Orchowski Lindsay M, Merrill Jennifer E, Oesterle Daniel W, Barnett Nancy P, Borsari Brian, Zlotnick Caron, Haikalis Michelle P, Bekowitz Alan D
Rhode Island Hospital, Providence, RI, United States.
Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, United States.
JMIR Form Res. 2023 Nov 23;7:e47354. doi: 10.2196/47354.
Sexual assault is prevalent on college campuses and most commonly is perpetrated by men. Problematically, there is a dearth of evidence-based prevention programs targeting men as perpetrators of sexual aggression. The Sexual Assault and Alcohol Feedback and Education (SAFE) program is an integrated alcohol and sexual assault prevention intervention for college men who engage in heavy drinking that aims to address sexual aggression proclivity and alcohol use outcomes by incorporating social norms theory, bystander intervention, and motivational interviewing.
This study aims to examine the initial feasibility-, acceptability-, and efficacy-related outcomes of a randomized pilot trial of an integrated alcohol and sexual assault prevention program for college men who engage in heavy drinking.
This study included 115 college men who engaged in heavy drinking, who were randomly assigned to the SAFE program or a mindfulness-based control condition (MBCC). The feasibility of implementation, adequacy of participant retention, fidelity and competency of program administration, and satisfaction and utility of the intervention were evaluated. The primary outcomes of alcohol use and sexual aggression were evaluated at 2 and 6 months after baseline. The secondary outcomes of perceived peer norms, risks for sexual aggression, and bystander intervention were also assessed. The extent to which the motivational interviewing session with personalized normative feedback facilitated changes in the proximal outcomes of drinking intentions, motivation to change, and self-efficacy was also examined.
The study procedures resulted in high program completion and retention (>80%), high fidelity to the program manual (>80% of the content included), high competency in program administration, and high ratings of satisfaction and program utility in addressing sexual relationships and alcohol use. Both groups reported declines in the number of drinks per week and number of heavy drinking days. Compared with the MBCC participants, the SAFE participants reported higher motivation to change alcohol use after the program, as well as greater use of alcohol protective behavioral strategies at 6 months. Compared with the MBCC participants, the SAFE participants also reported lower perceived peer engagement in sexual coercion, perceived peer comfort with sexism, and peer drinking norms at 2 and 6 months. However, no group differences were observed in sexual aggression severity, rape myth acceptance, or the labeling of sexual consent. Results regarding bystander intervention intentions were mixed, with the MBCC group showing decreased intentions at 2 months and the SAFE group reporting increased intentions at both 2 and 6 months.
The findings provide promising evidence for the feasibility, acceptability, utility, and preliminary efficacy of the SAFE program in reducing alcohol use and positively influencing perceived peer norms and intentions for bystander intervention among college men who drink.
ClinicalTrials.gov NCT05773027; https://clinicaltrials.gov/study/NCT05773027.
性侵犯在大学校园中很普遍，且大多数情况下是由男性实施的。问题在于，针对男性性侵犯者的循证预防项目匮乏。性侵犯与酒精反馈及教育（SAFE）项目是一项针对酗酒的大学男性的酒精与性侵犯综合预防干预措施，旨在通过纳入社会规范理论、旁观者干预和动机性访谈来解决性侵犯倾向及酒精使用问题。
本研究旨在检验一项针对酗酒的大学男性的酒精与性侵犯综合预防项目随机试点试验的初步可行性、可接受性及与疗效相关的结果。
本研究纳入了115名酗酒的大学男性，他们被随机分配到SAFE项目组或基于正念的对照组（MBCC）。评估了实施的可行性、参与者留存率、项目管理的保真度和能力，以及干预措施的满意度和实用性。在基线后2个月和6个月评估酒精使用和性侵犯的主要结果。还评估了同伴规范认知、性侵犯风险和旁观者干预的次要结果。还考察了个性化规范反馈的动机性访谈环节在多大程度上促进了饮酒意图、改变动机和自我效能等近端结果的变化。
研究程序导致了较高的项目完成率和留存率（>80%）、对项目手册的高保真度（包含>80%的内容）、项目管理的高能力，以及在处理性关系和酒精使用方面的高满意度和项目实用性评分。两组均报告每周饮酒量和重度饮酒天数有所下降。与MBCC参与者相比，SAFE参与者在项目结束后报告有更高的改变饮酒行为的动机，以及在6个月时更多地使用酒精保护行为策略。与MBCC参与者相比，SAFE参与者在2个月和6个月时还报告，其感知到的同伴参与性胁迫的程度、对性别歧视的同伴舒适度以及同伴饮酒规范较低。然而，在性侵犯严重程度、对强奸谬论的接受程度或性同意的认定方面未观察到组间差异。关于旁观者干预意图的结果不一，MBCC组在2个月时意图下降，而SAFE组在2个月和6个月时报告意图增加。
研究结果为SAFE项目在减少酒精使用以及对酗酒的大学男性的同伴规范认知和旁观者干预意图产生积极影响方面的可行性、可接受性、实用性和初步疗效提供了有前景的证据。
ClinicalTrials.gov NCT05773027；https://clinicaltrials.gov/study/NCT05773027
