Using a multimedia social marketing campaign to increase active bystanders on the college campus

Lessons learned: Implementing and adapting a multimedia campaign to promote heart health to college students

Objective: This one-year pilot study investigated the effectiveness of a multimedia campaign, Heart Healthy U (HHU), to increase awareness about the link between unhealthy behaviors and risk for heart disease among emerging adults on a college campus. This paper describes the implementation of HHU. Participants: The HHU campaign was implemented from the Fall of 2019 through Spring 2020 and during this time there were approximately 15,043 enrolled students at the south eastern U.S. college campus. Methods: The HHU campaign employed print (e.g., banners, posters, and yard signs) and electronic formats (e.g., email, Instagram). We designed the methods across three phases: (1) relationship building and formative research, (2) campaign development, and (3) the Heart Healthy U campaign launch. Results: The HHU encountered challenges when the novel coronavirus (COVID-19 or SARS-co-V2) interrupted campus life, however we relied on the electronic formats to reach students during the state-wide lockdown/quarantine mandates. In addition, there were two changes to the HHU health messages. First, we updated the health messages to illustrate that eating healthy and engaging in physical activity supports immune function. Next, we developed new health messages to address effects of physical isolation and anxiety by promoting psychological well-being during this historic public health crisis. Conclusions: We asked whether a multimedia campaign on a college campus could encourage emerging adults to consume fruits and vegetables and engage in physical activity according to the federally-recommended guidelines. It is essential that interventions intended to reach today's emerging adults be presented in formats that they use (e.g., social media platforms), supported by campus administrators, and endorsed by peer influencers. In conclusion, more intervention studies are needed to counter the unhealthy social norm behaviors common to college campus life that increase heart disease risk, particularly among marginalized populations.

Advancing a Comprehensive Multilevel Approach to Sexual Violence Prevention Using Existing Efficacious Programs

ABSTRACT

Sexual violence (SV) is a serious and long-standing public health problem on college campuses. At institutions of higher education, campus administrators, activists, and practitioners have worked for decades to address campus SV. Despite federally mandated campus SV prevention programming, rates of campus SV remain unchanged. The purpose of this commentary is to outline a strategy for enhancing campus SV prevention efforts using a comprehensive multilevel approach utilizing existing efficacious programs. The following three strategies for implementing optimal campus SV prevention are proposed, which include (a) the need to prioritize efficacy, (b) targeting multiple levels of the social ecology, and (c) leveraging the benefits of in-person programming and technology-driven prevention. A call to action is included for both institutions of higher education administrators and practitioners to implement and invest in comprehensive multilevel interventions using existing, efficacious SV programs, ideally combining a technology-based program with an in-person component. Furthermore, a coordinated effort between prevention and response is needed to achieve successful prevention of campus SV and revictimization, including a connection with the community for postassault interventions. Thus, implementing multilevel interventions on college campuses using existing evidence-based programs in combination with a coordinated community response of postassault interventions can bring the campus community together and is optimal to moving the needle on rates of campus SV.

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.

Social marketing program for dating violence bystander intervention on university campus: analyzing its effectiveness and sociocultural feasibility

The purpose of this study was to test the effectiveness and sociocultural feasibility of a dating violence (DV) bystander intervention program, called With-Us, implemented on university campus in South Korea. Participants were recruited from two universities, some as part of an intervention group (n = 99) and the others as part a comparison group (n = 67). The participants were assessed pre- and post-interventions in terms of their readiness and intention to help, as well as their efficacy. Analyses show that the program increased the readiness in bystanders to help victims. Contrarily, it was observed that older participants, males, and those having higher patriarchal gender stereotypes, were less likely to pay attention to the program. Based on the findings, we provided several suggestions to promote its effectiveness and sociocultural feasibility so that it could be efficiently applied in further studies.

