Inclusive Practices for Gender Minority College Students to Reduce Sexual Violence and Heavy Drinking

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Recent studies have highlighted the myriad health inequities faced by gender minority individuals (GM; those who identify as a gender other than they were assigned at birth) compared to cisgender individuals (i.e., gender identity matches their sex assigned at birth). GM university students, experience increased risk for hazardous drinking (i.e., heavy episodic drinking and excessive alcohol use) and sexual violence (SV) – key, interrelated issues of critical importance for prevention and intervention. Compounding these vulnerabilities, GM students face high rates of discrimination on university campuses that both drive heavy alcohol use and SV inequities and lead to distrust of potential support resources like College Health Centers (CHC). These substantial and persistent inequities make GM university students a priority population for interventions that reduce hazardous drinking and SV; however, there is a shortage of efficacious interventions specific to their needs. The parent study “Reducing Alcohol Involved Sexual violence in higher Education” (RAISE; R01AA023260) is a 30+ campus, cluster randomized trial that will test research-informed strategies to improve implementation of a prevention intervention in CHCs, integrate a safety decision aid (via computer or mobile device) to more directly target harm reduction among students particularly vulnerable to hazardous drinking and SV, and evaluate campus policies that increase accessibility and uptake of confidential services for students. RAISE centers students at elevated risk for SV and hazardous drinking: students with history of SV, students who identify as sexual/gender minority, and students with disabilities. This supplement enhances the parent study’s intervention by employing community-partnered methodologies to develop training for CHC providers designed specifically to increase their competence in addressing GM students’ health needs with a focus on alcohol use and SV. In Aim 1, we will develop a CHC-based training intervention to increase the provision of GM-competent care. In Aim 2, we will pilot the feasibility of implementing the CHC-based intervention in 15 randomized CHC sites from the parent study. We will conduct CHC provider surveys assessing their knowledge and attitudes about GM individuals and their knowledge, self-efficacy, and use of GM-inclusive practices. We will also interview CHC providers and GM service users from each intervention site. This research will produce the first rigorously evaluated GM-focused CHC-based provider training which has the potential to increase the accessibility of CHC’s for GM university students and ultimately lower rates of alcohol use and SV among this disproportionately impacted population.