Reducing Alcohol Involved Sexual violence in higher Education (RAISE)

This is a competitive renewal of a stakeholder-engaged study across 28 college campuses focused on tailored harm reduction interventions to reduce risk for sexual violence (SV) among undergraduate college students receiving care from college health and counseling centers (CHCs). “Reducing Alcohol Involved Sexual violence in higher Education (RAISE)” is a longitudinal study that builds on a previous cluster-randomized controlled trial on college campuses in Pennsylvania and West Virginia (R01 AA023260). We aim to reach students at elevated risk for SV and hazardous drinking, who are likely to seek care from CHCs as documented in our previous study. SV, particularly alcohol-involved SV, remains highly prevalent on college campuses. Our previous study found that a large proportion of students seeking care in CHCs have experienced SV victimization (n=2291, 64% of women, 32% of men report lifetime SV) which is associated with binge drinking. The previous RCT involved training CHC staff to deliver a brief educational intervention to reduce SV risk, titled “Giving Information for Trauma Support and Safety” (GIFTSS), to all students seeking care. Implementation varied across CHCs. Among students who received GIFTSS as intended, we found significant increases in self-efficacy to use harm reduction strategies and SV-related services. Students with history of SV had greater than four-fold increase in odds of disclosing this history to providers. We identified provider-, clinic- and campus-level changes needed to improve intervention delivery. To more directly target use of harm reduction strategies among students at elevated risk for SV and hazardous drinking, we also propose to integrate a safety decision aid (myPlan app for use on smartphone or computer) which increases harm reduction behaviors among college women experiencing partner violence. The focus of this renewal is to 1) test strategies to improve implementation of GIFTSS, 2) offer support for students at elevated risk for SV and hazardous drinking with tailored harm reduction strategies delivered via the myPlan app after the clinic visit, and 3) strengthen campus policies to promote access to SV services and reduce hazardous drinking. A 2x2 cluster randomized controlled trial will compare two implementation strategies for GIFTSS in CHCs (provider scripts vs. learning collaborative) focusing on undergraduate students ages 18-24 (N= 2400 across 28 campuses) with follow-up at 4 months and 12 months (Aim 1). We will evaluate the effectiveness of myPlan in increasing uptake of tailored harm reduction strategies for those at elevated risk for SV and hazardous drinking (Aim 2). Finally, we will assess for alcohol and SV policy changes on each campus that may increase access to and uptake of confidential services among students at elevated risk for hazardous drinking and SV (Aim 3).