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Perkins JM, Kakuhikire B, Baguma C, Meadows M, Abayateye R, Rasmussen JD, Satinsky EN, Gumisiriza P, Kananura J, Namara EB, Bangsberg DR, Tsai AC. Water Treatment Practices and Misperceived Social Norms among Women Living with Young Children in Rural Uganda. Am J Trop Med Hyg 2024; 111:627-637. [PMID: 38981491 PMCID: PMC11376185 DOI: 10.4269/ajtmh.23-0723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 01/26/2024] [Indexed: 07/11/2024] Open
Abstract
Access to water safe for consumption is critical for health and well-being, yet substantial structural barriers often necessitate household action to make water safer. Social norms about water treatment practices are understudied as a driver of personal water treatment practice. This study assesses reported and perceived water treatment practices among women in a rural, water insecure setting. We used cross-sectional data from a population-based study of women living with children under 5 years old across eight villages in southwest Uganda. Participants reported their typical household water treatment practices and what they perceived to be the common practices among most other women with young children in their own village. Modified multivariable Poisson regression models estimated the association between individual behavior and perceptions. Of 274 participants (78% response rate), 221 (81%) reported boiling water and 228 (83%) reported taking at least one action to make water safer. However, 135 (49%) misperceived most women with young children in their village not to boil their water, and 119 (43%) misperceived most to take no action. Participants who misperceived these norms were less likely to practice safe water treatment (e.g., for boiling water, adjusted relative risk = 0.80; 95% CI 0.69-0.92, P = 0.002), adjusting for other factors. Future research should assess whether making actual descriptive norms about local water treatment practices visible and salient (e.g., with messages such as "most women in this village boil their drinking water") corrects misperceived norms and increases safe water treatment practices by some and supports consistent safe practices by others.
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Affiliation(s)
- Jessica M Perkins
- Department of Human and Organizational Development, Peabody College, Vanderbilt University, Nashville, Tennessee
- Vanderbilt University Medical Center, Nashville, Tennessee
| | | | - Charles Baguma
- Mbarara University of Science and Technology, Mbarara, Uganda
| | - Meredith Meadows
- Department of Human and Organizational Development, Peabody College, Vanderbilt University, Nashville, Tennessee
| | | | | | - Emily N Satinsky
- Center for Global Health, Massachusetts General Hospital, Boston, Massachusetts
- Department of Psychology, University of Southern California, Los Angeles, California
| | | | - Justus Kananura
- Mbarara University of Science and Technology, Mbarara, Uganda
| | | | - David R Bangsberg
- Mbarara University of Science and Technology, Mbarara, Uganda
- VinUniversity, Hanoi, Vietnam
| | - Alexander C Tsai
- Mbarara University of Science and Technology, Mbarara, Uganda
- Center for Global Health, Massachusetts General Hospital, Boston, Massachusetts
- Harvard Medical School, Boston, Massachusetts
- Mongan Institute, Massachusetts General Hospital, Boston, Massachusetts
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McKenney EE, Cucchiara CL, Senanayake A, Gotham KO. "I Don't Care if it Would Kill the Mood. I'm Going to Use My Words": Perceptions and Use of Explicit Verbal Sexual Consent in Neurodiverse Undergraduate Students. JOURNAL OF SEX RESEARCH 2024:1-16. [PMID: 38904652 DOI: 10.1080/00224499.2024.2365273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/22/2024]
Abstract
Adults entering college, especially autistic individuals, may have a higher likelihood of unwanted or distressing sexual experiences. Additionally, autistic adults appear to endorse dissatisfying sexual education experiences and difficulties with consent cues. The current mixed-methods study examined the types of consent cues college students rely on and potential barriers to seeking sexual consent. We combined data from two studies of undergraduate students: 1) an in-person cross-sectional study exploring conceptualizations and interpretations of consent in autistic and non-autistic young adults (n = 30), and 2) an online, short-term longitudinal study examining predictors of mood concerns in neurodiverse students transitioning into their first semester at 4 northeastern United States university systems in Fall 2022 and 2023 (n = 230). In-person participants completed a semi-structured interview asking about consent expression and interpretation. Participants from both studies completed self-report surveys measuring autistic traits, attitudes and perceptions toward sexual consent, and sexual education history. Qualitative analysis suggested students preferred to rely on explicit verbal consent, but felt they were unusual for doing so. In contrast, quantitatively, students across both studies expressed comfort with explicit verbal consent, to a high and similar degree. Further research may benefit from investigating differences between young adults' perceived and actual sexual consent preferences of peers, with attention to neurodivergent individuals.
