College Health Center-based Alcohol and Sexual Violence Intervention
Condition: Sexual Assault; Alcohol Consumption; Intimate Partner Violence
MeSH terms: Alcohol Drinking
Study type: Interventional

Summary: 
      This study will offer the first formal assessment for sexual violence (SV) in the college
      student health center setting, developed for a high risk group of college students, and is
      designed to facilitate patient and provider comfort in discussing sexual violence and related
      abusive experiences (including the role of alcohol) via semi-scripted screening tools. The
      intervention specifically involves the training of all clinical staff (health educators,
      counselors, medical assistants, nurses, and clinicians) to deliver a universal education and
      brief counseling intervention titled GIFTSS (Giving Information for Trauma Support and
      Safety) to all clients seeking college health services integrated into usual clinical
      practice, provide universal education about SV regardless of disclosure, counsel clients on
      harm reduction strategies to reduce risk for SV, and provide supported referrals to sexual
      assault advocates, with the goal of reducing SV among college students.
    

Detailed description: 
      This is a stakeholder-engaged longitudinal study to test, via a 2-armed cluster randomized
      controlled trial , a brief harm reduction intervention to reduce risk for sexual violence
      among male and female college students ages 18-24 receiving care from college student health
      services (K = 28 colleges; baseline N = 2295). Sexual violence (SV) (including sexual
      coercion, non-consensual sexual contact, and rape) is common among college women, and over
      three quarters of women who have been sexually assaulted report that the first of such
      experiences occurred before the age of 25. Alcohol-related SV, in particular, is highly
      prevalent on college campuses, with about half of sexual assault cases occurring in the
      context of victim and/or perpetrator intoxication. Multiple pathways have been implicated in
      this association between alcohol and SV, with social norms regarding alcohol consumption and
      expectations for SV facilitating both the occurrence and underreporting of such violence.
      College student health centers remain an untapped setting to reach youth for both SV
      prevention and intervention. This study draws on several intervention studies by the
      investigative team, integrating successful components from each: 1) the bystander approach in
      which individuals are taught skills as active interveners in SV prevention rather than
      responding with apathy or tolerance is an effective strategy for promoting change within
      social contexts; 2) universal education about SV regardless of disclosure in the clinical
      setting can result in increased recognition of SV and use of relevant services; and 3) harm
      reduction strategies introduced by clinicians can increase intentions to use strategies to
      help oneself and friends that increase safety. The brief counseling intervention uses a
      palm-size educational card with information about SV and harm reduction given to all patients
      during clinical encounters. GIFTSS (Giving Information for Trauma Support and Safety)
      provides (a) patient education and assessment regarding SV; (b) discussion of harm reduction
      behaviors to reduce risk of SV for self and peers (including bystander intervention); and (c)
      supported referrals to victim services. Interventions effective in reaching more college-age
      young adults who either witness or experience SV are needed. College student health centers
      randomized into the GIFTSS intervention arm will receive training in this brief intervention
      integrated into routine college health visits. The control sites will receive a brief alcohol
      intervention. Compared to controls, male and female clients receiving the GIFTSS intervention
      are expected to have greater recognition of what constitutes SV and alcohol-related sexual
      risk (primary outcome), recognition of sexual coercion, self-efficacy to obtain sexual
      consent, self-efficacy to enact harm reduction strategies, intentions to intervene, and
      knowledge of and self-efficacy to use SV-related services (Aim 1). Among participants who
      have witnessed peer SV, those receiving GIFTSS will be more likely to report interventions to
      interrupt peer's harmful behaviors (Aim 2). Clients with SV victimization history who receive
      GIFTSS are expected to be more likely to disclose SV during their clinic visit, report
      greater use of SV-related services, and report less recent SV victimization at follow up
      compared to control clients (Aim 3).
    

Intervention name(s): GIFTSS; Brief alcohol use intervention
Intervention type(s): Behavioral; Behavioral
Intervention description(s): Universal education and brief counseling regarding sexual violence; Brief education and counseling intervention to promote safer alcohol use, reduce binge drinking
Other intervention name(s): Giving Information for Trauma Support and Safety
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Prevention
Keywords: Sexual assault; Alcohol consumption; Intimate partner violence