Bystander Intervention to Prevent Sexual Violence: The Overlooked Role of Bystander Alcohol Intoxication

Preliminary Efficacy of Positive Change(+Change): A Pilot Randomized Controlled Trial of an Integrated Alcohol and Sexual Assault Prevention Program Tailored by Gender and Sexual Orientation

The current study presents preliminary efficacy findings of a pilot randomized controlled trial of Positive Change© (+Change© ). +Change© utilizes personalized normative feedback to target alcohol use, sexual assault (SA) victimization, SA perpetration, and bystander intervention tailored for heterosexual cisgender men, heterosexual cisgender women, and sexual and gender-minoritized (SGM) groups. Participants included 165 undergraduate students aged 18 to 25 years old from a large public university in the Southwestern U.S. who engaged in past month heavy episodic drinking. Participants (57 cisgender heterosexual men; 54 cisgender heterosexual women; and 54 SGM) were randomized to +Change© (n = 83) or an assessment-only control (n = 82) and completed surveys online at baseline and 3-month follow-up in a parallel design with a 1:1 ratio (NCT04089137). The current study presents the secondary outcomes of the pilot randomized controlled trial which include alcohol use, SA victimization, SA perpetration, and bystander intervention behavior. +Change© was associated with significantly less severe SA victimization and more bystander intervention behavior at 3-month follow-up relative to the control. There were no significant differences between conditions in alcohol use at 3-month follow-up, however, the magnitude of decreases in drinking in the +Change© condition in this pilot study were consistent with other personalized normative feedback interventions. The present study was unable to assess differences in SA perpetration due to low base rates. No adverse effects among those receiving the intervention were observed. Findings suggested that +Change© may be a feasible strategy to prevent SA, by reducing student SA victimization and increasing bystander intervention. A fully powered randomized clinical trial is needed to examine the effects of +Change©.

Bystander Motivations and Barriers to Helping Intoxicated Peers

We examined the prevalence of self-reported motivations and barriers to helping intoxicated peers among emerging adults (N = 377; Mage = 18.64; 75% women, 88% White) attending a Southeastern university and whether motivations and barriers differed by age, gender, race, and class standing. Respondents aged 19-24 were more likely to endorse the motivation item "Because it was your "turn" to be the helper/designated driver (DD) that night" than eighteen-year-olds. Race differences were also reported for the motivation item, "Because the person was your friend", where White participants were more likely to endorse this item than non-White participants. Men also reported more Burden/Hassles-related barriers than did women.

Safer Bars: A cluster-randomized effectiveness evaluation of alcohol-related sexual violence prevention through bar staff bystander training

BACKGROUND

Sexual assault is consistently associated with social contexts that support high levels of alcohol consumption such as alcohol-serving establishments (i.e., bars). The significant rates of alcohol-involved sexual assault among college students demonstrate the critical need for evidence-based efforts to reduce alcohol-involved sexual assault in this population. Although bystander approaches have demonstrated some promise for reducing alcohol-involved sexual assault, to date no published studies have examined the effectiveness of implementing bystander prevention approaches with bar staff. Given the robust evidence indicating that bars serve as hot spots for sexual aggression, interventions that improve bar staff's ability to identify and intervene in sexually aggressive situations may offer a useful approach for reducing rates of alcohol-involved sexual assault.

METHODS

The Safer Bars study utilizes a cluster-randomized trial design that randomizes participants at the bar level into intervention and waitlist control arms. The sample includes bars (Nbars = 56) within a three-mile proximity to the three major public Arizona universities, with an average of 10 staff members per bar (Nstaff = 564). Assessments of individual-level and bar-level outcomes occur at baseline, training completion, and 3-months post-training, with an additional individual-level assessment at 6 months. Community-level effects are assessed using GIS data regarding police dispatches.

CONCLUSION

Safer Bars represents a novel, theory-driven approach to promote effective bystander behavior among bar staff working in close proximity to university campuses to reduce rates of alcohol-involved sexual assault.

Alcohol's Effects on the Bystander Decision-Making Model: A Systematic Literature Review

To decrease rates of sexual assault victimization, young people are encouraged to become involved when they see questionable sexual situations (i.e., be a prosocial bystander). Several factors can facilitate or inhibit intervention, including alcohol use. To inform bystander prevention programs that aim to address alcohol's impact on bystanders, the current study reviewed research focused on alcohol use and bystander decision making. In December 2022, the authors searched published studies from six major electronic databases. Empirical articles were deemed eligible if they examined alcohol and the bystander decision-making model within the context of sexual assault, were based in the United States or Canada, and not an intervention study; 32 studies were included in the final review. Across 32 studies published between 2015-2022, 12 assessed the proximal effects of alcohol on bystander constructs and the additional studies examined the distal effects of alcohol on bystander constructs. Alcohol use appeared to impede earlier steps of the bystander decision-making model; however, alcohol use was associated with impeding and facilitating bystander decision making at the latter half of the model. Overall, alcohol use appears to be negatively rather than positively associated with bystander constructs. Bystander intervention programs may want to move beyond the narrative of alcohol as a risk factor for sexual assault and discuss how alcohol impairs a bystanders' ability to recognize risk. More work is needed to ensure researchers assess alcohol consistently and with similar methods (number of drinks, subjective intoxication) to increase generalizability of findings to prevention programs.

College student alcohol use and confidence to intervene in interpersonal violence: Differences by gender and sexual orientation

Objectives: The current study examined the association between alcohol use frequency (ie, days a week one consumes alcohol), sexual and gender identity, and bystander confidence to intervene in interpersonal violence (ie, bystander self-efficacy). Participants: Participants were 750 undergraduate students aged 18-25 (260 heterosexual men, 260 heterosexual women, 59 SM men [54 cisgender, 5 transgender men], and 171 SM women [169 cisgender, 2 transgender women]). Methods: Participants completed an online survey about alcohol and sexual behaviors. Results: Results indicated that (1) alcohol use frequency was positively associated with greater bystander self-efficacy, (2) heterosexual men, compared to heterosexual women, reported lower bystander self-efficacy, and (3) the association between alcohol use frequency and bystander self-efficacy was significant and positive among heterosexual, but not SM, women. Conclusions: Prevention efforts may benefit from targeting individuals who drink more frequently and ensuring that they have the skills to effectively intervene.

UK and Australian University Students' Perceptions of the Nature of Sexual Assault and Intervening Behavior

Sexual assault is a global problem, with the risk highest among university students. Bystander intervention preventing sexual assaults has primarily been researched using quantitative methods to understand what factors influence it. However, both sexual assault and bystander intervention are complex with many subtle and overlapping issues that, when analyzed qualitatively, can offer new insights. The current study aimed to explore and develop a nuanced and comprehensive understanding of students' perceptions of sexual assault and bystander intervention across two universities, one in the United Kingdom and one in Australia. Thirty-nine university students (19 in the United Kingdom; 20 in Australia) took part in one-to-one semistructured interviews. Using inductive thematic analysis, two overarching themes were identified: (a) navigating the complex dynamics of sexual assault; and (b) decisions to intervene or not to intervene. Findings suggest that the complexity and ambiguity around sexual assault can forestall bystander intervention. As such, increasing education, awareness, and discussions around sexual assault and bystander intervention is vital to increase awareness of the problem and mobilize action from bystanders to prevent sexual assault.

Measuring Exposure to the Hazardous Drinking of Others and Perceived Opportunity to Intervene as a Bystander

OBJECTIVE

Excessive alcohol use is very prevalent among young adults, and consequences of drinking are often observed by witnesses. Understanding the circumstances under which witnesses of risky alcohol use help others and whether they perceive these circumstances as an opportunity to engage in bystander intervention are important, but valid measures of these constructs are needed. The current study is a psychometric evaluation of the Exposure to Hazardous Drinking in Others (EHDO) scale and a single-item indicator of Perceived Alcohol-Related Bystander Opportunity (PARBO).

