A Brief Computer-Based Sexual Assault Risk Reduction Program: A Feasibility,Acceptability,and Preliminary Efficacy Pilot Study

Abstract

Sexual victimization among college women is a common problem, necessitating the development of risk reduction programs that are both effective and acceptable to this population. Computer-based programs may be a cost- and time-effective option. This pilot study sought to examine the feasibility, acceptability, and preliminary efficacy of a computer-based risk reduction program. A total of 136 collegiate women were randomly assigned to receive either a computer-based risk reduction program or an educational program about campus resources (active control condition). Measures included predicted use of resistance techniques, risk detection, and acceptability of the program. No participants dropped out of the study, and acceptability ratings were generally high. Women reported learning new material from the program, preferring the computer-based program to large-group programs, and believing that other undergraduate women would benefit from the program. Furthermore, women reported they did not experience significant emotional disturbance due to the material. In addition, postintervention, the risk reduction program group had significantly better risk detection compared with the control group. The control group evidenced a reduction in predicted use of assertive resistance between pre- and postintervention assessments, while the risk reduction program group did not. Given preliminary support for the feasibility, acceptability, and preliminary efficacy of a brief, computerized risk reduction program, further research on computerized, online risk reduction programs, such as the one in this study, appears warranted.

Keywords

sexual assault risk reduction programs technology-based interventions

Sexual assault remains a prevalent issue on college campuses. Despite an increase in research on sexual victimization and risk reduction programs, rates of victimization remained relatively stable between the 1980s and early 2000s (Rozee & Koss, 2001). In fact, more than one fourth (26.2%) of collegiate women in one study reported experiencing a sexual assault during a 6-month period (Gidycz et al., 2007), and prevalence of sexual assault in a longitudinal study of undergraduate women ranged from approximately one fifth to one fourth (19.6% to 24.2%) in a single semester (Jordan, Combs, & Smith, 2014).

Because of the high rates of sexual victimization and the considerable negative outcomes (e.g., posttraumatic stress disorder, depression, sleep difficulties; Boudreaux, Kilpatrick, Resnick, Best, & Saunders, 1998; Sarkar & Sarkar, 2005) that many survivors experience, researchers need to identify effective risk reduction programs. It is important to note that to effectively prevent incidents of sexual assault, we must enact social change and develop programs to decrease the likelihood that individuals will engage in acts of sexual perpetration (Rozee & Koss, 2001). It is also generally believed that no prevention program can completely eliminate sexual assault (Yeater & O’Donohue, 1999). Therefore, teaching women about sexual assault, including ways to reduce risk of being victimized and increase the likelihood of escaping risky sexual situations, is necessary and worthy of investigation (Rozee & Koss, 2001). The purpose of the current pilot study was to examine the feasibility, acceptability, and preliminary efficacy of a computer-based risk reduction program.

Risk Detection and Resistance Techniques

Risk detection and use of assertive resistance strategies are two potentially modifiable behaviors that may affect women’s risk of sexual victimization. Women must be able to perceive that an interaction is becoming dangerous to know that she should react, which makes recognition of risk important for reducing odds of sexual assault (Norris, Nurius, & Dimeff, 1996). When in a risky or violent sexual situation, women can react in a variety of ways, and they often implement multiple resistance techniques prior to and during victimization (Gidycz, Van Wynsberghe, & Edwards, 2008). These different resistance techniques are not equally effective. Specifically, forceful and assertive techniques, such as fighting back, screaming, and fleeing, are more effective than nonforceful verbal resistance, such as pleading (see Anderson & Cahill, 2015, for a review). While, women may choose not to use assertive resistance techniques out of fear that they will experience worse physical injuries, researchers have found that there is no relationship between strategies used to resist and physical injuries incurred (Tark & Kleck, 2014).

Despite research demonstrating the effectiveness of assertive resistance, Ullman (1998) found that only 8.1% of women who reported a founded (i.e., supported) sexual assault to the police indicated that they used forceful physical resistance during the assault. Nearly 70% of a sample of college women who were victimized reported that they did not use any assertive resistance techniques, and almost half (47%) reported that they used nonforceful verbal resistance (Gidycz et al., 2008), which, as noted above, has been found to be ineffective (Ullman & Knight, 1993).

Sexual Assault Risk Reduction Programs

Most factors that increase risk of sexual assault can be conceptualized as variables that affect either risk detection or responses to risk (Messman-Moore & Long, 2003). Consistent with this idea, most sexual assault risk reduction programs are designed based on the idea that if a woman can detect that a situation is becoming dangerous, she can engage in more effective resistance (Rozee & Koss, 2001). Many programs also aim to increase use of assertive resistance techniques (Orchowski, Gidycz, & Raffle, 2008). Recently, it has been recommended that programs also address how to deal with psychological barriers that would make the use of assertive resistance techniques unlikely (e.g., embarrassment, fear of rejection, social anxiety; Gidycz, Rich, Orchowski, King, & Miller, 2006).

The Ohio University Sexual Assault Risk Reduction Program (Gidycz et al., 2001; Gidycz, Rich, et al., 2006) provides women with information about sexual assault and its prevalence (particularly local statistics), as well as two videos—I Thought It Could Never Happen to Me (Gidycz, Dowdall, Lynn, Marioni, & Loh, 1997) and Sexual Assault Risk Factors: A Training Video (Gidycz, Loh, et al., 1997). The first video consists of interviews with college women who have experienced a rape, and the second video highlights risk factors during a portrayal of a date rape (Gidycz et al., 2001). Unfortunately, the program did not reduce the likelihood of experiencing sexual assault during either of the follow-up periods, but participants who received the risk reduction program and who experienced moderate victimization during the first follow-up period were less likely to be revictimized during the second follow-up period than those in the control condition (Gidycz et al., 2001). The addition of self-defense training did not reduce risk of victimization during the follow-up periods (Gidycz, Rich, et al., 2006). Although addition of discussion about psychological barriers that could interfere with the use of the resistance techniques also did not affect rates of victimization when defined broadly, the intervention group did evidence lower rates of rape compared to the placebo group (Orchowski et al., 2008).

