Friend-based Intervention to Reduce Alcohol-Involved Sexual Assault Risk

ABSTRACT Approximately 1 in 5 U.S. college women is sexually assaulted and nearly half of these assaults involve alcohol. Alcohol-involved sexual assault (AISA) often occurs in social settings, and “bystander” interventions have been developed to incorporate the social environment into prevention efforts. Friends are central to the context of SA, as they are often present in social settings where SA risk begins to unfold. Friends are in an optimal position to identify risk as it emerges, and to take bystander action to prevent assault. Thus, friends are a logical focus for AISA intervention. In a Phase I study (R34 AA027046; Read/Livingston), our team completed the development and initial test of an innovative, friend-based motivational interviewing (FMI) intervention to reduce AISA risk. Delivered to pairs of friends (dyads) who socialize together, the intervention (Protecting Allies in Risky Situations; PAIRS) is designed to foster collaborative efforts to increase readiness for, and decrease barriers to helping behavior, and to plan together for assault prevention skills. In developmental studies women found our PAIRS FMI to be accessible, practical, empowering, and personally relevant. Our preliminary data also offered support for the effect of PAIRs on key targets, including readiness to intervene, decreasing barriers to helping behavior, and increasing friend-based assault protective behavior skills. The next step is to examine this intervention’s efficacy on a larger scale and against an active control condition. Accordingly, we now propose to conduct a Phase 2 trial to examine the efficacy of the PAIRS MI with a treatment-as-usual (TAU) condition, following participants over 1-year post-intervention (Aim 1). This larger trial also will address some key questions about mechanisms of intervention effects (Aim 2). This includes examination of target attitudes (readiness, perceived barriers) behaviors (protective behaviors), and the dyadic relationship as mechanisms of intervention outcome (mediation). A notable limitation of the extant literature on dyad-based MI is that studies have not taken partner effects into account. As a result, the complex and sometimes inter-dependent nature of change between two people who participate in an intervention together is not understood. Accordingly, in this study, we will examine both independent (i.e., effects of the intervention on each dyad member) and interdependent intervention effects (effects of the intervention through the partner). This Phase 2 trial will help to examine the efficacy of an intervention that harnesses the power of friends to address the significant public health problem of campus-based sexual assault. This study also will shed needed light on the mechanisms and complex nature of dyadic change that occurs in response to such an intervention. If successful, findings will lay the groundwork for a Phase 3 intervention trial.