Advancing a Comprehensive Multilevel Approach to Sexual Violence Prevention Using Existing Efficacious Programs.

ABSTRACT: Sexual violence (SV) is a serious and long-standing public health problem on college campuses. At institutions of higher education, campus administrators, activists, and practitioners have worked for decades to address campus SV. Despite federally mandated campus SV prevention programming, rates of campus SV remain unchanged. The purpose of this commentary is to outline a strategy for enhancing campus SV prevention efforts using a comprehensive multilevel approach utilizing existing efficacious programs. The following three strategies for implementing optimal campus SV prevention are proposed, which include (a) the need to prioritize efficacy, (b) targeting multiple levels of the social ecology, and (c) leveraging the benefits of in-person programming and technology-driven prevention. A call to action is included for both institutions of higher education administrators and practitioners to implement and invest in comprehensive multilevel interventions using existing, efficacious SV programs, ideally combining a technology-based program with an in-person component. Furthermore, a coordinated effort between prevention and response is needed to achieve successful prevention of campus SV and revictimization, including a connection with the community for postassault interventions. Thus, implementing multilevel interventions on college campuses using existing evidence-based programs in combination with a coordinated community response of postassault interventions can bring the campus community together and is optimal to moving the needle on rates of campus SV.

LGBTQ+-Affirming Campus Sexual and Relationship Violence Prevention: A Qualitative Study.

LGBTQ+ (e.g., lesbian, gay, bisexual, transgender, nonbinary, queer) people are often left out of campus sexual and relationship violence (SRV) prevention efforts despite experiencing higher rates of SRV. To inform LGBTQ+-affirming prevention efforts, we use a practice-to-research approach to aggregate wisdom from 32 LGBTQ+ professionals working to address campus SRV among LGBTQ+ college students garnered through semi-structured interviews. Participants shared four approaches to including or excluding LGBTQ+ students in campus SRV prevention programs as well as recommendations to cultivate more LGBTQ+-affirming campus SRV prevention efforts. We summarize recommendations for possible action steps at individual, relationship, community, and policy levels of the social ecological model for LGBTQ+-affirming campus SRV prevention.

Academic and Career Outcomes Following Sexual Assault in Early Adulthood: A Comparison of LGBQ+ and Heterosexual Women.

Young adults (aged 18-24) who identify as lesbian, gay, bisexual, or queer (LGBQ+) report high rates of sexual assault (SA) victimization, yet much of the research on adverse outcomes resulting from SA has overlooked LGBQ+ victims. A probability-based sample of 901 adults was recruited to examine the negative academic and career outcomes attributed to SA during early adulthood among LGBQ+ cisgender women. LGBQ+ women were more likely to report negative impacts on academic and career goals (e.g., changed course of study) and transitions (e.g., switched jobs) following SA victimization than heterosexual women. Implications for research and LGBQ+ services are discussed.

Comprehensive policies for victims of sexual assault returning to the campus classroom: Lessons from university sports-related concussion policies.

ObjectiveThe current paper presents a comparison of university policies and health and academic accommodations offered to undergraduate students following sexual assault (SA) and sports-related concussions (SRC). Procedures and protocols for universities to consider adapting from their SRC policies to their SA policies are detailed.Participants: The SRC and SA policies at the 50 United States public flagship universities were analyzed.Methods: The research team coded for a number of policy details including health referrals, academic and financial accommodations, and requirements for follow-up with university personnel.Results: Compared to SA polices, SRC policies at the public flagship universities offer more comprehensive academic accommodations and physical and mental health resources. Conclusions: Comprehensive policies for student SA survivors, like those available for students who suffer SRCs, would improve student health and academic outcomes and increase SA survivors' likelihood of graduating college, thereby reducing individual and societal human capital loses.

Sexual and Relationship Violence Among LGBTQ+ College Students: A Scoping Review.