METHOD

Young adults (N = 1,011; 46.0% women) who reported being around someone who showed signs of alcohol intoxication in the past 3 months were recruited via Qualtrics Panels. The initial item set for the EHDO was developed through qualitative methods and reflected observed or reported risks or consequences. Factor analyses and Item Response Theory analyses were used to reduce and categorize EHDO items, and construct validity was assessed for the EHDO and the PARBO item.

RESULTS

An initial set of 33 EHDO items was reduced to 21, representing two factors: Situational Risk Signs and Problematic Pattern. Both factors demonstrated good model fit, internal consistency, and evidence of convergent validity. The PARBO item showed good construct validity but was distinct from the EHDO.

CONCLUSIONS

These instruments are useful for measuring secondhand alcohol risks in a community and are particularly applicable for evaluating bystander intervention for alcohol risk.

How Do Bystanders Help in Drinking Situations: The Bystanders to Alcohol Risk Scale--Strategies

OBJECTIVE

Bystander intervention (BI) is a promising approach for promoting collective behavior change that has been applied to several domains, including sexual assault, bullying, and more recently, problematic alcohol use. Accurately measuring the strategies that bystanders use to reduce others' alcohol-related risk is an essential step toward improving bystanders' ability to reduce alcohol-related harm in their communities, but current measures of BI are not easily modifiable and applicable for alcohol-related BI. The current study aimed to develop a valid and reliable measure of the bystander construct most proximal to the reduction of risk: bystander strategies.

METHOD

Young adults (N = 1,011) who reported being around someone who showed signs of alcohol intoxication in the past 3 months were recruited via Qualtrics Panels to participate in an online survey; a subsample (n = 345) completed a 2-week follow-up. Psychometric evaluation included exploratory and confirmatory factor analyses, item response theory analyses, convergent validity, and test-retest reliability.

RESULTS

An initial set of 52 items was reduced to 17 items, representing two different factors. The first factor, Level 1, reflected strategies used during circumstances of acute risk. The second factor, Level 2, reflected strategies used to reduce risk for more longstanding problems with alcohol. Both factors demonstrated good model fit, strong internal consistency, evidence of convergent validity, and moderate test-retest reliability.

CONCLUSIONS

This novel measure can contribute to the production of knowledge about the use and efficacy of peer-focused strategies and the value of BI training for alcohol use.

Bystander intervention for problematic alcohol use among graduate and international students: opportunities and challenges

OBJECTIVES

Bystander intervention (BI) is a prevention approach commonly used for interpersonal violence, but is less studied for problematic alcohol use (PAU). Domestic graduate and international students' life experiences bring a unique context for the potential application of BI to PAU.

METHODS AND MEASURES

We conducted a mixed methods study that consisted of a needs assessment and focus groups at a southeastern university in the U.S. The aims of this study were to understand (1) differences in PAU BI opportunities for domestic graduate versus international students, (2) reasons for differences in PAU BI use, and (3) barriers/facilitators in use of PAU BI.

RESULTS

Overall, participants had few opportunities to use BI. Domestic graduate students had slightly more opportunities compared to international students. Most prominent reasons for lack of opportunities included not wanting to drive, the cost of drinking, and holding a graduate student identity (e.g. not interested in heavy drinking). Trusting others to be responsible for themselves was a common barrier noted for not using BI for PAU.

CONCLUSION

PAU BI programs should contextualize experiences of domestic graduate and international students to provide appropriate skill development that considers unique barriers and facilitators to intervention use.

Child sexual abuse and its determinants among children in Addis Ababa Ethiopia: Systematic review and meta-analysis

Child sexual abuse is a significant public health concern and a breach of basic human rights affecting millions of children each year globally. It is typically not reported by victims, hence it remains usually concealed. Except for single studies with varying reports, there is no national studies conducted on child sexual abuse in Ethiopia. Therefore, this review determined the pooled magnitude and determinants of sexual abuse among children in Ethiopia. Potential articles were searched from PubMed, Science Direct, Scopus, and Web of science using relevant searching key terms. The Joanna Briggs Institute (JBI) critical appraisal checklist was used to evaluate the quality of all selected articles. Data were analyzed using STATA Version 14 software. Publication bias was checked using Egger's test and funnel plot. Cochran's chi-squared test and I2 values were used to assess heterogeneity. A random-effects model was applied during meta-analysis. The pooled prevalence of sexual abuse among 5,979 children in Ethiopia was 41.15% (95% CI: 24.44, 57.86). Sex of children (OR: 2.14, 95%CI: 1.12, 4.06), smoking (OR: 4.48, 95%CI: 1.26, 76.79), khat chewing (OR: 3.68, 95%CI: 1.62, 21.93), and alcohol use (OR: 4.77, 95%CI: 2.22, 10.25) were the determinants of child sexual abuse. The main perpetrators of sexual abuse against children were neighbors, boy/girlfriends, family members, school teachers, and stranger person. Child sexual abuse commonly took place in the victim's or perpetrator's home, school, and neighbor's home. This review revealed that the magnitude of child sexual abuse in Ethiopia was relatively high and multiple factors determined the likelihood of sexual violence against children. Thus, policy-makers and concerned stakeholders should strengthen comprehensive sexual and reproductive health education to reduce the magnitude and consequences of child sexual abuse. Moreover, support with special attention should be given to children with mental illness and physical disabilities.

The Effects of Alcohol Intoxication on Perceptions of Consent and Refusal Indicators in a Fictional Alcohol-Involved Sexual Encounter

Alcohol intoxication may influence how bystanders interpret other people's consent and refusal cues. We examined the effects of alcohol intoxication on participants' perceptions of characters' consent and refusal indicators in a fictional vignette depicting an alcohol-involved sexual encounter. Young adults (n = 119, 52% women) participated in an alcohol administration experiment examining the influence of acute intoxication on bystander perceptions during a vignette depicting a character who is intoxicated and declines a sexual advance from another character, who ignores her refusal and continues to pursue sexual activity. Participants were randomly assigned to an alcohol or non-alcohol condition and then guided through a semi-structured interview in which we asked about the characters' consent and refusal cues. Interviews were analyzed using both inductive and deductive coding. Most participants eventually indicated the encounter was nonconsensual, but approximately 9% of participants described the encounter as entirely consensual and another 42% of participants described the interaction as initially consensual and then nonconsensual. Participants discussed nuanced accounts of consent and refusal cues, including indicators related to alcohol consumption. Disregarding intoxication and gender, participants eventually recognized the situation as nonconsensual and thus potentially risky. However, some participants recognized this risk earlier in the encounter than others. Consequently, bystanders who recognize risk later in a situation may have fewer opportunities to intervene before a situation escalates. We recommend sexual assault prevention educators take a more nuanced approach when discussing consent and refusal indicators, emphasizing contextual factors that may indicate risk.

