A Systematic Review of Bystander Interventions for the Prevention of Sexual Violence

Promoting sexual well-being of college students through wellness programs

Objective: Despite a growing emphasis on holistic student wellness in higher education, sexual well-being often remains neglected as part of wellness. We conducted a website content review to assess the broad utilization of wellness models and the specific integration of sexual well-being into wellness programs. Methods and results: Targeting 51 flagship and top 50 private institutions, we found that 82.35% of flagships and 64.00% of top private institutions mentioned some form of the wellness model. However, integration of the wellness model into on-campus or local resources varied considerably across institutions. Importantly, only two institutions (both private) addressed sexuality as its own unique dimension of wellness. Conclusion: The current study underscores the need for wellness programs to include a focus on sexual well-being. Skills and knowledge that college students learn through wellness programs can help them make better health decisions and improve their quality of life while in college and beyond.

Strategies for Implementing GlobalConsent to Prevent Sexual Violence in University Men (SCALE): study protocol for a national implementation trial

BACKGROUND

Globally, women 15-24 years are at heightened risk of sexual violence victimization, a risk factor for adverse mental, physical, and behavioral health outcomes. Sexual violence is common at universities and most often perpetrated by men, yet few evidence-based prevention strategies targeting men have been tested in low- and middle-income countries. GlobalConsent is a six-module, web-based educational program adapted from an efficacious U.S.-based program. Nine months post-treatment in a randomized trial in Vietnam, GlobalConsent reduced men's sexually violent behavior (odds ratio [OR] = 0.71, 95%CI 0.50-1.00) and increased prosocial intervening behavior (OR = 1.51, 1.00-2.28) relative to an attention-control. Evidence regarding optimal implementation strategies for scale up is needed.

METHODS

We will randomize six medical universities in North, Central, and South Vietnam to deliver GlobalConsent using two different packages of implementation strategies that vary in intensity. Higher-intensity strategies will include greater (1) pre- and post-implementation engagement with university leaders and faculty and (2) greater pre-implementation outreach, follow-up, and incentives for students to promote engagement and completion of GlobalConsent. Higher intensity universities will receive additional training and support for their added activities. We will compare implementation drivers and outcomes, intervention effectiveness, and cost-effectiveness across the two implementation bundles. Our mixed-methods comparative interrupted time series design includes (1) qualitative interviews and quantitative surveys with university leaders and implementation teams to assess implementation barriers and facilitators; (2) repeated surveys with leaders and faculty, implementation teams, and male students to assess multilevel implementation drivers and outcomes; (3) repeated surveys with male students to assess behavioral outcomes (sexual violence and intervening behavior) and mediating variables (knowledge, attitudes, affect, and capacities); and (4) time diaries and cost tracking to assess cost-effectiveness of the two implementation-strategies bundles.

DISCUSSION

This project is the first to assess packages of implementation strategies to deliver an efficacious web-based sexual violence prevention program for undergraduate men across all regions of Vietnam and synergizes with a violence-prevention training initiative (D43TW012188). This approach will produce rigorous evidence about how to disseminate GlobalConsent nationally, which holds promise to reduce gender-based health inequities linked to sexual violence as GlobalConsent is brought to scale.

TRIAL REGISTRATION

NCT06443541. Retrospectively registered with ClinicalTrials.gov. Registered on June 05, 2024.

Preventing Sexual Harassment in Higher Education: A Framework for Prevention Science Program Development

Sexual harassment is an intractable problem that harms the students, community, culture, and success of institutes of higher education (IHEs). The alarming prevalence of sexual harassment at IHEs highlights the urgent need for effective prevention programs. However, there are few empirically supported preventive interventions that effectively target the factors that most impact the determinants, trajectory, and short- and intermediate-term effects of sexual harassment. In this paper, we overview the problem of sexual harassment and propose an organizing framework to help IHEs develop effective interventions to prevent sexual harassment. Guided by prevention science, we propose a framework-modified from SAMHSA's (2019) guidelines for prevention practitioners-that underscores the criticality of trauma- and equity-informed characteristics in prevention programs. We offer a discussion on how IHEs must consider and evaluate the empirical evidence of effectiveness, flexibility, cultural competency, and sustainability when developing and adapting prevention programs to reduce and-ultimately-ameliorate sexual harassment. We conclude with recommendations that can provide a roadmap for higher education stakeholders and researchers to prevent this urgent public health concern.

Whom Would You Help? The Impact of Perpetrator and Victim Gender on Bystander Behavior During a Sexual Assault

We examined the impact of perpetrator and victim gender on bystander helping choices and assault perceptions. Participants (32 females, 37 males) read about two simultaneously occurring sexual assaults, indicated which victim they would help, and gave their perceptions of the assaults. We used a within-participants design that fully manipulated the perpetrator and victim gender for both assaults. Results showed female victims of male perpetrators and male victims of female perpetrators were most and least likely to be chosen for help, respectively. Cognitive networks derived from open-ended responses provided insight into the rationale used by participants to make helping decisions in ways that differed by perpetrator and victim gender.

Development and Validation of the Bystander Engagement Scale for Witnessed Intimate Partner Violence: A South Korean Version

Bystanders play a crucial role in assisting and rescuing victims of intimate partner violence (IPV) or sexual assault, thereby preventing further harm. Consequently, an increasing amount of research has focused on improving bystander interventions in such situations. While many existing scales that measure bystanders' willingness to intervene and their behaviors are likely tailored to Western settings and primarily focused on preventing sexual assaults, pursuing diversity to make these scales applicable to a variety of contexts is necessary. This study aimed to develop and validate a scale from South Korean samples that measure the likely level of bystander engagement in witnessed IPV situations, named the Bystander Engagement Scale for Witnessed Intimate Partner Violence (BESW-IPV). Preliminary items, developed to describe various IPV situations that a bystander might witness, underwent content validity testing through expert review and cognitive focus group interviews. Afterward, the scale was administered to 311 participants from the target population in South Korea. The scale's factor structure was assessed through exploratory factor analysis (EFA) and confirmed through confirmatory factor analysis (CFA). The reliability and validity were rigorously assessed. The final version of the BESW-IPV comprised 28 items. Through EFA, "direct IPV indicators" and "indirect IPV indicators" were identified. Together, these factors accounted for 76.10% of the total variance. CFA affirmed that the final model offers an acceptable fit. The scale's convergent and discriminant validities were also well established. The Cronbach's alpha and the McDonald's omega values were 0.98 and 0.99, respectively. In contrast to many existing tools that measure bystander intervention predominantly within the confines of Western educational settings, we believe that the BESW-IPV can be applied in broader contexts, especially in patriarchal environments. Further research is required to translate and validate this tool in different cultural contexts.