Although there has been increased attention to campus sexual and relationship violence (SRV) because of Title IX and the #MeToo movement, much of that attention has focused on victimization of cisgender heterosexual women. This scoping review uncovers information from empirical studies on what is known about LGBTQ+ (e.g., lesbian, gay, bisexual, transgender, queer, and nonbinary) students' experiences of campus SRV. Using rigorous scoping review methods (i.e., searches of 15 databases, searches of expert websites, hand searching, reference harvesting, and forward citation chaining), we identified 60 documents published since 2000 that contained findings from empirical studies related to LGBTQ+ students and SRV on U.S. college and university campuses. Through content analysis, we summarized findings around five key themes: (1) extent and types of victimization, (2) negative outcomes, (3) knowledge of and attitudes about SRV, (4) perspectives on SRV services and prevention education programs, and (5) recommendations from study authors based on their findings. Implications for research, practice, and policy based on these findings are discussed.

Campus Sexual Violence Prevention and Response: Lessons from a Pandemic to Inform Future Efforts.

The COVID-19 pandemic forced institutions of higher education to transition and work in ways that were new and innovative. Even though most colleges and universities transitioned to a virtual platform, the issues that students face continued, including sexual violence (SV). For many campus prevention and response professionals, reaching students during the pandemic posed unique challenges. The COVID-19 pandemic began when the project team was 18-months into a 4-year grant to administer and evaluate the efficacy of a SV prevention and response app, uSafeUS®, at 15 4-year colleges. In this paper, we describe the transition of engaging students with the app in traditional in-person settings to remote and hybrid learning settings. The project team, in collaboration with the campus partners, devised new ways to use the app to support victims of SV and their allies, along with campus professionals in their efforts to support students. These efforts included changes to collaboration (e.g., virtual platforms) and student engagement strategies. We describe how the lessons learned from this transition are important for continuing to engage campus communities in SV prevention and response, even as campuses slowly transitioned back to hybrid and in-person activities. The knowledge gained from this transition are attributable to an ongoing and open collaboration between campus practitioners and the project team.

Correlates of Bystander Intentions and Behavior among Community College Students in Situations of Sexual Violence.

Sexual violence (SV) is a public health problem on college campuses. Research suggests that bystanders can effectively prevent and respond in situations of SV. There is no research to date concerning correlates of bystander behavior (e.g., gender, perceptions of SV) on community college campuses. However, there are notable differences between students enrolled in two- and four-year colleges. We conducted two exploratory studies across seven community colleges in one northeastern state to examine correlates of bystander intentions and behavior. In Studies 1 and 2, the majority of respondents identified as women, heterosexual, and White. We administered online surveys that inquired about demographics, peer attitudes, knowledge of sexual consent, history of victimization, and intent to help (Study 1) or self-reported bystander behavior (Study 2). The first study (n = 1,067) demonstrated that gender (i.e., identifying as woman), less accepting peer attitudes toward SV, and greater knowledge of sexual consent and awareness of campus SV were significantly associated with bystander intentions. The second study (n = 1,506) indicated that age (i.e., younger than 25 years old), greater knowledge of sexual consent, and victimization history were associated with bystander behavior. Implications for research and practice are discussed.

Outcomes of Sexual Assault Victimization in Early Adulthood: National Estimates for University and Nonuniversity Students.

Across the United States, 20% of women ages 18 and over are victims of penetrative sexual assault, with the highest rates occurring in early adulthood (i.e., ages 18-24). Despite the high prevalence and severe mental and physical health problems resulting from sexual assault, with few exceptions, little is known about how victims of sexual assault attribute subsequent academic and career outcomes. Approximately 901 adult participants were recruited from a probability-based nationally representative sample to examine the prevalence of and outcomes attributed to sexual assault victimization experienced during early adulthood. Of the 36% of female participants who reported sexual assault perpetrated against them between the ages of 18 and 24, 69.5% attributed at least one negative academic or career outcome to the sexual assault. Participants who identified as White and who were over the age of 30 at the time of the survey were more likely to attribute negative academic and career outcomes as a result of a sexual assault perpetrated against them during early adulthood than women of color and younger women (i.e., ages 25-29). Our findings expand the knowledge on negative outcomes attributed to sexual assault and yields more questions about the larger societal impacts. More research is needed to understand the intersection between an assault during young adulthood and the demographic characteristics of survivors.

Staff and Patient Perspectives on Bystander Intervention Training to Address Patient-Initiated Sexual Harassment in Veterans Affairs Healthcare Settings.

