Safer Bars: A cluster-randomized effectiveness evaluation of alcohol-related sexual violence prevention through bar staff bystander training.

BACKGROUND: Sexual assault is consistently associated with social contexts that support high levels of alcohol consumption such as alcohol-serving establishments (i.e., bars). The significant rates of alcohol-involved sexual assault among college students demonstrate the critical need for evidence-based efforts to reduce alcohol-involved sexual assault in this population. Although bystander approaches have demonstrated some promise for reducing alcohol-involved sexual assault, to date no published studies have examined the effectiveness of implementing bystander prevention approaches with bar staff. Given the robust evidence indicating that bars serve as hot spots for sexual aggression, interventions that improve bar staff's ability to identify and intervene in sexually aggressive situations may offer a useful approach for reducing rates of alcohol-involved sexual assault. METHODS: The Safer Bars study utilizes a cluster-randomized trial design that randomizes participants at the bar level into intervention and waitlist control arms. The sample includes bars (Nbars = 56) within a three-mile proximity to the three major public Arizona universities, with an average of 10 staff members per bar (Nstaff = 564). Assessments of individual-level and bar-level outcomes occur at baseline, training completion, and 3-months post-training, with an additional individual-level assessment at 6 months. Community-level effects are assessed using GIS data regarding police dispatches. CONCLUSION: Safer Bars represents a novel, theory-driven approach to promote effective bystander behavior among bar staff working in close proximity to university campuses to reduce rates of alcohol-involved sexual assault.

The Scope of Rape Victimization and Perpetration Among National Samples of College Students Across 30 years.

Research Questions: Rape prevention practice and policy have roots in data from 1985. This study uses 2015 national data to project recent prevalence, assesses whether rates now differ from those of 30 years ago, and disaggregates 2015 prevalence into rape of alcohol incapacitated victims, rapes combining both alcohol and physical tactics, and violent rape. Methods: Cross-sectional analyses were conducted comparing two national samples. The first was collected in 1984-85 (Koss, Gidycz, & Wisniewski, 1987); the second was collected 30 years later in 2014-2015. Both surveys used in-person administration and measurement by the most current version at the time of the Sexual Experiences Survey (SES). Prevalence rates were compared using Bayesian binomial tests. Results: In 2015, 33.4% (1 in 3) of women reported experiencing rape or attempted rape and 12.7% of men reported perpetration (1 in 8). Using Jeffreys' label for effect size of the Bayes binomial (1961), both results are "decisively" greater than expected given the 1985 benchmarks of 27.9% for victimization and 7.7% for perpetration. Victimization when incapacitated characterized approximately 75% of incidents in 2015 up from 50% in 1985. Cautions apply as cross-sectional data does not establish causality and the recent data set involved the revised SES. Conclusions: Across 30 years, neither containment nor reduction of rape was demonstrated and the increasingly prominent association with alcohol was apparent. Among the men who disclosed raping, 9 of 10 incidents were alcohol-involved. Prevention focus might profitably be directed to constraining alcohol environments and policies that facilitate rape of incapacitated persons and on misconduct responses that are proportional to the harm caused to rape victims, thereby raising the perceived risks of perpetration.

Web-Based and mHealth Interventions for Intimate Partner Violence Victimization Prevention: A Systematic Review.

Mobile health (mHealth) technologies are increasingly used across health programming including intimate partner violence (IPV) prevention to optimize screening, educational outreach, and linkages to care via telehealth. We systematically evaluated current web-based and mHealth interventions, which include web- or mobile-based delivery methods for primary, secondary, and tertiary IPV victimization prevention. We searched MEDLINE/PubMed, Embase, CINAHL, PsycINFO, Open Grey, and Google Scholar for empirical studies published 1998-2019. Studies were included if they considered empirical data, participants in adult romantic relationships, IPV as a primary or secondary outcome, and an mHealth component. The Mixed Methods Appraisal Tool was used to record critical ratings of quality among studies selected for inclusion. We assessed variation in targeted populations, types of IPV addressed, and mHealth approaches used. Of 133 studies identified for full-text review, 31 were included. Computer-based screening with or without integrated education was the most common mHealth approach (n = 8, 26%), followed by safety decision aids (n = 7, 23%). Feasibility and acceptability were found to be generally high where assessed (23% of studies, n = 7). There was limited evidence around whether mHealth interventions better addressed population needs compared to conventional interventions. mHealth tools for IPV prevention are especially acceptable in health-care settings, on mobile phone platforms, or when connecting victims to health care. Despite enthusiasm in pilot projects, evidence for efficacy compared to conventional IPV prevention approaches is limited. A major strength of mHealth IPV prevention programming is the ability to tailor interventions to individual victim needs without extensive human resource expenditure by providers.

Victim voice in reenvisioning responses to sexual and physical violence nationally and internationally.

Internationally and in the United States many victims of sexual assault and domestic violence are unserved, underserved, or ill-served, especially those from the most vulnerable populations. Programs developed in the United States are routinely exported to developing countries but often without success. Notably, the failures seen internationally resemble those in the United States and are related to structural and attitudinal-cultural factors. Many victims do not disclose, and if they do seek services, they often report that available options mismatch their objectives, present accessibility challenges, disempower their pursuit of justice, and fail to augment needed resources. A deeper understanding of obstacles to effective service provision is needed if the United States is to continue to be an international partner in victim response and violence prevention. This article builds on what is known about service delivery challenges in U.S. programs to envision a path forward that concomitantly accommodates anticipation of shrinking resources, by (a) reviewing illustrative services and feedback from victims about utilizing them; (b) examining structural inequalities and the intersections of personal and contextual features that both increase vulnerability to victimization and decrease accessibility and acceptability of services; (c) advocating for reintroduction of direct victim voice into response planning to enhance reach and relevance; and (d) reorienting delivery systems, community partnerships, and Coordinated Community Response teams. The authors suggest as the way forward pairing direct victim voice with open-minded listening to expressed priorities, especially in vulnerable populations, and designing services accordingly. Through a process that prioritizes adaptation to diverse needs and cultures, U.S models can increase desirability, equity, and thrift at home as well as enhance international relevance. (PsycINFO Database Record