Identifying the Pathway to Implement Health Equity Assessment for Rape Prevention Education in American Samoa

The American Samoa Alliance Against Domestic & Sexual Violence has been awarded funding under the Centers for Disease Control and Prevention's (CDC) Rape Prevention Education (RPE) program for the next four years. This funding represents a significant opportunity for the Alliance to further its mission of preventing sexual violence within the Samoan community by implementing evidence-based strategies and culturally relevant practices. The workplan for the Alliance CDC Team, consisting of Communications Manager Marilyn Ho Ching, Communications Assistant Vatau Fanene, and Executive Director Jennifer Tofaeono, is centered on building the necessary infrastructure to enhance the internal capacity of the program. This will ensure effective facilitation and monitoring of prevention programs, practices, and policies that align with the unique cultural context of American Samoa.

The primary focus for this year is to develop and strengthen bystander intervention programs through the Social Ecological Model (SEM), which considers the various levels of influence on behavior: individual, relationship, community, and societal. The Social Ecological Model serves as a framework that recognizes the interwoven relationship between these factors and provides a comprehensive approach to preventing sexual violence by engaging individuals, fostering positive relationships, and creating supportive community and societal norms. The Alliance is committed to adapting this model to reflect Fa'aSamoa, the Samoan way of life, ensuring that prevention efforts resonate with the community's cultural values and social structures.

One of the key strategies under this grant is to create and strengthen bystander intervention programs specifically tailored for the Samoan community and other indigenous populations. Bystander intervention is a critical component of sexual violence prevention, as it empowers individuals to recognize and act upon potentially harmful situations before they escalate into violence. The Alliance will explore and adapt existing bystander intervention models that have been successful in similar cultural contexts. For instance, programs like *Bringing in the Bystander* and *Green Dot*, which have been implemented in various indigenous communities, offer valuable insights into how bystander intervention can be effectively promoted within tight-knit and culturally distinct groups.

Over the next few months, the Alliance will focus on conducting or leveraging existing primary prevention capacity assessments with an emphasis on health equity. Health equity in rape prevention education involves ensuring that all individuals, regardless of their socio-economic status, gender, sexual orientation, or cultural background, have equal access to resources, education, and support systems that protect them from sexual violence. In the context of American Samoa, where cultural norms and values heavily influence behavior, understanding and addressing health equity is vital to the success of any prevention effort.

To effectively address these issues, the Alliance will conduct interviews with key stakeholders, including community leaders, healthcare providers, educators, and social service agencies. These interviews will assess stakeholders' knowledge and understanding of health equity issues related to rape prevention and identify opportunities for collaboration. Through these discussions, the Alliance aims to uncover gaps in existing programs and resources, as well as cultural barriers that may prevent effective intervention and support. The insights gained will inform the development of tailored strategies that address the specific needs of the Samoan community.

Health equity issues in rape prevention education often stem from systemic inequalities that affect access to services and support. In American Samoa, factors such as geographic isolation, limited healthcare infrastructure, and cultural stigmas surrounding sexual violence can exacerbate these inequalities. For instance, Fa'aSamoa places a strong emphasis on family and communal harmony, which can sometimes discourage victims from speaking out against perpetrators, particularly if they are family members or close associates. Moreover, traditional gender roles may also influence how sexual violence is perceived and addressed within the community, potentially hindering the effectiveness of conventional prevention programs.

To overcome these challenges, the Alliance's work under the CDC RPE grant will prioritize culturally sensitive approaches that respect and incorporate Samoan values. This includes engaging elders and traditional leaders in prevention efforts, utilizing culturally relevant messaging in educational campaigns, and ensuring that intervention programs are accessible to all members of the community, including those in remote areas. By fostering a deeper understanding of health equity and its impact on rape prevention, the Alliance aims to create a more inclusive and effective response to sexual violence in American Samoa.

In conclusion, the CDC Rape Prevention Education grant program provides the American Samoa Alliance Against Domestic & Sexual Violence with a critical opportunity to build capacity and enhance its prevention efforts through culturally informed strategies. By focusing on bystander intervention and addressing health equity issues, the Alliance will work to create a safer and more supportive environment for all members of the Samoan community. As the Alliance moves forward with its workplan, it will continue to engage with stakeholders, assess needs, and develop interventions that align with Fa'aSamoa, ensuring that the community is both empowered and equipped to prevent sexual violence.

**Cited References:**

1. Banyard, V. L., Moynihan, M. M., & Plante, E. G. (2007). *Sexual violence prevention through bystander education: An experimental evaluation.* Journal of Community Psychology, 35(4), 463-481.
2. Nation, M., Crusto, C., Wandersman, A., Kumpfer, K. L., Seybolt, D., Morrissey-Kane, E., & Davino, K. (2003). *What works in prevention: Principles of effective prevention programs.* American Psychologist, 58(6-7), 449-456.
3. World Health Organization. (2021). *Health equity and its role in preventing violence against women.* WHO.
4. Wallerstein, N., & Duran, B. (2010). *Community-based participatory research contributions to intervention research: The intersection of science and practice to improve health equity.* American Journal of Public Health, 100(S1), S40-S46.