The Impact of a Public Health Campaign to Deter Viewing of Child Sexual Abuse Images Online: A Case Study of the UK Stop It Now! Campaign

Public campaigns offer an opportunity to prevent child sexual abuse by raising awareness and promoting help available to bystanders, victims, and those at risk of perpetrating the abuse. This paper explores the impact of The Lucy Faithfull Foundation's 'Stop It Now!' campaign in the UK (2015-2018) on help-seeking. Helpline calls (11,190 unique callers), website analytics (109,432 new website visitors) and three website-hosted surveys (N = 252) provided data on help-seeking, awareness, and self-reported behavior. Results indicated that there were more visitors to the help website during active campaigning periods, and helpline callers and website visitors were more likely to seek help after viewing campaign materials during active than non-active campaign periods. Help-seekers were predominantly men concerned about their own behavior. Survey 2 respondents concerned about their own behavior (n = 53) indicated that their awareness of the law (75.5%), and legal and personal consequences (67.9%) had changed after hearing about the campaign, and 66% reported a change in behavior. Public health campaigns may be an effective way to promote help-seeking and prevent abuse.

A Popular Approach, but Do They Work? A Systematic Review of Social Marketing Campaigns to Prevent Sexual Violence on College Campuses

College campuses continue to face high rates of sexual violence and social marketing campaigns have emerged as a common prevention strategy. However, there exists no summative research examining the effectiveness of this approach. A systematic search yielded 15 evaluations of eight unique prevention campaigns, which contributed to 38 individual outcome measures across four outcome categories (i.e., knowledge, attitudes, intentions/efficacy, and behavior). Summative results are mixed, but show promising campaign effects for increasing knowledge, modification of some attitudes toward sexual violence, intentions to participate, and actual participation in prevention activities. More evaluative research is needed for a comprehensive understanding of campaign effectiveness.

Leveraging Faith Communities to Prevent Violence against Women: Lessons from the Implementation and Delivery of the Motivating Action through Empowerment (MATE) Program

Gender-based violence is a human rights and public health issue, disproportionately affecting women. The Motivating Action Through Empowerment (MATE) bystander program aims to address violence against women by shifting focus from perpetrators and victims of violence to community responsibility for not accepting attitudes and behaviors that support or allow the violence to occur. Traditionally bystander programs have been delivered through institutions, most notably college campuses in the United States. The translation of bystander programs to community settings is not widely reported. This research aimed to understand whether a violence prevention program could be effectively delivered in a faith community setting; specifically, it focuses on the implementation of MATE in a Christian church network in the Gold Coast region of Queensland, Australia. Semi-structured interviews were conducted with ten church-based trainers in the MATE pilot program. Theoretically informed analysis using the COM-B behavior model identified that environmental factors had a large bearing on opportunities to deliver MATE workshops. This research identified six key lessons for MATE and other programs wishing to leverage faith communities: (1) Provide religious context; (2) Accommodate diversity; (3) Build faith leader capacity; (4) Employ social marketing; (5) Undertake co-design; (6) Actively administer, measure and monitor.

Promoting Compassionate Responses to Disclosures of Sexual Violence in University Settings: Exploring the Impact of a Social Marketing Campaign

This study explores a social marketing campaign aimed to promote compassionate responses to disclosures of sexual violence from peers and raise awareness of university-based formal support services. Findings from a survey ( n  =  189) and follow-up focus groups ( n  =  11) conducted with university students in Australia indicated that exposure to the campaign may support students’ self-perceived confidence in responding compassionately to disclosures of sexual violence and raise awareness of university-based formal support services. These findings suggest social marketing may be a useful tool to form part of universities’ sexual violence response and prevention strategies. These findings may help inform future university campaigns.

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.

Campus Sexual Violence Prevention and Response: Lessons from a Pandemic to Inform Future Efforts

The COVID-19 pandemic forced institutions of higher education to transition and work in ways that were new and innovative. Even though most colleges and universities transitioned to a virtual platform, the issues that students face continued, including sexual violence (SV). For many campus prevention and response professionals, reaching students during the pandemic posed unique challenges. The COVID-19 pandemic began when the project team was 18-months into a 4-year grant to administer and evaluate the efficacy of a SV prevention and response app, uSafeUS®, at 15 4-year colleges. In this paper, we describe the transition of engaging students with the app in traditional in-person settings to remote and hybrid learning settings. The project team, in collaboration with the campus partners, devised new ways to use the app to support victims of SV and their allies, along with campus professionals in their efforts to support students. These efforts included changes to collaboration (e.g., virtual platforms) and student engagement strategies. We describe how the lessons learned from this transition are important for continuing to engage campus communities in SV prevention and response, even as campuses slowly transitioned back to hybrid and in-person activities. The knowledge gained from this transition are attributable to an ongoing and open collaboration between campus practitioners and the project team.

