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Systems Change Analysis of SANE Programs: Identifying the Mediating Mechanisms of Criminal Justice System Impact

机译：saNE项目的制度变迁分析：识别刑事司法制度影响的中介机制

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The purpose of this project was to determine whether adult sexual assault cases in a Midwestern community were more likely to be investigated and prosecuted after the implementation of a Sexual Assault Nurse Examiner (SANE) program, and to identify the critical ingredients that contributed to that increase. Informed by a systems change theoretical model, the interrelationships between SANEs, legal professionals, victim advocates, and victims/survivors were examined as it is these linkages that may be instrumental to increased prosecution rates. The design of this project combined quasi-experimental quantitative methods to measure objective indices of change with qualitative methods to capture the processes that produce those changes. Police and court records, in addition to in-depth interviews with police, prosecutors, victims/survivors, and forensic nurses, were the primary data sources for this project. The first goal of this study was to examine whether adult sexual assault cases were more likely to be investigated and prosecuted after the implementation of a SANE program within the focal county. In Study 1, we used a rigorous quasi-experimental design to determine whether there was a change in prosecution rates pre-SANE to post-SANE. We collected N=156 pre-SANE hospital cases from January 1994 to August 1999, and N=141 SANE cases from September 1999 to December 2005 that were equivalent on multiple criteria, except that the pre-SANE cases were examined by hospital emergency department personnel and the post-SANE cases were examined in the focal program. Using longitudinal multilevel ordinal regression modeling, we found that case progression through the criminal justice system significantly increased pre- to post-SANE: more cases reached the final stages of prosecution (i.e., conviction at trial and/or guilty plea bargains) post-SANE. These findings are robust after accounting for changes in operation at the focal county prosecutors office and seasonal variation in rape reporting.

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