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Treat TA, Viken RJ, Westemeier O, Corbin WR. College men's use of protective behavioral strategies for sexual aggression, risky sexual behavior, and heavy episodic drinking. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2024; 38:360-371. [PMID: 37956027 PMCID: PMC11065594 DOI: 10.1037/adb0000965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2023]
Abstract
OBJECTIVE Sexually aggressive behavior (SAB), risky sexual behavior (RSB), and heavy episodic drinking (HED) are serious behavioral health problems among college men. The present study substantially revises and validates protective behavioral strategies (PBS) measures in the SAB and RSB domains; evaluates the relations among PBS usage in the SAB, RSB, and HED domains; and determines whether college men with SAB, RSB, or HED histories report lower PBS usage. METHOD College students who identified as men (n = 1,121) completed measures of PBS, SAB, RSB, HED, rape-supportive attitudes, sociosexuality, and bar/party attendance. RESULTS Factor analyses resulted in three PBS scales (SAB, RSB-General, and RSB-Protection) that showed good fit and cross-validated well. Average scores for all four PBS measures converged moderately to strongly. Men reporting histories of SAB, RSB, or HED reported much lower domain-specific PBS use, and domain-specific PBS predicted concurrent SAB, RSB, or HED in the presence of other established predictors. CONCLUSIONS Four well-developed and validated PBS measures now provide an expanded set of potential harm-reduction strategies for college men who drink and engage in sexual activity. Given the strong concurrent associations between PBS use and problems, as well as the interrelatedness of PBS use across domains, future research should examine the impact of simultaneous personalized normative feedback on PBS use across alcohol and sexual domains. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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Scaglione NM, Ward RM, Buben A, Turrisi R. Alcohol's Role in Sexual Decision Making in First-Year College Women: An Event-Level Assessment. PSYCHOLOGY OF WOMEN QUARTERLY 2024; 48:121-132. [PMID: 38895110 PMCID: PMC11185828 DOI: 10.1177/03616843231186319] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/21/2024]
Abstract
Sexual decision making is often grounded in social scripts that can be detrimental to women's healthy relationship and sexual development during the transition to college. Little is known about the malleable decision-making processes and drinking behaviors that influence sexual behaviors from day-to-day. We examined whether women were more likely to engage in sexual behaviors on days they had higher intentions and willingness to engage in sex or drink alcohol. We also explored interactions between sex- and alcohol-related decision constructs. Eighty-two first-year college women completed 14-days of ecological momentary assessment, reporting on alcohol- and sex-related intentions and willingness (3x daily) and daily drinking and sexual behaviors. We found partial support for our hypotheses: intentions and willingness to have sex were positively associated with sex behaviors, but willingness to drink was negatively associated with sex behaviors. Heavy drinking was associated with sexual behavior, even when women indicated no prior willingness to engage in sexual behavior on those days. Findings highlight the need to address event-level variability in sexual decision making, with a particular focus on how alcohol impacts these processes. Further, the robust association between sexual intentions and behavior suggests intention setting may be a particularly useful sexual empowerment education tool.
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Affiliation(s)
- Nichole M. Scaglione
- Department of Health Education and Behavior, University of Florida, Gainesville, FL
| | - Rose Marie Ward
- The Graduate School & Department of Psychology, University of Cincinnati, Cincinnati, OH
| | - Alex Buben
- Center for Behavioral Health Epidemiology, Implementation, and Evaluation Research, Community Health Research Division, RTI International, Research Triangle Park, NC
| | - Rob Turrisi
- Department of Biobehavioral Health & Bennett Pierce Prevention Research Center, The Pennsylvania State University, University Park, PA
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Todaro SM, Schulz CT, Rothstein M, Stamates AL, Ehlke S, Kelley M. Normative Perceptions of Sexual Behavior and Alcohol Use among Bisexual Women. Subst Use Misuse 2024; 59:785-791. [PMID: 38229244 DOI: 10.1080/10826084.2024.2302150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2024]
Abstract
Background: As compared to heterosexual and lesbian women, bisexual women report higher rates of alcohol, other substance use, and risky sexual behavior, and they experience more negative outcomes from these behaviors. Descriptive norms (i.e., perceptions of others' behavior) are an important predictor of risky behaviors, but scant research has examined whether bisexual women's perceptions of other bisexual women's alcohol use and sexual behavior are associated with their own alcohol or drug use during sex. Objectives: Consequently, the present study examined (1) whether perceived sex norms were related to engagement in sex and (2) the relative influence of drinking and sex norms on engaging in sex while drinking among bisexual women. Method: Data were collected from 225 self-identified bisexual women who completed an online survey about their typical weekly alcohol use, engagement in alcohol or drug use during sex in the past 30 days, and normative perceptions of drinking and sexual behavior. Results: Regression models demonstrated both sexual norms and drinking frequency norms were positively associated with alcohol or drug use during sex. In addition, only perceived norms of other bisexual women, compared to perceived norms of lesbian and heterosexual women, predicted engagement in sex. Conclusions: Bisexual women may be susceptible to normative perceptions, given their connectedness to a marginalized social group. Thus, alcohol prevention and intervention efforts aimed at reducing risky consequences among bisexual women should specifically consider drinking and sexual norms of other bisexual women.