The Primary Prevention of Sexual Violence Against Adolescents in School and Community Settings: A Scoping Review

Sexual Violence (SV) is a public health problem with serious long-term consequences for victims. This scoping review aimed at summarizing the implementation, methodology, characteristics, and efficacy of SV prevention programs conducted in school and community settings with middle and high school students. This study also gathered recommendations for future research. Studies were searched in three databases: EBSCOHOST, SCOPUS and Web of Science. Eighty-six peer-reviewed empirical studies about SV prevention programs applied in school and community settings with samples of middle and high school students were analyzed. Most original studies (46.3%) used sexual violence outcomes, although many approached sexual violence in the context of dating violence (43.3%). Most SV prevention programs were applied in the U.S.A. although studies were identified across the globe. Prevention programs tend to reduce SV attitudes, perpetration, and victimization and to increase SV knowledge, as well as bystander attitudes and behaviors. The evidence reveals the efficacy of these programs, although future studies are needed to clarify the specificities of SV prevention. This article provides recommendations considering the measurement of SV outcomes, the role of technology, the involvement of adults and communities, the timing of interventions, sexual education, and reporting practices.

A Scoping Review of Bystander-Based Sexual Violence Prevention Training for College Students in Fraternities and Sororities

Bystander-based sexual violence (SV) prevention trainings are offered on college campuses across the United States to meet federal Title IX requirements, as they have proven to be an effective strategy for violence prevention. Greek-affiliated students (fraternity and sorority members) are at a higher risk of sexual assault than their peers; however, few trainings consider the specific needs of this population, and program adaptations for this high-risk group may be needed. This scoping review identifies and describes the bystander trainings delivered to Greek-affiliated students in the US and Canada. An eight-database search was conducted following PRISMA-ScR guidelines. The review identified 81 unique sources, with 18 meeting the inclusion criteria. Eleven specific training programs were identified, encompassing qualitative, quantitative, and mixed-method studies. The thematic analysis revealed best practices, including the importance of peer leaders, interactive sessions, and tailored content to Greek culture, as well as barriers such as a lack of engagement and an inadequate session length. The review underscores the need for tailored interventions to effectively address the unique cultural characteristics and high-risk nature of Greek-affiliated students. These findings provide valuable insights for improving the design and implementation of bystander interventions to enhance their efficacy in preventing sexual violence within this population.

The Safe Sport Allies bystander training: developing a multi-layered program for youth sport participants and their coaches to prevent harassment and abuse in local sport clubs

Harassment and abuse represent a pervasive and critical problem in sport with far-reaching consequences. Survivors' testimonials underscore the profound and enduring impact of these experiences at individual, interpersonal, organizational and community level. Many of their stories reveal painful inaction from responsible adults in the sport organization, aggravating the harm. Other contributing factors to the harm inflicted include a culture of silence, lack of knowledge and understanding of what constitutes abuse, unawareness of reporting and supporting mechanisms, and fear of potential consequences. While effective bystander interventions have been developed outside the sport context, particularly targeting students in higher education, such initiatives have yet to be extensively adapted and assessed within the sport context. To address this gap, the Safe Sport Allies Erasmus+ collaborative partnership relied on the intervention mapping approach as a guiding framework to systematically develop a bystander training program (i.e., Safe Sport Allies) to train youth sport participants and youth sport coaches to act as effective bystanders. The current paper describes the comprehensive development process and provides an overview of implementation and evaluation possibilities. Throughout the paper, it is explained how each step of the Intervention Mapping approach shaped the Safe Sport Allies bystander training program. The program development, and the developed plans for implementation and evaluation are presented, shedding light on challenges encountered. The bystander training program developed in this paper and the implementation and evaluation plans can serve as an outline to build future interventions within this critical domain of safeguarding in sport.

Canadian Gender-Based Violence Prevention Programs: Gaps and Opportunities

Gender-based violence (GBV) prevention programs have long played an important part in both teaching the realities of GBV and training people in techniques to avert, mitigate, and respond to violence. This article examines the current state of GBV prevention training in Canada through an analysis of 81 GBV education programs provided by antiviolence organizations and universities. We identified notable gaps in topics relating to technology-facilitated violence and abuse in programs targeting men and in the provision of bystander intervention training. Each of these areas represents important, but as yet unrealized, opportunities in violence prevention.

Acceptability and feasibility of implementing the Enhanced Assess, Acknowledge, Act (EAAA) sexual assault prevention intervention on a U.S. university campus: Themes from qualitative interviews and written reflections

Objectives: Assess the acceptability of and self-reported behavioral change from participation in a sexual assault prevention intervention on a U.S. university campus. Participants: Thirty-one undergraduate students who identified as women and opted-in to participating in both the intervention and research. Methods: In-depth interviews and written reflections were collected. Analysis was thematic with three investigators coding and reaching consensus. Results: The EAAA program was well-liked by most participants, with positive behavior changes reported. Five key themes reflecting strengths of EAAA were identified, including improved verbal communication, reduced sexual assault myths, empowerment, recognizing and responding to danger cues, and learning about healthy sexuality. Three key themes reflecting challenges were identified, including time commitment, use of outdated program materials, and a single gender focus. Conclusions: EAAA translates well, with a few adaptations, to a residential campus environment in the U.S. Research is needed to assess program effectiveness in reducing sexual assault.