Looking out for You and Me: College students' Strategies for Preventing Sexual Assault in Drinking Contexts

Background: Sexual assault and heavy alcohol use are prevalent and interrelated public health concerns on university campuses. Surprisingly, however, few alcohol harm reduction interventions address this intersection to help students reduce both personal and community risks for sexual assault in college drinking contexts. Objectives: In the current study, students (ages 18-24) shared strategies they use to protect themselves and others from sexual assault in college drinking contexts, as well as challenges to implementing these strategies. A series of six focus groups were conducted across two universities in the U.S. (N = 35). Participants responded to open-ended questions focused on drinking and sexual assault (e.g., What are some of the things students might do to avoid or address situations where they feel pressured of coerced to hook up or have sex when they do not want to?). Results: Thematic analyses demonstrated students' awareness of protective behavioral and bystander intervention strategies that could help reduce vulnerability to experience sexual assault for themselves or others in drinking contexts. Perceived barriers to using bystander intervention strategies included student's own and friends' heavy drinking (decreased inhibitions, loss of autonomy), ambiguity in deciphering risk (lack of familiarity, minimization, diffusion of responsibility), and gender (gender norms, power imbalances). Conclusions: This study informs the development of interventions that help students identify strategies and overcome barriers to reduce risks for sexual assault in college drinking contexts.

College Women's Perceptions of a Friend-Based Intervention to Prevent Alcohol-Involved Sexual Assault

Sexual assault (SA), particularly alcohol-involved SA, remains prevalent among college women. Because SA often begins in social contexts, bystander intervention has become a popular approach to prevention. Bystander interventions train individuals to intervene on behalf of others, including strangers, despite research indicating that intervention is more likely to occur when the bystander has a relationship with the target. Shifting the focus to friends as potential bystanders capitalizes on the qualities of relationship and responsibility that facilitate intervention. College women (N = 35) participated in focus groups (N = 8) during which they viewed a video prototype of a friend-based motivational interviewing (FMI) intervention session conducted with a friend dyad and provided feedback about the relevance and feasibility of using such an approach to reduce SA among friends who drink together in social settings. Content analysis of focus group transcripts yielded three themes: a) Friends as Natural Bystanders; b) The Role of Alcohol in Intervention, and c) Receptivity to FMI intervention. Women indicated that they feel responsible for keeping their friends safe, and that this sense of responsibility facilitates helping behaviors. Women also described ways through which alcohol intoxication can affect helping behavior. Women expressed enthusiasm for the FMI intervention approach and identified its emphasis on friendship and flexible approaches to personal safety as strengths. Findings highlight the promise of FMI intervention approaches that capitalize on the strengths of women's friendship to create safety goals that align with participants' values and overcome barriers to intervention, including alcohol intoxication.

State Alcohol Policy Environments of U.S. Colleges: Predictors of Sexual Assault and Alcohol-Related Arrest and Disciplinary Action

INTRODUCTION

Binge drinking and sexual assault are serious inter-related public health problems faced by college students. State-level alcohol policy restrictiveness has been found to decrease binge drinking among college students and, therefore, may also reduce occurrences of alcohol-related criminal offenses. It was hypothesized that more restrictive state alcohol policy environments would be associated with fewer liquor law violations and sexual assault offenses on U.S. college campuses.

METHODS

Data were aggregated across 3 academic years (2016-2017, 2017-2018, and 2018-2019) and represented n=1,290 institutions. Zero-inflated negative binomial regression modeling was performed in 2022-2023 to evaluate associations of state-level young adult binge drinking and the Alcohol Policy Scale (APS) with the numbers of campus-level alcohol-related arrests, alcohol-related disciplinary actions, rape offenses, and fondling offenses reported in national Campus Safety and Security data.

RESULTS

Higher APS scores had direct associations with fewer alcohol-related arrests (1.79% decrease per one-unit increase in APS, p=0.05), alcohol-related disciplinary actions (2.27% decrease per one-unit increase in APS, p=0.027), and rape offenses (0.85% decrease per one-unit increase in APS, p=0.021). The associations APS scores had with disciplinary actions and rape offenses were partially and fully mediated, respectively, by state-level young adult binge drinking. No associations were found between APS and fondling offenses.

CONCLUSIONS

This cross-sectional study presents evidence that more restrictive state alcohol policies are associated with fewer alcohol-related arrests and disciplinary actions, and rape offenses on college campuses. Future research should identify the alcohol policy domains that are most protective against these outcomes.

Bystander opportunity in situations of alcohol and violence risk: Exploring the feasibility of collecting daily diary data

Objective: One strategy to address the health issues among college students is through bystander intervention. However, much is still unknown about bystander behavior. The purpose of the current study was to assess the feasibility of daily diary methodology as applied to bystander opportunity. Method: Using a convenience sample, we examined (1) the frequency at which students encounter alcohol use risk and SDV risk bystander opportunities, and (2) the association between participants' daily alcohol use and daily bystander opportunity. Participants were a small group of 32 college students (75% women; 100% heterosexual; 93.7% White; 6.3% multiracial; 3.1% Hispanic) who took up to nine daily diary surveys for a total of 207 days. Results: Over 80% of participants completed the required days. Participants experienced at least one bystander opportunity on 24% of days. Participants were significantly more likely to report an alcohol risk bystander opportunity on days when they drank alcohol, compared to non-drinking days.

Effectiveness of a Bystander Intervention Program to Increase Bystander Behaviors Across Latent Risk Groups of High Schoolers

Bystander intervention programs have established efficacy to increase bystander behaviors to prevent interpersonal violence (IPV). Little research has investigated intervention efficacy among latent risk classes among high school students. Data from a five-year randomized control trial were used to conduct multigroup path analyses to assess the association between type of training received and bystander outcomes moderated by risk groups identified via latent profile analysis (LPA). LPA was used to identify risk based on six indicators related to violence exposure, association with aggressive friends, and alcohol use. Bystander training received was the primary independent variable characterized as: no training, overview speech alone, or skills training. Outcomes included (a) observed bystander behaviors; (b) reactive bystander behaviors; or (c) proactive bystander behaviors. Three risk groups were identified via LPA: low risk, moderate risk witnesses of IPV, and highest risk victims and perpetrators. Of the bystander trainings received, overview speeches only increased reactive bystander behaviors among low risk students. The skills training was effective at increasing most bystander outcomes among all risk groups, with the largest effect sizes observed among the highest risk victims and perpetrators profile. Findings suggest that tailoring or modifying bystander training based on the risk profiles of youth may lead to greater potential to increase bystander behaviors to reduce risk of violence. Specifically, overview speech trainings should be targeted to low risk youth, while skills training primarily delivered to higher risk youth. These skills trainings could incorporate content related to trauma-informed care as well as associations with alcohol use, which may enhance their effectiveness further.

Study protocol for a randomized controlled trial of RealConsent2.0: a web-based intervention to promote prosocial alcohol-involved bystander behavior in young men

BACKGROUND

Sexual violence (SV) is a significant, global public health problem, particularly among young adults. Promising interventions exist, including prosocial bystander intervention programs that train bystanders to intervene in situations at-risk for SV. However, these programs suffer from critical weaknesses: (1) they do not address the proximal effect of alcohol use on bystander decision-making and (2) they rely on self-report measures to evaluate outcomes. To overcome these limitations, we integrate new content specific to alcohol use within the context of prosocial bystander intervention into an existing, evidence-based program, RealConsent1.0. The resulting program, RealConsent2.0, aims to facilitate bystander behavior among sober and intoxicated bystanders and uses a virtual reality (VR) environment to assess bystander behavior in the context of acute alcohol use.

METHODS

This protocol paper presents the design of a randomized controlled trial (RCT) in which we evaluate RealConsent2.0 for efficacy in increasing alcohol- and non-alcohol-involved bystander behavior compared to RealConsent1.0 or to an attention-control program ("Taking Charge"). The RCT is being implemented in Atlanta, GA, and Lincoln, NE. Participants will be 605, healthy men aged 21-25 years recruited through social media, community-based flyers, and university email lists. Eligible participants who provide informed consent and complete the baseline survey, which includes self-reported bystander behavior, are then randomized to one of six conditions: RealConsent2.0/alcohol, RealConsent2.0/placebo, RealConsent1.0/alcohol, RealConsent1.0/placebo, Taking Charge/alcohol, or Taking Charge/placebo. After completing their assigned program, participants complete a laboratory session in which they consume an alcohol (target BrAC: .08%) or placebo beverage and then engage in the Bystanders in Sexual Assault Virtual Environments (BSAVE), a virtual house party comprising situations in which participants have opportunities to intervene. Self-reported bystander behavior across alcohol and non-alcohol contexts is also assessed at 6- and 12-months post-intervention. Secondary outcomes include attitudes toward, outcome expectancies for, and self-efficacy for bystander behavior via self-report.

