Year of Publication



Public Health

Date Available


Degree Name

Dr. of Public Health (Dr.P.H.)

Committee Chair

Glen Mays, PhD, MPH

Committee Member

Richard C. Ingram, DrPH

Committee Member

Julie Cerel, PhD


Background: Kentucky has greater prevalence of sexual assault compared to the US overall, 37.5% versus 35.6% of all assault crimes respectively, translating to roughly 638,000 victims within the Commonwealth [1].Research identified sexual violence as the number one factor in development of PTSD among women. There are four times the prevalence of PTSD in victims of sexual violence versus other forms of trauma. [2, 3] The STAR program utilizes skills-based training methods to empower participants through improving a sense of safety and security, self-confidence, and self-efficacy to mitigate RR-PTSD symptoms leading to negative health outcomes.

Literature Review: Existing research has documented improved perceptions of safety among study participants utilizing animal assisted therapy (AAT) experiencing a traumatic stress situation. Unlike AAT isolated to clinical settings, service dogs are allowed under ADA to be with their client at all times, to provide ongoing condition management and disability assistance. Zapor et al. identified tailored interventions, fostering reliable and satisfying social support networks, as a vital component of successful programs addressing victims of violence [41]. Leech and Littlefield identified the role that positive support groups can have on the healing process of survivors [42] including: teach and promote use of coping skills, decrease social isolation, and to normalize experiences through engagement with others who have experienced similar trauma[22].

Methodology: The population of this program was adult (19 to 64 year old) women who were survivors of sexual assault and had a diagnosis of RR-PTSD. The program had three pillars: Safety and Security, Self-Confidence, and Self-Efficacy. The program had three programmatic components: service dog training classes 1-3 times per week, RR-PTSD face-to-face support group session once a week, and a daily social networking component. Analysis consisted of: patterns of change in measures, variation patterns across participants, direction and magnitude of change, pattern recognition, and whether change movement was in the expected direction. Median was utilized for reporting central tendency due to: the small number of participants, the presence of potential data outliers, inability to assume normal distribution, and the use of ordinal data.

Results: A completion percentage of approximately 93%, adherence to attendance protocols, and successful implementation by community partners answers affirmatively that the program was feasible to implement. The C-SSRS, PCL-5, Stanford Adapted Illness Intrusiveness Rating Scale, and the Stanford Chronic Illness Self-Efficacy Scale were successfully administered. The data gathered, analyzed and reported answers affirmatively the feasibility of obtaining measurable data.

Conclusion: Though complex and robust statistical analysis were not reasonable given the small cohort size for this pilot study, simple trend analysis for magnitude, directionality and trends towards expected outcomes were undertaken. Results suggest positive for improvement of symptomology for RR-PTSD, increased self-efficacy, self-reported improved sense of safety, security, self-confidence and self-esteem. All instruments show improvement from baseline, positive impact, and meet expected directionality for change. These outcomes all suggest a program that is likely to be beneficial to participants.

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