Preventing Sexual Violence: A Behavioral Problem Without a Behaviorally Informed Solution

What solutions can we find in the research literature for preventing sexual violence, and what psychological theories have guided these efforts? We gather all primary prevention efforts to reduce sexual violence from 1985 to 2018 and provide a bird's-eye view of the literature. We first review predominant theoretical approaches to sexual-violence perpetration prevention by highlighting three interventions that exemplify the zeitgeist of primary prevention efforts at various points during this time period. We find a throughline in primary prevention interventions: They aim to change attitudes, beliefs, and knowledge (i.e., ideas) to reduce sexual-violence perpetration and victimization. Our meta-analysis of these studies tests the efficacy of this approach directly and finds that although many interventions are successful at changing ideas, behavior change does not follow. There is little to no relationship between changing attitudes, beliefs, and knowledge and reducing victimization or perpetration. We also observe trends over time, including a shift from targeting a reduction in perpetration to targeting an increase in bystander intervention. We conclude by highlighting promising new strategies for measuring victimization and perpetration and calling for interventions that are informed by theories of behavior change and that center sexually violent behavior as the key outcome of interest.

Bystander Intervention in Football and Sports. A Quasi-Experimental Feasibility Study of a Bystander Violence Prevention Program in the United Kingdom

In recent years, social campaigns and high-profile cases have brought increased attention to violence against women. Athletes can be role models, shaping both prosocial and antisocial attitudes. Their engagement in violence prevention could be an effective tool to tackle violence against women through bystander intervention. This part of a mixed-method feasibility study reports on the quantitative evaluation of an evidence-led bystander program, Football Onside, implemented at a football club in South West England in June 2018 to February 2020. The study employed a quasi-experimental design with intervention and control groups. Football coaches and club members (n = 50) completed measures of rape and domestic abuse myths, bystander intent and efficacy, self-reported bystander behaviors, readiness for change, perceptions of peer helping and myth acceptance, law knowledge, and program evaluation. Fidelity was also assessed. The analysis compared between- and within-group differences in mean changes over time using mixed-effects models. Participant ratings of learning outcomes were high, and fidelity was maintained throughout the intervention. Between-group comparison revealed mixed results, with greater improvements in the intervention group for bystander intent and efficacy at post-test and follow-up, domestic abuse myths at post-test, and rape myth acceptance at follow-up. Model contrasts for within intervention group revealed improvements in rape and domestic abuse myth acceptance, bystander intent and efficacy, perceived law knowledge at both time points, and perceived peer myths and helping at post-test. At follow-up, intervention participants reported significantly higher engagement in bystander behaviors. No significant effects were found for perceived importance of legal knowledge. Our research highlights the potential efficacy of a bystander program tailored for football club members. Cluster-randomized control trials are now required to examine bystander attitudes and behavior change processes among professional athletes.

Socioecological Risk and Protective Factors for Sexual Victimization in Post-Secondary Students in Ireland: A Brief Report

Although numerous predictors of sexual violence (SV) have been identified, there is a need to further explore protective factors and examine the nature and strength of associations between predictors and SV outcomes using a hierarchical predictive model. Cross-sectional data from the My World Survey Post-Second Level (2019) in Ireland were used. The sample contained 8, 288 post-secondary students, 69% female, aged 18 to 25 years (M = 20.25, SD = 1.85). Univariate and multivariate binary logistic regression analyses were conducted to identify correlates of two SV outcomes (i.e., forced/pressured to have sex and being touched in a sexual manner without consent) across societal, community, relationship, and individual levels. Approximately 25% of females and 10% of males reported being forced/pressured to have sex, whereas 55% of females and 23% of males reported being touched in a sexual manner without consent. Key predictors of SV in multivariate analyses included being female and experiencing violence in a romantic relationship, whereas discrimination, living on campus or in rented accommodation (compared with living at home) were also significant predictors of both SV outcomes. Parental conflict, sexual initiation, depressive symptoms, older age, and an avoidant coping style significantly predicted being forced/pressured to have sex, whereas being bullied and engaging in problem drinking were unique predictors of being touched sexually without consent. Findings highlight the importance of considering salient risk and protective factors at the individual, relationship, community and societal level to predict SV and effectively guide the delivery of interventions and support services for post-secondary students affected by SV.

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

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

Negative Associations between Minority Stressors and Self-Reported Health Status among Sexual Minority Adults Living in Colombia

Colombia has extensive laws prohibiting discrimination against sexual minority people. However, violence and discrimination toward sexual minorities are still frequent. While a growing body of research shows that sexual minority people experience elevated rates of discrimination and domestic abuse globally, little research has been conducted on these issues affecting sexual minorities in Colombia specifically. Using minority stress theory as a conceptual framework, this paper aims to fill this gap by examining the prevalence of experiencing intimate partner violence (IPV) and witnessed discrimination and the relationship of these stressors to self-reported health among a national sample of sexual minority Colombians. We found that bisexual individuals experienced higher rates of physical and sexual IPV, compared to lesbian and gay individuals. Additionally, sexual minority Colombians who experienced IPV and witnessed discrimination were more likely to report having poorer health, compared to those who had not. We discuss the implications of our findings for future research and clinicians working with sexual minority clients.

Testing the effectiveness of interactive training on sexual harassment and assault in field science

Fieldwork is a critical tool for scientific research, particularly in applied disciplines. Yet fieldwork is often unsafe, especially for members of historically marginalized groups and people whose presence in scientific spaces threatens traditional hierarchies of power, authority, and legitimacy. Research is needed to identify interventions that prevent sexual harassment and assault from occurring in the first place. We conducted a quasi-experiment assessing the impacts of a 90-min interactive training on field-based staff in a United States state government agency. We hypothesized that the knowledge-based interventions, social modeling, and mastery experiences included in the training would increase participants' sexual harassment and assault prevention knowledge, self-efficacy, behavioural intention, and behaviour after the training compared to a control group of their peers. Treatment-control and pre-post training survey data indicate that the training increased participants' sexual harassment and assault prevention knowledge and prevention self-efficacy, and, to a lesser extent, behavioural intention. These increases persisted several months after the training for knowledge and self-efficacy. While we did not detect differences in the effect of the training for different groups, interestingly, post-hoc tests indicated that women and members of underrepresented racial groups generally scored lower compared to male and white respondents, suggesting that these groups self-assess their own capabilities differently. Finally, participants' likelihood to report incidents increased after the training but institutional reports remained low, emphasizing the importance of efforts to transform reporting systems and develop better methods to measure bystander actions. These results support the utility of a peer-led interactive intervention for improving workplace culture and safety in scientific fieldwork settings. PROTOCOL REGISTRATION: "The stage 1 protocol for this Registered Report was accepted in principle on August 24, 2022. The protocol, as accepted by the journal, can be found at: https://doi.org/10.6084/m9.figshare.21770165 .