While these studies represent admirable efforts to reduce women’s risk of victimization on college campuses, the programs examined in these studies were delivered in a large-group format. Group administration requires the availability of a large number of participants at the same time (e.g., convening all incoming students during orientation), and individuals who miss these events may have limited opportunities to “make-up” the material. Furthermore, this approach is also fairly resource-intensive, as many require the involvement of multiple staff members on a recurring basis. Due to these concerns, online programs are being implemented at some colleges and universities to comply with legislation such as Title IX of the Higher Education Amendments of 1972 and the Campus Sexual Violence Elimination (SaVE) Act that require schools to respond to sexual assault and provide training to students and employees, so research on computer-based risk reduction programs is needed.

A recent study examined a theoretically based risk reduction program administered in a small group format and found that the program was effective in reducing rates of attempted and completed rape, completed coercion, and unwanted sexual contact over a 1-year follow-up period (Senn et al., 2015). This intervention involved four 3-hr intervention sessions for a total of 12 hours of intervention; the mean number of women present in each intervention session was 9.4 (Senn et al., 2015). Small group programs and individually administered programs have increased flexibility in scheduling, but face-to-face individual administration of risk reduction programming in individual or small group formats for all college students (as required by the Clery Act, 2008) simply is not feasible. In addition, interventions that require several hours are likely to be perceived as burdensome to students, so brief interventions are important, as they are more cost and resource effective and reduce demands on student time, which may increase engagement in the material. Finally, technology-based programs offer increased portability, which would aid in dissemination of programming to nontraditional students (e.g., students enrolled in online courses). Therefore, given the continued high prevalence of sexual assault on college campuses, brief risk reduction programs that can be easily disseminated at a low cost per student are needed.

Few individually administered programs that do not require face-to-face interaction have been examined. In one study, a bibliotherapy (i.e., self-help book) approach was examined (Yeater, Naugle, O’Donohue, & Bradley, 2004). The treatment was not effective in reducing rates of victimization, but the treatment group did engage in fewer risky dating behaviors and reported improved sexual communication compared with the waitlist group after treatment (Yeater et al., 2004). In a recent study, a web-based intervention designed to reduce both risk of sexual assault and heavy episodic drinking among college women was found to reduce incidence of incapacitated rape, incidence and severity of sexual assault, and frequency of heavy episodic drinking among individuals with severe sexual assault history (Gilmore, Lewis, & George, 2015). Given the limited research in this area, further research on risk reduction interventions is needed.

Current Study and Hypotheses

The primary aim of this pilot study was to examine the methodological feasibility and acceptability of a brief, computer-based risk reduction program. In examining feasibility, one purpose of a pilot study is to examine the feasibility of the implementation methodology (e.g., retention; Leon, Davis, & Kraemer, 2011). It was expected that the implementation approach would be feasible, as evidenced by a retention rate of at least 90% (i.e., less than 10% of participants would terminate the program during the laboratory appointment); this retention rate was selected based on previous research, which has generally found high retention rates for studies of sexual assault risk reduction programs (e.g., 78% began the follow-up assessments in Gilmore et al., 2015; 88% completed the first follow-up in Orchowski et al., 2008; 91% of the intervention group completed three or more of the four intervention sessions in Senn et al., 2015; 95% completed the first follow-up in Yeater et al., 2004). In addition, it was hypothesized that participants would find the intervention acceptable and informative. Specifically, we expected ratings on an acceptability questionnaire to indicate, on average, that participants learned new information and preferred a computer-based program to a large-group format. While it is important to first establish the feasibility and acceptability of an intervention (e.g., Leon et al., 2011), a secondary aim of this study was to examine the preliminary efficacy of the intervention. It was anticipated that women who received the risk reduction program would have shorter response latencies on the audio vignette and report increased predicted use of assertive resistance techniques at posttest, compared with women who did not receive the program (control group).

Method

Participants and Procedures

All study procedures were approved by the Institutional Review Board at the university where the study was conducted. Female undergraduates at a large public university in the southeastern United States were recruited for an online survey using the Psychology Department’s study recruitment system over the course of two semesters. A total of 1,187 women began the online survey, and 1,095 (92.2%) completed the full survey. Participants received research participation credit for completing the online survey. Of those who completed the survey, 528 women were invited to participate in the in-lab portion of the study. To be eligible for the in-lab appointment, participants had to complete the entire online survey and respond incorrectly to no more than one of the items assessing random responding. A total of 136 women completed the in-lab assessment and were randomized to either the experimental risk reduction program or the active control condition. Assignment was determined prior to the study session using a random number generator. A Consolidated Standards of Reporting Trials (CONSORT) diagram depicting participant flow is presented in Figure 1. At the time of the study, sexual assault risk reduction programming was mandated on college campuses per the Clery Act (2008); therefore, all participants (i.e., those in both the risk reduction program and control conditions) received treatment as usual.

Figure 1.

CONSORT flow diagram.

The average age of participants was 19.40 years (SD = 1.26); the majority of participants were in their first or second year of college (38.2% and 25.0%, respectively). Most participants identified their race/ethnicity as White (78.7%) and their sexual orientation as heterosexual (94.9%). Less than half (44.1%) of participants were not in a romantic relationship; 39.0% were in a serious, committed relationship; and 12.5% were casually dating one person. Participants received research credit for completing the in-lab appointment; each participant also had a 1 out of 6 chance of receiving US$25.