Sexual and Dating Violence Bystander Intervention Programs within Institutions of Higher Education: Strategies for Research and Practice

This article presents strategies to promote researcher-practitioner collaborations in the development and evaluation of bystander intervention programs that address sexual and dating violence (SDV) at Institutions of Higher Education (IHEs). The benefits of practitioner partnerships with researchers are reviewed. We then review examples of researcher-practitioner collaborations to develop, implement, and evaluate bystander programs. Suggestions are also offered for researcher-practitioner collaborators to engage survivors of SDV and overlooked populations, such as racial, ethnic, gender, and sexual minorities, as ways to promote diversity. Lastly, we provide guidelines for researcher-practitioner collaborations to engage bystanders based on the lessons learned from these collaborations within and around the IHE community.

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

Scope and correlates of high school youths' exposure to dating and sexual violence prevention initiatives

The researchers examined the extent to which high school youth were exposed to dating and sexual violence (DSV) prevention types (e.g., social marketing campaign) across various locations (e.g., in-school) and how exposure to DSV prevention related to perceptions of social norms and collective efficacy. Participants included 877 high school youth who completed in-school surveys across three towns in New England. Most youth (92%) were exposed to DSV prevention. In general, active exposure and active participation, more so than passive exposure, were related to greater perceptions of collective efficacy and perceptions of social norms more intolerant of DSV. Results also suggested that online exposure to DSV prevention was the most consistent correlate of greater perceptions of collective efficacy and perceptions of social norms more intolerant of DSV. These findings provide clues about the types and locations that might be most effective at preventing DSV among youth.

Gendered Responses to Gendered Harms: Sexual Violence and Bystander Intervention at Australian Music Festivals

Bystander intervention has shown promise in preventing sexual violence in certain social contexts. Despite emerging evidence of pervasive sexual violence at music festivals, no research has considered bystander intervention in this setting. Drawing on an online survey conducted with 371 Australian festival attendees, we explore the role of gender on bystander intervention at music festivals. Findings point to significant gender differences, with women more willing and likely to intervene in a broader range of scenarios. We argue that responses to sexual violence are a collective responsibility shared by both women and men, as well as festival organizers and industry bodies.

How Community and Peer Perceptions Promote College Students' Pro-Social Bystander Actions to Prevent Sexual Violence

The prevalence of sexual violence crimes on U.S. college campuses is prompting institutions of higher education to increasingly invest in centers to support survivors and programs to prevent the violence before it happens. Understanding bystanders to sexual violence and what may motivate them to step in and help is a promising prevention strategy. The purpose of this study was to understand how potential active bystanders' (first-year college students) perceptions of community (including a sense of one's influence in the community and positive peer norms for helping) and individual beliefs about self (including sense of responsibility and self-efficacy) affect their self-reports of performing bystander behavior to address sexual violence risks. Participants were 948 students at two different universities (one a rural, primarily residential campus and the other an urban, mostly commuter campus) in the northeastern United States. Regression and path analysis quantitative results suggest that individual-level characteristics may mediate some of the impact that community-level norms and perceptions have on bystander outcomes, explaining some of the mixed findings in previous research. Prevention strategies should work to change community norms and perceptions of mattering and perceptions of community influence in addition to the more traditional focus on individual-level violence specific attitudes.

Sexual Assault, Sexual Orientation, and Reporting Among College Students

Research has demonstrated significantly higher rates of sexual assault victimization among lesbian, gay, bisexual and queer (LGBQ) students than heterosexual students, and the overwhelming majority of assaults are not reported to any official system. Given the potential for support services to provide valuable assistance and promote well-being after an assault, the present study explores whether LGBQ students report assaults at similar rates to heterosexual students. As part of the 2015 College Student Health Survey, 10,646 male and female college students at 2- and 4-year colleges in Minnesota provided data regarding sexual assault victimization; reporting to a health care provider, campus authority, police, or social contact; and sexual orientation (two items, including write-in). Chi-square tests were used to detect associations between sexual assault victimization and five sexual orientation groups; and between sexual orientation and assault reporting (for 523 assault incidents). Almost 6% of students reported that they had experienced sexual assault in the previous 12 months. Significant differences in assault experience were seen by sexual orientation groups, for both males and females. For example, rates of sexual assault were 2.5 to over 5 times higher among bisexual and queer/pansexual/other females than among heterosexual females. Reporting of sexual assault to health care providers, campus authorities or police was rare for both heterosexual and sexual minority students, and there were no significant differences in reporting across sexual orientation. LGBQ students and heterosexual students appear to be similarly comfortable accessing health care providers, police, and campus resources, suggesting that these services are not overtly biased or unwelcoming to sexual minorities. However, rates of sexual assault were considerably higher among sexual minority groups, suggesting a need for primary prevention that is appropriate and sensitive to the experiences of LGBQ students.