DISCUSSION

RealConsent2.0 is the first web-based intervention for young men that encourages and teaches skills to engage in prosocial bystander behavior to prevent SV while intoxicated. This is also the first study to assess the proximal effect of alcohol on bystander behavior via a VR environment.

TRIAL REGISTRATION

Clinicaltrials.gov, NCT04912492. Registered on 05 February 2021.

A Systematic Review of Validated Measures of U.S.-Based Bystander Intervention-Related Constructs

This review aimed to identify U.S.-based, construct-validated measures of bystander intervention. Following PRISMA-P guidelines, electronic databases were searched, and emails were solicited identifying 8,559 articles for title screening. Abstracts and full texts were double screened, resulting in 24 scales meeting inclusion criteria: (a) measured a bystander-related construct in a situation where there was a potential for actual or perceived imminent physical or emotional harm, (b) written in English, and (c) statistically validated on U.S. samples. Most scales addressed the domain of interpersonal violence (67%), with fewer relating to bias/bullying (8.2%), mental health crises (12.5%), and substance use (12.5%). Most scales (71%) assessed the "take action" step of the situational model. The modal construct represented was intent/willingness/likelihood to intervene (50%). The average number of items on a scale was 14, and most (79%) provided Likert-style response options. None of the validated scales assessing behavior first accounted for an opportunity. Sample sizes ranged from 163 to 3,397, with the modal setting from colleges. Overall, samples were young (21.8 years old), White (75%), women (64%), and heterosexual (89%). Results indicate the need to validate additional measures that capture the "interpreting the situation as problematic" step of the situational model. Scales also need to be validated using diverse samples, particularly within the mental health crisis domain. Across all domains, validated measures need to be developed that first account for an opportunity when measuring actual bystander behavior. The information gleaned can be used to assist researchers in selecting measures and guide future measure development.

Alcohol's Role in Campus Sexual Assault Bystander Behavior: A Systematic Review

Between 50% and 70% of campus sexual assaults (SA) involve alcohol and campuses frequently promote bystander intervention strategies to prevent SA in student party contexts. This systematic review evaluates the measurement and outcomes of quantitative studies on how alcohol affects campus SA bystander outcomes. Using four search strategies and rigorous systematic review methods, we conducted a review of 36 studies. We included studies published after 2,000 conducted with college students in the United States, its territories, and Canada which contained information on alcohol use and SA bystander outcomes (behaviors and upstream proxies). Only a third of included studies measured bystander behavior directly, the majority measured upstream proxies (e.g., intentions, self-efficacy). Most studies considered the influence of victim intoxication on bystander outcomes. No studies assessed the pharmacological or physiological effects of alcohol on bystander outcomes. A single study examined hypothetical bystander responses when intoxicated, one-third examined bystander's typical alcohol use in relation to bystander outcomes. Many findings are contradictory, including fundamental details such as how often students encounter SA involving alcohol or whether bystanders' alcohol use predicts outcomes. Findings suggest that students are less likely help intoxicated victims compared to sober victims, but there are clear moderating factors. Perpetrator intoxication was not studied in relation to bystander behavior and did not influence any upstream proxies. Evaluations of interventions on alcohol and bystander topics are promising yet more research is required. This review illuminates key gaps in the literature, including the need for validated measures and scenarios, event-level studies, and alcohol administration trials.

Gender equitable attitudes as a significant mediator of bystander intentions among sexual minority adolescents

INTRODUCTION

Bystander intervention is a promising approach for prevention of sexual violence. Assessing factors that may promote or hinder bystander intervention among sexual minority adolescents (i.e., lesbian, gay, bisexual, queer) is essential, given high rates of violence among sexual minority youth. Prior research examining barriers and facilitators of bystander intervention intentions does not consider how factors may vary by sexual identity. As such, the current study aimed to (1) examine how barriers and facilitators of bystander intentions, bystander intentions, and bystander behavior vary between heterosexual and sexual minority high school adolescents and (2) explore mediators of the association between sexual identity and bystander intervention intentions. We proposed that students' level of school connectedness, gender equitable attitudes, and anticipated positive consequences of bystander intervention (e.g., having a moral desire to help) would promote bystander intervention intentions, whereas binge drinking, and students anticipated negative consequences of bystander intervention (e.g., fear for one's own safety) would tend to weaken bystander intervention intentions.

METHODS

Participants included 2,645 10th grade students (Mage  = 15.37, SD = 0.61) recruited from high schools in the Northeast United States.

RESULTS

Sexual minority youth reported higher bystander intentions, bystander behavior, anticipated positive consequences of bystander intervention, gender equitable attitudes, and binge drinking relative to heterosexual youth. Sexual minority youth had lower school connectedness than heterosexual youth. Anticipated negative consequences of bystander intervention did not vary by group. Parallel linear regression analyses found that only anticipated positive consequences of bystander intervention and gender equitable attitudes fully mediated the relationships between sexual identity and bystander intentions.

CONCLUSIONS

Bystander intervention programs may benefit from attending to specific facilitators of bystander intervention among sexual minority youth, such as gender equitable attitudes.

The bystander intervention for problematic alcohol use model (BIPAUM)

Objective: The study aimed to identify phases of bystander intervention (BI) for problematic alcohol use (PAU) among college students. Participants: Twenty focus groups and nine interviews were conducted. Methods: Transcripts were thematically analyzed. Results: The phases of the Bystander Intervention for Problematic Alcohol Use Model (BIPAUM) include: (1) plan in advance, (2) notice and interpret a sign, (3) decide (i.e., assume responsibility, assess support/feasibility to intervene, and identify intervention strategy), (4) intervene, and (5) assess outcomes. Assessing outcomes loops to influence future behavior and each phase is influenced by barriers and facilitators. Conclusions: These unique phases should be considered when designing and evaluating intervention programs for PAU to meet students' needs and better reduce PAU. Future research should empirically test the BIPAUM. The results of the current study demonstrate a promising opportunity for applying BI to PAU, with the goal of reducing risky drinking among college students.

Sexual and Gender Minority Men's Bystander Behaviors and Barriers in Response to Witnessing Minor Sexual Aggression

Objective

Sexual and gender minority (SGM) men experience sexual assault victimization. Encouraging people to become involved when they witness high-risk sexual situations as a prosocial bystander is one preventative mechanism to address sexual assault victimization. However, research assessing the extent that SGM men will intervene when they witness a concerning male-to-male sexual situation and barriers that prevent intervention is lacking. We sought to address these gaps.

Method

SGM men (n = 323, Mage = 39.4, range 18-77) completed a web-administered survey. Participants were asked if they had witnessed a high-risk sexual situation and, if so, to describe how they intervened; if they did not intervene, they were asked to explain why not. Data were analyzed using thematic analysis.

Results

Nearly 50% (n = 157) of participants reported witnessing a situation that may require intervention, of those men 40% reported involvement. When SGM men intervened, their behaviors included direct and indirect verbal and nonverbal strategies. Reasons for not intervening included not appraising the situation as risky, not viewing it as their responsibility to intervene, or lacking the self-efficacy to act.