Measures

Unwanted sexual experiences

A modified version of the Sexual Experiences Survey–Short Form Victimization (SES-SFV; Koss et al., 2007) was used to assess unwanted sexual experiences both in the past 12 months and since the age of 14. While the original SES-SFV asks participants to report the number of times each incident occurred during each time period (i.e., 0, 1, 2, or 3+), the answer choices for this study were abbreviated to yes or no. A recent study found evidence of reliability and validity of information reported on the SES-SFV (Johnson, Murphy, & Gidycz, 2017). Specifically, internal consistency was excellent (α = .92), and good test-retest reliability was evidenced with 70% to 73% of women reporting exact matches for unwanted sexual experiences over a 2-week period. In addition, evidence of concurrent validity was demonstrated by findings that individuals who reported a history of unwanted sexual experiences on the SES-SFV reported higher levels of psychological symptoms on all 6 subscales (i.e., dissociation, anxiety, depression, sexual abuse trauma, sleep disturbance, and sexual problems) of the Trauma Symptom Checklist–40 (Briere & Runtz, 1989, as cited in Johnson et al., 2017).

Written sexual aggression story and behavioral responses

To assess predicted use of resistance techniques, participants read fictional stories describing an interaction between a woman and a man. These stories are slightly modified versions of one of the stories used by Norris and colleagues (2006). These stories were slightly modified to update them and make them applicable to college students (e.g., changing videocassette recorder [VCR] to digital videodisc [DVD] player). In addition, the second story is almost identical to the first, except that the names and activity were changed to allow for re-administration. The original story (pretest) was administered at the beginning of the in-lab appointment, and the second story (posttest) was administered after the participants had undergone their randomly assigned experimental condition.

The stories were written in the second person, and participants were asked to imagine that they were the female main character in the story. In the story, the female main character expresses to her friend that she does not wish to engage in sexual intercourse with the male main character; however, during the story, the male main character makes progressively more aggressive sexual advances (Norris et al., 2006).

At three points during the stories, participants were asked about their predicted behavioral responses: (a) after the man kisses her and touches her breasts; (b) after the man engages in over-clothes touching of her genitals; and (c) after the man states, while holding her down, that he plans to have intercourse with her despite her refusal (Norris et al., 2006). At all three points in the story, the female main character expresses that she does not wish to engage in that level of sexual contact. Five items assessed assertive resistance techniques (e.g., pushing the man away), 3 items measured passive resistance techniques (e.g., not trying to do anything because it seems hopeless), and 4 items measured polite resistance techniques (e.g., nicely or apologetically telling the man that she does not want to have sex; Norris et al., 2006). Participants are asked to indicate how likely it would be that they would engage in each of the behaviors on a 0 to 6 scale, where 0 = not at all likely, 3 = moderately likely, and 6 = very likely (Norris et al., 2006). The average score for each type of resistance technique at each of the three time points was computed. The three-factor structure of the resistance techniques was supported by a factor analysis (Norris et al., 2006). Furthermore, Cronbach’s alpha of the scales across time points was adequate to excellent (α = .85 to .90 for assertive resistance, α = .64 to .84 for polite resistance, and α = .60 to .78 for passive resistance; Norris et al., 2006). In this study, internal consistency across all three time points in both stories was adequate for most scales at most time points (α = .82 to .91 for assertive resistance, α = .50 to .83 for polite resistance, and α = .56 to .67 for passive resistance).

Audio vignette

To assess risk detection latency, participants listened to an audio recording of a different sexual encounter between two college students. They were instructed to indicate when the male should stop making sexual advances by pausing the audio recording. A version of the vignette used by Marx and Gross (1995) was obtained for use in this study. The recording lasts a total of 293 s, and it is composed of 6 segments: consensual interaction and kissing (0-81 s); polite resistance (82-92 s); continued refusal by the woman and apologies by the man (93-116 s); continued refusal by the woman and verbal pressure by the man (117-177 s); verbal assertive refusals by the woman and verbal threats by the man (178-240 s); and forced sexual intercourse (241-292 s; based on Marx & Soler-Baillo, 2005).

Acceptability questionnaire

A brief acceptability questionnaire was administered to participants who received the risk reduction program. Participants were asked to rate each question on a 5-point Likert-type scale (1 = completely disagree, 3 = neutral, 5 = completely agree). Participants were asked to indicate the degree to which they found the video to be realistic, the information provided to be realistic and truthful, and the program to be distressing. Participants also indicated if they learned new information from the program, if the materials provided would likely reduce the risk of sexual assault, if the materials would benefit most undergraduate females, and if they would prefer an individually administered computer-based program to a large-group intervention.

Risk reduction program and control condition

Risk reduction program

The risk reduction program in this study was designed to provide women with information about sexual assault, including risk factors for sexual assault and effectiveness of specific resistance techniques. The risk reduction program began with portions of the video I Thought It Could Never Happen to Me (Gidycz, Dowdall, et al., 1997); the video was shortened to last approximately 18.5 min (the total video is 33 min long) to try to ensure that the laboratory appointments lasted an hour or less total. It was hoped that by watching the video, women would learn that sexual victimization can and does happen to women in college. Furthermore, both women in the video were victimized by acquaintances, emphasizing the fact that rape is not only perpetrated by strangers. Finally, after telling their stories, the women discuss what they learned from their experience and what they wished to share with others. These portions provide information about risk detection and coping following a sexual assault.

After watching the video, women answered questions about sexual assault, which were created for the purpose of this study. The 14-item questionnaire was administered on the computer as part of an online questionnaire so that corrective feedback could be provided. These questions were designed to provide information about the prevalence of sexual assault, the definition of rape, the effects of sexual assault, the prevalence of date and acquaintance rape, the role of alcohol in sexual assault (including the role of voluntarily consumed substances), the effectiveness of resistance during a sexual assault, the fact that resistance has been found to not increase risk of injury, and the low rates of reporting of sexual assault to authorities. While the information about prevalence was included to increase women’s awareness of their own risk, other information was included to challenge any rape myths (e.g., rapes are only committed by strangers, date rape drugs are often involved when someone is too intoxicated to consent to intercourse, resisting a man will result in further injuries) that women may hold that could interfere with risk detection and/or use of assertive resistance techniques.

