Perceptions of Anticipated Peer Support for Survivors of Sexual Violence Among Students with Minoritized Identities.

Peers' attitudes toward survivors of sexual violence can impact their willingness to disclose. Students with minoritized identities may perceive and experience their campus environments as less supportive than peers with privileged identities. The purpose of this study was to examine perceptions of anticipated peer support for sexual violence survivors, using a cross-sectional study of 2,727 students. Linear regression modeling showed significant associations between students with minoritized identities and lower scores on perceptions of anticipated peer support for survivors. There were also several important interactions between specific overlapping student identities. The findings suggest that students with minoritized identities perceive anticipated peer support less favorably than those with privileged identities.

Bystander Intervention for the Prevention of Campus Sexual Violence: Opportunity, Frequency of Action, and Consequences for Confronting Those at Risk of Perpetration.

This cross-sectional study examined students' (Campus 1, n = 1,153; Campus 2, n = 1,113) experiences with four situations of direct confrontation of those at risk for sexual assault perpetration. The most reported opportunity was to confront those making false statements about sexual assault; many students reported more than one opportunity to intervene in the past year. Bystanders intervened most of the time across the four situations examined in this study. The most reported consequence of intervening was that no further harm was caused. More nuanced measures can offer practitioners further information to tailor sexual violence prevention programs.

Patterns of Gender Equitable Attitudes and Behaviors Among Young Men: Relationships With Violence Perpetration and Masculinity Ideologies.

This study used latent profile analysis with data from 481 U.S. men to examine patterns of men's attitudes toward gender equity and their engagement in gender-equitable (GE) behaviors. Five resulting profiles included groups with (a) high endorsement of both GE attitudes and behaviors, (b) low endorsement of both, (c) mid-range endorsement of both, (d) strong endorsement of GE attitudes, but low engagement in action, and (e) low endorsement of GE attitudes but high participation in GE behavior. Worryingly, this last group reported higher rates of violence perpetration than other groups, while simultaneously reporting higher rates of participation in gender-based violence prevention actions.

Sexual Violence Among Sorority Women: Victimization Experiences, Contexts, and Disclosure.

The purpose of this study was to examine and compare sexual violence (SV) victimization among sorority women and unaffiliated counterparts. Results showed sorority women were more likely than unaffiliated women to report experiencing some types of SV, consuming alcohol prior to victimization, and to identify their perpetrator as a hookup/casual partner. More women, regardless of affiliation, informally disclosed their victimization compared to formally reporting; many did not tell anyone because they did not think it was serious enough. The findings point to implications for harm reduction, bystander intervention, and primary prevention programming, as well as institutional policy to address SV.

College Students' Engagement in Violence Prevention Discussions with Peers.

The bystander intervention (BI) model recognizes a range of prosocial helping behaviors individuals can perform to support sexual and dating violence (S/DV) prevention efforts. Individuals can demonstrate a commitment to ending violence through proactive BI, such as participating in prevention initiatives or talking with peers about ways to keep safe, which are different than reactive BI behaviors when violence is underway. Given the anchoring of the BI model in Diffusion of Innovation Theory, which articulates the uptake of new behaviors throughout a population or community and the role of change agent aids in that process, investigating demographic, and other individual-level correlates, of proactive behaviors may help identify those students who are particularly positioned to help diffuse and normalize anti-violence behaviors. The purpose of this study was to examine (1) the occurrence of students' engagement in peer discussions about violence prevention in the past year and (2) the correlates of reporting to have those discussions among university students in a cross-sectional study implemented on two campuses in the Mid-Atlantic U.S. Results showed that the most common discussion was talking to friends about being safe in dating relationships and the least common was talking with friends about participating in violence-prevention-related activities, with 66.2% and 22.5% having done so, respectively. Women, younger students, and those reporting to know a survivor of either DV or SV were more likely to report having discussions, compared to men, older students, and those not knowing a survivor. Additional relationships were detected between other individual characteristics, knowledge about violence/victimization, and climate-related variables but differed depending on whether participants participated in the DV or SV-related survey module. Findings suggest the need for BI training initiatives to emphasize proactive engagement and peer discussions, and that gender continues to be a robust indicator of violence-prevention actions.