Integrating Sexual Assault Resistance, Bystander, and Men's Social Norms Strategies to Prevent Sexual Violence on College Campuses: A Call to Action

Sexual assault prevention on college campuses often includes programming directed at men, women, and all students as potential bystanders. Problematically, specific types of sexual assault prevention are often implemented on campuses in isolation, and sexual assault risk reduction and resistance education programs for women are rarely integrated with other approaches. With increasing focus on the problem of sexual assault on college campuses, it is timely to envision a comprehensive and interconnected prevention approach. Implementing comprehensive prevention packages that draw upon the strengths of existing approaches is necessary to move toward the common goal of making college campuses safer for all students. Toward this goal, this commentary unpacks the models and mechanisms on which current college sexual assault prevention strategies are based with the goal of examining the ways that they can better intersect. The authors conclude with suggestions for envisioning a more synthesized approach to campus sexual assault prevention, which includes integrated administration of programs for women, men, and all students as potential bystanders on college campuses.

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.

Correlates of Incoming Male College Students' Proclivity to Perpetrate Sexual Assault

This study examined incoming male college students' proclivity to perpetrate sexual assault at a large public university in the Northeast (n = 1,619). Overall, self-reported proclivity to perpetrate was low (between 20-26%). Students' perception that a peer would intervene as a bystander was negatively associated with proclivity, while acceptance of certain rape myths was positively associated with proclivity. Students who intended to join a fraternity and White students had increased proclivity to perpetrate using force or incapacitation. Based on these findings, recommendations for sexual assault prevention efforts are included.

"What would the neighbors do?" Measuring sexual and domestic violence prevention social norms among youth and adults

There is growing attention to how social processes in communities may contribute to domestic and sexual violence (DSV) and be a target for prevention efforts. Three main variables are collective efficacy and descriptive and injunctive norms. To date, few measures exist that assess these variables in the specific context of violence prevention. The current study sampled 3,866 adults and high-school youth in four communities in northern New England. Exploratory and confirmatory factor analyses examined the psychometrics of the scales. Scales reflecting collective efficacy, indirect public, and direct individualized descriptive norms, public and personal injunctive norms, and youth perceptions of adults' prevention actions demonstrated robust factor structures and adequate reliability and validity. These measures may prove useful for a diverse audience (e.g., practitioner, researchers) for assessing the effectiveness of community-level DSV prevention strategies.

Sexual violence victimization among community college students

Objective: To assess the prevalence of sexual violence victimization among a community college student population. Participants: In March 2017, students (800) from seven community colleges in a northeastern state participated in an online campus climate survey using the ARC3 Survey Instrument. Methods: We analyze demographic differences between participants who were victimized and those who were not, and we examine the relationship between participant victimization and well-being. Results: Participants who identified as female, younger than 26, not heterosexual, or a race other than Caucasian were significantly more likely to report victimization. Participants who reported victimization were significantly more likely to score negatively on well-being scales than those who did not. Conclusions: Sexual violence prevalence rates among community college students are similar to reported prevalence rates among traditional 4-year undergraduate students. Results suggest a need for increased research on sexual violence among the understudied community college student population.

Campus Sexual Assault: Future Directions for Research

Campus sexual assault (CSA) has received unprecedented attention over recent years, resulting in an abundance of federal guidance and mandates. In response, efforts to address and prevent CSA at Institutions of Higher Education (IHE) across the country have grown quickly, including the development and implementation of programs and policies. Because the changes on campuses have occurred at such a rapid pace, a number of gaps exist within the field of CSA research. To ensure that changes on IHE are evidence-based, there is a need to review the existing research available and the inquiry still needed, based on key areas outlined in federal guidance, the expressed needs of campus community members, survivors, and students who commit sexual offenses on college campuses. The purpose of this review is to summarize the empirical research related to CSA gained from the past two decades and identify areas in which further work is needed, specifically related to key areas identified in recent guidance provided to IHE. This article concludes with guidance for research moving forward to help strengthen response and prevention efforts.