Conclusion

SGM men reported similar barriers to intervention that heterosexual young adults encounter. Participants also provided a variety of intervention tactics that could be included in bystander intervention initiatives to increase their effectiveness and inclusivity. Additional efforts are needed to modify intervention initiatives at both the individual and community level.

Open pilot trial of an interactive digital application for campus sexual violence prevention

Digital applications, or "serious games" for health address learning goals in a cognitively active, interactive manner, with the potential for widespread dissemination. This study used a mixed methods approach to develop and conduct a formative evaluation of a digital application for sexual assault prevention. Make a change is a digital application that uses the principles of games for health to foster learning, engagement, and skill-building around risk and protective factors for sexual victimization, sexual aggression, and bystander intervention. The digital application includes four narrative chapters, six embedded activities, as well as a user-derived change plan in which individuals establish goals for behavior change following program completion. This multisite study at a 2- and a 4-year college utilized student interviews (n = 14), stakeholder interviews (n = 10), and focus groups with students (n = 40) to inform intervention development. A total of 41 college students then participated in an open trial and completed self-report surveys (pre, post, and 1-month follow-up) to evaluate the feasibility, acceptability, utility, and preliminary outcomes. Most of the sample reported enjoyment, usefulness, and perceived competence after completing the application. Data evidenced a trend to reduce the frequency of heavy drinking, and perceptions of social norms evidenced change over time. Findings support the feasibility and effectiveness of this novel format for the delivery of sexual assault prevention programming.

Effectiveness of Sexual Assault Protective Behaviors on the Daily Level: The Roles of Intoxication and Executive Control

Young adult women engage in a variety of behaviors aimed at reducing their risk of sexual assault (SA), termed sexual assault protective behavioral strategies (SA-PBS), yet the evidence demonstrating the effectiveness of SA-PBS in reducing SA risk has been relatively sparse and inconclusive. The current study examined the use of SA-PBS, the factor structure of a diverse array of SA-PBS, and their association with the occurrence of SA. The influence of state- and trait-level moderators on the association between SA-PBS and SA events was also examined. In a sample of community young adult women (N = 174), use of SA-PBS and the occurrence of same night SA were examined with a longitudinal burst design over 1 year that spanned 27 weekend nights when women were out in social contexts. We also examined the influence of state intoxication of alcohol use and trait effortful control (EC) on the relationship between SA-PBS factors and SA events. We found that SA-PBS cluster into two factors representing Proactive and Reactive SA-PBS. While Proactive PBS was not associated with SA, Reactive PBS were positively associated with a SA event occurring. There was no evidence in the current sample to support a moderating role of intoxication on the relationship between Proactive or Reactive PBS and SA. However, there was a marginal interaction effect found for the moderating role of EC on the relationship between Proactive PBS and SA. Our findings identify important differences in SA-PBS, and perhaps most importantly, suggest that not all strategies are created equal with respect to reducing risk.

The role of effortful control in mitigating negative consequences associated with emerging adult drinking

BACKGROUND

Identifying factors that protect against alcohol-related negative consequences associated with emerging adult drinking is a critical public health issue. It has been proposed that high levels of self-regulation moderate risks associated with drinking, decreasing alcohol-related negative consequences. Past research testing this possibility is limited by a lack of advanced methodology for testing moderation and failure to consider facets of self-regulation. This study addressed these limitations.

METHODS

Three hundred fifty-four community emerging adults (56% female; predominantly non-Hispanic Caucasian (83%) or African American (9%)) were assessed annually for 3 years. Moderational hypotheses were tested using multilevel models and the Johnson-Neyman technique was used to examine simple slopes. Data were organized such that repeated measures (level 1) were nested within participants (level 2) to test cross-sectional associations. Self-regulation was operationalized as effortful control and its facets (attentional, inhibitory, and activation control).

RESULTS

We found evidence of moderation. The association between alcohol use during a heavy drinking week and consequences weakened as effortful control increased. This pattern was supported for two facets (attentional and activation control), but not for inhibitory control. Regions of significance results revealed that this protective effect was only evident at very high levels of self-regulation.

CONCLUSIONS

The results provide some evidence that very high levels of attentional and activation control protect against alcohol-related negative consequences associated with drinking. Emerging adults who are very high in attentional and activation control are likely better able to control their attention and engage in goal-directed behavior, like leaving a party at a reasonable hour, or attending school and/or work when experiencing the punishing effects of a hangover. Results emphasize the importance of distinguishing facets of self-regulation when testing self-regulation models.

Barriers to addressing alcohol use in college sexual assault prevention: Where we stand and future steps

Purpose of Review

The aims of this paper are two-fold. First, we review the current evidence on sexual assault prevention programming that also targets alcohol. Second, we identify barriers to including alcohol use in sexual assault programs and provide recommendations to overcome these barriers.

Recent Findings

We identified six sexual assault programs that also include alcohol use content, four of which have yet to be rigorously evaluated. To further refine sexual assault prevention efforts, we identified four barriers that need to be overcome including: (1) alcohol and sexual assault prevent efforts are currently siloed, (2) fear of victim blaming when integrating alcohol into programs for women, (3) a lack of evidence on how alcohol impacts bystanders, and (4) uncertainty about how to include content related to alcohol and sexual consent communicated.

Summary

Researchers and preventionists with expertise in alcohol and/or sexual assault prevention need to work together with stakeholders and students on college campuses to overcome these barriers and address a key correlate of sexual assault.

Correlates of Bystander Intervention Attitudes and Intentions Among Young Adult Active Duty Male Soldiers

Sexual assault is a significant problem within the United States military. Bystander intervention skills training is recognized as a promising strategy for sexual assault prevention within both civilian and military populations. Sexual assault prevention programs which include training in bystander intervention teach individuals to notice situations that may pose a risk for harm and safely act to positively influence the outcome. This study examines correlates of bystander intervention attitudes and intentions among young adult active duty male soldiers (N = 282) between the ages of 18 and 24. Positive bystander intervention attitudes and intentions were associated with lower levels of rape myth acceptance, greater discomfort with sexism, lower likelihood of continuing an unwanted sexual advance after verbal resistance from a partner, greater likelihood of gaining verbal consent from a partner, and greater perceived peer approval for bystander intervention. In a multiple regression, perceived peer approval for bystander intervention and self-reported lower likelihood of continuing a sexual advance after verbal resistance from a partner emerged as significant predictors of positive bystander intervention attitudes and intentions (R² = .41). Given that perceptions of peer norms are modifiable, these findings highlight the importance of addressing peer norms in bystander intervention training programs for military personnel.

Posttraumatic cognitions and sexual assault: Understanding the role of cognition type in posttraumatic stress symptoms and problematic alcohol use

Identifying potential mechanisms underlying the association between posttraumatic stress symptoms (PTSS) and problematic alcohol use is an important target among college women who have experienced sexual assault. This study examined the role of posttraumatic cognitions in this association among college women (N = 530) who experienced either an alcohol-involved assault or non-alcohol-involved assault, using baseline assessment data from a larger study examining cognitive and emotional risk factors for problem drinking. Conditional path analysis was used to examine the indirect effects of posttraumatic cognitions on the association between PTSS and alcohol use consequences, with assault type as a moderator. The findings revealed a significant indirect path from PTSS to alcohol use consequences through posttraumatic cognitions, B = 0.21, SE = 0.04, p < .001, 95% CI [0.13, 0.29], β = .16, R2 = .32. Exploratory analyses revealed a significant conditional indirect effect through self-blame cognitions, R2 = .31, whereby the indirect effect of self-blame on the association between posttraumatic stress and alcohol consequences was present among participants who experienced alcohol-involved assault, B = 0.10, SE = 0.03, p < .001, 95% CI [0.06, 0.16], β = .07, but not among those who experienced a non-alcohol-involved assault, B = 0.03, SE = 0.03, p = 0.32, 95% CI [-0.02, 0.08], β = .02. Posttraumatic cognitions are a potential mechanism underlying the link between posttraumatic stress and alcohol consequences. Addressing posttraumatic cognitions, particularly those related to self-blame, may be an important target for interventions promoting healthy recovery following alcohol-involved assault.

