Assessing the feasibility, acceptability, and initial efficacy of a multiple behavior change intervention addressing alcohol use, sexual risk taking, and bystander intervention.

ABSTRACT

OBJECTIVE: Prevention programs that address the intersecting health problems of risky alcohol use, unsafe sexual behaviors, and sexual violence are needed. This pilot project assessed the feasibility, acceptability, and preliminary efficacy of a two-session group-based intervention, Sex Positive Lifestyles Addressing Alcohol & Sexual Health (SPLASH), targeting these highly interconnected risks for college students across genders. METHOD: A total of 217 participants (51.6% male, ages 18-24) took part in the SPLASH intervention or a nutrition/exercise control condition. SPLASH included three approaches aimed at reducing the incidence of alcohol problems, unsafe sex, and sexual victimization normative feedback to modify misperceptions around peers' drinking, sexual behaviors, and support of bystander intervention; drinking and sexual-related protective behavioral strategy training to enhance safer drinking and sex-risk behaviors; and bystander intervention skills training to promote bystander efficacy and engagement. Participants completed baseline and follow-up (1-month and 6-month) online assessments. RESULTS: SPLASH demonstrated high acceptability and feasibility, as well as preliminary efficacy. SPLASH participants reported strong acceptability of the intervention, particularly its integrated content and interactive, in-person group format. Successful enrollment (70% randomized) and retainment point to the feasibility of recruiting students to this two-session in-person intervention. Results showed sustained trends toward more accurate perceived sex-related norms and indications of increasing bystander norms among intervention but not control participants. CONCLUSIONS: Results demonstrate the potential for SPLASH to effectively address the interrelated health risks of risky alcohol use, unsafe sex, and sexual violence on college campuses and point to the need for larger-scale studies.