Promising Practice Questionnaire - Australian Centre for the Study of Sexual Assault

Promising Practice Database Submission Questionnaire

To submit a program to be considered for inclusion in the ACSSA Promising Practice Database please complete the following questions. Any additional supporting material you may wish to include can be emailed to acssa@aifs.gov.au or posted to ACSSA at The Australian Institute of Family Studies, Level 20, 485 La Trobe St, Melbourne Vic 3000.

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Back to information about the Promising Practice Database

Section A: Background Information

Program Title

Contact Details

Agency
Address
City
State
Postcode
Website
Contact Person/s
Position
Phone
Fax
Email

Funding Source

Please state the main funding source(s) for the program:

Program Duration and frequency

Start date
Has the program finished?	Yes	No
Completion date (if relevant)
Do you intend to run the program again?	Yes	No
Has the program been run previously?	Yes	No
If yes, how many times?

Section B: Program Content

This section asks for information about what the program is, its aims, where it operates and for whom it is intended.

Program Description

Please provide a brief description of the program/initiative. Please include the objectives and main activities involved (no more than 500 words).

Program Type

Please indicate the type of program/initiative (select more than one if appropriate).
Community awareness, promotion, advocacy programs
Service Delivery and therapeutic responses to victims/survivors
Indigenous service provision and training
Service provider professional development and training/Training for community groups/organisations
Disability service provision and training
Offender treatment program
Schools/education sector, children or young people (Prevention)
Other (please specify)

Geographical Area

	Local community		Regional centre or town
	Region - inner metropolitan		Rural
	Region - outer metropolitan		Remote Australia
	State/Territory wide		Australia wide

Additional comments about the area:

Target Group

Women victim/survivors of adult sexual assault
Adult survivors of child sexual abuse
Young people
People with disabilities
Indigenous communities
Criminal justice agencies
Men in the community
Culturally diverse communities
School community
Children
Male/victimsurvivors
Service providers
Police
Offenders
Others (please specify)

The following questions are about how the program meets the Promising Practice Criteria.

Focus

What need in the community does the program meet?

How did the program originate?

Development and innovation

Was any specific research (books, articles etc) used to inform the program? If so, please give details or attach list.

Is the program:
a replication of an existing program
a modification of an existing program
a new program

If a replication:

What is the name of the existing program?

What is the original target group(s)?

If the program has been modified, please explain how.

Access and Diversity

Has the program/initiative been designed with a specific community in mind (eg women with disability, indigenous women, women from CALD communities)?

What strategies have been attempted or have been succesful in making the program accessible to this group?

If the program is for a non-specified general population, have there been specific strategies used to make it accessible to marginalised groups? If so, please describe these strategies.

Does the program engage with other agencies/services/individuals that respond to sexual assault (eg mental health practitioners, police, courts, lawyers, doctors)? If so, please explain how they are involved.

Has the program been evaluated? If so, what are the results?

If the program has not been evaluated, what other evidence is there that the program is achieving its goals?

If the program has been designed for a particular group or community, could it be replicated or useful for other groups or communities in responding to sexual assault? If so, please briefly explain how.

Conceptual framework

Please describe the conceptual framework (eg any theories, literature, research or other understandings of sexual assault) informing the program/resource.

Section C: Program Outcomes

Publications

Has the program generated any publications, reports, videos, presentations or unpublished papers?
Yes No

If yes, please provide details (author, title, publishing details, date, price, online availability etc)

Is the program available for others to use? If yes, please provide details.

Copyright

Under the Copyright Act, we require you as copyright owner to assign to the Australian Institute of Family Studies (AIFS) a non-exclusive licence to include your project in the Promising Practice Programs Database on the Australian Centre for the Study of Sexual Assault (ACSSA) website.

Inclusion in the database allows users to print or download entries for personal use only for the purpose of private study, research, criticism or review, as permitted under copyright legislation. For any further dissemination written permission must be obtained from your organisation.

I (name)

of (organisation)

give the Australian Institute of Family Studies permission to include the information I have provided regarding

(name of project) on the Australian Centre for the Study of Sexual Assault Promising Practice Database.

Date

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