Getting to Outcomes® Handbook How to Strengthen Sexual Assault Prevention Activities in the Military
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The Department of Defense's (DoD's) 2019 Prevention Plan of Action (PPoA) calls for a comprehensive approach composed of integrated, research-based prevention activities, which are regularly evaluated, to successfully prevent sexual assault and harassment.
To achieve the goals of the PPoA, DoD contracted with the RAND National Defense Research Institute (NDRI) to provide a series of tools and supports for selected DoD installations across the military community.
NDRI based this support around the Getting To Outcomes®(GTO) model, a user-oriented ten-step process for comprehensive planning, implementation, and evaluation of various types of prevention activities and community initiatives.
Each GTO step in this handbook aligns with the PPoA to help DoD and other organizations select sexual assault prevention activities with evidence of effectiveness, and implement them with the highest quality possible while monitoring the process and outcomes obtained.
This handbook has been developed to provide a streamlined version of the parent, comprehensive version of the GTO Guide for use at military installations with GTO teams, planning, running, and evaluating sexual assault prevention activities.
What Is Getting To Outcomes®?
GTO is a ten-step process that supports program delivery or implementation by guiding the user through the key tasks needed to make a program a success.
Nearly two decades of RAND research has shown that organizations that use GTO improve their programs and get better outcomes than organizations that do not use GTO (Chinman et al., 2016; Acosta et al., 2013; Chinman et al., 2008).Learn more about Getting To Outcomes®
Getting To Outcomes® Steps: Sexual Assault Prevention Activities (SAPA)
Learn more about each step, whether in order or as your team needs.
Step 1: Identify and understand the priority problem(s) to focus on
Step 2: Set broad goals and specific desired outcomes for your SAPA
Step 3: Identify and select candidate SAPA with evidence of effectiveness
Step 4: Assess how well each candidate SAPA fits and eliminate from consideration any with poor fit
Step 5: Assess your capacity to implement remaining candidate SAPA as intended
Step 6: Plan SAPA implementation and evaluation
Steps 7-9: Use process and outcome evaluation results to improve or reconsider the SAPA you have evaluated
Step 10: Plan for sustaining effective SAPA
Why Use Getting To Outcomes to Strengthen Sexual Assault Prevention Activities in the Military?
DoD estimated in 2018 that about 20,500 active-duty service members had been sexually assaulted in the previous year.
Research shows that GTO improves planning and implementation by helping users step through a series of decisions to prioritize among local problems, select evidence-based or evidence-informed programs or other activities that have measurable outcomes, and then deliver a program that fits and for which the organization has the needed resources or capacity, all with the highest quality possible.
Table 1: Sexual Assault Prevention Activities That Get Results and Lead to Reduced Risk and Potentially Reduced Incidence of Sexual Assault
|Decreased support for rape myths/harmful social norms||Encourage positive bystander behavior||Increase in risk perception||Increase in self-defense skills||Decrease in alcohol misuse|
|Perpetration Prevention with Men|
|The Men's Program||yes||yes||no||no||no|
|Coaching Boys into Men||no||yes||no||no||no|
|A Man Respects a Woman||yes||no||no||no||no|
|Know Your Power||no||yes||no||no||no|
|Bringing in the Bystander||yes||yes||no||no||no|
|Enhanced Assess, Acknowledge, Act (EAAA)||yes||no||yes||yes||no|
|Alcohol Misuse Prevention|
How to Use This Handbook
This handbook has been developed to provide a streamlined version of GTO for use at military installations with GTO teams, planning, running, and evaluating SAPA. The parent, comprehensive GTO guide is available on this website. A set of additional resources from the parent guide are provided as standalone companions to this handbook. They are referenced at each GTO step in the following pages. This site also includes an example of using GTO to plan a SAPA in a fictional military scenario.
The handbook leads SAPA implementation teams through the ten steps of GTO. For each step, there is one page that includes:
- an overview of the GTO step—what it is, why it is important, and how to do it
- key points about each step including the link between the GTO step and the relevant domain from the DoD PPoA
- a section with links to resources for more information to help complete each step.
Two worksheets are included: The SAPA Overview will help you develop a thumbnail overview of your whole SAPA (GTO Steps 1–6), and the Evaluation Summary and CQI Review Worksheet will help you understand and use your evaluation results to make and document decisions about improving your SAPA (GTO Steps 7–9).
The following list of characteristics clarifies what we define as a SAPA for the purposes of this handbook.
- involves an intervention, efforts designed to affect a specific outcome, or the direct provision of services—for example, bystander training
- has a target audience including active duty, National Guard, or reserve component service members and/or their family members and civilian employees
- includes policies and practices, in addition to programs.
A SAPA is not
- standard or routine care, such as clinical care, or a focus on clinical education
- screening tools that are not directly associated with an intervention, such as assessments designed to help recognize signs of trauma
- a one-way passive transmission of information with no intervention designed to affect a particular outcome (for example, websites with phone numbers, brochure distribution)
- a research project that does not involve an intervention or an intervention that is a clinical trial.
- a DoD Instruction, memorandum, or report
- an advisory team, task force, or other group or conference
- an administrative department, office, or center.
Who Should Use This Handbook
This handbook is intended to be used by military site SAPA GTO implementation teams at any point in their process—including focus problem identification, SAPA selection, detailed planning, implementation, evaluation and improvement, and sustainability planning.
- Three or four individuals on the implementation team should coordinate logistics and serve as primary participants in the GTO process. One or more members should have some GTO training. See a list of Getting To Outcomes training webinars.
- Optimally, the site implementation team should include a noncommissioned officer and an officer. Both are suggested because they will have appreciably different and unique points of view when it comes to implementation and will provide requisite capacity daily to accomplish required tasks.
- Someone on the team should provide a direct link between the site implementation team and command or site leadership to expedite decisionmaking and approvals.
- Leadership buy-in is critical to the success of any SAPA; therefore, engaging decisionmakers before, throughout, and after the process is a core task of the GTO team. See Engaging Leadership Before, During, and After Implementing Sexual Assault Prevention Activities in the Military for a thorough discussion of leadership engagement.
Acosta, Joie, Matthew Chinman, Patricia Ebener, Patrick S. Malone, Susan Paddock, Andrea Phillips, Peter Scales, and Mary Ellen Slaughter, "An Intervention to Improve Program Implementation: Findings from a Two-Year Cluster Randomized Trial of Assets—Getting To Outcomes," Implementation Science, Vol. 8, No. 1, 2013, p. 87.
Breslin, Rachel A., Lisa Davis, Kimberly Hylton, Ariel Hill, William Klauberg, Mark Petusky, and Ashlea Klahr, 2018 Workplace and Gender Relations of Active Duty Members: Overview Report, Alexandria, Va.: Office of People Analytics, U.S. Department of Defense, OPA Report No. 2019-027, May 2019.
Chinman, Matthew, Joie D. Acosta, Patricia Ebener, Patrick S. Malone, and Mary Ellen Slaughter, "Can Implementation Support Help Community-Based Settings Better Deliver Evidence-Based Sexual Health Promotion Programs?" Implementation Science, Vol. 11, No. 1, May 2016, pp. 78–93.
Chinman, Matthew, Sarah Beth Hunter, Patricia A. Ebener, Susan M. Paddock, Lindsey Stillman, Pamela Imm, and Abraham H. Wandersman, "The Getting To Outcomes Demonstration and Evaluation: An Illustration of the Prevention Support System," American Journal of Community Psychology, Vol. 41, No. 3-4, June 2008, pp. 206–224