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.

Can Virtual Reality be Used for the Prevention of Peer Sexual Harassment in Adolescence? First Evaluation of the Virtual-PRO Program

Objective: The present study analyzed the Virtual-PRO program's efficacy in preventing peer sexual harassment by promoting the bystanders' active intervention and incorporating a virtual reality (VR) component. The impact of the program on sexist attitudes, moral disengagement, the intention to intervene as bystanders, and the involvement in sexual aggression and victimization was tested. Method: Virtual-PRO is a VR-enhanced sexual harassment curricular prevention program of six one-hour sessions. The evaluation comprised a pre-test, a post-test after the intervention, and a follow-up measure at three months. In the study, 579 Spanish adolescent students aged between 12 and 17 years (M = 14.76, SD = 0.88; 47.1% boys) were randomly grouped into experimental (n = 286) and control (n = 293) conditions. Results: The Virtual-PRO program effectively controlled participants' levels of sexism and reduced moral disengagement in the experimental group compared to the control group three months after the intervention. The program also showed positive results in changing bystander behavior, increasing the intention to intervene when the victim was not a friend. Finally, visual/verbal and online victimization decreased in the experimental group and increased in the control group. No differences were found for physical sexual victimization and sexual aggression. Conclusions: The first trial of the Virtual-PRO program is promising and highlights the use of VR as a sexual harassment prevention tool. Follow-up measures are essential to determine the impact of interventions accurately.

Empirically-based dynamic risk and protective factors for sexual offending

This review provides an overview and update of empirical evidence for psychologically meaningful dynamic risk factors and protective factors for sexual offending. Using the review by Mann et al. (2010) as a starting point, we reviewed relevant literature that has appeared since this publication, focusing on meta-analyses, systematic and scoping reviews of dynamic risk factors, recent evaluations of commonly used dynamic assessment tools, and studies of dynamic risk and protective factors in community samples in addition to clinical or forensic samples. Two risk factors previously deemed promising by Mann et al. (2010), hostility towards women and dysfunctional coping (conceptualized as hostile masculinity and emotional regulation deficits, respectively, in this review), could now be considered supported using this review's criteria of three or more studies demonstrating an effect size of 0.15 or greater. No new risk factors were identified. We conducted a broader search of protective factors in recognition of the relative newness of this literature: Positive social support was the only protective factor identified as empirically supported. We also discuss situational risk and protective factors.

Evaluating a Theory-Based Online Program for Preventing Sexual Aggression: An Experimental-Longitudinal Study With German University Students

This pre-registered study evaluated an intervention designed to reduce sexual aggression perpetration and victimization by changing risky scripts for consensual sexual interactions and corresponding risky sexual behavior, and by improving sexual self-esteem, refusal assertiveness, and initiation assertiveness. In a four-wave longitudinal study covering 23 months, 1181 university students in Germany (762 female) were randomly assigned to an intervention and a no-intervention control group. The intervention group completed six weekly modules addressing the targeted theory-based risk and vulnerability factors of sexual aggression perpetration and victimization. Controlling for baseline levels (T1), the intervention group showed less risky sexual scripts one week post-intervention (T2), which predicted less risky sexual behavior nine months later (T3), which predicted lower odds of sexual aggression perpetration and victimization 12 months later (T4). No direct intervention effects on rates of sexual aggression perpetration and victimization at T3 and T4 were found. No indirect intervention effect on sexual aggression was found via sexual self-esteem and sexual assertiveness. However, sexual self-esteem at T2, which was higher in the intervention group, predicted lower odds of sexual aggression victimization at T3 via higher initiation assertiveness at T3. Implications for reducing sexual aggression and conceptualizing risk and vulnerability factors of sexual aggression are discussed.

Nursing students' experiences of sexual harassment - A qualitative study from feminist identity perspective

AIM

To explore experiences of sexual harassment among nursing students in an East Asian region and to gain knowledge of the underlying factors influencing nursing students' conceptualization of and response to sexual harassment.

BACKGROUND

Nursing students are susceptible to sexual harassment due to gender and power inequality in healthcare systems. Sexual harassment has an adverse impact on the students' physical and mental health. Studies on sexual harassment among nursing students are limited and reported significantly varied occurrence prevalence in different cultures. Feminist identity theory can provide a framework to examine social-culturally constructed perceptions of sexual harassment.

DESIGN

A qualitative descriptive study.

METHODS

The study was conducted in Macau, a Special Administrative Region of China. Purposive sampling was applied. Twenty-six nursing students and five nursing educators participated in the study. Semi-structured interviews were conducted. Thematic analysis was used to analyze the interview data. A series of measures were applied to enhance the trustworthiness of the study.

RESULTS

While most of the students had not experienced or heard of sexual harassment, a limited number claimed sexual harassment as a frequently encountered instance. The students expressed uncertainty about what constituted sexual harassment, mainly due to a lack of exposure to information on sexual harassment. They were caught in a dilemma between exerting nursing professional virtues and exposing the misconduct of the suspected perpetrators, leading to taking passive approaches of ignoring and avoiding as the primary coping strategies. In contrast, nursing educators advocated proactive approaches as coping strategies to address sexual harassment.

CONCLUSIONS

A conflict between nursing professional identity and feminist identity is observed among nursing students. Healthcare institutions and nursing schools should develop interventions to enhance nursing students' assertiveness to sexual harassment.