The proposed risk reduction program was primarily based on McFall’s model of social processing (McFall, 1982). As noted above, the primary risk factors (e.g., alcohol use) for sexual assault appear to work by reducing either risk detection or assertive responding (Messman-Moore & Long, 2003). The social processing model aligns well with this idea, as decoding skills (i.e., skills related to how the situation is perceived) are the first step in the model. The video and questions targeted decoding skills by presenting factual information about sexual assault and by attempting to dispel misconceptions about sexual assault. For example, it was explained that rape is broader than just vaginal sex (e.g., it can involve oral or anal sex, as well), that sexual assault is frequently perpetrated by people known to the victim rather than strangers, and that rape can occur when a victim is too intoxicated to consent, even if physical force is not used. With this information, women may be better able to recognize risky situations (e.g., in a wider range of sexual situations, when they are with acquaintances and friends, and when they have consumed substances). The second stage of the model involves decision making. The program also attempted to provide information about risks associated with the use of assertive resistance, which may help women to be more open to choosing these strategies.

Active control condition

The control condition consisted of a brief video on time management (approximately 18 min long; University of Central Florida Student Academic Resource Center, 2011) and an online questionnaire designed to provide information about campus resources at the university where the study was conducted. While the full video lasts 37 min, participants only watched the first 18 min, approximately the length of the risk reduction program video. Just as in the risk reduction program condition, participants received corrective feedback based on their responses to the informational questions. The number of questions administered in each condition (risk reduction and control) was identical. In addition, the words sexual assault and rape were included in the feedback for the questions in this condition so that all participants, regardless of condition, were primed with these words, although notably to different degrees. Given that the control condition matched the risk reduction program intervention in nonspecific factors (i.e., duration, intensity, attention), the control condition was considered an active control (e.g., Grossman, Niemann, Schmidt, & Walach, 2004; Shallcross et al., 2015).

Data Analyses

All data were entered into Predictive Analytics Software (PASW) 18.0.0 for analysis. An independent samples t test was used to evaluate whether response latency on the audio vignette differed between the two groups. Response latency was missing for two participants. Both of these participants appeared to misunderstand the directions for this portion of the study, as they did not pause the audio recording, but when asked after the audio recording, they stated that the male in the recording should have stopped making sexual advances at some point. Therefore, only 134 participants were included in this analysis.

To examine the effects of experimental condition (i.e., risk reduction program vs. control), separate ANCOVAs were run for each type of resistance (i.e., assertive, polite, and passive) at each level of coercion (i.e., breast fondling, genital fondling, and rape threat). Scores from the pretest written story were entered as covariates in the corresponding analyses, and scores from the posttest written story were the dependent variables.

Results

More than half (n = 76; 55.9%) of the participants reported they had experienced some type of sexual assault since the age of 14; prevalence of specific types of sexual assault ranged from 20.6% for completed rape to 47.1% for unwanted sexual contact. Descriptive statistics for the outcome variables are presented in Table 1. There were no differences between participants in the risk reduction program group and those in the control group on the pretest resistance scores (all p’s > .124). The two groups also did not differ in the proportion of participants who had experienced any past victimization, unwanted sexual contact, attempted coercion, coercion, attempted rape, or rape (all p’s > .447).

Table 1.

Descriptive Statistics for Outcome Variables.

Type of Resistance	Type of Unwanted Sexual Contact	Time Point	Risk Reduction Program (n = 69)		Control Group (n = 67)
Type of Resistance	Type of Unwanted Sexual Contact	Time Point	M	SD	M	SD
Assertive	Breast Fondling	Pretest	2.27	1.33	2.36	1.18
		Posttest	2.19	1.52	1.72	1.29
	Genital Fondling	Pretest	3.55	1.53	3.66	1.42
		Posttest	3.50	1.67	3.37	1.55
	Rape Threat	Pretest	4.84	1.44	5.03	1.23
		Posttest	4.83	1.54	4.99	1.28
Polite	Breast Fondling	Pretest	3.96	0.89	3.92	1.03
		Posttest	4.11	1.17	3.87	1.23
	Genital Fondling	Pretest	3.73	1.27	3.70	1.17
		Posttest	3.87	1.33	3.85	1.35
	Rape Threat	Pretest	2.89	1.79	3.00	1.56
		Posttest	3.11	1.87	3.12	1.73
Passive	Breast Fondling	Pretest	0.69	0.77	0.92	0.95
		Posttest	0.72	0.93	0.84	0.90
	Genital Fondling	Pretest	0.57	0.81	0.54	0.80
		Posttest	0.64	0.96	0.64	0.82
	Rape Threat	Pretest	0.46	0.76	0.49	0.81
		Posttest	0.49	0.92	0.45	0.74
Response latency	Audio vignette (time in seconds)	Posttest	99.25	28.13	112.39	30.31

No participants requested to discontinue the in-lab appointment, and no study appointments were terminated early due to negative reactions of participants. The descriptive statistics for the acceptability questions are presented in Table 2. Overall, the item means and distributions indicate that participants found both the video and the information in the questions realistic, participants were not distressed by the material, they learned new information, they believed the program would be beneficial to most undergraduate females, and they would prefer a computer-based program to a large-group program.

Table 2.

Descriptive Statistics of Acceptability Questions (n = 69).

Question	M	SD	Minimum	Maximum
The video was realistic.	3.99	1.06	1	5
The questions about sexual assault provided realistic and truthful information.	4.57	0.58	3	5
The materials (i.e., the video and questions about sexual assault) were distressing to watch and read.	2.51	1.11	1	5
I learned new information about sexual assault by participating in this study.	4.16	0.96	1	5
The materials (i.e., the video and questions about sexual assault) contained information that would reduce the risk of sexual assault.	3.67	1.00	1	5
Most undergraduate females would benefit from seeing the video and receiving the information in the questions.	4.09	0.85	1	5
If given the choice between a presentation about sexual assault administered in a large-group setting (e.g., in an auditorium with a large number of students) and a computer program that could be completed individually (e.g., the video and questions viewed today), I would prefer the computer program.	4.25	0.93	1	5

Note. All items used a 1 to 5 Likert-type scale (1 = Completely disagree, 3 = Neutral, 5 = Completely agree).

