Acceptability of RealConsent: A Sexual Violence Web-Based Risk Reduction Program for College Women.

Acceptability of a sexual violence (SV) risk reduction program called RealConsent designed for first-year female college students was conducted as part of a larger, randomized controlled trial. RealConsent uses web-based and mobile technology to deliver four 45-minute theoretically and empirically derived modules designed to increase knowledge, affect attitudes and normative beliefs, increase bystander and other protective behaviors, and reduce alcohol misuse. Educational entertainment is used throughout the program to achieve these aims. A total of 444 first-year female college students recruited from three Southeastern universities who were eligible and provided informed consent were randomized to RealConsent. Acceptability was ascertained both quantitatively and qualitatively through a survey administered following the completion of each of four modules. Results suggest that overall, RealConsent was viewed as relatable, realistic, and relevant. Most participants rated modules as good/excellent in quality, in organization, and in the conveying of a high degree of knowledge regarding alcohol misuse, consent for sex, sexual communication, defense strategies, protective strategies, and intervening to prevent SV. Suggestions to improve RealConsent centered on having more content inclusive of sexual and gender-minoritized students. Results suggest that RealConsent is an acceptable SV risk reduction program among first-year female college students and may have advantages for dissemination over in-person programs due to its web-based and mobile technology.

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

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

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

BACKGROUND: Sexual violence (SV) is a significant, global public health problem, particularly among young adults. Promising interventions exist, including prosocial bystander intervention programs that train bystanders to intervene in situations at-risk for SV. However, these programs suffer from critical weaknesses: (1) they do not address the proximal effect of alcohol use on bystander decision-making and (2) they rely on self-report measures to evaluate outcomes. To overcome these limitations, we integrate new content specific to alcohol use within the context of prosocial bystander intervention into an existing, evidence-based program, RealConsent1.0. The resulting program, RealConsent2.0, aims to facilitate bystander behavior among sober and intoxicated bystanders and uses a virtual reality (VR) environment to assess bystander behavior in the context of acute alcohol use. METHODS: This protocol paper presents the design of a randomized controlled trial (RCT) in which we evaluate RealConsent2.0 for efficacy in increasing alcohol- and non-alcohol-involved bystander behavior compared to RealConsent1.0 or to an attention-control program ("Taking Charge"). The RCT is being implemented in Atlanta, GA, and Lincoln, NE. Participants will be 605, healthy men aged 21-25 years recruited through social media, community-based flyers, and university email lists. Eligible participants who provide informed consent and complete the baseline survey, which includes self-reported bystander behavior, are then randomized to one of six conditions: RealConsent2.0/alcohol, RealConsent2.0/placebo, RealConsent1.0/alcohol, RealConsent1.0/placebo, Taking Charge/alcohol, or Taking Charge/placebo. After completing their assigned program, participants complete a laboratory session in which they consume an alcohol (target BrAC: .08%) or placebo beverage and then engage in the Bystanders in Sexual Assault Virtual Environments (BSAVE), a virtual house party comprising situations in which participants have opportunities to intervene. Self-reported bystander behavior across alcohol and non-alcohol contexts is also assessed at 6- and 12-months post-intervention. Secondary outcomes include attitudes toward, outcome expectancies for, and self-efficacy for bystander behavior via self-report. DISCUSSION: RealConsent2.0 is the first web-based intervention for young men that encourages and teaches skills to engage in prosocial bystander behavior to prevent SV while intoxicated. This is also the first study to assess the proximal effect of alcohol on bystander behavior via a VR environment. TRIAL REGISTRATION: Clinicaltrials.gov, NCT04912492. Registered on 05 February 2021.

Hey ChatGPT, Let's Talk About Sexual Consent.