An Evaluation of Two Dating Violence Prevention Programs on a College Campus

Dating violence is a serious and prevalent public health problem that is associated with numerous negative physical and psychological health outcomes, and yet there has been limited evaluation of prevention programs on college campuses. A recent innovation in campus prevention focuses on mobilizing bystanders to take action. To date, bystander programs have mainly been compared with no treatment control groups raising questions about what value is added to dating violence prevention by focusing on bystanders. This study compared a single 90-min bystander education program for dating violence prevention with a traditional awareness education program, as well as with a no education control group. Using a quasi-experimental pre-test/post-test design with follow-up at 2 months, a sample of predominately freshmen college students was randomized to either the bystander ( n = 369) or traditional awareness ( n = 376) dating violence education program. A non-randomized control group of freshmen students who did not receive any education were also surveyed ( n = 224). Students completed measures of attitudes, including rape myth acceptance, bystander efficacy, and intent to help as well as behavioral measures related to bystander action and victimization. Results showed that the bystander education program was more effective at changing attitudes, beliefs, efficacy, intentions, and self-reported behaviors compared with the traditional awareness education program. Both programs were significantly more effective than no education. The findings of this study have important implications for future dating violence prevention educational programming, emphasizing the value of bystander education programs for primary dating violence prevention among college students.

Impact of Exposure to Sexual Violence Prevention Messages on Students' Bystander Behavior

Bystander intervention is a prevention strategy commonly used to address campus sexual violence. Increasingly, there are calls for prevention efforts to be multilevel and ongoing. The current study investigated the impact of receiving varied prevention messages throughout adolescence and into early adulthood to determine whether it influences college students' awareness of sexual violence, willingness to intervene as a helpful bystander, and actual prosocial bystander behavior. These questions were tested through administration of an online survey to a racially and ethnically diverse sample of 1,047 undergraduate students at a large, urban university in the mid-Atlantic. Results found that most students received information about sexual violence prior to coming to campus from a variety of sources, and that the sources varied significantly by gender and race. Regression analysis found that greater exposure to prevention messages prior to coming to college was significantly associated with greater bystander intentions and behavior even after accounting for gender and race and exposure since coming to college. The findings provide initial support to expand the scope of prevention efforts and to begin them prior to college.

Long-term impacts of college sexual assaults on women survivors' educational and career attainments

OBJECTIVE

To examine the well-documented mental and physical health problems suffered by undergraduate women sexually assaulted while on campus with an exploration of how the trauma impacts a survivor's lifetime education trajectory and career attainment.

PARTICIPANTS

In November and December 2015, researchers recruited US participants using an online crowdsourcing tool and a Listserv for sexual violence prevention and response professionals.

METHODS

Of 316 women who completed initial screening, 89 qualified to complete a Qualtrics survey. Eighty-one participants completed the online survey, and 32 participated in phone interviews.

RESULTS

Ninety-one percent of the participants reported health problems related to the assault that they attributed to difficulties they faced in their attainment of their education and career goals.

CONCLUSIONS

The findings suggest the importance of simultaneously examining the effects of human capital losses and mental and physical health problems attributed to the costly public health problem of campus sexual assault.

Social Marketing Campaigns as a Teaching Strategy for Health Promotion

Current nursing students are more technologically adept than past generations; they are accustomed to using technology in their everyday life. Proficiency in technology is a major asset, and as such, nursing education should provide for opportunities with technology that will support future practice. This article reports on a group project effectively used to capitalize on this skill while encouraging active engagement in learning about health promotion. Student groups created a social marketing campaign consisting of a summary of their campaign, one infogram, and one 30-second video focused on a topic area from Healthy People 2020.

