College Health Center-based Alcohol and Sexual Violence Intervention

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).

Inclusion Criteria:

- Ages 18-24

- Able to read English

- Seeking care at the college health center for any reason

Exclusion Criteria:

- Younger than 18 or older than 24 years

- Not seeking care at the college health center