Access to sexual health education, such as education on sexual consent, is limited in the US. Artificial intelligence (AI), such as ChatGPT, provides a potential opportunity to increase access to sexual consent information and education. However, what ChatGPT knows about sexual consent and if this aligns with the current evidence-based literature on sexual consent is unclear. The goal of this research commentary was to explore what ChatGPT knows about sexual consent with a focus on: 1) the definition of consent, 2) how consent could be communicated, and 3) the impact that substances have on consent. We also examined the reliability of ChatGPT's responses by having three different researchers ask ChatGPT the same set of questions. Across our questions, ChatGPT provided similar and comprehensive responses that discussed key features of consent - that consent is freely given or reversible. ChatGPT provided examples of different verbal and nonverbal cues people can use to communicate and interpret consent and discussed the ways that substances can impact consent communication. Overall, ChatGPT could be a potential resource for educators and young people who seek information about sexual consent; however, we should proceed with caution. ChatGPT is not a replacement for an educator but rather a way to increase access to education.

A Web-Based Sexual Violence, Alcohol Misuse, and Bystander Intervention Program for College Women (RealConsent): Randomized Controlled Trial.

BACKGROUND: Sexual violence (SV) incidence among college women has been invariant for the past 20 years. Innovative prevention strategies that are low resource and technology driven but demonstrate efficacy are greatly needed. OBJECTIVE: The aim of this study was to determine the efficacy of a novel theoretically driven internet-based intervention for first-year college students who identify as women (RealConsent) in reducing their risk of exposure to SV and alcohol misuse as well as increasing alcohol protective and bystander behaviors. METHODS: This randomized controlled trial involved first-year college students who identified as women (n=881) attending 1 of 3 universities in the southeastern United States. Participants aged 18 to 20 years were randomized to RealConsent (444/881, 50.4%) or to an attention-matched placebo control (437/881, 49.6%). RealConsent is fully automated and consists of four 45-minute modules that incorporate entertainment-education media and proven behavior change techniques. The primary outcome was exposure to SV; the secondary outcomes were alcohol protective behaviors, dating risk behaviors, alcohol misuse, and bystander behavior. Study outcomes were assessed at baseline and 6-month follow-up. RESULTS: Among participants with some exposure to SV, those in the RealConsent group experienced less exposure to SV than the placebo group (adjusted incidence rate ratio 0.48, 95% CI 0.33-0.69; P=.002). Furthermore, participants in the RealConsent group engaged in more alcohol protective behaviors (adjusted odds ratio 1.17, 95% CI 0.12-2.22; P=.03) and were less likely to binge drink (adjusted incidence rate ratio 0.81, 95% CI 0.67-0.97; P=.003). Finally, participants in the RealConsent group who had 100% dosage were more likely to engage in bystander behavior than those with <100% dosage plus placebo group (adjusted odds ratio 1.72, 95% CI 1.17-2.55; P=.006). CONCLUSIONS: A comprehensive exposure to SV, alcohol use, and bystander educational program was successful in decreasing the occurrence of exposure to SV among those most at risk and in increasing alcohol protective behaviors. Because of its web-based and mobile technologies, RealConsent can be easily disseminated and holds potential for reducing campus SV. TRIAL REGISTRATION: ClinicalTrials.gov NCT03726437; https://clinicaltrials.gov/ct2/show/NCT03726437.

Frequency of Visiting Alcohol-Serving Establishments, Bystander Efficacy, and Barriers to Sexual Aggression Bystander Intervention Among College Students.

Bystanders can play an important role in sexual aggression (SA) prevention, particularly those often present at bars and clubs where SA commonly occurs. Yet, more frequent patrons of bars and clubs may experience more barriers to intervening due to social norms that encourage aggression in these environments. Having greater confidence to intervene in SA may mitigate this relationship. This study examined these associations among 290 undergraduate students (Mage = 20.03; SDage = 20.03; 50% women) who completed measures of past semester bar and club attendance, bystander efficacy (i.e., confidence), and barriers to intervention. Moderation analyses using PROCESS indicated (1) a conditional main effect of bystander efficacy being associated with less failure to take intervention responsibility; (2) bar and club attendance was associated with less audience inhibition (i.e., failure to intervene due to concerns of looking foolish) among those higher (b = -0.30, p = 0.005), but not lower (b = 0.16, p = 0.183), in bystander efficacy. Bystander training programs should consider specifically targeting college students who attend bars and clubs more frequently, as they likely have more intervention opportunities, and provide them with skills to confidently intervene in SA while socializing in those settings.