Bystander Intoxication and Appraisal of Sexual Assault Risk: A Field Study of Emerging Adult Bargoers

Emerging adults are especially vulnerable to experiencing alcohol-related sexual assault. While bystanders play a critical role in preventing sexual assault, little is known about how bystander alcohol intoxication affects the intervention process-particularly in naturalistic settings. We recruited 315 emerging adult bargoers ages 21-29 (46% women; 28% non-college attending; 81% White) from a high-density bar area to provide responses to a sexual assault vignette and complete a breath alcohol concentration test. In this field-based study, we found a negative direct association between intoxication and appraisal of risk in the hypothetical sexual assault situation. We also found a negative indirect relation of intoxication on perceptions of personal responsibility to intervene and confidence in the ability to intervene, statistically mediated through reduced risk appraisal. Findings add to the limited literature in laboratory-based settings suggesting that bystander intoxication interferes with sexual assault intervention and help inform effective bystander intervention programming for emerging adults.

Correlates of Bystander Intervention Among Heavy Drinking College Men

The present study utilized survey assessments to examine correlates of bystander intervention intentions among heavy drinking college men (N = 210). Intentions to engage in bystander intervention were associated with fewer heavy drinking days, lower alcohol-related consequences, greater use of strategies to limit drinking, and lower endorsement of alcohol expectancies. A range of constructs commonly associated with perpetration of sexual aggression demonstrated a negative association with intentions to engage in bystander intervention. Multivariate analyses revealed that greater use of strategies to limit drinking and lower pornography use emerged as predictors of intentions to engage in bystander intervention.

Examining the Effect of Perceived Responsibility on Online Bystander Intervention, Target Hardening, and Inaction

Failure to take responsibility for intervening has been identified as a primary barrier to bystander intervention. Building on these findings, we examine how perceptions of responsibility affect responses to witnessing victimization in the online realm-a topic that has received limited attention. Using a maximum-likelihood selection model, we analyze data from the Pew American Trends Panel (N = 3709) to estimate the effects of respondents' perceptions of the role different groups should play in addressing online harassment on their likelihood to engage in intervention, target hardening, or inaction in response to witnessing online harassment, conditioned upon their likelihood of having witnessed such behavior. Findings indicate that the greater role respondents believe online users should have in addressing online harassment, the more likely they are to intervene. (b = .310). The greater role respondents believe law enforcement or elected officials should have in addressing online harassment, the less likely they are to intervene (b = -.135 and -.072, respectively). These findings have implications for future efforts to curb online harassment through users' crime prevention efforts.

A Mixed Media Campaign to Promote Bystander Intervention and Reduce Alcohol Use Among College Students: A Pilot Study

This study examined the limited efficacy of a mixed media campaign that promoted bystander intervention as a sexual violence (SV) prevention strategy and aimed to decrease alcohol use. A quasi-experimental design was used to assess the limited efficacy of the Be a Watch Dawg mixed media campaign implemented at a large Southeastern public university in 2017. Social marketing along with social cognitive theory, social norms theory, and theory of planned behavior were utilized as the framework for the campaign. Be a Watch Dawg promoted bystander intervention in SV risk situations and targeted bystanders' alcohol use via social media (e.g., Facebook, Instagram, and Twitter) and printed materials (e.g., posters, stickers, and handbills). Participants included 244 undergraduate students 18 to 24 years of age. Study outcomes included bystander intervention, intentions to intervene, and alcohol use. Adjusted linear regression and logistic regression models were used to examine differences in outcomes between pre and postcampaign samples as well as associations with campaign exposure. Significant increases in bystander intervention were observed between the pre and postcampaign samples. Campaign exposure was marginally related to intentions to intervene but was not significantly associated with bystander intervention. Social media analytics revealed that the campaign reached 39,466 social media users and received 50,854 impressions and 19,523 views. A mixed media campaign may be a promising and low-resource approach to increase bystander intervention as a strategy to combat campus SV.

Sexual Violence Among Sorority Women: Victimization Experiences, Contexts, and Disclosure

The purpose of this study was to examine and compare sexual violence (SV) victimization among sorority women and unaffiliated counterparts. Results showed sorority women were more likely than unaffiliated women to report experiencing some types of SV, consuming alcohol prior to victimization, and to identify their perpetrator as a hookup/casual partner. More women, regardless of affiliation, informally disclosed their victimization compared to formally reporting; many did not tell anyone because they did not think it was serious enough. The findings point to implications for harm reduction, bystander intervention, and primary prevention programming, as well as institutional policy to address SV.

Event-specific and individual factors impacting college students' decisions to intervene in a potentially risky scenario

Universities have attempted to address sexual violence on campuses through various prevention programs, including bystander intervention. Unfortunately, the extant literature on bystander intervention has primarily focused on bystander characteristics. Little is known about how situational characteristics affect the likelihood of intervening during sexual violence; yet, these variables have the potential to influence the effectiveness of bystander intervention programs. Using data collected from college students (N = 626) at a single university located in a large Southern metropolitan city, the present study utilizes a factorial survey design to investigate the impact of location, victim/offender sex, and perceptions of alcohol use on self-reported probability of intervention in an ambiguous sexual scenario. Results indicate that participants were more likely to intervene in scenarios that depicted a fraternity-hosted social (vs. on-campus) and less likely when there was a female perpetrator and a male victim. Perceived alcohol use did not impact intervention.

Web-Based Alcohol and Sexual Assault Prevention Program With Tailored Content Based on Gender and Sexual Orientation: Preliminary Outcomes and Usability Study of Positive Change (+Change)

Background

Alcohol use and sexual assault are common on college campuses in the United States, and the rates of occurrence differ based on gender identity and sexual orientation.

Objective

We aimed to provide an assessment of the usability and preliminary outcomes of Positive Change (+Change), a program that provides integrated personalized feedback to target alcohol use, sexual assault victimization, sexual assault perpetration, and bystander intervention among cisgender heterosexual men, cisgender heterosexual women, and sexual minority men and women.

Methods

Participants included 24 undergraduate students from a large university in the Southwestern United States aged between 18 and 25 years who engaged in heavy episodic drinking in the past month. All procedures were conducted on the web, and participants completed a baseline survey, +Change, and a follow-up survey immediately after completing +Change.

Results

Our findings indicated that +Change was acceptable and usable among all participants, despite gender identity or sexual orientation. Furthermore, there were preliminary outcomes indicating the benefit for efficacy testing of +Change.

Conclusions

Importantly, +Change is the first program to target alcohol use, sexual assault victimization, sexual assault perpetration, and bystander intervention within the same program and to provide personalized content based on gender identity and sexual orientation.

