A Stage II Assessment of Mechanisms of Change and Efficacy of a Culturally Specific Intervention to Reduce Sexual Revictimization in College - Project Summary More than one third of women who experience sexual assault (SA) during college experience an additional SA, or sexual revictimization (SRV), before graduating. Comparison of negative consequences associated with SA and SRV (i.e., depression, anxiety, PTSD, suicide, substance use, reduced grades, missed classes) indicate that severity increases with multiple assaults. However, most SA programs do not include elements that are critical for preventing SRV for those at greatest risk: Women with a history of SA victimization, heavy drinkers, and women of color. Therefore, a critical need exists to develop effective SA prevention programs for college women that include culturally specific elements, strategies to reduce heavy drinking, and a focus on the pernicious problem of SRV. In Stage 1a/1b research, we successfully developed and evaluated the feasibility and acceptability of the Revictimization Prevention for College Women (RPCW; R34 AA026910), a culturally specific intervention for Black and White college women that is designed to reduce SRV and heavy alcohol use. The RPCW is delivered over 4 hours in one week during two group sessions and two online learning units. Group sessions use culturally specific videos depicting heterosexual social situations embedded with risk cues for SRV, discussions about risk awareness, emotional responses and strategies for responding to risk, knowledge of potential barriers/alternatives to responding, and practice of assertive resistance to sexual threats. The online units focus on safe drinking and alcohol reduction strategies (e.g., normative feedback) and safe dating practices that complement the in-person sessions. Acceptability and feasibility of the RPCW were good and efficacy estimates (i.e., 65% relative risk reduction of SRV from baseline to 6-month follow-up; average decrease of 3.7 HED days from pre-intervention to 3-month follow-up) were promising. To build on the success of this Stage 1 research, we propose to conduct a fully powered Stage II Efficacy Trial to test the culturally specific RPCW compared to an appropriate control (health education time and attention control) over a 6-month follow-up period with a sample of 840 college women (50% Black) at two universities. In addition, we will test two mechanisms of behavioral change through which the RPCW decreases risk for SRV: (1) increased recognition of SA risk cues, and (2) decreased heavy drinking. The first mechanism involves the RPCW’s focus on improving SA risk recognition, which will provide women with the opportunity to recognize a sexual threat and choose an assertive response to decrease SRV. The second mechanism involves the RPCW’s inclusion of an alcohol intervention to decrease heavy drinking and consequent intoxication in social situations and thus decrease likelihood of cognitive and physical impairment that could diminish risk recognition and assertive responding to sexual threat. Both putative mechanisms involve improving women’s ability to recognize risk and decide on and implement an assertive response to a sexual threat to prevent SRV. If the RPCW is found to be effective, findings will be used to move to a Stage III Implementation Trial.