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

INTRODUCTION

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

A Theory-Based Intervention to Reduce Risk and Vulnerability Factors of Sexual Aggression Perpetration and Victimization in German University Students

The current study evaluated an intervention program, designed by the authors and based on the theory of sexual scripts and social learning theory, to reduce empirically established risk and vulnerability factors of sexual aggression. A sample of 1,181 university students in Germany (762 female) were randomly assigned to an intervention and a no-intervention control group. The intervention group completed six modules addressing established antecedents of sexual aggression perpetration and victimization: risky sexual scripts, risky sexual behavior, low sexual self-esteem, low sexual assertiveness, acceptance of sexual coercion, and perceived realism of pornography. After baseline (T1), intervention effects were measured one week after the last module (T2), nine months later (T3), and another 12 months later (T4). The intervention group showed significantly less risky sexual scripts and higher sexual self-esteem at T2, T3, and T4. The intervention indirectly reduced risky sexual behavior at T3 and T4 via less risky sexual scripts at T2 and increased sexual assertiveness at T3 and T4 via higher sexual self-esteem at T2. No intervention effects were found on the acceptance of sexual coercion and pornography realism. The implications of the findings for reducing the prevalence of sexual aggression perpetration and victimization are discussed.

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.

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.

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.

Overlap Between Exposure to Suicidal Behavior and Indirect Interpersonal Violence: Evidence for a More Integrated Approach to Violence Research

This study examines the overlap between indirect exposure to forms of interpersonal violence and suicidal behavior, and the impact of the co-occurrence of these exposures on indicators of depressed mood and substance use among adolescents. Participants were a national sample of 3,917 youth aged 14-15 years, recruited online between June 2018 and March 2020, including an oversample of sexual and gender minority youth. Eight in ten (81.3%) youth reported exposure to indirect interpersonal violence and/or suicidal behavior in their lifetimes: 39.5% reported only interpersonal violence exposure, 5.9% only suicidal behavior exposure, and 35.9% reported both. Youth who reported exposure to interpersonal violence were almost three times more likely (adjusted odds ratio [OR] = 2.78, p < .001) to also report suicidal behavior exposure. Compared with youth having no indirect violence exposure, those with only interpersonal violence exposure were 2.25 times more likely (p < .001), those with only exposure to suicidal behavior 2.93 times more likely (p < .001), and those with both were 5.63 times more likely to report recent depressed mood. The unadjusted odds of any substance use was significantly elevated for each type of indirect violence exposure, with the highest odds seen among youth with dual interpersonal violence and suicide exposure (OR = 4.87, p < .001). For both outcomes, significant findings remained but were attenuated after adjusting for demographic characteristics, non-victimization adversity exposure, and cumulative direct victimization. Findings suggest that the combination of exposure to interpersonal violence and suicidal behavior appears to be particularly impactful. Results highlight that assessment of trauma exposure among adolescents needs to be more comprehensive and include not only direct and indirect interpersonal violence, but also knowledge of other people's suicidal thoughts and behaviors.

The Application of Bystander Intervention Scripts: Implications for Guardianship in Action

Responding to high rates of interpersonal victimization and perpetration among adolescents, schools have implemented bystander intervention (BI) training to educate students to intervene to prevent or stop violence. These trainings function much like an application of scripts for guardianship in action. The current study builds on the overlapping and complementary bodies of BI and routine activities research by testing whether participation in BI training, namely Green Dot (GD), influences individuals' underlying ability to intervene. Using four years of survey data collected from high school students (N = 2,374-3,443), we use item response theory to model the difficulty of engaging in different BI behaviors. We then estimate multivariate ordinary least squares regression models, one for each year, to estimate the effect of GD training on students' ability to intervene. The item response theory results show that BI behaviors differ in terms of how "difficult" they are for respondents to engage in. Findings show that in each year, GD training increased students' underlying ability to intervene. Our findings suggest BI training and guardianship in action scripts should take into account this varying difficulty of intervention behaviors to best train individuals for successful intervention to prevent victimization.

The Effectiveness of College Dating Violence Prevention Programs: A Meta-Analysis

Due in part to their involvement with social activities on campus, college students experience an increased risk of dating violence. Recent legislation such as the Campus SaVE Act (which requires U.S. colleges to offer training on sexual assault, domestic violence, stalking, and sexual harassment to all incoming students) has contributed to the increase in prevention programming offered across postsecondary campuses, as well as subsequent research examining the effectiveness of these prevention efforts. The current study provides a systematic review and meta-analysis of college dating violence prevention programs. A systematic search of 28 databases and numerous gray literature sources identified an initial 14,540 articles of which 315 were deemed potentially eligible for inclusion. Studies were selected if they (1) evaluated a college dating prevention program/campaign, (2) reported one of five outcomes (knowledge, attitudes, or bystander efficacy, intentions, or behavior), (3) had a minimum sample size of 20 in the treatment group, (4) used a pre/post and/or comparison group design, and (5) were published in English or French between January 2000 and October 2020. We calculated 53 effect sizes from 31 studies and conducted separate meta-analyses on various categories of outcome measures. Findings suggest that college dating violence prevention programs are effective at increasing knowledge and attitudes toward dating violence, as well as bystander skills, but are not effective at increasing bystander behaviors. Findings from moderator analyses suggest that several program components influence the strength of treatment effects. Implications for improving the effectiveness of college dating violence prevention programs are discussed.

Behavioral Intentions of Bystanders to Image-Based Sexual Abuse: A Preliminary Focus Group Study with a University Student Sample

Image-based sexual abuse (IBSA) represents a form of technology-facilitated sexual abuse that encompasses the taking, creating, and/or sharing (including threats to share) of nude or sexual images without consent. Unlike physical sexual violence contexts, little is known regarding if and how bystanders intervene in IBSA contexts. The current preliminary study aimed to address this gap in the literature. Specifically, seven focus groups with a sample of 35 university students (31 females, 4 males) were conducted to explore how they think they would behave (i.e., their behavioral intentions) if they were bystanders to three different IBSA scenarios: non-consensual taking, non-consensual sharing, and threatening to share nude or sexual images. Transcripts were analyzed using thematic analysis and the following themes were identified: perpetrator-centered action, victim-centered action, justice-centered action, and intervention as a well-informed and controlled process. Participants discussed how they would intervene by approaching the perpetrator, either in a confrontational or non-confrontational way, or approach the victim to inform them of what was happening, provide advice, or to support them. They also discussed involving the police. However, some group members were against these forms of intervention, particularly approaching the perpetrator and involving the police. Finally, many participants indicated that their actions need to be well-informed. These findings highlight a wide range of bystander actions in IBSA contexts that have implications for the development of policies, educational materials, and measures of bystander intervention behavior in future research.

