www.tcfv.org 


State association for organizations and individuals working on sexual assault issues. www.taasa.org 

E-121 A STRATEGIC PLAN TO PREVENT VIOLENCE AGAINST WOMEN IN TEXAS


Social Change and VAW Prevention Information 

Alternatives to Domestic Aggression 

Information on batterer intervention and prevention. www.csswashtenaw.org/ada 

Prevention Pathways 

Information and resources on model prevention programs, evaluation, and program 

implementation. Not limited to VAW. http://preventionpathways.samhsa.gov/default.cfm 

Transforming Communities 

Based in San Francisco CA, this organization provides technical assistance and resources to DV 

prevention efforts using a community organizing model. www.transformcommunities.org 

Articles/Papers Online: 

Fullwood, Catlin P., Family Violence Prevention Fund. “Preventing Family Violence: Community 

Engagement Makes the Difference.” http://endabuse.org/programs/children/files/Preventing.pdf 

Hart, Barbara J. Coordinated Community Approaches to Domestic Violence. Paper presented at 

the Strategic Planning Workshop on Violence Against Women, National Institute of Justice, 

Washington D.C.: March 31, 1995. Online. Available: www.mincava.umn.edu/hart/nij.htm. 

Minnesota Program Development, Inc., The Duluth Model. Online. 

Available: www.duluth—model.org/. 

VAW Prevention with Children and Youth 

Colorado Anti-Bullying Project 

Links to Anti-Bullying sites www.no-bully.com/links.html 

National Youth Violence Prevention Resource Center 

Link to publications on VAW prevention topics. Sponsored by the CDC, many of the resources are 

links to CDC web pages. http://www.safeyouth.org/pubs/inetmatcatselect.cfm 

VAW and the Lesbian/Gay/Bisexual/Transgender Community 

Community United Against Violence (CUAV) 

Information on domestic violence within the LGBT community. www.xq.com/cuav 

Gay Men’s Domestic Violence Project 

Advocacy and resources for gay men experiencing DV. www.gmdvp.org 

Network for Battered Lesbians and Bisexual Women 

Advocacy and resources for lesbian and bisexual women experiencing DV. 

www.thenetworklared.org 


E-122


VAW and Communities of Color 

Asian and Pacific Islander Institute on Domestic Violence 

National forum for information, research, resources and other issues about VAW in Asian and 

Pacific Islander communities. www.apiahf.org/apidvinstitute 

Institute on Domestic Violence in the African American Community 

Research and advocacy addressing VAW among African Americans. www.dvinstitute.org. 

Mending the Sacred Hoop Technical Assistance Project 

Information and research addressing VAW in Native American communities. 

www.msh-ta.org/index.htm 

National Latino Alliance for the Elimination of Domestic Violence 

National advocacy organization working to end DV in Latino communities.www.dvalianza.org 

Article Online: 

Davis, Angela. “The Color of Violence Against Women.” Keynote address presented at the Color 

Lines Color of Violence Conference, Santa Cruz: March 2002. 


VAW and Elderly 

National Center on Elder Abuse 

Information on all types of elder abuse, including sexual and domestic abuse. 

http://www.elderabusecenter.org/ 

National Committee for the Prevention of Elder Abuse 

Legislative and policy work to end ally types of elder abuse. http://www.preventelderabuse.org/ 

VAW and People with Disabilities 

Center for Research on Women with Disabilities (CROWD) 

Resources/publications on DV and SA and women with disabilities. www.bcm.tmc.edu/crowd 

Disabled Women’s Network (DAWN) Ontario 

Information and resources on many issues facing women with disabilities, including VAW. 

http://dawn.thot.net 

E-123 A STRATEGIC PLAN TO PREVENT VIOLENCE AGAINST WOMEN IN TEXAS


Incarcerated Men, Women, and Youth 

Stop Prisoner Rape (SPR) 

Outreach, education and advocacy to stop sexual violence toward incarcerated men, women and 

youth. www.spr.org 

Religion and VAW 

Center for the Prevention of Sexual and Domestic Violence 

Inter-religious educational resource addressing SA and DV from the perspective of faith 

communities. www.cpsdv.org 

Health Screening for VAW 

California Medical Training Center 

Trains medical professionals to address DV and SA. www.mtc.ucdmc.ucdavis.edu 

Family Violence Prevention Fund. 

The National Consensus Guidelines on Identifying and Responding to Domestic Violence 

Victimization in Health Care Settingswww.endabuse.org/programs. 

National Health Resource Center on Domestic Violence (project of FVPF) 

Support, training, and resources for health care professionals and policy makers 

www.endabuse.org/health 


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