Sexual Assault Prevention for Heavy Drinking College Men: Development and Feasibility of an Integrated Approach

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 Student Perceptions of the Root Causes of Sexual Violence Before and After a Curricular Intervention

Campus sexual violence is prevalent and consequential. After a climate survey at our university revealed high rates of sexual violence, a semester-long academic course was designed as a curricular intervention for first-year students. This study examines an assignment completed at the beginning and end of the course. Students were asked: "What are the root causes of sexual violence?" Thematic analysis of papers revealed that many students altered or expanded their thinking to more complex, structural factors compared to their initial perceptions. An academic course may broaden students' understanding of the determinants of sexual violence.

Preventing sexual violence in sexual orientation and gender diverse communities: A call to action

Background: Members of the lesbian, gay, bisexual, transgender, queer, and other sexual orientation and gender diverse (SOGD) communities are at disproportionately higher risk for sexual violence compared to cisgender heterosexual people. Despite this elevated risk, relatively few sexual violence prevention efforts effectively reduce these victimization disparities based on sexual orientation or gender identity.Objective: This narrative review provides an overview of the prevalence of sexual violence in the SOGD communities, delineates risk factors for sexual victimization among SOGD community members, and reviews and evaluates existing prevention efforts for the SOGD communities. We outline specific recommendations for ensuring that prevention efforts meet the needs of the SOGD communities.Method: Drawing on ecological systems theory and public health approaches to sexual violence prevention, we outline current approaches and opportunities for preventionists and scholars to push the field forward.Results: There have been promising prevention programmes designed to be implemented within SOGD communities specifically; however, it is important that general primary prevention programmes endeavour to specifically address sexual violence perpetrated against SOGD people. While many packaged programmes that endeavour to prevent sexual violence across all gender identities and sexual orientations are inclusive of SOGD participants, more programming is needed that integrates anti-oppression training to target social norms that perpetuate SOGD-specific rape myths and normalize sexual violence against SOGD community members.Conclusion: Ecological prevention strategies in line with a public health approach for primary prevention may be particularly valuable for reducing victimization disparities based on SOGD status and identity. Comprehensive sexual education and anti-discrimination policies should be considered front-line prevention programming. To assess if these strategies are effective, the implementation of large-scale surveillance surveys that use comprehensive assessments of sexual orientation, gender identity, and sexual violence are needed. Using theoretically grounded implementation strategies for prevention programmes can ensure effective programme delivery.

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.

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.

Integrated Alcohol Use and Sexual Assault Prevention Program for College Men Who Engage in Heavy Drinking: Randomized Pilot Study

BACKGROUND

Sexual assault is prevalent on college campuses and most commonly is perpetrated by men. Problematically, there is a dearth of evidence-based prevention programs targeting men as perpetrators of sexual aggression. The Sexual Assault and Alcohol Feedback and Education (SAFE) program is an integrated alcohol and sexual assault prevention intervention for college men who engage in heavy drinking that aims to address sexual aggression proclivity and alcohol use outcomes by incorporating social norms theory, bystander intervention, and motivational interviewing.

OBJECTIVE

This study aims to examine the initial feasibility-, acceptability-, and efficacy-related outcomes of a randomized pilot trial of an integrated alcohol and sexual assault prevention program for college men who engage in heavy drinking.

METHODS

This study included 115 college men who engaged in heavy drinking, who were randomly assigned to the SAFE program or a mindfulness-based control condition (MBCC). The feasibility of implementation, adequacy of participant retention, fidelity and competency of program administration, and satisfaction and utility of the intervention were evaluated. The primary outcomes of alcohol use and sexual aggression were evaluated at 2 and 6 months after baseline. The secondary outcomes of perceived peer norms, risks for sexual aggression, and bystander intervention were also assessed. The extent to which the motivational interviewing session with personalized normative feedback facilitated changes in the proximal outcomes of drinking intentions, motivation to change, and self-efficacy was also examined.

RESULTS

The study procedures resulted in high program completion and retention (>80%), high fidelity to the program manual (>80% of the content included), high competency in program administration, and high ratings of satisfaction and program utility in addressing sexual relationships and alcohol use. Both groups reported declines in the number of drinks per week and number of heavy drinking days. Compared with the MBCC participants, the SAFE participants reported higher motivation to change alcohol use after the program, as well as greater use of alcohol protective behavioral strategies at 6 months. Compared with the MBCC participants, the SAFE participants also reported lower perceived peer engagement in sexual coercion, perceived peer comfort with sexism, and peer drinking norms at 2 and 6 months. However, no group differences were observed in sexual aggression severity, rape myth acceptance, or the labeling of sexual consent. Results regarding bystander intervention intentions were mixed, with the MBCC group showing decreased intentions at 2 months and the SAFE group reporting increased intentions at both 2 and 6 months.