Do I Say or Let it Go? Emotions Predict How People Respond to Receiving Sexual Objectification at Work

Many people are reluctant to report sexual objectification at work. We tested whether emotions determine how people respond to sexual objectification at work. In Study 1 (N = 159) women recalled a time that they had experienced sexual objectification at work. Participants then rated their emotions in this situation and how they responded. Anger positively and a shame-based emotion (rejection) negatively predicted taking action against the perpetrator (active response). In contrast, shame positively predicted women blaming themselves (self-blame). Moreover, pride positively and anger negatively predicted women viewing the action positively (e.g., as flattering, benign response). In Study 2 (N = 135) women imagined themselves receiving either a highly objectifying or ambiguous comment at work. Being objectified increased negative emotions and decreased pride. Moral outrage (i.e., anger and disgust) positively whilst shame-based emotions negatively predicted active responding. Shame-based emotions positively predicted self-blame, whilst pride positively and anger negatively predicted benign responding. Therefore, emotions determine how people respond to sexual objectification at work. Promoting moral outrage and reducing other emotions (e.g., shame, fear, and pride) may make women (a) more willing to report sexual objectification at work and (b) less likely to blame themselves or view such actions positively (i.e., benign responses).

Selflife: A Life Skills Development Tool to Prevent Sexual Violence among Healthcare Students

BACKGROUND

in France, 14.5% of women and 3.9% of men aged 20-69 years have experienced sexual violence. Of these, 40% will go on to develop posttraumatic stress disorder. Sexual violence is therefore a major public health issue. In the present study, we tested a life skills development tool (Selflife) designed to prevent sexual violence in a population of healthcare students.

METHODS

a total of 225 French healthcare students were randomly divided into a control group using case studies (n = 114) and a group using Selflife (n = 111) to discuss the topic of sexual violence. After the session, they completed self-report questionnaires collecting sociodemographic data and probing their feelings about their participation, their life skills, and their verdict on the intervention.

RESULTS

compared with controls, participants in the Selflife group reported gaining more knowledge about sexual violence, a greater sense of improving their life skills, and greater satisfaction with the intervention.

CONCLUSIONS

these results suggest that, in addition to providing information about sexual violence, Selflife helped students develop their life skills, thereby empowering them to act when confronted with sexual violence. Its impact on prevalence and on the psychological and psychiatric consequences remains to be assessed.

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.

Fostering college students' responsibility as prosocial bystanders to sexual violence prevention: A meta-analysis of the Bringing in the Bystander program

Objective: To synthesize research examining the effectiveness of the sexual violence bystander program Bringing in the Bystander (BitB). Participants: The analytic sample included 2083 youth in the treatment group and 969 in the comparison group. Method: A search strategy that included a total of 45 search terms was applied to 28 electronic databases. Results: The systematic search yielded a final analytic sample of 14 evaluations, with 38 independent effect sizes calculated across four outcome measures: rape myth attitudes (n = 11), bystander efficacy (n = 11), bystander intentions (n = 11), and bystander behavior (n = 5). The BitB program produced significant, positive pooled effects on measures of rape-supportive attitudes, bystander efficacy, and bystander intentions. Conclusions: The overall results are promising and suggest that the BitB education program may be an effective tool for targeting sexual violence on campuses.

Anticipatory concerns about violence within social networks: Prevalence and implications for prevention

Most research on exposure to violence focuses on direct victimization, offending, or witnessed violence, yet many people also experience concerns about potential violence in their environments and social networks. Using a state-representative survey of California adults (n = 2870) administered in July 2020, we estimate the prevalence of anticipatory concerns about violence within respondents' social networks and describe characteristics of the persons at perceived risk of violence, reasons for respondents' concerns, and actions undertaken by respondents to reduce that risk. Approximately 1 in 5 respondents knew at least one person, usually a friend or extended family member, whom they perceived to be at risk of other- or self-directed violence. Among respondents living with the person at perceived risk, about one-quarter reported household firearm ownership. Alcohol and substance misuse and a history of violence were among respondents' top reasons for concern; serious mental illness and firearm access also contributed to concerns. About one-quarter of respondents with such concerns said harm was likely or very likely to occur in the next year. Most respondents reported having taken action to reduce the risk of violence, including providing resources and asking family or friends to help; few acted to reduce access to lethal means. The most common reasons for inaction were the perception that a dangerous situation was unlikely and that it was a personal matter. Our findings can help inform a broader understanding of exposure to violence and interventions that leverage the knowledge of those close to persons at risk to prevent violence.

Bystander Intervention in Intimate Partner Violence: An Audio Vignette Study of Heterosexual, Gay, and Lesbian Dating Partners

Intimate partner violence (IPV) is a prolific and growing issue that can have long-lasting negative consequences for the health and safety of those involved. Bystander intervention is one method for helping to combat incidents of IPV, as research suggests that bystanders are frequently present at the scene of assaults and incidents of IPV. This study explored individual differences of bystanders that may influence whether they decide to intervene in an unfolding incident of IPV, as well as how the likelihood of intervening may vary as a function of the apparent gender or sexual orientation of the individuals involved in an incident of IPV. Participants were recruited from an online survey platform to obtain a balanced sample of heterosexual and sexual minority individuals. Participants completed a bystander task where they listened to an audio vignette of an unfolding IPV incident and were instructed to stop the audio if/when they would intervene in a real-life context. Participants were randomly assigned to listen to one of four versions of the vignette in which the apparent gender of the aggressor and victim were manipulated. Results revealed participants were more likely to intervene if they identified as a sexual minority (vs. as a heterosexual), reported less rape myth acceptance, or had greater endorsement of gender equality. Results also revealed that associations between bystander characteristics and intervening behavior largely did not differ across vignette conditions, suggesting that they may influence the likelihood of intervening consistently across incidents of IPV regardless of the apparent gender and sexual orientation of the aggressor and victim. However, participants in general were most likely to intervene in the male aggressor/female victim vignette. Implications for IPV prevention programming-including the need to include more diverse and less heteronormative depictions of IPV-are discussed.