Trial Registration

ClinicalTrials.gov NCT04089137; https://clinicaltrials.gov/ct2/show/NCT04089137

Friends-Based Protective Strategies and Unwanted Sexual Experiences: A Daily Diary Examination of First Year College Women

Risk for unwanted sexual experiences can emerge in social contexts-the same contexts that early college women navigate with their friends. Though friends naturally engage in prevention strategies, less is known about how capable guardianship influences risk. Using multilevel structural equation modeling, the present study examined guardianship at the person- and situation-level. First year college women (N = 132) completed eight weekends of daily surveys. We examined whether guardianship (e.g., more friends present, greater proportion of female friends, no intoxicated friends) would reduce unwanted sexual experience risk and if this relation was mediated by friends-based strategy use. An alternative model was also tested with the same predictors, but unwanted sexual experiences as the mediator and friends-based strategy use as the outcome. Over half (58%) of extended weekend nights with friends involved drinking or using drugs. Friends-based strategies were used on 29% of nights. Across models, being with one or more intoxicated friends was associated with friends-based strategy use and an unwanted sexual experience, but only at the situation-level. Parents, educators, and policy makers can encourage college women to draw on their social networks to enhance safety. Interventions could incorporate more universal strategies for responding to risk in social contexts.

Correlates of Men's Bystander Intervention to Prevent Sexual and Relationship Violence: The Role of Masculine Discrepancy Stress

Extant literature suggests that men may be less likely than women to engage in prosocial bystander behavior to interrupt sexual and relationship violence. However, there has been little consideration of the influence of masculine gender role discrepancy and masculine discrepancy stress (i.e., stress that occurs when men perceive themselves as falling short of traditional gender norms) on men's bystander beliefs and behaviors. The current study fills an important gap in the literature by assessing the influence of masculine gender role discrepancy and masculine discrepancy stress on a range of prosocial bystander behaviors through their influence on the bystander decision-making process. Participants were 356 undergraduate men recruited from two different Southeastern U.S. universities who completed online surveys assessing self-perceptions of gender role discrepancy, consequent discrepancy stress, bystander decision-making, and bystander behavior in sexual and relationship violence contexts. Path models indicated significant conditional indirect effects of masculine gender role discrepancy on proactive bystander behaviors (i.e., behaviors related to making a plan in advance of being in a risky situation) and bystander behavior in drinking situations across levels of masculine discrepancy stress. Specifically, men who believed that they are less masculine than the typical man reported more pros to intervention in sexual and relationship violence than cons, and thus reported intervening more, but only if they were high in masculine discrepancy stress. Findings suggest that bystander intervention programs should explicitly address and challenge rigid expectations of what it means to be "manly" to transform gender expectations perpetuating sexual and relationship violence.

Weekly Drinking and Binge Drinking Mediate the Association Between Drinking Location and Sexual Coercion

It has been well documented that alcohol use is a risk factor for sexual assault. However, few studies have examined how alcohol use is associated with sexual coercion experiences. Furthermore, off-campus parties and bars are drinking locations where alcohol use is high among college students. It is important to determine other risk factors, such as the drinking location, that may affect alcohol use and sexual coercion. The current study examined whether alcohol use (drinks per week and binge drinking) mediated the association between drinking location frequency (off-campus party and bar/restaurant) and experiencing sexual coercion in the past 30 days. Participants were N = 295 young adult (M_age = 21.17 years, SD = 2.70) undergraduate women who reported drinking at least once in the past 30 days and completed an online survey. Results revealed that 88 (29.8%) participants experienced sexual coercion in the past 30 days. Participants who experienced sexual coercion in the past 30 days reported greater drinks per week, were more likely to binge drink, and reported drinking more frequently at off-campus parties than those who had not experienced sexual coercion. Drinks per week significantly mediated the relationship between drinking location frequency (off-campus party and bar/restaurant) and sexual coercion. Specifically, more frequent drinking at off-campus parties and bars/restaurants was associated with greater drinks per week, which in turn was related to experiencing sexual coercion in the past 30 days. Binge drinking significantly mediated the association between frequency of drinking at a bar/restaurant and sexual coercion, but not off-campus drinking frequency. Findings suggest that college student alcohol interventions that target harm reduction should consider including information about how the drinking location may intersect with alcohol use to increase risk for sexual coercion.

Alcohol and cannabis co-use and social context as risk pathways to sexual assault

Objective: Simultaneous use of alcohol in combination with cannabis ("co-use") is common among young adults, and associated with myriad consequences. Yet no studies have examined how co-use may confer vulnerability for sexual assault (SA). Further, though both co-use and SA commonly occur in social settings, there have been no examinations of the role that co-use may play in the broader social context that leads to assault risk. This was the objective of the present study. Method: In a community sample of young adult women, (N = 174; Mage = 22.6), we examined risk pathways to SA, guided by Routine Activities Theory (Mustaine & Tewksbury, Criminal Justice Review, 2002, 27, 89). Using a longitudinal burst design with 27 daily assessments across 1 year, women reported on their own and others' alcohol, cannabis, and co-use, and on social context and assault experiences. Results: Multilevel path model results showed alcohol and cannabis co-use to confer unique risk for SA, above and beyond the influence of use of either substance alone. Intoxication and components of the co-use social context (proximity to offenders) mediated this risk. Importantly, we observed a key role for co-use by others within the social context in assault risk. Conclusions: This study adds to the literature by providing a nuanced and contextual account of how cannabis-alcohol co-use may lead to assault vulnerability in young adult women. Findings underscore the need for intervention efforts that expand their focus to include the broader social context, and the role that the use and co-use behaviors of others may play within this context. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Male Role Norms, Heavy Drinking, and Bystander Behavior for Sexual Aggression

Bystander training programs have proliferated on college campuses to prevent alcohol and non-alcohol-related sexual aggression. However, many programs fail to address the effects of a bystander's alcohol use on intervention. This is not surprising due to the limited research examining this association. To this end, the present study examined how heavy drinking and a known correlate of intervention, men's adherence to traditional masculinity, are jointly and independently associated with bystander behavior in drinking contexts. Participants were 148 community men between the ages of 21 and 30 who completed measures of heavy drinking, adherence to traditional male role norms, and prior bystander behavior in drinking contexts aimed at helping friends and strangers. Hierarchical linear regressions demonstrated that adherence to the belief that men should attain social status was associated with more frequent bystander behavior for friends, whereas adherence to the belief that men should avoid stereotypical feminine activities was associated with less frequent bystander behavior for friends. In addition, the relation between adherence to the belief that men should avoid stereotypical feminine activities and bystander behavior for friends was significant and negative among heavy drinkers but not among non-heavy drinkers. Findings suggest that men who avoid stereotypical feminine activities may be most inhibited from intervening to help friends in party contexts if they are heavy, compared with non-heavy, drinkers. These men are likely consuming alcohol in these party contexts and may benefit from targeted, gender-specific, interventions.

Addressing alcohol's role in campus sexual assault: Prevention educator perspectives

Alcohol use is implicated in 50 to 70% of campus sexual assaults (CSA). Despite research, practice, and policy guidance that campus prevention efforts should address alcohol's role in CSA, there is limited guidance for prevention educators and administrators on how to actually do so. Participants: Campus-based sexual assault prevention educators (n = 23) were recruited between May and July 2017 from the Campus Advocacy and Prevention Professionals Association (CAPPA) listserv using purposive sampling. Methods: A qualitative study design using a critical feminist participatory action approach was used to conduct in-depth semi-structured phone interviews. Results: Participants described six key steps forward to address alcohol's role in CSA (a) proactivity; (b) consistency; (c) nuance; (d) equity; and (e) authenticity. Conclusions: To address alcohol's role in CSA, prevention educators need (a) concrete messaging, (b) evidence-based interventions, and (c) evaluation of campus culture change efforts.

Alcohol Intoxication Impairs the Bystander Intervention Process in a Hypothetical Sexual Assault: A Field Investigation

OBJECTIVE

High rates of alcohol-related sexual assault among young adults represent a significant public health problem. Bystander intervention programs are a promising strategy to reduce sexual assault incidence. However, little is known about how bystander intoxication may modify bystander intervention effectiveness. We examined the role of bystander intoxication and intoxication levels of the hypothetical victim and perpetrator on outcomes associated with Latané and Darley's (1970) steps of bystander intervention, which include noticing a situation, assessment of risk and need for intervention, taking personal responsibility for intervening, and selecting an intervention.