CONCLUSIONS

The findings provide promising evidence for the feasibility, acceptability, utility, and preliminary efficacy of the SAFE program in reducing alcohol use and positively influencing perceived peer norms and intentions for bystander intervention among college men who drink.

TRIAL REGISTRATION

ClinicalTrials.gov NCT05773027; https://clinicaltrials.gov/study/NCT05773027.

The Intersection between Alcohol use and Sexual Activity among Young Adult Male U.S. Service Members

Aims

The current study explores drinking habits, preferences for alcohol use before sexual activity, and alcohol-related sexual behavior among young adult male active duty service members in the United States.

Background

Hazardous alcohol use is a significant problem among United States military service members. Whereas the association between alcohol use and sexual assault is well documented in civilian samples, less is known regarding the intersection of alcohol use and sexual activity among soldiers.

Objective

Descriptive statistics were utilized to summarize drinking habits, preferences for alcohol use before sexual activity, and alcohol-related sexual behavior.

Methods

A sample of 338 active-duty male service members between the ages of 18 and 24 were recruited from a large military post in the Southeastern United States. Constructs were assessed using self-report surveys.

Results

Participants reported consuming alcohol, on average, 5.6 times over the prior month. Average alcohol consumption was reported to be 7.8 beverages per drinking occasion. Participants reported engaging in heavy drinking an average of 2.9 times over the past 30 days. On average, service members reported a preference for 1.3 drinks before sexual activity. Furthermore, 75.2% of participants preferred to be sober during sex, and 82.1% preferred to engage in sexual activity with a sober partner. Approximately 14% of the sample reported using alcohol to improve their chances of having sex.

Conclusion

These findings highlight high rates of alcohol use among soldiers. Nonetheless, young adult male soldiers report a preference for sexual activity while sober. Understanding the co-occurrence of alcohol use and sexual activity has the potential to inform the development of integrated alcohol and sexual assault prevention programs for service members.

Bystander intervention to prevent firearm injury: A qualitative study of 4-H shooting sports participants

This qualitative study examines how youth and adult members of 4-H Shooting Sports clubs perceive firearm injury risk and risk reduction, and the applicability of a bystander intervention (BI) risk reduction framework in this community. Semistructured interviews were conducted with 11 youth and 13 adult members of 4-H Shooting Sports clubs across nine US states from March to December of 2021 until thematic saturation was reached. Deductive and inductive thematic qualitative analyses were performed. Six overarching themes emerged: (1) The tendency to view firearm injury as predominantly unintentional in nature; (2) Acknowledgment of a wide array of risks for firearm injury; (3) Perceived barriers to bystander action to prevent firearm injury including knowledge, confidence, and consequences of action; (4) Facilitators of bystander action including a sense of civic responsibility; (5) Direct and indirect strategies to address potential risks for firearm injury; and (6) Belief that BI skills training would be useful for 4-H Shooting Sports. Findings lay the groundwork for applying BI skills training as an approach to firearm injury prevention in 4-H Shooting Sports, similar to how BI has been applied to other types of injury (i.e., sexual assault). 4-H Shooting Sports club members' sense of civic responsibility is a key facilitator. Prevention efforts should attend to the broad array of ways in which firearm injury occurs, including suicide, mass shootings, homicide, and intimate partner violence, as well as unintentional injury.

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.

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.

Profiles of Men's Rape Myth Beliefs and the Association With Rape Proclivity

The two constructs of rape myth acceptance (RMA) and rape proclivity are associated with sexual violence (SV) perpetration. Further understanding these constructs can help improve prevention efforts aimed at reducing SV perpetration. Latent profile analysis was conducted to examine typologies of RMA among 474 incoming college men and found that male college students can be categorized into four profiles. Some groups endorsed lower or mid-levels of rape myths (RMs) and others endorsed higher levels of some or all RMs, indicating the heterogeneity of RM beliefs. And within each subgroup of college men's RMA, intention to join an all-male sports team and/or a fraternity (two risk factors) and bystander attitudes (a protective factor) were examined as covariates in the model. Bystander attitudes appear to act as a protective factor as they are higher among profiles of men with lower RMA. Furthermore, this study examined the four subgroups (latent profiles) of college men based on their RMA to examine whether membership within each subgroup/profile is differentially associated with rape proclivity. The findings indicate that subgroups of men with high levels of RMA have higher mean rape proclivity scores compared to the subgroup of men with the lowest level of RMA. Implications for prevention programming tailored for high-risk groups of men, based on their RMA beliefs, as well as possible future research within this area are discussed.