"Everybody's Really Close-Knit": Disconnections Between Helping Victims of Intimate Partner Violence and More General Helping in Rural Communities

Social support is key to well-being for victims of intimate partner violence (IPV), and bystanders have an important role to play in preventing IPV by taking action when there is risk for violence. The current study used qualitative interviews to explore young adults' perspectives on helping in situations of IPV, and more general helping, in the rural communities in which they resided. Participants were 74 individuals between the ages of 18 and 24 years from 16 rural counties across the eastern United States. Participants generally described their communities as close-knit and helpful, especially around daily hassles (e.g., broken down car) and unusual circumstances (e.g., house fire). Although participants generated ways in which community members help IPV victims, these mostly focused on providing support or taking action in the aftermath of IPV as opposed to more preventive actions. Lack of financial resources were uniquely cited as a barrier to more general helping, whereas concerns about privacy and lack of deservingness of help were barriers to both general helping and helping in IPV situations, although these were more pronounced in IPV situations than general helping situations. Taken together, these results suggest that although people generally see their communities as helpful and close-knit, these perceptions and scripts did not necessarily translate to helping in situations of IPV. Bystander intervention programs are needed that provide more specific helping scripts for IPV.

Evaluations of Sexual Assault Prevention Programs in Military Settings: A Synthesis of the Research Literature

The prevention of sexual assault (SA) in the U.S. military is a significant priority. This study applied the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to a literature search that identified research evaluating SA prevention programs conducted within military settings. Only six studies published between 2005 and 2016 met criteria for inclusion in the review. Studies demonstrated high heterogeneity in the: (1) conceptual framework of the prevention approach; (2) target population and timing of administration; (3) study recruitment methods; (4) methodological design; (5) method of delivery, program dosage and theory of change; and (6) outcome administration and efficacy. Scientific rigor according to the Oxford Center for Evidence-based Medicine was also variable. Several gaps in the research base were identified. Specifically, research evaluating SA prevention programs have only been conducted among U.S. Army and U.S. Navy samples. Most studies did not examine whether program participation was associated with reductions in rates of sexual violence. Studies also lacked utilization of a long-term follow-up period. Additionally, studies did not reflect the types of SA prevention programs currently being implemented in military settings. Taken together, further research is needed to enhance the evidence base for SA prevention in the military, and to evaluate the effectiveness of the approaches currently being conducted with service members.

"Consent is Good, Joyous, Sexy": A banner campaign to market consent to college students

OBJECTIVE

This study assessed the recall of, reaction to, and understanding of a brief campus banner campaign promoting consent in sexual relationships, and determined whether campaign exposure was associated with subsequent engagement in activities related to sexual assault education, awareness, and prevention.

PARTICIPANTS

A stratified random sample of 1,200 undergraduates was recruited during fall of 2010; 628 (52.3%) participated.

METHODS

To account for history and maturation, an experimental research design was employed with an online survey.

RESULTS

Direct and indirect campaign exposure was associated with increased action. Students expressed primarily positive reactions to and appeared to understand the consent message. The campaign appealed to and was associated with increased activity among a wide range of students with one exception: a negative effect was observed for business students.

CONCLUSIONS

Colorful banners with pithy, upbeat messages hold promise for engaging undergraduates in conversations and proactive activities related to sexual assault prevention.

Bystander Intervention Among College Men: The Role of Alcohol and Correlates of Sexual Aggression

Current efforts to reduce sexual violence in college campuses underscore the role of engaging men in prosocial bystander behavior. The current study implemented an online survey to explore associations between engaging in heavy drinking and attitudes toward bystander intervention among a sample of college men (N = 242). Correlates of sexual aggression were also explored as mediators of the hypothesized relationship between engaging in heavy drinking and attitudes toward bystander intervention. Data indicated that men who engaged in two or more episodes of heavy drinking over the past month reported lower prosocial bystander attitudes compared with men who did not engage in such behavior. The association between engaging in heavy drinking and lower prosocial bystander attitudes was mediated by men's perception of their peers' approval for sexual aggression, their own comfort with sexism, and engagement in coercive sexual behavior. Implications for sexual assault prevention are discussed.

Conveying campus sexual misconduct policy information to college and university students: Results from a 7-campus study

OBJECTIVE

To examine the efficacy of different methods (ie, in-class policy reading; in-class policy reading and discussion; no reading or discussion) to deliver campus sexual misconduct policy information to students on 7 campuses.