The two experimental conditions differed significantly on response latency during the audio vignette, t(132) = 2.603, p = .010. The participants who received the risk reduction program had shorter response latencies than the control group, meaning they detected risk more quickly than the control group (see M’s in Table 1).

Results of the ANCOVAs examining resistance scores from the posttest are presented in Table 3. Condition was only a significant predictor of assertive resistance at the lowest level of coercion (i.e., breast fondling). Participants in the risk reduction program condition had significantly higher assertive resistance scores on the posttest compared with participants in the control condition. It is important to note that examination of the means in Table 1 reveals that both groups decreased in their predicted use of assertive resistance at the breast-fondling level of coercion between Story #1 and Story #2; therefore, the results of the ANCOVA suggest that participants who received the risk reduction program had less of a decrease in predicted use of assertive resistance compared with the control group. Condition was not a significant predictor of assertive resistance scores at the genital-fondling or rape-threat levels of coercion or of polite or passive resistance scores at any level of coercion.

Table 3.

ANCOVA of the Effect of Experimental Condition on Resistance Scores on the Posttest Written Story.

Outcome (Posttest Score)		Step	Predictor(s)	R ²	Adj. R²	F	ΔR ²	ΔF	b	β	t
Type of Resistance	Type of Unwanted Sexual Contact	Step	Predictor(s)	R ²	Adj. R²	F	ΔR ²	ΔF	b	β	t
Assertive	Breast Fondling	1	Pretest Score	.512	.508	140.510***	—	—	.812	.715	11.854***
		2	Pretest Score	.549	.542	80.807***	.037	10.814**	.820	.722	12.389***
			Condition						.545	.192	3.288**
Assertive	Genital Fondling	1	Pretest Score	.645	.642	243.066***	—	—	.875	.803	15.591***
		2	Pretest Score	.650	.644	123.252***	.005	1.866	.877	.805	15.679***
			Condition						.225	.070	1.366
Assertive	Rape Threat	1	Pretest Score	.849	.848	752.208***	—	—	.975	.921	27.426***
		2	Pretest Score	.849	.847	373.535***	.000	.072	.976	.922	27.280***
			Condition						.026	.009	.789
Polite	Breast Fondling	1	Pretest Score	.570	.567	177.955***	—	—	.944	.755	13.340***
		2	Pretest Score	.577	.571	90.776***	.007	2.115	.941	.753	13.360***
			Condition						.196	.082	1.454
Polite	Genital Fondling	1	Pretest Score	.486	.482	126.540***	—	—	.767	.697	11.249***
		2	Pretest Score	.486	.478	62.799***	.000	.001	.767	.697	11.206***
			Condition						−.004	−.002	−.027
Polite	Rape Threat	1	Pretest Score	.747	.745	394.969***	—	—	.928	.864	19.874***
		2	Pretest Score	.747	.744	196.669***	.001	.334	.929	.865	19.833***
			Condition						.090	.025	.578
Passive	Breast Fondling	1	Pretest Score	.567	.564	175.339***	—	—	.791	.753	13.242***
		2	Pretest Score	.568	.561	87.414***	.001	.346	.795	.757	13.171***
			Condition						.062	.034	.588
Passive	Genital Fondling	1	Pretest Score	.558	.554	169.001***	—	—	.832	.747	13.000***
		2	Pretest Score	.558	.551	83.906***	.000	.032	.833	.747	12.954***
			Condition						−.018	−.010	−.178
Passive	Rape Threat	1	Pretest Score	.534	.530	153.467***	—	—	.779	.731	12.388***
		2	Pre-test Score	.535	.528	76.652***	.002	.458	.780	.732	12.375***
			Condition						.066	.040	.677

Note. Condition was dummy coded (1 = risk reduction program); Pretest Score = the pretest score for the same type of resistance and type of unwanted sexual contact as the outcome. Adj. R² = adjusted R²; ΔR² = Change in R²; ΔF = F statistic for the change in models.

p < .01. ***p < .001.

Discussion

Using a randomized design with an active control condition, this study examined the feasibility and preliminary impact of a computer-based risk reduction program for sexual victimization in college women. This risk reduction program is unique in that it does not require a face-to-face component. The primary content of this program was based on other risk reduction programs (e.g., Gidycz et al., 2001; Gidycz, Rich, et al., 2006), and it was theoretically grounded in a model of social processing (McFall, 1982).

Before evaluating efficacy of an intervention program, it is important that the program is found to be both feasible to administer and acceptable to the target population (e.g., Leon et al., 2011). The study design was found to be feasible, as none of the participants dropped out or ended participation early. Furthermore, the clinician on call for the appointments was never needed to talk to any of the participants. Therefore, it appears that this program is not only feasible, but also potentially highly transportable. It may not be necessary to have another person (e.g., program facilitator) to monitor stress and reactivity, and perhaps the program could be delivered to women in their own homes via the Internet.

In addition, participants who received the risk reduction program found it to be acceptable. Overall, participants reported that they believed both the video and questions were realistic and provided truthful information with the majority of participants responding on the “agree” end of the Likert-type scale to both items. While some participants agreed with the statement that the materials were distressing, the average response was in the “disagree to neutral” range with the majority of participants disagreeing with the statement. Participants also reported, on average, that they learned new information from the study, that the information would be helpful in reducing risk of sexual victimization, and that the information would be helpful for most undergraduate females. Finally, participants reported preferring the computer-based program to a program administered in a large-group setting. This finding is encouraging because computer-based programs can be less expensive to administer and be tailored to individual needs more easily than large-group interventions (Card et al., 2011). Also, the results were similar to the acceptability of a bibliotherapy approach to risk reduction programming (Yeater et al., 2004).

