A Qualitative Analysis of Bystander Intervention Among Heavy-Drinking College Men

College students' perceptions of positive and negative drinking-related sexual experiences

Objective: During young adulthood, drinking and sexual behaviors are both normative and inextricably linked. While this association is well documented, little is known about how students define positive and negative drinking-related sexual experiences. Methods: Thirty-five undergraduates participated in a focus group about sexual experiences in the context of drinking. Thematic analysis was utilized to identify themes in the data. Results: Students' descriptions of positive drinking-related sexual encounters included having a good time, feeling safe, maintaining control over alcohol, as well as feeling safe in drinking contexts where sexual partners are located. Students' perceptions of negative experiences included specific consequences such as a damaged reputation, loss of control due to alcohol, and concern of engagement in sex when they or a partner was too intoxicated to consent. Conclusion: Gaining a better understanding of how college students view positive and negative drinking-related sexual experiences could inform interventions aimed at promoting student well-being.

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.

Qualitative Analysis of Bystander Intervention Among Young Adult Male Soldiers Who Engage in At-Risk Drinking

Bystander intervention-when someone intervenes to help in situations that pose a risk for harm-is a promising strategy for sexual violence prevention. In the current study, a sample of U.S. Army male soldiers (N = 10; ages 18-24) who engaged in at-risk drinking completed a 90-min individual semi-structured interview to understand the ways in which soldiers intervene to address risk for sexual violence. Two independent raters coded soldier responses using thematic analysis and identified eight main themes: (a) recognizing risk for sexual violence; (b) labeling situations as problematic and taking responsibility; (c) facilitators of intervention; (d) barriers to intervention; (e) intervention strategies; (f) reactions and consequences to intervention; (g) alcohol's influence on intervention; and (h) using bystander intervention to shift cultural norms. As soldiers reported noticing more extreme risks for violence, prevention interventions may help service members identify situations earlier in the continuum of harm. Soldiers anticipated intervening in a way that was physical and aggressive, which could facilitate physical altercation and result in collateral misconduct. Results from the present study reveal ways that bystander intervention programs for civilians can be tailored to address the unique individual, situational, and contextual factors relevant to the military. These findings also highlight the importance of teaching soldiers indirect and nonaggressive strategies for intervention.

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.

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.

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.

A Systematic Review Exploring Variables Related to Bystander Intervention in Sexual Violence Contexts

This article presents a systematic review of the available literature which has investigated the role of key variables in facilitating or inhibiting bystander intervention (including direct intervention, tertiary and secondary prevention) in sexual violence (SV) contexts. Studies exploring the role of individual, situational and contextual variables were grouped to provide a narrative overview of bystanders' personal characteristics as well as the immediate and wider contexts which may be influencing their bystander behaviour. A systematic search of published literature from four electronic databases identified 2526 articles that were screened, of which 85 studies met the inclusion criteria. Most studies focused upon the role of individual variables, in particular gender of bystander. This body of work finds females are more likely to intervene than males; however, not all studies report these differences and in some cases, this is influenced by the type of intervention behaviour being considered. Regarding situational variables, the most commonly researched variable was the presence of other bystanders, although the role of this variable as inhibiting or facilitating was not clear. Finally, the most commonly researched contextual variable was social norms towards intervention, which has consistently shown greater bystander intervention when there is a belief that peers support such behaviour. Very few studies considered the interaction between these variables. Therefore, it is important for future research to consider this gap in the literature so that we can obtain a more well-rounded understanding of variables that can inhibit and facilitate bystander intervention in SV contexts.