INTRODUCTION: One in four women veteran patients experience public harassment by men veterans at Veterans Affairs (VA) health care facilities. Bystander intervention training-teaching bystanders to identify harassment, assess appropriate responses, and safely intervene before, during, or after an event-is a popular strategy for addressing harassment in military and education settings. We explored staff and veteran patient perspectives on bystander intervention training to address harassment of women veterans in VA health care settings. METHODS: We conducted 24 staff interviews and 15 veteran patient discussion groups (eight men's groups and seven women's groups) at four VA Medical Centers. We analyzed transcripts using the constant comparative method. RESULTS: Participants expressed divergent views about bystander intervention training to address harassment of women veteran patients at VA. Most participants supported training staff in bystander intervention, but support for training patients was mixed. Participants identified potential benefits of bystander intervention, including staff and patient empowerment and improvements to organizational culture. They also identified potential concerns, including provocation of conflict between patients, lack of buy-in among the VA community, and difficulty in identifying intervention-appropriate situations. Finally, participants offered recommendations for tailoring training content and format to the VA context. CONCLUSIONS: Bystander intervention training has the potential to raise collective responsibility for addressing harassment of women in VA and other health care contexts. However, our results illustrate divergent stakeholder views that underscore the importance of engaging and educating stakeholders, securing buy-in, and tailoring bystander intervention programs to local contexts before implementation.

A Collaborative Community College Sexual Violence Prevention and Response Effort: Climate Study Results to Assess Impact.

Although 2-year institutions report higher rates of sexual violence (SV) than 4-year institutions, few resources exist to address SV on these campuses. The present study describes and assesses the impact of a 3-year initiative to engage personnel and students at seven 2-year colleges and community professionals to increase the effectiveness of SV prevention and response strategies. We administered a climate survey during the first and third year of this initiative. Compared with 2017 participants, 2019 participants reported increases in awareness of campus resources and perceptions of SV. Implications and suggestions for prevention and response efforts at 2-year institutions are discussed.

Exploring the Usage of a Violence Prevention and Response App Among Community College Students.

Sexual assault is a significant problem on college campuses. To date, much of the research on prevention and response has been conducted with students enrolled at traditional 4-year institutions. Limited research exists on 2-year institutions (also known as community colleges), which enroll a more diverse population (e.g., economic, gender, racial, and ethnic minorities) who are more vulnerable to victimization. Yet, 2-year institutions have few resources dedicated to the prevention of and response to sexual violence. Advances in technology, including mobile apps, have provided additional avenues to easily disseminate prevention and response information to college students. Mobile apps may be especially beneficial for community colleges given their diverse population and limited resources. Therefore, the present study examined a sample of community college students who reported downloading a violence prevention and response mobile app, uSafeUS, and their reasons for downloading. Participants were recruited from seven community colleges in a northeastern state and completed an online campus climate survey. Results indicate that participants who downloaded uSafeUS were more likely to perceive they were safe from campus sexual violence and receive information regarding campus sexual violence from their college than participants who did not download the app. Participants also reported downloading uSafeUS to keep themselves safe, to help a friend, and because they liked the sexual violence prevention and resource features. Female participants were more likely than male participants to download uSafeUS to keep themselves safe and because they liked the sexual violence resource information. Implications for research and practice are discussed.

Gender Differences in Veterans' Perceptions of Harassment on Veterans Health Administration Grounds.

PURPOSE: Stranger harassment at Veterans Health Administration (VA) facilities is prevalent, affecting one in four women veteran VA primary care users. Harassment interferes with health care quality and may result in veterans forgoing or delaying needed care. To better understand this phenomenon, gender-stratified discussion groups were held with men and women veterans. This article examines gender differences in veterans' perceptions and experiences of harassment on VA grounds. METHODS: We conducted a total of 15 discussion groups at four VA medical centers, eight with men (n = 57) and seven with women (n = 38). Transcripts were coded using the constant comparative method and analyzed for overarching themes. RESULTS: Awareness of harassment was not uniformly high among participants. Although women voiced clear understandings and experiences of specific behaviors constituting harassment (e.g., cat-calls, sexual comments), many men expressed confusion about how to differentiate between harassment, "harmless flirting," and general friendliness; they were unsure which behaviors "cross a line." Furthermore, men placed the onus on women for setting boundaries, whereas women indicated it was not their responsibility to "train" men about acceptable behavior. Men and women agreed that VA staff hold primary responsibility for preventing and managing harassment. CONCLUSIONS: Substantive gender differences in understandings of harassment exist among veteran VA users. To minimize harassment, veterans recommend education of men veteran VA users, and staff-oriented trainings. Privacy, safety, dignity, and security are the cornerstones of women veterans' health care, per VA policy. Harassment undermines these standards, impeding women's access to VA care and compromising both their health outcomes and health care experiences. Understanding harassment through a gendered lens is a critical step in designing comprehensive initiatives that respond to diverse viewpoints and experiences.