The Theory of Planned Behavior & Bystander Intention: Differences Based on Gender and Heavy Episodic Drinking.

Research indicates that people who engage in heavy episodic drinking (HED) report less intention to intervene and intervention behavior to prevent sexual violence. Researchers have also found gender differences across bystander intention, bystander confidence, and intervention behavior. However, research in this area could benefit from use of an evidence-based health behavior theory. The theory of planned behavior (TPB) posits that personal attitudes, subjective norms, and perceived behavioral control (PBC) predict behavioral intention. Substantial evidence supports the utility of the TPB for predicting behavioral intention in a variety of health-related behaviors, yet few researchers have applied this theory when predicting bystander intention to prevent sexual violence. Undergraduate students (N = 395) from a southern university (77% female; 70% White, Non-Hispanic) completed a modified Sexual Assault Bystander Behavior Questionnaire and the Daily Drinking Questionnaire. Our findings did not reveal significant differences in attitudes, subjective norms, PBC, nor intention based on HED; however, there were significant differences based on gender, with women indicating more positive attitudes and supportive subjective norms regarding bystander intervention. Multiple regression analysis indicated that theoretical antecedents of intention positively predicted bystander intention, however, the relations were not moderated by prior engagement in HED. These findings support the utility of the TPB for predicting bystander intention to intervene; however, they do not support previous research examining how HED influences bystanders' intention to engage in prosocial actions.

History of Sexual Assault Perpetration and Violence-Related Prosocial Tendencies Among Men by Fraternity Affiliation Status.

The purpose of this cross-sectional study was to examine self-reported sexual assault perpetration history, as well as violence prevention-related prosocial tendencies, among fraternity men, unaffiliated men with membership intentions, and unaffiliated men without membership intentions with data from 262,634 college men in the United States. Results indicate that fraternity status was related to sexual assault perpetration, both prior to and while at their current institution of higher education; both perpetration history and fraternity status significantly related to diminished violence prevention-related prosocial tendencies. The findings have important implications for future research and practice to reduce the incidents of sexual assault on college campuses.

The Chivalrous Bystander: The Role of Gender-Based Beliefs and Empathy on Bystander Behavior and Perceived Barriers to Intervention.

Despite substantial evidence demonstrating a relation between gender-based beliefs and violence against women, there has been little research examining whether sexist attitudes are related to prosocial bystander behavior. Understanding psychosocial influences on bystanders' behavior could inform bystander training programs on college campuses, and so the current study examined the unique and joint effects of three gender-based attitudes (rape myth acceptance, hostile sexism, and benevolent sexism) and empathy in predicting bystander behavior and perceived barriers to intervention in situations that undergraduates (N = 500; 70% female; Mage = 18.86 years) had experienced in the prior year. Benevolent sexism was the only gender-based attitude consistently associated with bystander behavior and perceived barriers. After accounting for participant empathy, benevolent sexism uniquely predicted less intervention in post-assault situations, greater perceived barriers in pre- and post-assault situations, and greater Failure to Perceive Responsibility and Skill Deficit barriers across situations. Associations between gender-based attitudes and bystander behavior also differed for men and women, with rape myth acceptance predicting greater Failure to Perceive Responsibility barriers and benevolent sexism predicting greater Skill Deficit barriers for women but not men. These results suggest that existing bystander education programs can be improved by explicitly addressing benevolent sexist beliefs and promoting empathy for victims of assault.

Life Course and Socioecological Influences on Gender-Equitable Attitudes Among Men: A Scoping Review.

