College Health Center-based Alcohol and Sexual Violence Intervention

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DESCRIPTION (provided by applicant): This is a stakeholder-engaged longitudinal study to test, via a 2-armed cluster randomized controlled trial, a brief harm reduction intervention to reduce risk for alcohol-related sexual violence among male and female youth ages 18-24 receiving care from college student health services (K = 20 colleges; baseline N = 2200). Sexual violence (SV) (including sexual coercion, non-consensual sexual contact, and rape) is common among college women, and over three quarters of women who have been sexually assaulted report that the first of such experiences occurred before the age of 25. Alcohol-related SV, in particular, is highly prevalent on college campuses, with about half of sexual assault cases occurring in the context of victim and/or perpetrator intoxication. Multiple pathways have been implicated in this association between alcohol and SV, with social norms regarding alcohol consumption and expectations for SV facilitating both the occurrence and underreporting of such violence. College student health centers remain an untapped setting to reach youth for both SV prevention and intervention. This study draws on several intervention studies by the investigative team, integrating successful components from each: 1) the bystander approach in which individuals are taught skills as active interveners in SV prevention rather than responding with apathy or tolerance is an effective strategy for promoting change within social contexts; 2) universal education about SV regardless of disclosure in the clinical setting can result in increased recognition of SV and use of relevant services; and 3) harm reduction strategies introduced by clinicians can increase intentions to use strategies to help oneself and friends that increase safety. The brief counseling intervention uses a palm-size safety card with information about SV and harm reduction given to all patients during clinical encounters. GIFTS (Giving Information for Trauma Support and Safety) provides (a) patient education and assessment regarding SV; (b) discussion of harm reduction behaviors to reduce risk of alcohol-related SV for self and peers (including bystander intervention); and (c) supported referrals to victim services. Interventions effective in reaching more college-age youth who either witness or experience alcohol-related SV are needed. Ten college student health centers will be randomized to receive training in the brief intervention integrated into routine college health visits. Compared to controls, male and female clients receiving the GIFTS intervention are expected to have greater recognition of what constitutes alcohol-related SV, knowledge of and self-efficacy to enact harm reduction strategies, intentions to intervene, and knowledge of and self-efficacy to use SV-related services (Aim 1). Among youth who have witnessed peer SV, youth receiving GIFTS will be more likely to report interventions to interrupt peer's harmful behaviors (Aim 2). Clients with SV victimization history who receive GIFTS are expected to be more likely to disclose SV during their clinic visit, report greater use of SV-related services, and report less recent SV victimization at follow up compared to control clients (Aim 3).