Implementing school-wide sexual assault prevention in middle schools: A qualitative analysis of school stakeholder perspectives

Sexual assault and harassment are significant problems that begin early in the lifespan. The current study sought to understand the contextual factors that influence the implementation of school-wide sexual assault prevention programs in middle schools that focus on fostering community norms change. The Consolidated Framework for Implementation Research (CFIR) is a menu of constructs arranged across 5 domains that assists stakeholders in assessing and identifying site-specific determinants of successful intervention implementation. In the present study, researchers conducted a series of 10 interviews with middle school stakeholders (i.e., principals, guidance counselors, teachers) to document characteristics inside and outside of the school environment (i.e., cultural norms, relative priority, prior interventions, implementation climate) relevant to the implementation of prevention programming, using the CFIR as a guiding framework for analysis. Whereas schools recognized the importance of implementing violence prevention programming, stakeholders reported several other competing demands (i.e., time, resources) that make it difficult to implement rigorous programming without support from an outside agency/team. Community agencies and research teams hoping to implement violence prevention in middle schools can benefit from using stakeholder interviews grounded in the CFIR model to gain a better awareness of the school- and community-specific factors that are likely to influence successful implementation of violence prevention programs in middle schools.

A randomized controlled trial of an online alcohol and sexual risk prevention program for college students studying abroad

INTRODUCTION

American college students who study abroad experience increases in their drinking behavior, concerning risky sexual behaviors, and high rates of sexual violence while abroad. Despite these concerns, institutions offer limited programming to students prior to departure to address these risks and no empirically supported interventions currently exist that are targeted toward preventing increased drinking, risky sexual behavior, and sexual violence abroad. To help address alcohol and sexual risk abroad, we designed a brief, single-session online predeparture intervention focused on risk and protective factors known to associate with alcohol and sexual risk abroad.

METHODS

Using a sample of 650 college students from 40 home institutions, we conducted a randomized controlled trial of the intervention and tested its effects on drinking (drinks per week, binge drinking frequency, alcohol related-consequences), risky sexual behaviors, and sexual violence victimization during the trip abroad (first month, last month abroad) and one-month and three-months after return home.

RESULTS

We observed small, but nonsignificant, intervention effects on drinks per week and binge drinking days during the first month abroad and three months after they had returned home to the United States, and small, significant effects on risky sexual behaviors during the first month abroad. The study found no observable effects at any time point for alcohol-related consequences or for sexual violence victimization abroad.

CONCLUSIONS

Though mostly nonsignificant, small initial intervention effects were promising in this first empirical test of an alcohol and sexual risk prevention program for study abroad students. However, students may need more intensive programming with booster sessions to experience lasting intervention effects during this particularly high-risk period.

CLINICALTRIALS

GOV IDENTIFIER

NCT03928067.

Sexual and Gender Minority Inclusivity in Bystander Intervention Programs to Prevent Violence on College Campuses: A Critical Review

Sexual and gender minority (SGM) individuals are at increased risk for experiencing sexual violence. Bystander intervention training programs are a first-line prevention recommendation for reducing sexual and dating violence on college campuses. Little is known regarding the extent to which SGM individuals are represented in the content of bystander intervention programs or are included in studies examining the effectiveness of bystander intervention programs. The present critical review aimed to fill this gap in knowledge. Twenty-eight empirical peer-reviewed evaluations of bystander intervention programs aimed at reducing dating violence or sexual assault on college campuses were examined. Three studies (10.7%) described including content representing SGM individuals in the program. Personal communication with study authors indicated that-although not mentioned in the publication-many programs describe rates of violence among SGM students. When describing the study sample, six studies (21.4%) indicated that transgender, nonbinary, or students classified as "other" were included in the research. Approximately two thirds of studies (67.9%) did not describe participants' sexual orientation. No studies reported outcomes specifically among SGM individuals, and two (7.1%) mentioned a lack of SGM inclusion as a study limitation. Work is needed to better represent SGM individuals in the content of bystander intervention programs and ensure adequate representation of SGM individuals in studies examining the effectiveness of bystander intervention programs.

