Reducing Alcohol Involved Sexual violence in higher Education (RAISE)

这是一项针对28所大学校园的学生参与研究的竞争性更新， 减少伤害干预措施，以降低本科大学生的性暴力风险（SV） 接受大学健康和咨询中心（CHCs）的护理。“减少酒精涉及性暴力- “高等教育中的教育水平（RAISE）”是一项纵向研究，建立在以前的集群随机对照基础上， 在宾夕法尼亚州和西弗吉尼亚州的大学校园进行的拖钓试验（R 01 AA 023260）。我们的目标是达到斯图- SV和危险饮酒风险升高的学生：有SV病史的学生， 性/性别少数群体和残疾学生（占我们先前样本的65%）。SV，尤其是酒精- 涉及SV，仍然在大学校园非常普遍。我们之前的研究发现， 在社区卫生中心寻求护理的学生中有2291人经历过SV受害（n=2291，64%的女性，32%的男性 报告终身SV），这与暴饮暴食有关。被认定为性或性别少数的学生， 认可残疾（即，身体、情感、感觉、神经和学习障碍）的报告， 与学生相比，SV的终生患病率较高，与更大的酗酒几率相关 不暴露于SV。之前的RCT涉及培训CHC工作人员提供简短的教育干预， 降低SV风险，题为“提供创伤支持和安全信息”（GIFTSS），所有学生寻求 在乎各社区卫生中心的执行情况各不相同。在按预期收到GIFTSS的学生中，我们发现了信号- 使用减少伤害策略和SV相关服务的自我效能显著增加。学生们和他的- SV的保守党向供应商披露这段历史的几率增加了四倍多。我们确认了亲- 需要在医院、诊所和校园层面进行变革，以改善干预措施的提供。为了更直接地针对使用 在SV和危险饮酒风险升高的学生中，我们还建议采取减少伤害的策略， 集成安全决策辅助工具（智能手机或电脑上使用的myPlan应用程序），可增加伤害减少， 在经历伴侣暴力的大学女性中的行为。这次更新的重点是1）测试 改善GIFTSS实施的策略，2）为SV和haz风险升高的学生提供支持- 在诊所就诊后，通过myPlan应用程序提供量身定制的减少伤害策略， 加强校园政策，以促进获得SV服务和减少危险饮酒。一个2x2集群 一项随机对照试验将比较GIFTSS在CHC中的两种实施策略（提供者脚本 vs.学习协作），重点关注18-24岁的本科生（28个校区的N= 2400） 在4个月和12个月时进行随访（目标1）。我们将评估myPlan在提高 为SV和危险饮酒风险升高的人群采取量身定制的降低危害策略（目标2）。 最后，我们将评估每个校园的酒精和SV政策变化，这些变化可能会增加学生获得和 在危险饮酒和SV风险较高的学生中使用保密服务（目标3）。

This is a competitive renewal of a stakeholder-engaged study across 28 college campuses focused on tailored harm reduction interventions to reduce risk for sexual violence (SV) among undergraduate college students receiving care from college health and counseling centers (CHCs). “Reducing Alcohol Involved Sexual vio- lence in higher Education (RAISE)” is a longitudinal study that builds on a previous cluster-randomized con- trolled trial on college campuses in Pennsylvania and West Virginia (R01 AA023260). We aim to reach stu- dents at elevated risk for SV and hazardous drinking: students with history of SV, students who identify as sex- ual/gender minority, and students who have disabilities (65% of our previous sample). SV, particularly alcohol- involved SV, remains highly prevalent on college campuses. Our previous study found that a large proportion of students seeking care in CHCs have experienced SV victimization (n=2291, 64% of women, 32% of men report lifetime SV) which is associated with binge drinking. Students identifying as sexual or gender minority or endorsing a disability (i.e., physical, emotional, sensory, neurologic, and learning impairments) report particu- larly high lifetime prevalence of SV that is associated with greater odds of binge drinking compared to students not exposed to SV. The previous RCT involved training CHC staff to deliver a brief educational intervention to reduce SV risk, titled “Giving Information for Trauma Support and Safety” (GIFTSS), to all students seeking care. Implementation varied across CHCs. Among students who received GIFTSS as intended, we found sig- nificant increases in self-efficacy to use harm reduction strategies and SV-related services. Students with his- tory of SV had greater than four-fold increase in odds of disclosing this history to providers. We identified pro- vider-, clinic-and campus-level changes needed to improve intervention delivery. To more directly target use of harm reduction strategies among students at elevated risk for SV and hazardous drinking, we also propose to integrate a safety decision aid (myPlan app for use on smartphone or computer) which increases harm reduc- tion behaviors among college women experiencing partner violence. The focus of this renewal is to 1) test strategies to improve implementation of GIFTSS, 2) offer support for students at elevated risk for SV and haz- ardous drinking with tailored harm reduction strategies delivered via the myPlan app after the clinic visit, and 3) strengthen campus policies to promote access to SV services and reduce hazardous drinking. A 2x2 cluster randomized controlled trial will compare two implementation strategies for GIFTSS in CHCs (provider scripts vs. learning collaborative) focusing on undergraduate students ages 18-24 (N= 2400 across 28 campuses) with follow-up at 4 months and 12 months (Aim 1). We will evaluate the effectiveness of myPlan in increasing uptake of tailored harm reduction strategies for those at elevated risk for SV and hazardous drinking (Aim 2). Finally, we will assess for alcohol and SV policy changes on each campus that may increase access to and uptake of confidential services among students at elevated risk for hazardous drinking and SV (Aim 3).