Emerging research suggests that holding gender-equitable attitudes (GEA) is associated with decreased risk of gender-based violence perpetration and increased willingness to engage in violence preventative actions among men. GEA, defined here as support for political, economic, and social equity across gender in both public and private spheres, may therefore constitute a protective factor against perpetration and a promotive factor in fostering healthy relationships and communities. Forces that shape GEA throughout boys' and young men's lives are less well articulated. The purpose of this exploratory, scoping review was to synthesize cross-disciplinary research to distill life-course influences on the development of GEA among men. Three databases and Google Scholar were searched to locate peer-reviewed studies that empirically examined GEA as an outcome of childhood, adolescent, or young adulthood factors. Sixty-nine articles were located that, collectively, used data from 97 different countries and identified 22 potential life-course influences on men's GEA. Across studies, facilitators of equitable attitudes included higher levels of education, exposure to gender transformative prevention programming, and having parents who held, modeled, and communicated gender-equitable beliefs. Hindrances to equitable attitudes included but were not limited to religiosity, the transition to fatherhood, and having mostly male peer groups. Findings suggest that opportunities to foster equitable attitudes exist across the life course and both inside and outside of formal prevention or education interventions.

Bystander Intervention Opportunities and Prosocial Behaviors Among Gender and Sexual Minority College Students.

Bystander intervention education has proliferated as a popular strategy to address campus interpersonal violence, including intimate partner and sexual violence, which remain major public health concerns. Much of the work on bystander engagement, however, is cis- and heteronormative (i.e., centered on those individuals whose gender identity aligns with their biological sex at birth and/or who identify as heterosexual), thus failing to capture the experiences of students who identify as gender or sexual minorities (GSM), a population at increased risk for interpersonal violence. Research has demonstrated that cisgender females face an increased likelihood of victimization, which is related to greater awareness of intimate partner and sexual violence and results in more prosocial intentions and prosocial behaviors. The question remains whether this extends beyond cisgender females. The current study is a secondary analysis of data collected in a web-based sexual assault prevention course designed for undergraduate students and implemented at their respective institutions. Data from 474,395 undergraduate students, aged 18-23 years, were used to answer the research question. Results indicate that students' bystander intervention opportunities and prosocial behaviors differ based on GSM status. For example, although cisgender bisexual women, transwomen, and genderqueer/gender nonconforming (GNC) students were more likely to report having the opportunity to intervene in sexual assault situations, relative to cisgender heterosexual women, the latter two groups were less likely to intervene. Further, cisgender gay and bisexual men, as well as transmen and genderqueer/GNC students were more likely to report having the opportunity to intervene in dating abuse situations, relative to cisgender heterosexual men, and cisgender gay men were more likely to report having intervened. Given the call for centering research on minoritized student experiences, this research is a vital step toward recognizing the diversity of those experiences for GSM students, a population at risk for victimization.

Exposure to Campus Messages about Dating and Sexual Violence: A Latent Class Analysis.

This study investigates college students' exposure to messages about campus dating and sexual violence (DSV) to discover classes of students based on the message source. Latent class analysis was performed with data assessing 5,284 students' exposure to 16 different sources of information regarding DSV, from having a professor discuss these topics to participating in related campus events. Several variables were included in the analysis to understand students' class membership in relation to pertinent student demographic factors. The best model indicated that there are five classes of students based on their exposure to messages, with some subgroups of students having high exposure to various sources of messages about DSV while others have low exposure. Still other subgroups are primarily exposed to messages through nonactive or noninstitutional sources of information. Subgroups of students, based on their exposure to DSV messaging, also differ regarding demographic makeup. The implications from these results include the need to tailor DSV programming on campus to subgroups of students based on their varying baseline levels of message exposure. As students are exposed to messaging through differing sources, including passive and noninstitutional, institutions can use this information when designing outreach efforts to better fit with the needs of various subgroups of students.

Undergraduate Students as Bystanders to Sexual Violence Risks: Differences in Reported Intervention Opportunities and Behaviors by Racial Identity.