Impacts of GlobalConsent, a Web-Based Social Norms Edutainment Program, on Sexually Violent Behavior and Bystander Behavior Among University Men in Vietnam: Randomized Controlled Trial

BACKGROUND

Sexual violence against women is prevalent worldwide. Prevention programs that treat men as allies and integrate a bystander framework are emerging in lower income settings, but evidence of their effectiveness is conflicting.

OBJECTIVE

This study aimed to test the impact of GlobalConsent on sexually violent behavior and prosocial bystander behavior among university men in Vietnam.

METHODS

We used a double-blind, parallel intervention versus control group design with 1:1 randomization at 2 universities. A total of 793 consenting heterosexual or bisexual men aged 18-24 years who matriculated in September 2019 were enrolled and assigned randomly to GlobalConsent or an attention-control adolescent health education (AHEAD) program. GlobalConsent is an adapted, theory-based, 6-module web-based intervention with diverse behavior change techniques and a locally produced serial drama. AHEAD is a customized, 6-module attention-control program on adolescent health. Both the programs were delivered to computers and smartphones over 12 weeks. Self-reported sexually violent behaviors toward women in the prior 6 months and prosocial bystander behaviors in the prior year were measured at 0, 6, and 12 months.

RESULTS

More than 92.7% (735/793) of men in both study arms completed at least 1 program module, and >90.2% (715/793) of men completed all 6 modules. At baseline, a notable percentage of men reported any sexually violent behavior (GlobalConsent: 123/396, 31.1%; AHEAD: 103/397, 25.9%) in the prior 6 months. Among men receiving GlobalConsent, the odds of reporting a high level (at least 2 acts) of sexually violent behavior at the endline were 1.3 times the odds at baseline. Among men receiving AHEAD, the corresponding odds ratio was higher at 2.7. The odds of reporting any bystander behavior at endline were 0.7 times the odds at baseline for GlobalConsent, and the corresponding odds ratio for AHEAD was lower at 0.5.

CONCLUSIONS

Compared with a health attention-control condition, GlobalConsent has sustained favorable impacts on sexually violent behavior and prosocial bystander behavior among matriculating university men in Vietnam, who would otherwise face increasing risks of sexually violent behavior. GlobalConsent shows promise for national scale-up and regional adaptations.

TRIAL REGISTRATION

ClinicalTrials.gov NCT04147455; https://clinicaltrials.gov/ct2/show/NCT04147455.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

RR2-10.1186/s12889-020-09454-2.

Stop Sexual Harassment: A study protocol for a cluster randomised controlled trial in secondary schools in Norway

Background

Sexual- and gendered harassment are normalised in many peer groups, yet their associations with mental health concerns among adolescents are well-established. School based interventions that prevent and reduce sexual and gendered harassment among younger adolescents are scarce. For schools, protecting pupils from harassment may be challenging if the behaviour is trivialised among the pupils themselves. In the current study, the school intervention "Stop Sexual Harassment" was therefore developed to help teachers and pupils detect, address and stop sexual and gendered harassment among pupils ages 13-15 in Norwegian secondary schools.

Methods

In this study the effectiveness of "Stop Sexual Harassment" is evaluated via a cluster randomised controlled trial among pupils and teachers at 38 secondary schools. Schools were randomised into intervention and control groups. Primary outcomes are sexual and gendered harassment victimisation and perpetration, which will be assessed by the administration of questionnaires to pupils and teachers at baseline, and 2-, and 7-months follow-up. A process evaluation of the intervention implementation will be conducted through focus group interviews with pupils and teachers to gain insight about their experiences with the program components and implementation of the intervention.

Discussion

If the intervention yields positive effects, large-scale implementation of the program may be offered for secondary schools. The program may thus reduce sexual and gendered harassment among young adolescents.

Clinical trial registration

clinicaltrial.gov; identifier: NCT04716400.

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.

Barriers to Bystander Intervention in Sexual Harassment: The Dark Triad and Rape Myth acceptance in Indonesia, Singapore, and United Kingdom

Bystanders have an important role in preventing sexual violence, but they are often reluctant to intervene due to a range of barriers. In this study, we investigated relationships between the Dark Triad of personality (i.e. psychopathy, Machiavellianism and narcissism), rape myth acceptance and five bystander barriers. We addressed the paucity of research by collecting data from three countries (Indonesia, Singapore, and United Kingdom). In total, 716 University staff and students participated in an online survey. We found very few country-level differences in the correlations between the variables. In regression analyses, Machiavellianism and rape myth acceptance both had significant, positive relationships with failure to identify risk, failure to take responsibility, skills deficits and audience inhibition. Narcissism and psychopathy were significantly, negatively associated with audience inhibition and skills deficits. Findings indicate similarity in predictors of perceived barriers to bystander intervention across the three countries.

Creating Clarity and Crew Courage: Preventive and Promotive Measures for a Maritime Industry Without Bullying and Harassment

Seafaring shares many characteristics with contemporary working life ashore. However, a major difference is that seafarers can spend up to 12 months aboard a ship that constitutes a work, living and recreational environment. Onboard work includes many stressors that can potentially contribute to workplace bullying and harassment, which in turn can affect safety critical operations. The aim of this study was to identify underlying causes in the organizational and social work environment that can cause workplace bullying and harassment at sea, and to suggest appropriate preventive and promotive strategies and measures. Data were collected mainly through World Café workshops with 56 participants from the Swedish maritime industry. Seafarer occupational health, safety, and wellbeing is largely determined by interdependent factors at micro, meso, and macro levels, where different stakeholders play various roles. Strategies and measures starting at the individual seafarer, and gradually expanding outwards toward the maritime industry are suggested. It is important that a victim of bullying or harassment receives adequate support. Creating crew courage enables employees to both recognize troubling situations and know how to act and respond to a situation. To bridge the gap between policy and practice, the legislative framework needs translating into practical procedures to make sense to the middle manager at the sharp end, with limited knowledge, time, resources, and decision latitude. Future research should evaluate the effectiveness of work environment interventions - what works, for whom, and under which circumstances.

