In-School Evaluation of Bystander: A Game-Based Intervention for Sexual Violence Prevention

Study Overview
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Brief Summary
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The investigators have developed a game-based sexual violence prevention program that uses a bystander intervention approach. This program is called Bystander and was designed for use with high school students in grades 9-12. The goal of this research is to evaluate the efficacy and feasibility of Bystander when implemented in a school setting. The research will capture data on knowledge about sexual violence and harassment, as well as attitudes, self-efficacy, perceived social norms and behavioral intentions around bystander behaviors. This research will consist of a baseline survey, program participation, a immediate post-program survey, and a 3-month follow up survey with youth participants. It will also involve qualitative in-depth interviews with school staff and administration about the program.

Detailed Description
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Using the investigators' experience in game-based learning, digital media, behavior theory, and adolescent sexual and reproductive health, the investigators have developed a digital game-based sexual violence prevention program-Bystander-to be used with high school students to teach them about prosocial bystander behaviors and decrease acceptance of common rape myths. The goal of this research is to evaluate the efficacy and feasibility of Bystander when implemented in a school setting. This study will evaluate Bystander, a four-module intervention program. Each module is designed to last one school class period. It includes 20 minutes of individual gameplay through an interactive narrative featuring prosocial bystander behaviors and discussions dispelling rape myths. Each module also includes facilitated class discussion about the topics covered that day. The research team will conduct a pre/post efficacy and feasibility study that will capture data through a pre-, immediate post-, and 3-month follow up survey on knowledge about sexual violence and harassment, as well as attitudes, self-efficacy, perceived social norms and behavioral intentions around bystander behaviors (all measured at pre-, immediate post- and follow-up time points). It will also capture demographic information and previous bystander behaviors at baseline. It will finally involve qualitative in-depth interviews with school staff and administration about the program.

Official Title
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In-School Evaluation of Bystander: A Game-Based Intervention for Sexual Violence Prevention

Conditions
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Bystander Behavioral Intentions

Intervention / Treatment
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* Behavioral: Bystander, a game-based bystander intervention program
* Behavioral: Infection City, a game-based program about meningitis


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age 13-19 years A student in grades 9-12 at one of three identified study site schools Able to speak and read English at a 7th grade level Provide informed consent and express willingness to complete the follow-up survey.

Ages Eligible for Study
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Minimum Age: 13 Years
Maximum Age: 19 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Crossover Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Intervention<br>Two schools (all students grades 9-12) will serve as the intervention group.Participants will complete a baseline survey that will take no longer than 30 minutes. Afterwards, a trained facilitator will delivery a game-based bystander intervention program aimed at teaching students the knowledge and skills to prevent or intervene in instances in sexual harassment and violence among peers. This will last for 4 class periods (approximately 45 minutes each period, 180 minutes total). Afterwards, participants will complete an immediate post-program survey lasting no more than 30 minutes. Three months later, students will fill out an a follow up survey lasting no more than 30 minutes. School staff and administrators will be interviewed to gather their insights on the program's feasibility and acceptability. | Behavioral: Bystander, a game-based bystander intervention program<br>* A game-based, high school age-appropriate program delivered by trained facilitators for sexual violence and harassment intervention<br>|
| Placebo Comparator: Delayed Control<br>One school (all students grades 9-12) will serve as a delayed control group. Participants will complete a baseline survey that will take no longer than 30 minutes. Afterwards, a trained facilitator will delivery a game-based health program unrelated to sexual health, sexual violence, sexual harassment, and bystander behaviors. This will last for 4 class periods (approximately 45 minutes each period, 180 minutes total). Afterwards, participants will complete an immediate post-program survey lasting no more than 30 minutes. Three months later, students will fill out an a follow up survey lasting no more than 30 minutes. After completing the follow-up survey, this group will follow the same procedures to deliver the bystander program and capture data outlined for the intervention group. | Behavioral: Bystander, a game-based bystander intervention program<br>* A game-based, high school age-appropriate program delivered by trained facilitators for sexual violence and harassment intervention<br>Behavioral: Infection City, a game-based program about meningitis<br>* A game-based, high school age-appropriate program delivered by trained facilitators to teach students about meningitis.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| change in bystander behavioral intention | measured via validated 11-item Bystander Attitude Scale-Revised by McMahon et al 2014 | pre, immediate post, 3 month follow up | 
| change in attitudes towards sexual violence and harassment | measured via validated 22-item Modified Illinois Rape Myth Acceptance Scale by McMahon 2011 | pre, immediate post, 3 month follow up | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| change in knowledge of sexual harassment and violence | measured via validated 7-item Legal Knowledge Scale (Maxwell 2003) | pre, immediate post, 3 month follow up | 
| change in knowledge of sexual harassment and violence | measured via Knowledge of Sexual Violence and Harassment index (Banyard et al 2005) | pre, immediate post, 3 month follow up | 
| change in perceived social norms for bystander behaviors | measured via validated Social Norms Scale from Gidycz et al 2011 | pre, immediate post, 3 month follow up | 
| change in self-efficacy for bystander behaviors | measured via validated 14-item Bystander Efficacy Scale by Banyard et al 2004 | pre, immediate post, 3 month follow up | 
| change in self-efficacy for bystander behaviors | measured via validated 10-item MVP Efficacy Scale by Ward 2001 | pre, immediate post, 3 month follow up | 
| change in decisional balance for bystander behaviors | measured via validated 10-item Bystander Decisional Balance Scale by Banyard 2004 | pre, immediate post, 3 month follow up | 
| change in normative beliefs around sexual violence | measured via validated 8-item Reaction to Offensive Language Scale--Comfort Subscale by Loh 2005 | pre, immediate post, 3 month follow up |