PARTICIPANTS

A total of 1,195 participants at 7 colleges and universities participated in the study from August to October 2014. Participants were randomly assigned at the class level and completed pretest and posttest surveys assessing knowledge of campus policy and resources and confidence to seek help for sexual assault.

RESULTS

Students exposed to a larger dosage of material (in-class policy reading plus discussion) showed greater positive changes in attitudes and knowledge than students who did not receive information or were only read the policy. However, on some indices, students who were only read the policy showed positive outcomes compared with students receiving no intervention.

CONCLUSION

Colleges and universities must use engaging methods to disseminate campus sexual misconduct policies to students.

Reducing Sexual Assault on Campus: Lessons From the Movement to Prevent Drunk Driving

I examined similarities and differences between the movement to prevent drunk driving of the 1980s, and current efforts to prevent and address campus sexual assault. As college and university administrators design policies and initiatives to reduce campus sexual assault in response to new federal legislation and regulation, they can apply lessons from successful public health initiatives to reduce drunk driving initiated more than 3 decades ago. I illustrate how interventions at the 5 levels of the social-ecological model, and messages that address entrenched cultural attitudes condoning sexual assault and blaming its victims can be used to combat campus sexual assault as a crime and a public health problem. I also show how efforts to promote community engagement can change behavioral norms and reduce offenses.

Call for research on bystander intervention to prevent sexual violence: the role of campus environments

An important next step for the field is to determine what setting-level factors beyond the individual are critical to fostering campus environments that support pro-social, helpful bystander intervention action to prevent sexual violence. Therefore, the purpose of this paper is to provide a research agenda to investigate key areas of the campus environment and their potential influence on bystander intervention. To create the research agenda, a number of steps were followed including: (1) systematically reviewing the larger bystander literature to identify key environmental areas, (2) assessing what research is available specific to college campuses and sexual assault in each of these areas, and (3) outlining future research to address each of these areas on college campuses and determine their applicability to sexual violence situations. Five main groups of factors were found to influence bystander intervention beyond the individual, group and situational levels, including: social norms, sense of community, pro-social modeling, policies, and the physical environment. Certain areas of research on environmental influences on bystander intervention are more developed such as social norms, with little research on areas such as policies and the physical environment. However, further research is needed in each of the identified five areas to help identify how college campuses can support bystander intervention.

Encouraging responses in sexual and relationship violence prevention: what program effects remain 1 year later?

Colleges and universities are high-risk settings for sexual and relationship violence. To address these problems, institutions of higher education have implemented prevention programs, many of which train students as potential bystanders who can step in to help diffuse risky situations, identify and challenge perpetrators, and assist victims. The impact of bystander sexual and relationship violence prevention programs on long-term behavior of bystanders has remained a key unanswered question for those who seek to offer the most effective programs as well as for policy makers. In this study, the researchers experimentally evaluated the effectiveness of the Bringing in the Bystander® in-person program. Participants were 948 1st-year college students of whom 47.8% were women and 85.2% identified as White (15% also identified as Hispanic in a separate question) between the ages of 18 and 24 at two universities (one a rural, primarily residential campus and the other an urban, highly commuter campus) in the northeastern United States. To date, this is the first study to have found positive behavior changes as long-lasting as 1 year following an educational workshop focusing on engaging bystanders in preventing sexual and relationship violence. Even so, many questions remain to be answered about prevention and intervention of this type. More prospective research is needed on bystander-focused prevention of these forms of violence to help understand and better predict the complicated relationships both between and among the attitudes and behaviors related to preventing sexual and relationship violence. In this regard, we make specific recommendations for designing and evaluating programs based on our findings relating to the importance of moderators, especially two key understudied ones, readiness to help and opportunity to intervene.

Changing Attitudes About Being a Bystander to Violence

Bystander approaches to reducing sexual violence train community members in prosocial roles to interrupt situations with risk of sexual violence and be supportive community allies after an assault. This study employs a true experimental design to evaluate the effectiveness of Bringing in the Bystander™ through 1-year post-implementation with first-year students from two universities (one rural, primarily residential; one urban, heavily commuter). We found significant change in bystander attitudes for male and female student program participants compared with the control group on both campuses, although the pattern of change depended on the combination of gender and campus.