Although substantial research has been dedicated to understanding the demographic and psychosocial correlates of bystander intervention behavior related to sexual violence, as well as the effectiveness of bystander training programs, both lines of inquiry often fail to examine potential differences in bystander intervention opportunities and behavior based on students' racial identity. Indeed, current research generally suffers from a lack of diversity in the study samples. Given this gap in the literature, the purpose of this study is to examine whether-and how-students' racial identity (White, non-Hispanic, African American, Asian American, Hispanic and multiracial) is associated with their reported intervention opportunities and prosocial response as bystanders to sexual violence risks. In the fall of 2014, undergraduate students (N = 9,358) completed web-based surveys to assess bystander intervention opportunities and behavior for six high-risk situations. Tests of independence revealed racial identity was significantly associated with bystander opportunities for four of the six situations, and logistic regression revealed that White students had significantly higher odds of reporting these intervention opportunities, compared with students of color. Tests of independence revealed that racial identity was not significantly associated with bystander intervention behavior, although logistic regression analysis revealed Asian American students had significantly lower odds of reporting prosocial intervention response for one situation, compared with White counterparts. In response to growing concerns about campus sexual violence, institutions of higher education are increasingly adopting bystander training programs to engage students as prosocial helpers who can intervene in risk situations. In line with these findings, research of this nature should include samples that reflect the diversity of their campus communities, explore what types of opportunities students of color identify as potential for intervention, and ensure these situations are captured in bystander behavior measures used in the field.

Students as Prosocial Bystanders to Sexual Assault: Demographic Correlates of Intervention Norms, Intentions, and Missed Opportunities.

Sexual assault is a major public health issue. Bystander engagement programs are becoming widely used to combat sexual assault on college campuses. The purpose of this study was to examine students' intervention norms, intentions, opportunities, and behaviors as bystanders to sexual assault. Undergraduate students (N = 779) completed the Sexual Assault Bystander Behavior Questionnaire in the fall of 2014. The t tests revealed differences in students' intervention norms, intentions, opportunities, and missed opportunities based on sex, race/ethnicity, athletic participation, and fraternity/sorority membership. The findings support the use of additional measures to assess bystander behavior and to identify student subpopulations that may benefit from programs aimed at increasing prosocial intervention.

Beyond Yes or No: Understanding Undergraduate Students' Responses as Bystanders to Sexual Assault Risk Situations.

The White House Task Force to Protect Students From Sexual Assault recommends bystander engagement programming as part of campus sexual assault prevention efforts. Measuring students' bystander behavior, and thus, assessing the effectiveness of such programming, is a challenging endeavor due to the range of risk situations students may witness, as well as the nuances in potential barriers students may face in these situations. Currently, many studies include dichotomous measures of bystander behavior without gathering further information about students' opportunities to intervene, barriers to intervening, and intervention strategies. The current study sought to implement a more comprehensive approach to understanding the types of sexual assault risk situations students report to witness, as well as their response in those situations, reasons for not intervening, and any gender differences therein. In 2014, undergraduate students (n = 9,358) at a large, public university in the Northeast completed a web-based survey to assess bystander opportunities and responses for six different risk situations. Results show that prosocial bystander responses varied depending on the risk situation. Of those students with opportunities to intervene, noninterveners reported the situation was "none of their business" or that they were "unsure of what to do." Interveners reported to have either "confronted the situation directly" or "went and got assistance." We also observed significant gender differences in students' reported intervention opportunities and bystander responses. The findings of this study have several important implications for bystander engagement programming and future research.

"She Wasn't Resisting": Students' Barriers to Prosocial Intervention as Bystanders to Sexual Assault Risk Situations.

The White House Task Force to Protect Students from Sexual Assault recommends bystander training as part of campus sexual assault prevention efforts. The current study sought to understand salient themes among students' qualitative responses for why they did not intervene in sexual assault risk situations. In 2014, undergraduate students ( N = 9,358) at a large public university completed a web-based survey to assess bystander opportunities and responses for six risk situations. Content coding analysis indicated that students report several unique barriers to intervention. These findings have important implications for bystander training programs, as well as future research on bystander behavior.