Preliminary efficacy was partially supported, although it must be emphasized that impact was evaluated via a laboratory-based task, which may not fully predict risk detection and assertiveness in actual high-risk situations. Participants in the risk reduction program condition had significantly shorter response latencies during the audio vignette compared with those in the control condition. This finding suggests that the participants in the risk reduction program detected risk in the vignette significantly earlier than did the control participants. While the extant literature on the relationship between risk detection in vignettes and victimization has yielded inconsistent findings, studies that have used the Marx and Gross (1995) recording have found that delayed response latency is associated with increased likelihood of victimization (Gidycz, McNamara, & Edwards, 2006). Therefore, the finding of improved risk detection among participants in the risk reduction program, compared with the control condition, is very encouraging as risk recognition is a key factor in reducing the likelihood of a woman experiencing sexual victimization (Norris et al., 1996).

Experimental condition was significantly associated with posttest predicted use of assertive resistance at the lowest level of coercion (i.e., breast fondling). However, while the results of the ANCOVA indicated that the participants who received the risk reduction program had significantly higher average assertive resistance scores on the posttest written story than the control group, the descriptive statistics showed that this difference was due to the fact that the control group decreased more than the risk reduction program group in predicted use of assertive resistance in response to coercive breast fondling. The risk reduction program group showed only small decreases in assertive resistance between the two stories. Therefore, the hypothesis that the risk reduction program would increase participants’ predicted use of assertive resistance was not supported.

Although no decrease in assertive resistance between the two administrations was anticipated, the control group decreased in assertive resistance at the least severe level of sexual advances while the risk reduction program group’s scores did not change significantly. Specifically, because the two stories were nearly identical, it was expected that predicted behavioral responses would be trait-based and, therefore, would not change over time without intervention. While this finding is surprising, Orchowski et al. (2008) found that their placebo control group decreased in self-protective behaviors over a 4-month follow-up period, and the authors hypothesized that “it is likely that the use of protective behaviors may generally decline as women acclimate to college and feel safer in their surroundings” (p. 214). However, given that this study also found a decrease in predicted use of assertive resistance (arguably a self-protective behavior) within a single session, other explanations for this phenomenon should be examined. It is possible that having read almost the same story before and predicting that the story would again increase in sexual advances as it progressed, control participants chose to delay their assertive resistance until later in the vignette, possibly being somewhat desensitized to sexual advances due to familiarity with the progression in the first story. In contrast, the participants in the risk reduction program, possibly due to the information they received, were not desensitized.

Although the hope was that participants who received the risk reduction program would increase in predicted use of assertive resistance, given that the control group evidenced a decrease in assertive resistance, the fact that the participants in the risk reduction program showed little change in their assertive resistance scores between the two stories is encouraging, particularly given the brief nature of the risk reduction program in this study. The finding suggests that programs that present information about prevalence of sexual victimization, risk of sexual victimization by acquaintances and romantic partners, and effectiveness of resistance techniques can maintain predicted use of assertive resistance techniques. Furthermore, these findings suggest that discussion of resistance techniques is an important part of risk reduction programs, which is consistent with the revised Ohio University Sexual Assault Risk Reduction Program (Gidycz, Rich, et al., 2006; Orchowski et al., 2008). Although further research is warranted and necessary, it seems that this discussion should include the possibility that women’s use of assertive resistance may decrease if a person is exposed to unwanted sexual advances repeatedly.

Limitations

These findings should be considered in light of the limitations of this study. One limitation of this study is that the efficacy of the risk reduction program was only assessed immediately after program administration. Therefore, it is unclear whether the effects of the risk reduction program were sustained. In addition, the risk reduction program, which is intended to be administered in the participants’ home or other location of their choosing without the presence of a research assistant, was administered in a laboratory setting with a research assistant present. While this procedure limits the external validity of the study, establishing initial feasibility within the lab was important to ensure that participants did not experience negative emotional reactions to the material. Furthermore, the risk reduction program in this study was very brief, as the entire study appointment, including the completion of all measures, typically lasted 1 hr or less. The program may not be potent enough to produce lasting change, but it may be useful as a preliminary awareness building program, a booster or augmentative program, or to prepare women for additional risk reduction programs. In addition, predicted use of resistance, not actual use of resistance strategies, was assessed. Predicted behavioral responses may not accurately reflect how individuals will respond in risky sexual scenarios, and, therefore, extension of these findings in studies involving follow-up assessments is needed. The measure of predicted use of resistance strategies also assumes that the individual would want to resist at that stage and that each level of unwanted sexual contact is more severe than the previous one; however, it is possible that not all participants viewed the scenario in this way. Also, the measure of risk detection (i.e., response latency on the audio recording) was only administered once, after the participants received their assigned program, so change in risk detection was not assessed. Finally, although consistent with university demographics, the sample was predominately White.

Future Directions

Given that this study demonstrated that a computer-based risk reduction program is both feasible and acceptable, additional studies on the efficacy of this type of program are warranted. Future studies should examine the longevity of the program effects as well as whether the program actually reduces risk of victimization. Future studies should also examine if the addition of assertiveness training could increase the efficacy of these programs. Examination of whether computer-based trainings can include practice activities (e.g., practice scenarios or avatar-based interactions) to further increase behavior change is also needed. In addition, studies that examine other types of risk reduction programs (e.g., large-group programs) may consider augmentation with computer-based booster sessions. If used in conjunction with other programs, including bystander intervention programs, computer-based programs may offer opportunities to provide didactic training to allow more time for skills practice in the face-to-face programs, which may help to increase self-efficacy to use assertive resistance strategies. While individually administered, computer-based interventions offer advantages (e.g., portability), it is important to consider the possible disadvantages of these formats (e.g., lack of opportunity for group discussion, lack of opportunity to engage in behavioral practice with others) to ensure that risk reduction programs are as effective as possible. Therefore, direct comparisons of these two types of interventions are warranted. As noted above, to prevent rape, programs aimed at preventing perpetration are needed, as the full responsibility for sexual assault lies with the perpetrator. Therefore, it is important that programs incorporate information to minimize victim-blaming and self-blame, when sexual assault does occur, regardless of whether assertive resistance techniques were used. Finally, given that undergraduate men also experience sexual assault at concerning rates (see Peterson, Voller, Polusny, & Murdoch, 2011, for review), research examining risk reduction programs for men is needed.