Theoretical mediators of GlobalConsent: An adapted web-based sexual violence prevention program for university men in Vietnam

Sexual violence remains a global problem that disproportionately affects women. Though sexual violence interventions exist, few have been implemented in low- or middle-income countries, and none in Vietnam for young men. We adapted a sexual violence prevention intervention (RealConsent) developed for college men in the U.S. and conducted a randomized controlled trial of the adapted intervention (GlobalConsent) with college men in Vietnam. We assessed the effects of GlobalConsent on sexually violent behavior and prosocial bystander behavior, directly and through theoretically targeted mediators. The study design entailed a double-blind, parallel intervention-control-group design in two universities. Consenting heterosexual or bisexual men 18-24 years starting university in September 2019 (n = 793) completed a baseline survey and were assigned with 1:1 randomization to GlobalConsent or attention control. Both programs were web-based and lasted 12 weeks. Path analysis was performed to study the mediating effects of cognition/knowledge, beliefs/attitudes, affect, and efficacy/intention variables measured at six months on sexually violent behavior and prosocial bystander behavior measured at 12 months. In parallel multiple-mediator models, initiating GlobalConsent lowered the odds of sexually violent behavior mainly indirectly, via knowledge of sexual violence legality and harm and victim empathy and increased the odds of prosocial bystander behavior directly and indirectly, through knowledge of sexual violence legality and harm and bystander capacities. The efficacious direct and indirect effects of GlobalConsent support the cross-cultural applicability of its underlying theory of change and findings from mediation analyses of its sister program RealConsent, suggesting GlobalConsent's national scalability and adaptability across Southeast Asia.

Exploring Definitions of Consent and Healthy Relationships Among College Students with Disabilities: "I think it's fuzzy"

Purpose

College students with disabilities (SWDs) experience elevated rates of sexual violence and intimate partner violence compared with their non-disabled peers. While tailored interventions for these pressing health issues are needed, current research lacks investigation into how SWDs conceptualize relevant key concepts, such as consent and healthy relationships.

Method

This descriptive qualitative study explored these concepts through semi-structured interviews with college SWDs (n=49), 18-24 years old, in Pennsylvania and West Virginia.

Results

The results culminated in six rich, descriptive themes addressing: 1) interpersonal and intrapersonal skills necessary for relationship health; 2) normalization of unhealthy treatment by a partner due to manipulation, denial, and love for the partner; 3) how dichotomous definitions of consent interfere with practical application in lived experiences; 4) how active consent can be both facilitated and hindered within the context of a romantic relationship; 5) perceptions that healthcare providers aim to elicit disclosures of abuse rather than initiate a discussion about relationship health; and 6) students' reticence to disclose abuse to healthcare providers due to mistrust and fear over loss of agency.

Conclusions

These results contradict historic narratives that SWDs do not have the same sexual and relationship beliefs and experiences as other students and highlight the perspectives of this marginalized population. Implications for campus prevention programming and healthcare practices include incorporating intersections of disability and violence, discussing the nuances of consent and substance use, and creating conversations about relationship health that are transparent, non-judgmental, and include a broad range of types of abuse.

Tackling Oppressive Beliefs and Sexual Violence on College Campuses: Evaluation of an Innovative Theater-Based Intervention

BACKGROUND

Sexual violence (SV) prevalence remains high among U.S. college campuses; prevention strategies may benefit from addressing socially oppressive beliefs, including racism, sexism, and heterosexism that all directly link to attitudes and beliefs related to SV.

AIMS

The objective of this study is to evaluate the potential efficacy of a novel student-driven, theater-based intervention in shifting beliefs regarding racism, heterosexism, and SV.

METHOD

Data were utilized from paired pre- and posttest surveys (n = 272) from undergraduate students, at a university in the Southeastern United States, who attended a student-driven theater production covering topics of SV, heterosexism, and racism. The survey included questions on rape myth acceptance, heteronormative attitudes and beliefs, perceived racism on campus, and relevant respondent demographic information.

RESULTS

After viewing the theater production, participants demonstrated significant decreases pretest-posttest in rape myth acceptance, (ΔM = 0.04, SD = 0.25), t(261) = 2.57, p = .01, heteronormative attitudes and beliefs, (ΔM = 0.09, SD = 0.36), t(267) = 3.32, p = .0001, and an increased pretest-posttest in perceived racism on campus, (ΔM = -0.15, SD = 0.47), t(266) = -5.15, p < .0001. For rape myth acceptance and heteronormative attitudes and beliefs, no apparent differences were present by race, gender identity, sexual orientation, or year in school. Only White and mixed-race students' levels of perceived prevalence racism increased when examined by race.

IMPLICATIONS

Findings from this study suggest that theater interventions may not only be an effective tool for addressing SV on campus, but also targeting other forms of discrimination, including sexism, homophobia, and racism among students.

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.

How Does Green Dot Bystander Training in High School and Beyond Impact Attitudes Toward Violence and Sexism in a Prospective Cohort?

Bystander interventions are recognized as "promising" programming to reduce sexual violence. Gaps in current evaluations include limited follow-up post-training (beyond 24 months) and knowledge of additional bystander training during follow-up.In this prospective cohort study, nested in a cluster randomized controlled trial (RCT), three cohorts of high school (HS) seniors were recruited (Fall 2013-2015) and followed through Spring 2018 (n = 1,831). Training was based on their school cluster RCT assignment and receipt of additional Green Dot (GD) training after HS. Training was hypothesized to be associated with lower scores indicating less acceptance of violence or sexism.Sixty percent reported GD training after HS (68.7% of 986 in intervention and 50% of 845 in control conditions). No significant differences (p < .05) were observed by GD training for four of the five violence acceptance or sexism attitudinal measures at recruitment or final surveys. For "ambivalent sexism" alone was there a significant reduction in scale scores over time in the intervention versus control condition. Additional GD training after the RCT significantly reduced neither violence acceptance nor sexism scores over time.GD training does not appear to have a consistent longer-term impact on reducing violence acceptance and sexism.