Revising existing instruments for measuring bystander intervention opportunity and frequency of prosocial response for the prevention of sexual violence.

Institutions of higher education increasingly offer training programmes to engage students' as pro-social bystanders who can intervene in situations related to sexual violence. The purpose of this study was to assess the usage of a bystander behaviour measurement tool that captures both students' intervention opportunities and frequency of prosocial response. University undergraduate students in the Northwestern USA (n=474) completed online surveys in the Fall of 2016. Results show that students have opportunities to intervene in a variety of situations at the three levels of prevention for campus sexual violence and they do not always intervene. The frequency of students' prosocial bystander response ranged, for those with the opportunity, from 'never' to 'always'; students reported varying degrees of intervention frequency depending on the situation. A bystander intervention behaviour instrument measuring opportunity and frequency of response can be a valuable tool for assessing the effectiveness of bystander training programmes.

Control, Norms, and Attitudes: Differences Between Students Who Do and Do Not Intervene as Bystanders to Sexual Assault.

Sexual assault is a major concern on the U.S. college campus. Engaging students as pro-social bystanders has become more common as a potentially effective mechanism for reducing the incidence of sexual assault and mitigating the harm of assaults that have already occurred. Understanding the influences of pro-social bystander behavior is imperative to developing effective programs, and the use of an evidence-based theoretical framework can help identify the differences between students who intervene and those who do not when presented with the opportunity. A sample of 815 undergraduate university students completed the Sexual Assault Bystander Behavior Questionnaire, a survey based on the theory of planned behavior (TPB) that investigates students' perceived behavioral control to intervene, subjective norms that support intervening, attitudes toward intervening, and intent to intervene in the future. Two-tailed t tests revealed interveners reported significantly greater perceived behavioral control than non-interveners for eight of the 12 intervention behaviors, more supportive subjective norms than non-interveners for seven of the 12 intervention behaviors, more positive attitudes than non-interveners for only one of the 12 intervention behaviors, and greater intent to intervene in the future for six of the 12 intervention behaviors. Differences in the four TPB variables were not consistent for the 12 intervention behaviors. The use of a theoretical framework found to be effective in explaining-and changing-other health-related behaviors, and the inquiry into students' opportunities to intervene to compare against their reported intervention behaviors, is new to this body of literature and contributes to the understanding of the influences of pro-social bystander behavior.

Predictors of access to healthcare: what matters to rural Appalachians?

OBJECTIVE: Lack of access to healthcare is frequently cited as a primary reason for health disparities globally, especially in poor, rural areas such as Appalachia in the U.S. This study examined predictors of perceived access to healthcare among residents in a poor, medically underserved, rural Appalachian community. METHODS: The study was guided by the revised behavioral model of healthcare services utilization. Self-reported survey data were obtained from a convenience sample of 921 residents in rural Tennessee. RESULTS: The majority of respondents in this study did not perceive access to healthcare to be a problem in their community. Financial factors, health status, and associated social factors negatively affected only a small number respondents' perceptions of access to healthcare. CONCLUSIONS: Despite the presence of multiple factors previously shown to affect access to healthcare, the majority of respondents in this study did not perceive access to healthcare to be a problem in their community. Results of this study suggest that to understand an individual's passage through the healthcare system, the contextual aspects of healthcare utilization, should be added to coverage, services, timeliness, and workforce as a fifth component of access to healthcare. Assessing perceived need and associated cultural factors that affect individuals' concepts of health and wellness represent important areas for future exploration to explain observed health disparities. Additionally, findings showed that having sufficient quality and quantity of healthcare professionals and services in a community or region may be necessary, but not sufficient to explain health disparities and the underlying reasons why individuals choose or choose not to seek health services.