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Affiliation(s)
| | | | | | | | - Sarah Ehlke
- Old Dominion University, Norfolk, Virginia, USA
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Anderson JC, Nguyen MU, Huynh W, Sharif K, Moret JED. Enhancing Campus Safety: Exploring Student Perspectives on a Text Message-Delivered Intervention for Addressing Sexual Violence and Alcohol Use. JOURNAL OF FORENSIC NURSING 2024; 20:30-42. [PMID: 38019029 PMCID: PMC10922041 DOI: 10.1097/jfn.0000000000000454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2023]
Abstract
BACKGROUND Alcohol-related sexual violence, including sexual coercion, nonconsensual contact, and rape, is prevalent on college campuses. AIM The purpose of the study was to investigate college students' feedback and recommendations regarding content for a text-message-delivered harm reduction intervention to jointly address alcohol use and alcohol's role in sexual violence risk. METHODS This qualitative thematic study used focus groups and individual interviews to collect feedback from 61 college students between February 2019 and July 2020. RESULTS Targeted recruitment resulted in a sample that was nearly half queer/ lesbian, gay, bisexual (46.2%) or trans* (9.8%) identified students. Participants endorsed text messaging as an effective way to reach college students but diverged in specific content they felt was relevant and appropriate for a universal education intervention. Students preferred content describing individual strategies versus those requiring collaboration from friends or potential sex partners. Students also preferred content phrased as suggestions or questions versus declarative statements. Although most participants recognized the value of content related to consent, sexual violence, sexual health, and resources, a few male-identifying participants failed to recognize that content as important to their experience. Maintaining brevity while discussing consent in the overlapping settings of drinking and interpersonal relationships was described as a particular challenge. IMPACT OF THIS WORK ON CAMPUS SEXUAL ASSAULT AND FORENSIC NURSING Students in our sample highlighted the challenges of sharing sexual violence and alcohol-related harm reduction text messaging because of the complexities of rape culture, consent, and interpersonal dynamics during college student drinking events.
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Affiliation(s)
- Jocelyn C. Anderson
- Associate Professor; College of Nursing, University of Arkansas for Medical Science; 4301 West Markhan Street, Slot 529, Little Rock, AR 72205
| | - Meghan U. Nguyen
- Undergraduate Research Assistant; Ross and Carol Nese College of Nursing, Pennsylvania State University
| | - Wendy Huynh
- Undergraduate Research Assistant; Ross and Carol Nese College of Nursing, Pennsylvania State University
| | - Khadeeja Sharif
- Undergraduate Research Assistant; Ross and Carol Nese College of Nursing, Pennsylvania State University
| | - Jessica E. Draughon Moret
- Associate Professor; Betty Irene Moore School of Nursing, University of California, Davis @DrDraughon
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Wiseblatt AF, Testa M, Read JP. Do Risk Factors for Incapacitated and Other Sexual Assault Differ for Black and White College Women? A Preliminary Investigation. Violence Against Women 2023:10778012231216717. [PMID: 38018096 PMCID: PMC11130078 DOI: 10.1177/10778012231216717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2023]
Abstract
Heavy episodic drinking (HED) and hookups are risk factors for college women's sexual assault (SA). Black women engage in these behaviors less frequently than White women. We prospectively examined HED and hookups as mechanisms of incapacitated SA (ISA) and other SA (OSA) risks for Black and White first-year college women and sociocontextual factors that may contribute differentially to risk. In mediation analyses, Black women's less frequent HED predicted lower ISA. SA characteristics (e.g., setting) also differed by race. Mechanisms and types of assault risk may not be the same for all college women, an important consideration for intervention efforts.
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Affiliation(s)
| | - Maria Testa
- Department of Psychology, University at Buffalo, Buffalo, USA
- Clinical and Research Institute on Addictions, University at Buffalo, Buffalo, USA
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Beckmeyer JJ, Herbenick D, Eastman-Mueller H. Sexual pleasure during college students' most recent partnered sexual experiences. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023; 71:2550-2561. [PMID: 34634225 DOI: 10.1080/07448481.2021.1978461] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 07/16/2021] [Accepted: 09/05/2021] [Indexed: 06/13/2023]
Abstract
ObjectiveWe explored college students' sexual pleasure using a new self-report measure, the Body, Emotions, Sensations, Touch/Trust (B.E.S.T.) Scale of Sexual Pleasure. Participants: Data were from 3997 randomly sampled students with a partnered sexual experience. Methods: Students completed an online survey about their most recent partnered sexual experience. Data was collected in January 2020. Results: Students find the nonphysical aspects of partnered sex (e.g., emotions, trust, connection with partners) as pleasurable as physical aspects (e.g., behaviors engaged and received, bodily sensations). Self-reported arousal, wantedness, and emotional intimacy were the strongest correlates of male, female, and transgender/gender non-binary students' sexual pleasure. Few sexual behaviors were associated with sexual pleasure and only one - cuddling for women - was associated with greater sexual pleasure. Conclusions: Students find their partnered sexual experiences pleasurable. Students' sex may be more pleasurable when they feel ready for sex, desire sex, and feel close to their partners.