Conclusion

This study demonstrated the feasibility and acceptability of a computer-based risk reduction program for college women. In addition, the results suggest that the program may be efficacious in improving risk detection and preventing declines in assertive resistance over time at low levels of sexual coercion; however, replication of these findings and extension to actual risk of sexual assault is needed before the program can be deemed effective. Women reported learning new material from the program, preferring the computer-based program to large-group programs, and believing that other undergraduate women would benefit from the program. Furthermore, women were not overly disturbed emotionally by the material. Women who received the program also did not evidence a decrease in predicted use of assertive resistance between the two stories, which was present in the control group. The women who received the program also displayed superior risk detection compared with the control group. Based on these findings, additional research into computer-based risk reduction programs is warranted.

Footnotes

Acknowledgements

We would like to thank Danny Axsom, Bethany C. Bray, Jungmeen Kim-Spoon, and Robert S. Stephens for consulting on the design, conduct, and statistical analyses for this study. Special thanks to Drs. Gross, Marx, and Norris for sharing their assessment measures with us and to Dr. Gidycz for granting us permission to use the video I Thought It Could Never Happen to Me. We would also like to thank Kathleen Driscoll, Morgan Pesso, Maxie Sayer, Courtney Souter, and Catherine Vasquez for their assistance with data collection for this study.

Authors’ Note

This study was completed as part of the first author’s doctoral dissertation.

Declaration of Conflicting Interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This research was supported by a research award from the Virginia Tech Graduate Research Development Program.

ORCID iD

Amie R. Newins

Author Biographies

Amie R. Newins, PhD, is an assistant professor in the Department of Psychology at University of Central Florida (UCF). She is the director of the Stress, Health, and Anxiety Research (SHARE) Lab and the director of Continuing Education for UCF RESTORES. Her research interests center on the relationship between anxiety and behaviors and events associated with health risk. Her two primary areas of research emphasis are (a) risk factors for sexual victimization and risk reduction programming and (b) the relationship between anxiety and substance use. In addition, she is interested in the development and evaluation of interventions to treat trauma-related disorders.

Susan W. White, PhD, is a professor in the Department of Psychology at Virginia Tech, where she directs the Psychosocial Interventions Lab. Her research interests are primarily in the field of developmental psychopathology. Her research addresses identification of transdiagnostic mechanisms underlying psychopathology, including how they develop and how they can best be targeted in treatment.

References

Anderson

R. E.

Cahill

S. P.

(2015). Behavioral response to threat (BRTT) as a key behavior for sexual assault risk reduction intervention: A critical review. Aggression and Violent Behavior, 25, 304-313. doi:10.1016/j.avb.2015.09.015

Boudreaux

Kilpatrick

D. G.

Resnick

H. S.

Best

C. L.

Saunders

B. E.

(1998). Criminal victimization, posttraumatic stress disorder and comorbid psychopathology among a community sample of women. Journal of Traumatic Stress, 11, 665-678. doi:10.1023/A:1024437215004

Card

J. J.

Kuhn

Solomon

Benner

T. A.

Wingood

G. M.

DiClemente

R. J.

(2011). Translating an effective group-based HIV prevention program to a program delivered primarily by a computer: Methods and outcomes. AIDS Education and Prevention, 23, 159-174.

Clery Act, 20 U.S.C. § 1092(f) (2008).

Gidycz

C. A.

Loh

Lobo

Rich

Lynn

S. J.

Pashdag

(2007). Reciprocal relationships among alcohol use, risk perception, and sexual victimization: A prospective analysis. Journal of American College Health, 56, 5-14. doi:10.3200/JACH.56.1.5-14

Gidycz

C. A.

Lynn

S. J.

Rich

C. L.

Marioni

N. L.

Loh

Blackwell

L. M.

. . . Pashdag

(2001). The evaluation of a sexual assault risk reduction program: A multisite investigation. Journal of Consulting and Clinical Psychology, 69, 1073-1078. doi:10.1037/0022-006x.69.6.1073

Gidycz

C. A.

McNamara

J. R.

Edwards

K. M.

(2006). Women’s risk perception and sexual victimization: A review of the literature. Aggression and Violent Behavior, 11, 441-456. doi:10.1016/j.avb.2006.01.004

Gidycz

C. A.

Rich

C. L.

Orchowski

King

Miller

A. K.

(2006). The evaluation of a sexual assault self-defense and risk-reduction program for college women: A prospective study. Psychology of Women Quarterly, 30, 173-186. doi:10.1111/j.1471-6402.2006.00280.x

Gidycz

C. A.

Van Wynsberghe

Edwards

K. M.

(2008). Prediction of women’s utilization of resistance strategies in a sexual assault situation: A prospective study. Journal of Interpersonal Violence, 23, 571-588. doi:10.1177/0886260507313531

10.

Gidycz

C. A.

(Producer and Director), Dowdall

C. L.

Lynn

S. J.

Marioni

N. L.

Loh

(Assistant Directors). (1997). I thought it could never happen to me [Film]. (Available from Gidycz

Christine A.

, Department of Psychology, Ohio University, Athens, OH 45701)

11.

Gidycz

C. A.

(Producer and Director), Loh

Marioni

N. L.

Dowdall

C. L.

Lynn

S. J.

Hanson-Breitenbecher

(Assistant Directors). (1997). Sexual assault risk factors: A training video [Film]. (Available from Gidycz

Christine A.

, Department of Psychology, Ohio University, Athens, OH 45701)

12.

Gilmore

A. K.

Lewis

M. A.

George

W. H.

(2015). A randomized controlled trial targeting alcohol use and sexual assault risk among college women at high risk for victimization. Behaviour Research and Therapy, 74, 38-49. doi: 10.1016/j.brat.2015.08.007

13.