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.

What Stops Unwanted Sexual and Social Advances Made by Heavy Drinking College Men?

Although rates of sexual aggression are high among college men who engage in heavy drinking, little is known regarding how often heavy drinking college men initiate unwanted sexual advances towards women that could lead to a potential sexual assault or the reasons why these advances stop or proceed. The present study describes heavy drinking college men's (N = 210) initiation of unwanted sexual and social advances towards women, as well as outcomes of these interactions, including how often these behaviors continue, and men's perception of what stopped the behavior over a 3-month period. Men indicated whether they were in a situation where a sexual partner noted that she does not want sexual activity to proceed further, initiated unwanted sexual contact, initiated unwanted sexual intercourse, attempted to give a woman alcohol when she did not appear to want to drink, or attempted to take a woman to an isolated location when she did not appear to want to go. These unwanted sexual and social advances most often stopped because of women's verbal resistance (i.e., saying "stop" or "no"), or because men engaged in a discussion regarding the women's limits or choices. Given that none of the unwanted sexual or social advances stopped because of bystander intervention, the present study highlights the importance of raising awareness of the effectiveness of women's resistance tactics and continuing to train bystanders to notice and take action to address risky situations.

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.

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.

Social Cognitive Processes Underlying Normative Misperception of Sexual Judgments

Acquaintance-initiated sexually aggressive behavior (SAB) is a widespread problem on college campuses, and intervention strategies thus far have not produced sustained reductions in SAB. Peer-related social norms and cognitive processes underlying sexual decision-making have separately been implicated in SAB. The present study integrates this work by examining the effect of perspective (self vs. typical college male referent) on college men's judgments of the justifiability of unwanted sexual advances, determining the cognitive processes underlying men's misperceptions, and evaluating rape-supportive attitudes (RSA) as a correlate of the implicated processes. College men attracted to women (n = 217) completed the Heterosocial Perception Survey-Revised, in which they judged the justifiability of a man's increasingly intimate sexual advances as a woman responds increasingly negatively. Participants completed the Heterosocial Perception Survey-Revised from their own perspective and from the typical college male perspective. Participants also completed questionnaires assessing RSA and demographics. Undergraduate men, and particularly those endorsing more RSA, greatly overestimated how much the typical college male perceives increasingly nonconsensual behavior as justified. Three cognitive processes were strongly implicated in this misperception. When responding from the self-perspective, RSA correlated significantly with all cognitive processes. These findings illustrate the utility of integrating work on social norms and cognitive processing to document the global effect of perspective on average justifiability ratings and the perspective effect on cognitive processes underlying the ratings. Future work should evaluate personalized normative feedback and cognitive-training approaches to target misperceptions of peers' sexual judgments, given the well-established relation between sexual misperception and SAB risk.

An Ecological Momentary Assessment of College Women's Decisions to Use Protective Behavioral Strategies

Protective behavioral strategies (PBS) have been associated with reduced risk for sexual assault victimization in college women. Sexual assault risk reduction programs have had limited success increasing PBS use, particularly among heavy drinkers, suggesting a need for additional research on the malleable predictors of PBS use. Whereas longitudinal studies show women's decisions to use PBS can be both planned and reactive, little is known about the decision-making processes that affect PBS use on drinking days, when sexual assault risk may be elevated. The current study used ecological momentary assessment to examine variability in the associations between decision-making and PBS use within and across drinking days in first-semester college women. Participants (56 female drinkers) completed a 14-day protocol with three daily measures of intentions and willingness to use PBS, and once-daily diaries of PBS use. Multilevel models examined between-day and within-day effects of intentions and willingness to use PBS with regards to sexual assault PBS (e.g., communicating sexual boundaries) and drinking PBS (e.g., limiting alcohol consumption), respectively. On days when sexual assault PBS willingness increased throughout the day, women tended to use more sexual assault PBS. This association was strongest among women who were typically less willing to use these PBS. Among women who were the least willing to use drinking PBS, their drinking PBS use decreased on days when they reported increased willingness to use them. Decisions to use sexual assault and drinking PBS on drinking days were qualified by women's typical levels of willingness to use the different PBS. This suggests the need for a multi-faceted intervention strategy that targets both typical and event-level risk. Individual-level alcohol and sexual assault risk reduction approaches could be enhanced with event-level PBS messaging and evaluation.