Developing and Piloting Videogames to Increase College and University Students' Awareness and Efficacy of the Bystander Role in Incidents of Sexual Violence.

OBJECTIVE: Researchers at the Prevention Innovations Research Center at the University of New Hampshire and the Tiltfactor Laboratory at Dartmouth College collaborated with students to create two videogames to teach college students bystander intervention skills in situations of sexual and relationship violence and stalking. MATERIALS AND METHODS: A key strength of the present study is the collaboration with students to educate game development. The research team pooled its ideas to create a trivia game and an interactive scenario game that were pilot tested on first-year students in a midsized campus of a northeastern university. "Each game included subject matter related to sexual assault and bystander intervention, as well as general campus information so the main themes of the game would not be overt and potentially cause participants to resist shifting their attitudes about sexual assault and bystander intervention." Participants completed a pretest and posttest at each testing session and were invited to complete an online follow-up survey 4 weeks following the session. RESULTS: Researchers found that both games had a significant impact on participant bystander efficacy and attitude scores. The interactive scenario game was especially effective in increasing male attitudes toward bystander intervention. The results were most salient for the posttest; however, there was also an increase in male attitudes at the 4-week follow-up. CONCLUSION: The student input was invaluable to the success of the game prototypes. With their help, we concluded that gameplay shows promise as an effective way to introduce the concept of bystander intervention and increase bystander attitudes and efficacy in situations of sexual and relationship violence and stalking to first-year college students.

Sexual violence victimization among community college students.

Objective: To assess the prevalence of sexual violence victimization among a community college student population. Participants: In March 2017, students (800) from seven community colleges in a northeastern state participated in an online campus climate survey using the ARC3 Survey Instrument. Methods: We analyze demographic differences between participants who were victimized and those who were not, and we examine the relationship between participant victimization and well-being. Results: Participants who identified as female, younger than 26, not heterosexual, or a race other than Caucasian were significantly more likely to report victimization. Participants who reported victimization were significantly more likely to score negatively on well-being scales than those who did not. Conclusions: Sexual violence prevalence rates among community college students are similar to reported prevalence rates among traditional 4-year undergraduate students. Results suggest a need for increased research on sexual violence among the understudied community college student population.

Reducing Sexual Assault on Campus: Lessons From the Movement to Prevent Drunk Driving.

I examined similarities and differences between the movement to prevent drunk driving of the 1980s, and current efforts to prevent and address campus sexual assault. As college and university administrators design policies and initiatives to reduce campus sexual assault in response to new federal legislation and regulation, they can apply lessons from successful public health initiatives to reduce drunk driving initiated more than 3 decades ago. I illustrate how interventions at the 5 levels of the social-ecological model, and messages that address entrenched cultural attitudes condoning sexual assault and blaming its victims can be used to combat campus sexual assault as a crime and a public health problem. I also show how efforts to promote community engagement can change behavioral norms and reduce offenses.

Changing attitudes about being a bystander to violence: translating an in-person sexual violence prevention program to a new campus.

Bystander approaches to reducing sexual violence train community members in prosocial roles to interrupt situations with risk of sexual violence and be supportive community allies after an assault. This study employs a true experimental design to evaluate the effectiveness of Bringing in the Bystander™ through 1-year post-implementation with first-year students from two universities (one rural, primarily residential; one urban, heavily commuter). We found significant change in bystander attitudes for male and female student program participants compared with the control group on both campuses, although the pattern of change depended on the combination of gender and campus.

Encouraging responses in sexual and relationship violence prevention: what program effects remain 1 year later?

