Department of Health Policy and Behavioral Science, School of Public Health, Georgia State University, Atlanta, GA, United States.
Department Population Health Sciences, School of Public Health, Georgia State University, Atlanta, GA, United States.
J Med Internet Res. 2023 Jun 21;25:e43740. doi: 10.2196/43740.
Sexual violence (SV) incidence among college women has been invariant for the past 20 years. Innovative prevention strategies that are low resource and technology driven but demonstrate efficacy are greatly needed.
The aim of this study was to determine the efficacy of a novel theoretically driven internet-based intervention for first-year college students who identify as women (RealConsent) in reducing their risk of exposure to SV and alcohol misuse as well as increasing alcohol protective and bystander behaviors.
This randomized controlled trial involved first-year college students who identified as women (n=881) attending 1 of 3 universities in the southeastern United States. Participants aged 18 to 20 years were randomized to RealConsent (444/881, 50.4%) or to an attention-matched placebo control (437/881, 49.6%). RealConsent is fully automated and consists of four 45-minute modules that incorporate entertainment-education media and proven behavior change techniques. The primary outcome was exposure to SV; the secondary outcomes were alcohol protective behaviors, dating risk behaviors, alcohol misuse, and bystander behavior. Study outcomes were assessed at baseline and 6-month follow-up.
Among participants with some exposure to SV, those in the RealConsent group experienced less exposure to SV than the placebo group (adjusted incidence rate ratio 0.48, 95% CI 0.33-0.69; P=.002). Furthermore, participants in the RealConsent group engaged in more alcohol protective behaviors (adjusted odds ratio 1.17, 95% CI 0.12-2.22; P=.03) and were less likely to binge drink (adjusted incidence rate ratio 0.81, 95% CI 0.67-0.97; P=.003). Finally, participants in the RealConsent group who had 100% dosage were more likely to engage in bystander behavior than those with <100% dosage plus placebo group (adjusted odds ratio 1.72, 95% CI 1.17-2.55; P=.006).
A comprehensive exposure to SV, alcohol use, and bystander educational program was successful in decreasing the occurrence of exposure to SV among those most at risk and in increasing alcohol protective behaviors. Because of its web-based and mobile technologies, RealConsent can be easily disseminated and holds potential for reducing campus SV.
ClinicalTrials.gov NCT03726437; https://clinicaltrials.gov/ct2/show/NCT03726437.
过去 20 年来，大学生中发生的性暴力（SV）事件一直没有变化。非常需要创新的预防策略，这些策略资源和技术投入低，但具有疗效。
本研究旨在确定一种新的基于理论的互联网干预措施对识别为女性的一年级大学生（RealConsent）的效果，该措施旨在降低她们接触 SV 和酗酒的风险，并增加酒精保护和旁观者行为。
这项随机对照试验涉及 3 所美国东南部大学的 881 名识别为女性的一年级大学生。年龄在 18 至 20 岁的参与者被随机分配到 RealConsent（444/881，50.4%）或注意力匹配的安慰剂对照组（437/881，49.6%）。RealConsent 是完全自动化的，由四个 45 分钟的模块组成，结合娱乐教育媒体和经过验证的行为改变技术。主要结局是接触 SV；次要结局是酒精保护行为、约会风险行为、酗酒和旁观者行为。在基线和 6 个月随访时评估研究结果。
在有一定 SV 暴露的参与者中，RealConsent 组的 SV 暴露程度低于安慰剂组（调整后的发病率比 0.48，95%CI 0.33-0.69；P=.002）。此外，RealConsent 组的参与者采取了更多的酒精保护行为（调整后的优势比 1.17，95%CI 0.12-2.22；P=.03），并且更少的人酗酒（调整后的发病率比 0.81，95%CI 0.67-0.97；P=.003）。最后，接受 100%剂量的 RealConsent 组比接受<100%剂量加安慰剂组更有可能采取旁观者行为（调整后的优势比 1.72，95%CI 1.17-2.55；P=.006）。
一项全面的 SV、酒精使用和旁观者教育计划成功地降低了高危人群中 SV 的发生，并增加了酒精保护行为。由于其基于网络和移动技术，RealConsent 可以很容易地传播，并有可能减少校园 SV。
ClinicalTrials.gov NCT03726437；https://clinicaltrials.gov/ct2/show/NCT03726437.
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