SCALE: Strategies for Implementing GlobalConsent to Prevent Sexual Violence in University Men

点击翻译按钮获取中文摘要

PROJECT SUMMARY ABSTRACT Significance. Globally and in Asia/Pacific, women 15–24 years (y) are at heightened risk of exposure to sexual violence, including at university. The burden of sexual violence is higher for women than men, and men most often are the perpetrators. Sexual violence in adolescence is a risk factor for gender-differentiated mental, physical, and behavioral health conditions in adulthood and is costly for victims and societies. Evidence-based prevention programs tailored to university men in low- and middle-income countries (LMICs) are rare. Our team developed GlobalConsent, a theory-based, six-module educational entertainment program adapted from an efficacious program tested with university men in the US. In a large attention-controlled trial at two universities in North Vietnam, GlobalConsent reduced men’s sexually violent behavior (OR=0.71, 95%CI 0.50-1.00) and increased pro-social bystander behavior (OR=1.51, 1.00-2.28) 9 months post-treatment. Evidence on real-world implementation is needed. Aims. We will compare the 1) implementation, 2) implementation drivers and outcomes, 3) implementation effectiveness, and 4) cost-effectiveness of delivering GlobalConsent using one of two bundled implementation strategies. Approach. We will randomize six medical universities in North, Central, and South Vietnam to deliver GlobalConsent to eligible first-year male students using lower-intensity (standard) or higher-intensity implementation strategies salient to university stakeholders in Vietnam. Higher-intensity strategies will include those in the lower-intensity group plus more 1) implementation and post-implementation educational outreach with university leaders, 2) pre-implementation leadership training and external implementation support to university facilitators, and 3) pre-implementation educational outreach, implementa- tion follow-up, and incentives to foster student adherence and demand to complete GlobalConsent. Our mixed- methods comparative interrupted time-series design includes 1) qualitative research with university leaders and implementation teams to compare implementation and implementation settings; 2) repeated surveys with leaders, implementation teams, faculty, and male students to compare implementation drivers and outcomes, 3) 10 quarterly surveys with male students to compare primary behavioral and secondary knowledge, attitudinal, and affective outcomes, and 4) cost data to compare the cost effectiveness of the two implementation strategies bundles on incidents of sexual violence averted. Innovation/Impact. This project is the first to assess two bundled implementation strategies to deliver an efficacious web-based sexual-violence-prevention program tailored to university men in Vietnam. Including university partners across Vietnam enables us to test these strategies in diverse regions and to synergize this effort with in an on-going violence-prevention training initiative (D43TW012188). Our state-of-the-art approach will produce rigorous evidence that can inform dialogue with officials about how to deliver GlobalConsent nationally. This project is poised to reduce gender-based health inequities linked to early sexual violence and to strengthen national capacity to bring GlobalConsent to scale.