Improving college campus-based prevention of violence against women: a strategic plan for research built on multipronged practices and policies

Growing awareness of the scope of violence against women (VAW) on college campuses has led to innovations in intervention and prevention These efforts have often followed best practices in prevention, have targeted different campus populations, and used varied tools. Prevention evaluation on campuses is increasing. This review briefly summarizes what we have learned about preventing VAW on campus from evaluation research and then describes a roadmap for where research needs to go. To date, most work focuses almost exclusively on sexual violence, concentrates on single programs on one campus, focuses on attitude outcomes, and most research explores main effects of program utility. More complex prevention and research models are needed including the use of multipronged prevention approaches and researching their synergistic effects; investigation of more specific program effects to better unpack what essential elements of different prevention tools are driving changes; and more complex analyses of outcomes including exploration of moderating variables. This research agenda has implications for new programs, policies, and research designs including the importance of partnerships between practitioners and researchers to actualize these goals.

A web-based sexual violence bystander intervention for male college students: randomized controlled trial

Background

Bystander intervention approaches offer promise for reducing rates of sexual violence on college campuses. Most interventions are in-person small-group formats, which limit their reach and reduce their overall public health impact.

Objective

This study evaluated the efficacy of RealConsent, a Web-based bystander approach to sexual violence prevention, in enhancing prosocial intervening behaviors and preventing sexual violence perpetration.

Methods

A random probability sample of 743 male undergraduate students (aged 18 to 24 years) attending a large, urban university located in the southeastern United States was recruited online and randomized to either RealConsent (n=376) or a Web-based general health promotion program (n=367). Participants were surveyed online at baseline, postintervention, and 6-months postintervention. RealConsent was delivered via a password-protected Web portal that contained six 30-minute media-based and interactive modules covering knowledge of informed consent, communication skills regarding sex, the role of alcohol and male socialization in sexual violence, empathy for rape victims, and bystander education. Primary outcomes were self-reported prosocial intervening behaviors and sexual violence perpetration. Secondary outcomes were theoretical mediators (eg, knowledge, attitudes).

Results

At 6-month follow-up RealConsent participants intervened more often (P=.04) and engaged in less sexual violence perpetration (P=.04) compared to controls. In addition, RealConsent participants reported greater legal knowledge of sexual assault (P<.001), greater knowledge of effective consent (P<.001), less rape myths (P<.001), greater empathy for rape victims (P<.001), less negative date rape attitudes (P<.001), less hostility toward women (P=.01), greater intentions to intervene (P=.04), less hyper-gender ideology (P<.001), less positive outcome expectancies for nonconsensual sex (P=.03), more positive outcome expectancies for intervening (P<.001), and less comfort with other men’s inappropriate behaviors (P<.001).

Conclusions

Our results support the efficacy of RealConsent. Due to its Web-based format, RealConsent has potential for broad-based dissemination thereby increasing its overall public health impact on sexual violence.

Trial Registration

Clinicaltrials.gov: NCT01903876; http://clinicaltrials.gov/show/NCT01903876 (Archived by WebCite at http://www.webcitation.org/6S1PXxWKt).

To act or not to act, that is the question? Barriers and facilitators of bystander intervention

A promising line of inquiry in sexual violence prevention involves training potential bystanders to intervene in situations where there is risk for violence. Theories of bystander intervention often discuss barriers to helping behavior, but there has been little empirical inquiry into this question. We will present findings of a study of both barriers and facilitators of helping behavior in the context of sexual violence among first-semester college students. Two hundred and forty-two first year college students completed surveys during their first year of college. Measures included assessment of bystander behavior, perceived barriers to helping, as well as a variety of other variables identified in the literature as key correlates of helping. Quantitative and qualitative analyses were used to (a) describe barriers and facilitators of helping, (b) examine the relationship between barriers and self-reports of helping, and (c) model individual differences in helping behavior. In quantitative analyses, barriers, as assessed in this study, were better predictors of helping behavior directed at strangers than helping of friends. Results suggested that open-ended responses about the facilitators and barriers to helping for sexual violence map well onto social-psychological models of bystander behavior, and that greater prosocial tendencies, an intrapersonal variable, increase actual helping behavior. A more specific understanding of what promotes and hinders helping can be used to enhance prevention education efforts focused on increasing helpful bystander actions.