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Affiliation(s)
- Jonathon J Beckmeyer
- Department of Counseling and Learning Sciences, West Virginia University, Morgantown, West Virginia, USA
- Center for Sexual Health Promotion, Indiana University, Bloomington, Indiana, USA
| | - Debby Herbenick
- Center for Sexual Health Promotion, Indiana University, Bloomington, Indiana, USA
- Department of Applied Health Science, Indiana University, Bloomington, Indiana, USA
| | - Heather Eastman-Mueller
- Center for Sexual Health Promotion, Indiana University, Bloomington, Indiana, USA
- Department of Applied Health Science, Indiana University, Bloomington, Indiana, USA
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Schuster I, Tomaszewska P, Krahé B. A Theory-Based Intervention to Reduce Risk and Vulnerability Factors of Sexual Aggression Perpetration and Victimization in German University Students. JOURNAL OF SEX RESEARCH 2023; 60:1206-1221. [PMID: 36043887 DOI: 10.1080/00224499.2022.2105290] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The current study evaluated an intervention program, designed by the authors and based on the theory of sexual scripts and social learning theory, to reduce empirically established risk and vulnerability factors of sexual aggression. A sample of 1,181 university students in Germany (762 female) were randomly assigned to an intervention and a no-intervention control group. The intervention group completed six modules addressing established antecedents of sexual aggression perpetration and victimization: risky sexual scripts, risky sexual behavior, low sexual self-esteem, low sexual assertiveness, acceptance of sexual coercion, and perceived realism of pornography. After baseline (T1), intervention effects were measured one week after the last module (T2), nine months later (T3), and another 12 months later (T4). The intervention group showed significantly less risky sexual scripts and higher sexual self-esteem at T2, T3, and T4. The intervention indirectly reduced risky sexual behavior at T3 and T4 via less risky sexual scripts at T2 and increased sexual assertiveness at T3 and T4 via higher sexual self-esteem at T2. No intervention effects were found on the acceptance of sexual coercion and pornography realism. The implications of the findings for reducing the prevalence of sexual aggression perpetration and victimization are discussed.
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Affiliation(s)
| | | | - Barbara Krahé
- Department of Psychology, University of Potsdam, Germany
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10
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Bhuptani PH, Kenney SR, Napper LE, Orchowski LM. Pornography Use, Perceived Peer Norms, and Attitudes Toward Women: A Study of College Men. AMERICAN JOURNAL OF SEXUALITY EDUCATION 2023; 19:280-301. [PMID: 39171277 PMCID: PMC11335322 DOI: 10.1080/15546128.2023.2233414] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/23/2024]
Abstract
Men's negative attitudes toward women is a known risk factor for sexual aggression perpetration. Sexual aggression is a widespread public health concern, especially among emerging adults, and is associated with a multitude of negative consequences. The current study evaluated whether pornography-related perceived peer norms, own approval, and self-reported use are associated with negative attitudes towards women in a sample of college men. Types of pornography examined included: pornography (in general), pornography that included portrayals of bondage, whipping, and spanking but without explicit dissent (i.e., pornography that depicted bondage/physical aggression), as well as pornography consisting of sexually explicit rape depictions in which force is used. Self-report measures assessing the frequency of pornography exposure, self-acceptance of pornography use, and perceived peer norms were collected from 283 college men. A multiple linear regression model revealed that only perceived peer norms for acceptance of pornography that depicted rape was positively associated with negative attitudes toward women. Findings highlight the importance of better understanding and addressing perceived peer norms in sexual assault prevention programs for college men.