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

Examining Women's Sexual Assault Victimization Experiences since Entering College via Two Behavioral Assessments

Measuring sexual assault experiences is considered a methodological challenge in survey research. Researchers can test the validity of sexual assault measures by comparing responses to different, albeit related, measures of sexual assault to determine if they identify similar groups of women. The goal of this study was to compare two measures of sexual assault victimization to determine if women report experiencing sexual assault in both assessments. Cisgender college women (n = 902) completed two separate measures of sexual victimization: the Sexual Coercion Inventory (SCI) and Sexual Experience Survey-Short Form Victimization (SES-SFV). Responses to both measures were coded to identify different sexual assault experiences (i.e., unwanted touching, attempted, and completed oral, vaginal, or anal rape) resulting from verbal coercion, threats of force, and use of force since enrolling in the university. Results suggested the SES-SFV produced higher overall rates of sexual assault experiences than the SCI. Specifically, the SES-SFV elicited more non-consensual sexual experiences resulting from threats and use of force, whereas the SCI elicited more non-consensual sexual experiences resulting from verbal coercion. Findings suggested discrepant responding across the two measures. Development of comprehensive sexual assault measures that fully capture women's victimization experiences is warranted.

A Qualitative Analysis of Sexual Consent among Heavy-drinking College Men

The current study sought to examine how heavy-drinking college men describe communication of sexual interest and sexual consent. Thematic analysis of semi-structured interviews with 12 heavy-drinking college men identified three themes. Themes included: (a) expectations about parties and sexual activity, (b) observing and communicating sexual interest, and (c) communication of sexual consent. Men reported visiting drinking environments to locate women who they assumed would be open to sexual advances. In these environments, sexual interest was inferred indirectly through shared alcohol use. Anticipating token resistance men reported "trying and trying again" to pursue escalating types of sexual activity. Consent was inferred when participants did not hear "no" from a sexual partner, highlighting the importance of continued education on verbal consent in the context of sexual assault prevention programs.

The Chivalrous Bystander: The Role of Gender-Based Beliefs and Empathy on Bystander Behavior and Perceived Barriers to Intervention

Despite substantial evidence demonstrating a relation between gender-based beliefs and violence against women, there has been little research examining whether sexist attitudes are related to prosocial bystander behavior. Understanding psychosocial influences on bystanders' behavior could inform bystander training programs on college campuses, and so the current study examined the unique and joint effects of three gender-based attitudes (rape myth acceptance, hostile sexism, and benevolent sexism) and empathy in predicting bystander behavior and perceived barriers to intervention in situations that undergraduates (N = 500; 70% female; M_age = 18.86 years) had experienced in the prior year. Benevolent sexism was the only gender-based attitude consistently associated with bystander behavior and perceived barriers. After accounting for participant empathy, benevolent sexism uniquely predicted less intervention in post-assault situations, greater perceived barriers in pre- and post-assault situations, and greater Failure to Perceive Responsibility and Skill Deficit barriers across situations. Associations between gender-based attitudes and bystander behavior also differed for men and women, with rape myth acceptance predicting greater Failure to Perceive Responsibility barriers and benevolent sexism predicting greater Skill Deficit barriers for women but not men. These results suggest that existing bystander education programs can be improved by explicitly addressing benevolent sexist beliefs and promoting empathy for victims of assault.

A laboratory study of the effects of men's acute alcohol intoxication, perceptions of women's intoxication, and masculine gender role stress on the perpetration of sexual aggression

BACKGROUND

Although research has established an association between alcohol use and sexual assault, few studies have examined how characteristics of the perpetrator may influence sexual aggression depending upon whether alcohol is consumed by the perpetrator and/or the victim. This laboratory-based investigation was designed to disentangle the effects of individual differences in masculine gender role stress (MGRS) and the perpetration of sexual aggression as a function of (1) men's acute alcohol intoxication and (2) whether a woman was consuming alcohol or not.

METHOD

A community sample of 156 men participated in two laboratory sessions, during which they completed a self-report measure of MGRS (Session 1) and a modified version of the sexual imposition paradigm after consuming an alcoholic or non-alcoholic beverage (Session 2). In this paradigm, participants and a male friend were told that an ostensible female participant had consumed or not consumed alcohol. They were also told that she did not wish to view sexual content. Participants were then provided the opportunity to make the female confederate view a sexually or non-sexually explicit film. Sexual aggression was operationalized by selection of the sexually explicit film.

RESULTS

A hierarchical logistic regression showed that men higher in MGRS who were intoxicated were (1) more likely than sober men to select the sexually explicit film when the woman was intoxicated and (2) less likely than sober men to select the sexually explicit film when the woman was sober.