Alcohol use and alcohol-related consequences based on gender and sexual orientation among college students.

BACKGROUND AND OBJECTIVES: Research has not yet investigated how the association between alcohol and alcohol-related consequences differs across cisgender heterosexual women (CHW), cisgender heterosexual men (CHM), and sexual and gender minority (SGM) college students. METHODS: Participants were N = 754 college students (34.5% CHW [n = 260]; 34.5% CHM [n = 260]; 31.0% SGM [n = 234]) between the ages 18 and 25 who completed a survey on sexual orientation, gender identity, alcohol use (i.e., average drinks per week), and alcohol-related consequences. RESULTS: Among individuals who reported alcohol use, CHM reported significantly more drinks per week compared to CHW and SGM. The logistic model of a zero-inflated negative binomial regression indicated that excess zeros in the alcohol-related consequences were more likely among (1) nondrinkers and (2) SGM compared to CHM. The count portion of the model indicated that, among drinkers, there was a positive association between drinks per week and alcohol-related consequences. Estimated alcohol-related consequences per drink were 1.90% higher among CHW than CHM and 2.76% higher among SGM than CHM. Exploratory analyses did not find significant differences in outcomes between cisgender female and male sexual minority students. DISCUSSION AND CONCLUSION: Findings suggest that although CHW and SGM students consume less alcohol than CHM, these students experience more alcohol-related consequences per drink. SCIENTIFIC SIGNIFICANCE: This study advances the field's knowledge of alcohol use patterns and consequences among SGM college students. There is a need for alcohol education programming that is tailored to the unique experiences, identities, and minority stressors of SGM college students.

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.

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.

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 (ß = .96, p = .003), but not low benevolent sexism (ß=.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.

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

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

Theoretical Mediators of RealConsent: A Web-Based Sexual Violence Prevention and Bystander Education Program.

This study examined the process by which a web-based sexual violence (SV) prevention program (i.e., RealConsent) prevents SV perpetration and increases bystander behaviors. Data from 743 college men who participated in a randomized controlled trial were analyzed. Simple and multiple-mediation models were estimated, using several theoretical constructs to assess the mechanisms through which RealConsent produced significant effects on SV perpetration and prosocial bystander or intervening behaviors. The results indicated that knowledge of effective consent for sex, hostility toward women, date rape attitudes, and hyper-gender male ideology significantly mediated the effects of RealConsent on SV perpetration in the multiple-mediator model. Furthermore, intentions to intervene significantly mediated the effects of RealConsent on prosocial bystander behaviors in the multiple-mediator model. The results show that the RealConsent program works to prevent SV perpetration and prosocial bystander behaviors via several theoretically proposed mediators central to the development and content of the program. The results also provide strong evidence that SV and bystander education for college men may benefit from including an explicit focus on decreasing negative norms related to women (e.g., hostility, date rape attitudes, hyper-gender ideology) and through increasing college men's knowledge of consent and intentions to intervene.

Sexual misconduct policies and administrator perceptions among 4-year colleges and universities in Georgia.

OBJECTIVES: Following changes in federal regulations, the current study was an examination of differences in institutional responses to sexual violence among Georgia colleges and universities during 2013 and 2014. PARTICIPANTS: A total of 24 four-year institutions located in the state of Georgia were included. METHOD: Data were collected from various sources in phases from March 2013 to December 2015 and included institutional characteristics from each college website, a content analysis of college annual security reports and sexual misconduct policies, and a college administrator online survey. RESULTS: Seventy percent of the institutions were deemed "Clery compliant" in 2013 but only 12%, in 2014. There was substantial variability in definitions used in sexual misconduct policies and with respect to the description of investigation and adjudication procedures. CONCLUSIONS: There is extensive variability in institutional responses to sexual violence across universities and colleges despite recent media attention and federal guidance.