Colleges and universities are high-risk settings for sexual and relationship violence. To address these problems, institutions of higher education have implemented prevention programs, many of which train students as potential bystanders who can step in to help diffuse risky situations, identify and challenge perpetrators, and assist victims. The impact of bystander sexual and relationship violence prevention programs on long-term behavior of bystanders has remained a key unanswered question for those who seek to offer the most effective programs as well as for policy makers. In this study, the researchers experimentally evaluated the effectiveness of the Bringing in the Bystander® in-person program. Participants were 948 1st-year college students of whom 47.8% were women and 85.2% identified as White (15% also identified as Hispanic in a separate question) between the ages of 18 and 24 at two universities (one a rural, primarily residential campus and the other an urban, highly commuter campus) in the northeastern United States. To date, this is the first study to have found positive behavior changes as long-lasting as 1 year following an educational workshop focusing on engaging bystanders in preventing sexual and relationship violence. Even so, many questions remain to be answered about prevention and intervention of this type. More prospective research is needed on bystander-focused prevention of these forms of violence to help understand and better predict the complicated relationships both between and among the attitudes and behaviors related to preventing sexual and relationship violence. In this regard, we make specific recommendations for designing and evaluating programs based on our findings relating to the importance of moderators, especially two key understudied ones, readiness to help and opportunity to intervene.

Addressing sexual and relationship violence in the LGBT community using a bystander framework.

Sexual and relationship violence are two major public health issues that affect an alarming number of undergraduate students. As a result, many colleges and universities have protocols to serve victims of these forms of violence. Despite federal legislation stating that all students should have equitable experiences, current protocols and programs focus primarily on heterosexual students. College student victims of sexual and relationship violence who identify as lesbian, gay, bisexual, or transgender can face particular challenges, including disclosure of their sexual and gender orientations, and revictimization when seeking services. In recent years an increasing number of campuses have adopted bystander prevention strategies to address sexual and relationship violence. These strategies seek to engage community members in the prevention of sexual and relationship violence by training them to identify and safely intervene in situations where sexual or relationship violence is about to occur, is occurring, or has occurred. In this article we review published bystander prevention strategies that focus on preventing sexual and relationship violence in the campus community, and discuss how bystander strategies are addressing or can address relationship and sexual violence in the LGBT community.

Using a multimedia social marketing campaign to increase active bystanders on the college campus.

OBJECTIVE: To evaluate the campus-wide administration of the Know Your Power bystander-oriented social marketing campaign. PARTICIPANTS: Undergraduate students at a public college were invited to participate in a public awareness survey before and after the 6-week campaign administration in February and March 2009. METHODS: Pretest and posttests were administered (N = 353) to examine if exposure to the campaign changed students' stage of scale scores. RESULTS: Exposure to the social marketing campaign increased participants' awareness of their role in reducing sexual and relationship violence and stalking, increased their expressed willingness to get involved in reducing the incidence these types of violence, and resulted in participants being more likely to report having taken action to reduce these types of violence. CONCLUSIONS: As college students explore their role as community members, it is an opportunity for college educators to design and administer prevention messages highlighting behavioral norms to be explored and adopted.

Translating sexual assault prevention from a college campus to a United States military installation: piloting the know-your-power bystander social marketing campaign.

One population that shares both similar and different characteristics with traditional college-age students is the U.S. Military. Similarities include a high concentration of 18- to 26-year-olds dealing with new found independence, peer pressure, and the presence of social norms that support violence and hypermasculinity. Sexual violence is a major public health problem in the United States, and because of the similarities in the age group of college and military populations, the problems regarding sexual violence in both constituencies have been well-documented. In the current pilot study we seek to add to both current knowledge about and promising practices of translating prevention strategies from one target audience to another. We describe how we translated, administered, and evaluated a bystander intervention social marketing campaign focused on sexual assault prevention that had been found to significantly affect attitude change on a college campus for a U.S. Army installation in Europe. In addition to demonstrating the process of translating prevention strategies across target audiences, findings from this pilot study contribute to the evaluation data on the effectiveness of sexual violence prevention strategies implemented with members of the U.S. Military. From our analysis, we see that research participants indicate that the degree to which the images resonate with them and the familiarity of the context (i.e., social self-identification) significantly effect the participants' personal responsibility for reducing sexual assault, confidence in acting as a bystander, and reported engagement as a bystander.