CONCLUSIONS

These findings suggest that the perpetration of sexual aggression is most likely among men with higher MGRS when there is concordance in drinking (i.e., when either the man and woman are both drinking or are both not drinking).

History of Sexual Assault Perpetration and Violence-Related Prosocial Tendencies Among Men by Fraternity Affiliation Status

The purpose of this cross-sectional study was to examine self-reported sexual assault perpetration history, as well as violence prevention-related prosocial tendencies, among fraternity men, unaffiliated men with membership intentions, and unaffiliated men without membership intentions with data from 262,634 college men in the United States. Results indicate that fraternity status was related to sexual assault perpetration, both prior to and while at their current institution of higher education; both perpetration history and fraternity status significantly related to diminished violence prevention-related prosocial tendencies. The findings have important implications for future research and practice to reduce the incidents of sexual assault on college campuses.

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.

Selection and socialization accounts of the relation between fraternity membership and sexual aggression

OBJECTIVE

The current project aims to enhance our understanding of the well-established relation between fraternity membership and sexual aggression on college campuses. Most prior research has been cross-sectional and unable to distinguish selection and socialization accounts of the relation, and only one prior longitudinal study has simultaneously examined selection and socialization effects.

METHOD

Fraternity membership, sexual aggression, binge drinking, sociosexual attitudes and behaviors, and perceived peer sexual aggression were assessed for 772 male participants (n = 116 fraternity members) in a longitudinal survey study from the summer prior to college through Year 2 of college.

RESULTS

Longitudinal path analyses revealed three key findings. First, fraternity membership was prospectively correlated with sexual aggression in Years 1 and 2 of college (socialization effect), controlling for selection effects, when the two prospective paths were constrained to be equivalent. Second, more frequent binge drinking and sociosexual attitudes prior to college prospectively correlated with an increased likelihood of joining a fraternity (selection effect), and both selection variables indirectly correlated with future sexual aggression via fraternity membership. Third, fraternity membership was associated with increased binge drinking and perceived peer sexual aggression (socialization effects).

CONCLUSIONS

These findings identify critical targets for the prevention of sexually aggressive behavior that are linked to fraternity membership: Binge drinking and sociosexual attitudes. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Alcohol Use and Risk Factors for Sexual Aggression: Differences According to Relationship Status

The present study examined the ways alcohol use and risk factors for sexual assault perpetration vary by relationship status. Participants included 242 college men (age = 18-22 years) from a northeastern university who identified as being single or in a casual or committed dating relationship with a female partner. ANCOVAs and paired t tests compared individuals who were single, casually dating, and in committed relationships on self-reported alcohol use during sexual situations, beliefs about sexual communication, behavior associated with sexual aggression, and peer approval of sexual aggression. Differences in alcohol use during sexual situations and behavior associated with sexual aggression according to relationship status emerged. Post hoc analyses examining whether alcohol use during sexual situations moderated significant associations between relationship status and behavior associated with sexual aggression suggested that men in committed relationships who endorsed more frequent alcohol use during sexual situations also endorsed more behavior associated with sexual aggression. Findings suggest that individuals in committed relationships who often use alcohol during sexual situations may be at increased risk of sexually aggressive behavior.

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 "White Knight" effect: Benevolent sexism accounts for bystander intervention in party situations among high status men

Prior research indicates that adherence to the male role norm suggesting men should seek to attain social status (i.e., status) is positively related to prosocial bystander attitudes and behavior; however, moderators of this effect have yet to be examined. One construct that may influence this effect is benevolent sexism. The present study sought to fill this gap in the literature. Participants were 148 men 21-30 years of age from the metro Atlanta area who reported that they had engaged in heavy drinking at least three times in the past year. A moderation model was used to examine the independent and interactive effects of adherence to the status norm and benevolent sexism on bystander behavior within party settings for friends and strangers. The model predicting bystander behavior towards friends showed a significant interaction between status and benevolent sexism (b = .59, p = .021). The association between adherence to the status norm and bystander behavior was significant and positive among men who reported high benevolent sexism (β = .96, p = .003), but not low benevolent sexism (β=.15, p=.619). No such effects were detected for bystander behavior for strangers. Findings suggest that males who hold traditional male ideologies around chivalry may be more likely to engage in prosocial bystander behavior towards women in party situations, perhaps as a way of demonstrating their high status. These findings have implications for future programming for men.