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Affiliation(s)
- Prachi H. Bhuptani
- Rhode Island Hospital
- Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Shannon R. Kenney
- Behavioral Medicine and Addictions Research, Butler Hospital, Providence, Rhode Island
- Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Lucy E. Napper
- Department of Psychology and Health, Medicine, and Society Program, Lehigh University
| | - Lindsay M. Orchowski
- Rhode Island Hospital
- Warren Alpert Medical School of Brown University, Providence, Rhode Island
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Kettrey HH, Thompson MP, Marx RA, Davis AJ. Effects of Campus Sexual Assault Prevention Programs on Attitudes and Behaviors Among American College Students: A Systematic Review and Meta-Analysis. J Adolesc Health 2023; 72:831-844. [PMID: 37037692 DOI: 10.1016/j.jadohealth.2023.02.022] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 12/30/2022] [Accepted: 02/15/2023] [Indexed: 04/12/2023]
Abstract
The US Campus Sexual Assault Violence Elimination (SaVE) Act of 2013 mandates that all higher education institutions receiving federal funds offer incoming students primary prevention and awareness programming addressing sexual violence. Yet, there is no thorough and up-to-date quantitative synthesis of the effects of campus sexual assault prevention programs on sexual assault attitudes/knowledge and behaviors. Thus, we conducted a systematic review of the literature and a meta-analysis of experimental and high-quality quasi-experimental research examining effects of college sexual assault prevention programs on sexual assault attitudes and behaviors. Our synthesis of 385 effect sizes from 80 eligible studies disseminated between 1991 and 2021 indicates campus sexual assault programs have a more pronounced effect on attitudes/knowledge than on violence. Effects on sexual assault victimization were significant but small (g = 0.15) and effects on sexual assault perpetration were nonsignificant. Moderator analyses indicate programs that use a risk reduction framework are associated with less favorable outcomes than programs that do not use a risk reduction framework. Considering the limited effect of campus sexual assault prevention programs on violence, we recommend programming efforts move beyond a focus on individuals and, instead, adopt an ecological perspective targeting individuals, social relationships, community factors, and societal factors.
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Affiliation(s)
- Heather Hensman Kettrey
- Department of Sociology, Anthropology and Criminal Justice, Clemson University, Clemson, South Carolina.
| | - Martie P Thompson
- Department of Public Health and Exercise Science, Appalachian State University, Boone, North Carolina
| | | | - Alyssa J Davis
- Department of Sociology, Vanderbilt University, Nashville, Tennessee
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Ray AE, Mun EY, Lewis MA, Litt DM, Stapleton JL, Tan L, Buller DB, Zhou Z, Bush HM, Himelhoch S. Cross-Tailoring Integrative Alcohol and Risky Sexual Behavior Feedback for College Students: Protocol for a Hybrid Type 1 Effectiveness-Implementation Trial. JMIR Res Protoc 2023; 12:e43986. [PMID: 36716301 PMCID: PMC10131715 DOI: 10.2196/43986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 01/04/2023] [Accepted: 01/23/2023] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Underage drinking and related risky sexual behavior (RSB) are major public health concerns on United States college campuses. Although technology-delivered personalized feedback interventions (PFIs) are considered a best practice for individual-level campus alcohol prevention, there is room for improving the effectiveness of this approach with regard to alcohol-related RSB. OBJECTIVE The aims of this study are to (1) evaluate the impact of a brief PFI that integrates content on alcohol use and RSB and is adapted to include a novel cross-tailored dynamic feedback (CDF) component for at-risk first-year college students and (2) identify implementation factors critical to the CDF's success to facilitate future scale-up in campus settings. METHODS This study uses a hybrid type 1 effectiveness-implementation design and will be conducted in 3 phases. Phase 1 is a stakeholder-engaged PFI+CDF adaptation guided by focus groups and usability testing. In phase 2, 600 first-year college students who drink and are sexually active will be recruited from 2 sites (n=300 per site) to participate in a 4-group randomized controlled trial to examine the effectiveness of PFI+CDF in reducing alcohol-related RSB. Eligible participants will complete a baseline survey during the first week of the semester and follow-up surveys at 1, 2, 3, 6, and 13 months post baseline. Phase 3 is a qualitative evaluation with stakeholders to better understand relevant implementation factors. RESULTS Recruitment and enrollment for phase 1 began in January 2022. Recruitment for phases 2 and 3 is planned for the summer of 2023 and 2024, respectively. Upon collection of data, the effectiveness of PFI+CDF will be examined, and factors critical to implementation will be evaluated. CONCLUSIONS This hybrid type 1 trial is designed to impact the field by testing an innovative adaptation that extends evidence-based alcohol programs to reduce alcohol-related RSB and provides insights related to implementation to bridge the gap between research and practice at the university level. TRIAL REGISTRATION ClinicalTrials.gov NCT05011903; https://clinicaltrials.gov/ct2/show/NCT05011903. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/43986.