Grossman

Niemann

Schmidt

Walach

(2004). Mindfulness-based stress reduction and health benefits: A meta-analysis. Journal of Psychosomatic Research, 57, 35-43. doi:10.1016/S0022-3999(03)00573-7

14.

Johnson

S. M.

Murphy

M. J.

Gidycz

C. A.

(2017). Reliability and validity of the Sexual Experiences Survey–Short Forms Victimization and Perpetration. Violence and Victims, 32, 78-92. doi:10.1891/0886-6708.VV-D-15-00110

15.

Jordan

C. E.

Combs

J. L.

Smith

G. T.

(2014). An exploration of sexual victimization and academic performance among college women. Trauma, Violence & Abuse, 15, 191-200. doi:10.1177/1524838014520637

16.

Koss

M. P.

Abbey

Campbell

Cook

Norris

Testa

. . . White

(2007). Revising the SES: A collaborative process to improve assessment of sexual aggression and victimization. Psychology of Women Quarterly, 31, 357-370. doi:10.1111/j.1471-6402.2007.00385.x

17.

Leon

A. C.

Davis

L. L.

Kraemer

H. C.

(2011). The role and interpretation of pilot studies in clinical research. Journal of Psychiatric Research, 45, 626-629. doi:10.1016/j.jpsychires.2010.10.008

18.

Marx

B. P.

Gross

A. M.

(1995). Date rape: An analysis of two contextual variables. Behavior Modification, 19, 451-463. doi:10.1177/01454455950194003

19.

Marx

B. P.

Soler-Baillo

J. M.

(2005). The relationships among risk recognition, autonomic and self-reported arousal, and posttraumatic stress symptomatology in acknowledged and unacknowledged victims of sexual assault. Psychosomatic Medicine, 67, 618-624. doi:10.1097/01.psy.0000171809.12117.79

20.

McFall

R. M.

(1982). A review and reformulation of the concept of social skills. Behavioral Assessment, 4, 1-33. doi:10.1007/bf01321377

21.

Messman-Moore

T. L.

Long

P. J.

(2003). The role of childhood sexual abuse sequelae in the sexual revictimization of women: An empirical review and theoretical reformulation. Clinical Psychology Review, 23, 537-571. doi:10.1016/s0272-7358(02)00203-9

22.

Norris

George

W. H.

Stoner

S. A.

Masters

N. T.

Zawacki

Davis

K. C.

(2006). Women’s responses to sexual aggression: The effects of childhood trauma, alcohol, and prior relationship. Experimental and Clinical Psychopharmacology, 14, 402-411. doi:10.1037/1064-1297.14.3.402

23.

Norris

Nurius

P. S.

Dimeff

L. A.

(1996). Through her eyes: Factors affecting women’s perception of and resistance to acquaintance sexual aggression threat. Psychology of Women Quarterly, 20, 123-145. doi:10.1111/j.1471-6402.1996.tb00668.x

24.

Orchowski

L. M.

Gidycz

C. A.

Raffle

(2008). Evaluation of a sexual assault risk reduction and self-defense program: A prospective analysis of a revised protocol. Psychology of Women Quarterly, 32, 204-218. doi:10.1111/j.1471-6402.2008.00425.x

25.

Peterson

Z. D.

Voller

E. K.

Polusny

M. A.

Murdoch

(2011). Prevalence and consequences of adult sexual assault of men: Review of empirical findings and state of the literature. Clinical Psychology Review, 31, 1-24. doi:10.1016/j.cpr.2010.08.006

26.

Rozee

P. D.

Koss

M. P.

(2001). Rape: A century of resistance. Psychology of Women Quarterly, 25, 295-311. doi:10.1111/1471-6402.00030

27.

Sarkar

N. N.

Sarkar

(2005). Sexual assault on woman: Its impact on her life and living in society. Sexual and Relationship Therapy, 20, 407-419. doi:10.1080/14681990500249502

28.

Senn

C. Y.

Eliasziw

Barata

P. C.

Thurston

W. E.

Newby-Clark

I. R.

Radtke

H. L.

Hobden

K. L.

(2015). Efficacy of a sexual assault resistance program for university women. The New England Journal of Medicine, 372, 2326-2335. doi:10.1056/NEJMsa1411131

29.

Shallcross

A. J.

Gross

J. J.

Visvanathan

P. D.

Kumar

Palfrey

Ford

B. Q.

. . . Mauss

I. B.

(2015). Relapse prevention in major depressive disorder: Mindfulness-based cognitive therapy versus an active control condition. Journal of Consulting and Clinical Psychology, 83, 964-975. doi:10.1037/ccp0000050

30.

Tark

Kleck

(2014). Resisting rape: The effects of victim self-protection on rape completion and injury. Violence Against Women, 20, 270-292. doi:10.1177/1077801214526050

31.

Ullman

S. E.

(1998). Does offender violence escalate when rape victims fight back? Journal of Interpersonal Violence, 13, 179-192. doi:10.1177/088626098013002001

32.

Ullman

S. E.

Knight

R. A.

(1993). The efficacy of women’s resistance strategies in rape situations. Psychology of Women Quarterly, 17, 23-38. doi:10.1111/j.1471-6402.1993.tb00674.x

33.

University of Central Florida Student Academic Resource Center. (Producer). (2011). Time management [Video file]. Retrieved from http://www.youtube.com/watch?v=Qy_2dnrWRMc

34.

Yeater

E. A.

Naugle

A. E.

O’Donohue

Bradley

A. R.

(2004). Sexual assault prevention with college-aged women: A bibliotherapy approach. Violence and Victims, 19, 593-612. doi:10.1891/vivi.19.5.593.63685

35.

Yeater

E. A.

O’Donohue

(1999). Sexual assault prevention programs: Current issues, future directions, and the potential efficacy of interventions with women. Clinical Psychology Review, 19, 739-771. doi:10.1016/s0272-7358(98)00075-0