Web-Based Alcohol and Sexual Assault Prevention Program With Tailored Content Based on Gender and Sexual Orientation: Preliminary Outcomes and Usability Study of Positive Change (+Change)

Abstract

Background Alcohol use and sexual assault are common on college campuses in the United States, and the rates of occurrence differ based on gender identity and sexual orientation. Objective We aimed to provide an assessment of the usability and preliminary outcomes of Positive Change (+Change), a program that provides integrated personalized feedback to target alcohol use, sexual assault victimization, sexual assault perpetration, and bystander intervention among cisgender heterosexual men, cisgender heterosexual women, and sexual minority men and women. Methods Participants included 24 undergraduate students from a large university in the Southwestern United States aged between 18 and 25 years who engaged in heavy episodic drinking in the past month. All procedures were conducted on the web, and participants completed a baseline survey, +Change, and a follow-up survey immediately after completing +Change. Results Our findings indicated that +Change was acceptable and usable among all participants, despite gender identity or sexual orientation. Furthermore, there were preliminary outcomes indicating the benefit for efficacy testing of +Change. Conclusions Importantly, +Change is the first program to target alcohol use, sexual assault victimization, sexual assault perpetration, and bystander intervention within the same program and to provide personalized content based on gender identity and sexual orientation. Trial Registration ClinicalTrials.gov NCT04089137; https://clinicaltrials.gov/ct2/show/NCT04089137

Teen Well Check : an e-health prevention program for substance use, sexual assault, and sexual risk behaviors for adolescents in primary care

“… Target outcome Theoretical framework Prevention components Substance use Motivational Interviewing (Naar-King & Suarez, 2011 ) Screening, reinforcement for non-use, self-identified consequences of use (Dimeff et al, 1999 ; Naar-King & Suarez, 2011 ; National Institute on Alcohol Abuse and Alcoholism, 2011 ) Social Norms Theory (Borsari & Carey, 2001 ; Collins et al, 1985 ; Lewis & Neighbors, 2004 ; Perkins, 2002 ) Correcting misperceptions of perceived and actual peer norms of alcohol and drug use Ecological Framework (Bronfenbrenner, 1979 ) Increase communication skills with peers (including romantic and sexual partners), parents, and medical providers regarding use Negative Reinforcement Theory (Skinner, 1958 ) Psychoeducation on traumatic stress symptoms and use of substances to cope with traumatic stress symptoms, encouraging active coping strategies Substance use before sex Sex-Related Substance Use Expectancies (e.g. Alcohol and Marijuana Expectancy Theory) (Hendershot et al, 2010 ) Interactive feedback regarding sex-related substance use expectancies (Gilmore et al, 2022 ) Impairment Theories (e.g. Alcohol Myopia Theory) (Steele & Josephs, 1990 ) Interactive feedback applying alcohol myopia theory to sexual decision-making (Gilmore et al, 2022 ) Sexual risk behaviours Social Norms Theory Correcting misperceptions of perceived and actual peer norms of sexual risk behaviours (Lewis et al, 2014 ) Skills Deficit Model Interactive education to increase condom use, condom use self-efficacy, and sexual communication skills Sexual assault victimization Ecological Framework...…”

“…Alcohol and Marijuana Expectancy Theory) (Hendershot et al, 2010 ) Interactive feedback regarding sex-related substance use expectancies (Gilmore et al, 2022 ) Impairment Theories (e.g. Alcohol Myopia Theory) (Steele & Josephs, 1990 ) Interactive feedback applying alcohol myopia theory to sexual decision-making (Gilmore et al, 2022 ) Sexual risk behaviours Social Norms Theory Correcting misperceptions of perceived and actual peer norms of sexual risk behaviours (Lewis et al, 2014 ) Skills Deficit Model Interactive education to increase condom use, condom use self-efficacy, and sexual communication skills Sexual assault victimization Ecological Framework/Cognitive Mediational Model (Gidycz et al, 2006 ; Nurius & Norris, 1996 ; Ullman, 2014 ) Increase sexual communication skills, sexual assault risk perception skills, and effective use of resistance strategies through scenarios (Gilmore et al, 2022 ) Sexual assault bystander intervention Social Norms Theory/Bystander Education (Fischer et al, 2011 ; Jouriles et al, 2018 ; Labhardt et al, 2017 ; Latané & Darley, 1970 ; Latané & Nida, 1981 ; Latané & Rodin, 1969 ) Interactive bystander education, psychoeducation on substance use and bystander intervention (Gilmore et al, 2022 ) …”

Preventing sexual violence in sexual orientation and gender diverse communities: A call to action

“…To date, a limited number of prevention programmes exist that are tailored to address the needs of the SOGD population. To our knowledge, only one integrated alcohol and sexual assault prevention programme – +Change (Positive Change) – has been specifically developed to simultaneously target theoretically and empirically derived individual-level risk factors for sexual victimization among SOGD college students (Gilmore et al, 2022 ). Given the high co-occurrence between alcohol use and sexual assault in some settings (Abbey, 2011 ), programmes that integrate alcohol use and sexual assault prevention together show considerable promise in preventing both sexual victimization and perpetration (Gilmore et al, 2022 ; Orchowski, Barnett, et al, 2018 ).…”

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

“…Several efficacious campus SV prevention and risk reduction programs (e.g., programs that teach assertiveness and resistance education) delivered at the individual level target prevention of perpetration and reducing risk of victimization, whereas some also teach bystander intervention skills, for example, The Men's Project (Gidycz et al, 2011), RealConsent (Salazar et al, 2014, 2023), positive change (Gilmore et al, 2015, 2022), the Enhanced Assess, Acknowledge, Act Sexual Assault Resistance program (Senn et al, 2015), and Ship Happens (Potter et al, 2018, 2021). To highlight a few of these programs, for example, among college men, RealConsent was effective in reducing SV perpetration and in increasing bystander behavior (Salazar et al, 2014).…”