A Multi-Topic Bystander Intervention Program for Upper-Level Undergraduate Students: Outcomes in Sexual Violence, Racism, and High-Risk Alcohol Situations

Few bystander intervention trainings programs have evaluated behavioral outcomes in previously trained upper-level undergraduate students. Rigorous study designs are necessary to understand how multi-topic programs influence student outcomes to intervene against sexual violence, racism, and high-risk alcohol situations. A single-session bystander training for emphasizing communication strategies was developed for juniors and seniors on a private, Midwestern college campus. The training addressed sexual violence, racism, and high-risk alcohol situations and was evaluated using a randomized waitlist-control design in student-housing units. Online Qualtrics surveys were completed by 101 student participants (57 in the intervention group and 44 in the control group). Students responded to nine harm scenarios involving sexual violence, racism, and high-risk alcohol situations at baseline and 7 weeks follow-up. Between-group changes in scores were compared to determine the effect of the program on students' (a) readiness to intervene; (b) confidence to intervene; (c) bystander behaviors among students who witnessed actual or potentially harmful events; and (d) bystander reports of their experiences. Qualitative analysis assessed how the program influenced the use of positive verbal communication strategies. Program effects increased positive bystander experiences when helping someone who had too much to drink and needed assistance. Over time both groups reported increased confidence levels to intervene when someone intoxicated was being isolated with sexual intent. There were no further significant findings in readiness, confidence, behaviors, or other experiences, though some positive nonsignificant trends emerged. The program demonstrated little efficacy. Results suggest opportunities to improve bystander outcomes in low-risk primary prevention situations and racist scenarios, suggesting that targeted intervention of these outcomes may be useful when developing programming with previously-trained students. As universities expand prevention work beyond the first year, lessons learned may help inform multi-year programming across health topics to prevent harm and create healthier college campuses.

BYSTANDER INTERVENTION AMONG DRINKING GAMERS Bystander Intervention Among College Student Drinking Gamers: Sexual Assault Attitudes, Self-Efficacy, and Intent to Intervene

Heavy drinking and sexual assault warrant significant concern on U.S. college campuses as emerging evidence suggests that the risk for sexual victimization is amplified in the context of high-risk drinking behavior. Despite recent attention to sexual assault (e.g., MeToo Movement), rates of perpetration remain largely unchanged. In applying the bystander intervention framework, our understanding of the relation between key factors that may facilitate or prevent behavioral action, or when and how these factors are most salient, is limited. The present study examined whether bystander attitudes and bystander self-efficacy interact to predict bystander intent to intervene. Hypotheses were tested among college student drinking gamers, a group at particular risk for involvement in situations of sexual violence. Participants (N = 964) were traditional college-aged student drinking gamers recruited from three universities across the East and Southern Central United States. After controlling for Greek affiliation, prior intervention training and social desirability, hypotheses were partially supported. Higher rape supportive attitudes (rape myth acceptance) were negatively associated with bystander intent to intervene across all participants, but bystander self-efficacy significantly moderated the relation between bystander attitudes (rape myth acceptance) and bystander intent to intervene only among women college student drinking gamers. The interaction effect was not significant among men. For all participants, there was a significant relation between bystander self-efficacy and bystander intent to intervene such that as self-efficacy increases, bystander intent to intervene increases. The discussion addresses implications for sexual assault prevention programs on college campuses and directions for future research.

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.

The Theory of Planned Behavior & Bystander Intention: Differences Based on Gender and Heavy Episodic Drinking

Research indicates that people who engage in heavy episodic drinking (HED) report less intention to intervene and intervention behavior to prevent sexual violence. Researchers have also found gender differences across bystander intention, bystander confidence, and intervention behavior. However, research in this area could benefit from use of an evidence-based health behavior theory. The theory of planned behavior (TPB) posits that personal attitudes, subjective norms, and perceived behavioral control (PBC) predict behavioral intention. Substantial evidence supports the utility of the TPB for predicting behavioral intention in a variety of health-related behaviors, yet few researchers have applied this theory when predicting bystander intention to prevent sexual violence. Undergraduate students (N = 395) from a southern university (77% female; 70% White, Non-Hispanic) completed a modified Sexual Assault Bystander Behavior Questionnaire and the Daily Drinking Questionnaire. Our findings did not reveal significant differences in attitudes, subjective norms, PBC, nor intention based on HED; however, there were significant differences based on gender, with women indicating more positive attitudes and supportive subjective norms regarding bystander intervention. Multiple regression analysis indicated that theoretical antecedents of intention positively predicted bystander intention, however, the relations were not moderated by prior engagement in HED. These findings support the utility of the TPB for predicting bystander intention to intervene; however, they do not support previous research examining how HED influences bystanders' intention to engage in prosocial actions.