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Affiliation(s)
- Anne E Ray
- Department of Health, Behavior & Society, College of Public Health, University of Kentucky, Lexington, KY, United States
| | - Eun-Young Mun
- Department of Health Behavior and Health Systems, School of Public Health, The University of North Texas Health Science Center at Fort Worth, Fort Worth, TX, United States
| | - Melissa A Lewis
- Department of Health Behavior and Health Systems, School of Public Health, The University of North Texas Health Science Center at Fort Worth, Fort Worth, TX, United States
| | - Dana M Litt
- Department of Health Behavior and Health Systems, School of Public Health, The University of North Texas Health Science Center at Fort Worth, Fort Worth, TX, United States
| | - Jerod L Stapleton
- Department of Health, Behavior & Society, College of Public Health, University of Kentucky, Lexington, KY, United States
| | - Lin Tan
- Department of Health Behavior and Health Systems, School of Public Health, The University of North Texas Health Science Center at Fort Worth, Fort Worth, TX, United States
| | | | - Zhengyang Zhou
- Department of Biostatistics and Epidemiology, School of Public Health, The University of North Texas Health Science Center at Fort Worth, Fort Worth, TX, United States
| | - Heather M Bush
- Department of Biostatistics, College of Public Health, University of Kentucky, Lexington, KY, United States
| | - Seth Himelhoch
- Department of Psychiatry, College of Medicine, University of Kentucky, Lexington, KY, United States
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Kilpatrick DG, Hahn CK. Understanding and Addressing Alcohol and Sexual Violence: We Have Made Progress but Still Have Miles to Go. NEBRASKA SYMPOSIUM ON MOTIVATION 2023. [DOI: 10.1007/978-3-031-24426-1_7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/29/2023]
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Parrott DJ, Leone RM, Schipani-McLaughlin AM, Salazar LF, Nizam Z, Gilmore A. Alcohol-Related Sexual Violence Perpetration Toward Sexual and Gender Minority Populations: A Critical Review and Call to Action. NEBRASKA SYMPOSIUM ON MOTIVATION 2023. [DOI: 10.1007/978-3-031-24426-1_5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/28/2023]
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15
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Perceptions About Local ART Adherence Norms and Personal Adherence Behavior Among Adults Living with HIV in Rural Uganda. AIDS Behav 2022; 26:1892-1904. [PMID: 35034237 DOI: 10.1007/s10461-021-03540-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/22/2021] [Indexed: 01/08/2023]
Abstract
Although misperceived norms often drive personal health behaviors, we do not know about this phenomenon in the context of antiretroviral therapy (ART) adherence. We conducted a cross-sectional study including all persons living with HIV (PLWH) on ART across eight villages in one parish in a rural region of southwestern Uganda. We used surveys to measure personal reports of ART adherence (not missing any doses of ART in the past 7 days was considered optimal adherence whereas missing doses was considered suboptimal adherence) and perceived norms about the local ART adherence norm (whether or not each individual thought 'most other PLWH on ART in this parish' missed any doses in the past 7 days). Multivariable Poisson regression models were used to estimate the association between perceived norms and personal adherence. Among 159 PLWH on ART (95% response rate), 142 (89%) reported no missed doses. However, 119 (75%) thought most individuals in this population of PLWH on ART were sub-optimally adherent. This misperception about the local ART adherence norm was prevalent in every subgroup of PLWH. Misperceiving the local ART adherence norm to be sub-optimal adherence was associated with a reduced likelihood of optimal adherence among married PLWH (adjusted relative risk [aRR] = 0.83; 95% confidence interval [CI] 0.71-0.97). The association was similar but imprecisely estimated for all PLWH (aRR = 0.91; 95% CI 0.82-1.01). Interventions to correct misperceived ART adherence norms as a stand-alone intervention or as a complement to other adherence promotion programs may influence ART adherence behavior and perhaps reduce HIV-related stigma.
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Sell NM, Testa M. Is bringing one's own alcohol to parties protective or risky? A prospective examination of sexual victimization among first-year college women. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2022; 70:968-972. [PMID: 32693704 PMCID: PMC7856164 DOI: 10.1080/07448481.2020.1791883] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 06/15/2020] [Accepted: 06/28/2020] [Indexed: 05/03/2023]
Abstract
ObjectiveThis study assessed whether college women who bring their own alcohol to parties (BYOB) are less vulnerable to sexual victimization (SV). Participants: Participants were 652 female freshmen (M age = 18.04 years) at a large, public university. Methods: Women were recruited by email to complete online surveys of their drinking-related behaviors and sexual experiences in September (T1) and November (T2) of their first college semester. Results: Approximately 47% of our sample reported BYOB. Women who reported BYOB more frequently at T1 were more likely to report SV at T2 when accounting for risk factors, including prior SV, heavy episodic drinking, and hookups. Specifically, BYOB predicted contact and rape, but not coercion. Conclusions: Findings suggested BYOB does not prevent college SV, but rather may increase risk. We encourage college health professionals and researchers to target BYOB to better understand this common behavior and help students recognize potential for associated harm.