METHOD

In a field setting, participants were recruited from a downtown area surrounded by several drinking establishments. After providing informed consent, 327 participants (45% women) ages 21 - 29 years listened to one of four sexual assault vignettes (varied by victim and perpetrator intoxication), responded to questionnaires assessing outcomes related to steps of bystander intervention, and completed a field breathalyzer test to measure intoxication level.

RESULTS

We found that increased participant intoxication was related to decreased accuracy of situation recall and assessment of risk and need for intervention, but not ratings of personal responsibility to intervene, chosen intervention strategy, or confidence to intervene.

CONCLUSIONS

Intoxication could influence how a bystander interprets a hypothetical nonconsensual sexual interaction at the level of accurate situation recall and risk assessment. If the early steps of information processing are impaired by intoxication, later steps of intervention enactment may not occur successfully. Bystander intervention programming may consider incorporating training to overcome the impairing effects of intoxication for identifying harmful situations and choosing to intervene.

The relationship between binge drinking and prosocial bystander behavior among college men

Objectives: This study prospectively examined binge drinking's effect on prosocial bystander behavior and indicators of bystander behavior: intentions to intervene, self-efficacy to intervene, and positive outcome expectancies for intervening. Participants: College men were recruited from February to April 2010. Methods: Pre- and posttest surveys were administered as part of a randomized controlled trial (n = 743). Potential confounders were identified using Pearson product-moment correlations. Controlling for covariates, multiple linear regression was used to examine whether binge drinking was predictive of prosocial bystander behavior and indicators of bystander behavior. Results: Binge drinking was related to lower bystander behavior (p<.05), lower intentions to intervene (p<.001), and less positive outcome expectancies for intervening (p<.05). Conclusions: Binge drinking may reduce the ability to notice a risk situation and intervene as a prosocial bystander. Results highlight the need for bystander programs to address alcohol use within the context of bystander behavior.

Effect of Alcohol Intoxication on Bystander Intervention in a Vignette Depiction of Sexual Assault

OBJECTIVE

Alcohol-related sexual violence remains a public health problem. Despite the popularity of sexual assault bystander intervention programs, these may be limited in addressing bystander intoxication because the effects of intoxication on intervening in a sexual assault are unknown. Therefore, we tested the effects of alcohol intoxication on the five steps of bystander intervention in a sexual assault vignette.

METHOD

Young adults (N = 128; 50% women) were randomly assigned to consume alcohol (target blood alcohol concentration = 0.08%; n = 64) or a nonalcoholic control beverage (n = 64) in a bar-laboratory. Next, participants were presented with a vignette describing events occurring in a convivial drinking context that ends with nonconsensual sexual behavior. Latané and Darley's bystander intervention model steps were assessed in a semistructured interview.

RESULTS

Participants in the control condition recalled the story more accurately (Step 1: notice the event) and reported greater risk/need for intervention (Step 2), but they did not differ on the latter three steps of bystander intervention compared with alcohol-condition participants. Intoxication effects were similar for men and women. Furthermore, risk/need for intervention (Step 2) partially mediated the effect of alcohol condition on personal responsibility (Step 3) and relative benefits versus costs from intervening (Step 4).

CONCLUSIONS

Prevention programs should consider the effects of alcohol on detecting a sexual assault and the need to intervene. If intoxicated bystanders do not detect a sexual assault, then bystanders will not reach the crucial steps (i.e., taking responsibility for intervening; willingness and ability to intervene) required to intervene successfully.

Effect of Alcohol Intoxication on Bystander Intervention in a Vignette Depiction of Sexual Assault

OBJECTIVE

Alcohol-related sexual violence remains a public health problem. Despite the popularity of sexual assault bystander intervention programs, these may be limited in addressing bystander intoxication because the effects of intoxication on intervening in a sexual assault are unknown. Therefore, we tested the effects of alcohol intoxication on the five steps of bystander intervention in a sexual assault vignette.

METHOD

Young adults (N = 128; 50% women) were randomly assigned to consume alcohol (target blood alcohol concentration = 0.08%; n = 64) or a nonalcoholic control beverage (n = 64) in a bar-laboratory. Next, participants were presented with a vignette describing events occurring in a convivial drinking context that ends with nonconsensual sexual behavior. Latané and Darley's bystander intervention model steps were assessed in a semistructured interview.

RESULTS

Participants in the control condition recalled the story more accurately (Step 1: notice the event) and reported greater risk/need for intervention (Step 2), but they did not differ on the latter three steps of bystander intervention compared with alcohol-condition participants. Intoxication effects were similar for men and women. Furthermore, risk/need for intervention (Step 2) partially mediated the effect of alcohol condition on personal responsibility (Step 3) and relative benefits versus costs from intervening (Step 4).

CONCLUSIONS

Prevention programs should consider the effects of alcohol on detecting a sexual assault and the need to intervene. If intoxicated bystanders do not detect a sexual assault, then bystanders will not reach the crucial steps (i.e., taking responsibility for intervening; willingness and ability to intervene) required to intervene successfully.

Acute Alcohol Intoxication Inhibits Bystander Intervention Behavior for Sexual Aggression Among Men with High Intent to Help

BACKGROUND

Bystander training programs aim to encourage third-party witnesses to intervene in high-risk sexual situations; however, these programs rarely focus on training bystanders to effectively intervene when intoxicated. This is not surprising due to the limited evidence on the proximal effects of alcohol on bystander intervention for sexual aggression. To this end, the aim of the present study was to test the effects of men's self-reported intent to help strangers and acute alcohol intoxication on the likelihood and speed of sexual aggression intervention.

METHODS

Participants were 74 men who completed a measure of intent to help (Session 1) and were randomly assigned to consume alcohol or a no-alcohol control beverage (Session 2). Next, they engaged in a novel laboratory paradigm in which they and 4 other confederates (2 men, 2 women) watched a female confederate, who reported a strong dislike of sexual content in the media, view a sexually explicit film which they could stop at any time. Bystander intervention was operationalized as whether and how quickly participants stopped the film.

RESULTS

Findings indicated that (i) intent to help strangers predicted faster sexual aggression intervention and (ii) intent to help strangers predicted a higher likelihood and faster rate of sexual aggression intervention among sober, but not intoxicated, men. This latter finding suggests that among men who endorsed a high willingness to intervene in sexual aggression, alcohol intoxication decreased intervention behavior.

CONCLUSIONS

Results demonstrate that alcohol functions as a barrier to intervention for men who would otherwise intervene. Findings are interpreted using an integrative framework for intoxicated sexual aggression intervention and highlight the need for bystander training programs to incorporate alcohol interventions to reduce heavy drinking and psychoeducation to train bystanders how to intervene when intoxicated.

Sexual Assault Survivor Reports of Missed Bystander Opportunities: The Role of Alcohol, Sexual Objectification, and Relational Factors

Examination of situations in which bystanders missed intervention opportunities to prevent sexual assault can advance our understanding of how bystanders can prevent sexual assault. The present study utilized an incident-specific approach based on reports from 427 female sexual assault victims (ages 18-25 years) recruited via Mechanical Turk. Results indicate that bystanders had an opportunity to intervene before 23% of sexual assaults, alcohol use in settings with bystanders was widespread (by perpetrators, victims, and bystanders), and several factors were more common in situations involving missed intervention opportunity. Findings provide useful information for continued development of bystander training and new directions in bystander research.