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.

"Is It My Responsibility?": A Qualitative Review of University Students' Perspectives on Bystander Behavior

Bystander interventions focus on framing violence as a community problem and encourage all community members to act as prosocial bystanders if they witness a dangerous situation. Research has demonstrated there are multiple barriers and facilitators that might discourage or encourage an individual to act as a prosocial bystander. A qualitative interpretive meta-synthesis (QIMS) of existing literature was conducted to determine university students' perspectives on bystander facilitators and barriers. A systematic search of the literature was completed to identify articles that included university students' perspectives on bystander facilitators and barriers, utilized a qualitative methodology, and contained participant quotations in the published article. The search yielded 181 articles and after screening 10 articles were included in the QIMS. The original themes and participant quotations were qualitatively coded to develop five new themes: (1) the impact of alcohol, (2) beliefs about responsibility, (3) peer perceptions, (4) indicators and situational dilemmas, and (5) the role of friendship and group impact. The results of this synthesis reveal important implications for the continued development of bystander intervention programs for universities. By incorporating the perspectives of university students, bystander intervention programs may be more effective at encouraging students to be prosocial bystanders by confronting perceived barriers to intervention.

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.

Bystanders to Prevent Peer Sexual Violence: Understanding Patterns of Prosocial Behavior Over Time from Early to Later Adolescence

Programs to prevent peer sexual violence that encourage positive bystander intervention are proliferating. Yet, little is known about how these prosocial behaviors unfold over time across middle to later adolescence. The current study examined helpful bystander actions over three years among students in grades 7-10 (mean age 13.7, range 12-18) at baseline (N = 2539, 53.2% girls). Surveys assessed bystander behavior, social norms, and use of alcohol. Multilevel logistic regression examined patterns of change over time, as well as how changes in attitudes and binge drinking predicted changes in taking bystander action to prevent peer violence. Positive bystander behaviors overall decreased over time, consistent with previous work on bullying. Higher positive social norms and lower denial of sexual violence as a problem were associated with more positive helping behaviors across different waves of data. These findings suggest that the effectiveness of bystander intervention training for peer sexual violence prevention may be enhanced by developing strategies to work against the observed developmental decline in helping, perhaps by social marketing campaigns that can bolster positive social norms.

Reactions to Actions: Exploring How Types of Bystander Action Are Linked to Positive and Negative Consequences

Sexual and dating violence (SDV) are growing public health problems in the United States. Prevention programs have sought to engage potential bystanders so they can safely and effectively intervene in situations involving SDV. However, the ability of these programs to prepare bystanders may be limited if they do not address the possible outcomes of their actions. Few studies have examined positive and negative consequences of bystander action, and only one has examined how various types of action impact these consequences. The purpose of our study was to explore how specific types of bystander actions and their number of actions were related to positive and negative consequences. We recruited participants (N = 615) through Amazon's Mechanical Turk and a university subject pool, all of whom were between the ages of 18 and 24. Participants described the type of action they took in response to risk for SDV (i.e., harassing comments, dating violence, unwanted sexual advances, and controlling behavior). We performed a content analysis on participants' written responses about the type of action taken. New measures of bystander consequences were used to examine bystander feelings and reactions of others (e.g., the victim, perpetrator). A range of action types were identified (i.e., direct, distract, distance, delegate, and physical action). Of note, direct action toward the perpetrator was related to more negative feelings and responses, whereas distract and distance action were associated with more positive feelings and responses from others. Further, taking multiple actions (as opposed to a single one) was related to more positive feelings and responses from others. Implications for research and practice are discussed, with a specific focus on prevention programming.

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.