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Affiliation(s)
- Nichole M. Sell
- Clinical and Research Institute on Addictions and Department of Psychology, University at Buffalo, Buffalo, New York, United States
| | - Maria Testa
- Clinical and Research Institute on Addictions and Department of Psychology, University at Buffalo, Buffalo, New York, United States
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Testa M. What Are the Chances? Perceived Risk of Sexual Victimization for Self and Others Among College Women. VIOLENCE AND VICTIMS 2022; 37:141-162. [PMID: 35165164 DOI: 10.1891/vv-d-20-00170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Awareness of vulnerability to a negative outcome is considered a necessary first step to risk reduction and prevention behaviors. Accordingly, sexual assault awareness programs have sought to inform college students of the prevalence of college sexual victimization and the risk factors that contribute. The goal of the current study was to consider the degree to which incoming college freshman women recognize their risk of experiencing sexual victimization and to examine whether risk factors such as alcohol use contribute to those perceived chances. Freshman women (N = 252) were recruited via email early in the Fall semester to participate in an online survey. As expected, women perceived their own chances of sexual victimization (21.4%) to be lower than those of the average freshman at the same university (43.7%). Prior sexual victimization, typical drinking, and expected hookups predicted higher perceived risk of being victimized. Only prior victimization predicted higher perceived risk of sexual victimization for others. On average, freshman women acknowledge their substantial risk of experiencing sexual victimization during their first year of college and overestimate the chances that others will be victimized. Findings show high awareness of sexual assault and its risk factors among college students but point toward a need for prevention that goes beyond education and awareness campaigns.
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Affiliation(s)
- Maria Testa
- Department of Psychology, Clinical and Research Institute on Addictions, University at Buffalo
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18
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Perkins JM, Kakuhikire B, Baguma C, Jurinsky J, Rasmussen JD, Satinsky EN, Namara E, Ahereza P, Kyokunda V, Perkins HW, Hahn JA, Bangsberg DR, Tsai AC. Overestimation of alcohol consumption norms as a driver of alcohol consumption: a whole-population network study of men across eight villages in rural, southwestern Uganda. Addiction 2022; 117:68-81. [PMID: 34159646 PMCID: PMC8759576 DOI: 10.1111/add.15615] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 01/20/2021] [Accepted: 05/09/2021] [Indexed: 01/03/2023]
Abstract
BACKGROUND AND AIMS Little is known about how perceived norms about alcohol consumption may influence high alcohol consumption rates in Uganda. This study estimated the accuracy of perceived norms about men's alcohol consumption and estimated the association between perceived norms and personal alcohol consumption. DESIGN Cross-sectional, whole-population, sociocentric social network study. SETTING Eight rural villages in Rwampara District, southwestern Uganda in 2016-18. PARTICIPANTS A total of 719 men aged 18 years and older (representing 91% of permanent resident men). MEASUREMENTS Self-reported frequent (≥ 4 days per week) and heavy alcohol consumption (six or more drinks on one occasion, more than three occasions of intoxication, or spending an excessive amount on alcohol). Participants also reported whether they thought most other men in their village engaged in frequent and heavy alcohol consumption (perceived norms). Using the network study design, we calculated alcohol consumption behavior within villages and social networks. Perceived norms were compared with aggregated self-reports. Multivariable Poisson regression models were used to estimate the association between perceived norms and individual behavior. FINDINGS Throughout villages, frequent and heavy alcohol consumption ranged from 7 to 37%. However, 527 (74%) participants perceived, contrary to fact, that most other men in their villages frequently consumed alcohol, and 576 (81%) perceived that most others heavily consumed alcohol. Overestimation of alcohol consumption by others was pervasive among socio-demographic subgroups and was present irrespective of the actual consumption behavior at the village level and within social networks. Men who misperceived these alcohol consumption behaviors as being common were more likely to engage in frequent [adjusted relative risk (aRR) = 3.98; 95% confidence interval (CI) = 1.69-9.34) and heavy (aRR = 4.75; 95% CI = 2.33-9.69) alcohol consumption themselves. CONCLUSIONS Most men in eight rural Ugandan villages incorrectly thought that frequent and heavy alcohol consumption were common among men in their villages. These misperceived norms had a strong positive association with individual drinking behavior.
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Affiliation(s)
- Jessica M. Perkins
- Peabody College of Education and Human Development, Vanderbilt University, Nashville, TN, USA,Vanderbilt Institute of Global Health, Vanderbilt University Medical Center, Nashville, TN, USA,Corresponding author: Dr. Jessica M. Perkins, , Phone: (615) 875-3289, Fax: 615-343-2661
| | | | - Charles Baguma
- Mbarara University of Science and Technology, Mbarara, Uganda
| | - Jordan Jurinsky
- Peabody College of Education and Human Development, Vanderbilt University, Nashville, TN, USA
| | | | - Emily N. Satinsky
- Center for Global Health, Massachusetts General Hospital, Boston MA USA
| | | | - Phionah Ahereza
- Mbarara University of Science and Technology, Mbarara, Uganda
| | - Viola Kyokunda
- Mbarara University of Science and Technology, Mbarara, Uganda
| | | | - Judith A. Hahn
- University of California at San Francisco, San Francisco, CA, USA
| | - David R. Bangsberg
- Mbarara University of Science and Technology, Mbarara, Uganda,Oregon Health & Science University-Portland State University School of Public Health, Portland, OR, USA
| | - Alexander C. Tsai
- Mbarara University of Science and Technology, Mbarara, Uganda,Center for Global Health, Massachusetts General Hospital, Boston MA USA,Harvard Medical School, Boston, MA, USA,Mongan Institute, Massachusetts General Hospital, Boston MA USA
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Krahé B, Berger A. Pathways from College Students' Cognitive Scripts for Consensual Sex to Sexual Victimization: A Three-Wave Longitudinal Study. JOURNAL OF SEX RESEARCH 2021; 58:1130-1139. [PMID: 34494461 DOI: 10.1080/00224499.2021.1972922] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Sexual scripts serve as cognitive representations of typical elements of sexual interactions that guide sexual behavior. To the extent that cognitive scripts for consensual sex comprise elements associated with a risk of experiencing nonconsensual sex, they may be indirectly linked to sexual victimization via risky sexual behavior. A longitudinal study with 2,425 college students in Germany (58% female) examined pathways from sexual scripts for consensual sex, sexual behavior, and sexual victimization over three data waves separated by 12-month intervals. Sexual scripts and behavior were defined as risky to the extent that they include known vulnerability factors for sexual victimization (casual sex, alcohol consumption, ambiguous communication of sexual intentions). Path analyses confirmed that more risky sexual scripts prospectively predicted more risky sexual behavior, which predicted higher odds of sexual victimization. The findings held for men and women and participants with exclusively opposite-sex and both same- and opposite-sex contacts. Moreover, reciprocal influences between risky scripts and risky sexual behavior were found over time, confirming the proposed mutual reinforcement of scripts and behavior. The findings have implications for conceptualizing the role of scripts for consensual sex as vulnerability factors for sexual victimization among women and men and may inform intervention efforts.
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Affiliation(s)
- Barbara Krahé
- Department of Psychology, University of Potsdam (Germany)
| | - Anja Berger
- Department of Psychology, University of Potsdam (Germany)
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Wesche R, Claxton SE, Waterman EA. Emotional Outcomes of Casual Sexual Relationships and Experiences: A Systematic Review. JOURNAL OF SEX RESEARCH 2021; 58:1069-1084. [PMID: 32991206 PMCID: PMC8579856 DOI: 10.1080/00224499.2020.1821163] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
Casual sexual relationships and experiences (CSREs) are common and emotionally significant occurrences. Given the uncommitted, often emotionally complicated nature of CSREs, researchers have asked whether these experiences may have positive and/or negative emotional consequences. We reviewed 71 quantitative articles examining emotional outcomes of CSREs, including subjective emotional reactions (e.g., excitement, regret) and emotional health (e.g., depression, self-esteem). Overall, people evaluated their CSREs more positively than negatively. In contrast, CSREs were associated with short-term declines in emotional health in most studies examining changes in emotional health within a year of CSRE involvement. Emotional outcomes of CSREs differed across people and situations. Women and individuals with less permissive attitudes toward CSREs experienced worse emotional outcomes of CSREs. Alcohol use prior to CSREs, not being sexually satisfied, and not knowing a partner well were also associated with worse emotional outcomes. These findings suggest directions for prevention/intervention related to CSREs. For example, skill-building related to sexual decision-making may help individuals decide whether, and under what circumstances, CSREs are likely to result in positive or negative emotional outcomes. In addition, the limitations of extant research suggest directions for future inquiry (e.g., examining whether verbal and nonverbal consent practices predict emotional outcomes of CSREs).
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Affiliation(s)
- Rose Wesche
- Department of Human Development and Family Science, Virginia Polytechnic Institute and State University, Blacksburg, VA
| | | | - Emily A. Waterman
- Nebraska Center for Research on Children, Youth, Families and Schools, University of Nebraska-Lincoln, Lincoln, NE
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21
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Prentice D, Paluck EL. Engineering social change using social norms: lessons from the study of collective action. Curr Opin Psychol 2020; 35:138-142. [PMID: 32746001 DOI: 10.1016/j.copsyc.2020.06.012] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 06/22/2020] [Accepted: 06/23/2020] [Indexed: 12/14/2022]
Abstract
Behavioral interventions have embraced social norms as information that can be communicated in simple messages to motivate behavior change. This article argues for the value and necessity of recognizing that social-norm interventions are grounded in group processes. This approach has three major benefits that more than offset the costs of its greater theoretical and practical complexity. One, it improves the effectiveness of existing interventions, including those that target the normative beliefs of individuals. Two, it opens up new intervention strategies that broaden the range of mechanisms used to change behavior. Three, it connects research on social-norm interventions with theories and research on rallies, rebellions, riots, and other forms of collective action.
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Affiliation(s)
- Deborah Prentice
- Peretsman Scully Hall, Princeton University, Princeton, NJ, USA.
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