Who Is Considered a Potential Victim,Perpetrator,or Bystander? A Systematic Review and Meta-Analysis of Research Evaluating Gender-Specific Campus Sexual Assault Prevention Programs Implemented in the United States

Abstract

Campus sexual assault is a problem that overwhelmingly affects cisgender women and transgender, genderqueer/questioning, and nonbinary (TGQN) students. Yet, students of any gender may be perpetrators or victims of assault. Thus, it is important that prevention programs incorporate a range of scenarios that depict different genders as both perpetrators and victims, while also acknowledging the differential risk between gender groups. Gender-specific programming is one way of achieving this goal. In this systematic review and meta-analysis, we synthesized studies evaluating campus sexual assault prevention programs implemented with specified gender groups in the United States. Through a comprehensive literature search, we identified 38 studies that met eligibility criteria and were disseminated through 2021 (N = 22 women’s studies; N = 16 men’s studies; N = 0 TGQN studies). Programs overwhelmingly portrayed women as victims and men as perpetrators or bystanders while largely ignoring experiences of TGQN students. A greater proportion of women’s programs included risk reduction content that relayed tactics participants may use to avoid victimization. A greater proportion of men’s programs included bystander content that emphasized ways participants may stop others from committing sexual assault. Women’s programs had a small but significant and favorable effect on victimization, but studies evaluating these programs did not measure perpetration outcomes. Men’s programs had a non-significant effect on perpetration but victimization outcomes were not measured. Gender-specific prevention programming should begin to reflect the differential risks of perpetration and victimization across gender identities, and the effects of this program content should be rigorously evaluated.

Keywords

prevention sexual assault college/university bystander

According to data from the 2019 Association of American Universities (AAU) Campus Climate Survey on Sexual Assault and Misconduct, 13% of responding students reported experiencing nonconsensual sexual contact (NCSC) since enrolling in college (Cantor et al., 2020). Survey findings pointed to important gender disparities in risk. Among undergraduate students, 25.9% of cisgender women and 22.8% of transgender, genderqueer/questioning, and nonbinary (TGQN) students reported experiencing NCSC victimization since enrollment. This is a substantially greater risk than that of cisgender men, whose victimization prevalence was 6.8%. Just as patterns of victimization differ among genders, so too do patterns of help-seeking: among those who experienced NCSC, fewer cisgender men (17.8% experiencing penetration; 9.9% experiencing sexual touching) contacted a program or resource for help compared to cisgender women (29.5% penetration; 12.3% sexual touching) and TGQN students (42.9% penetration; 20.8% sexual touching).

Although cisgender men are at considerably lower risk of victimization than cisgender women or QN students, college students of all genders can be victims and perpetrators of sexual assault. Among those students who reported experiencing NCSC victimization on the AAU survey, almost all cisgender women and approximately three-quarters of TGQN students identified the perpetrator as a cisgender man, whereas slightly less than one-third of cisgender men identified the perpetrator as a cisgender man (Cantor et al., 2020). Two-thirds of cisgender men who experienced victimization identified the perpetrator as a cisgender woman, compared to approximately one-fifth of TGQN students and almost no cisgender women. About one 10th of TGQN students who experienced victimization identified the perpetrator as a TGQN student whereas cisgender women and cisgender men almost never identified the perpetrator as TGQN (Cantor et al., 2020).

As the authors of a comprehensive synthesis of systematic review articles concluded, sexual assault prevention programs should incorporate a range of scenarios in which people representing diverse gender identities are perpetrators and victims (Kovalenko et al., 2022). However, this recommendation has yet to be regularly implemented in practice. We recently conducted a systematic review and meta-analysis of research evaluating the effects of campus sexual assault prevention programs implemented in the United States (Kettrey et al., 2023). We found that approximately three-quarters of the studies included in our review evaluated programs that portrayed perpetrators as (presumably cisgender) men and/or victims as (presumably cisgender) women. The remainder of studies evaluated programs that portrayed perpetrators and/or victims in a gender-neutral manner. No sexual assault prevention program typified women as perpetrators or men as victims, and TGQN students were not clearly represented by program content. As Messner (2016) argues, prevention efforts that portray men as perpetrators and women as victims of sexual assault draw attention to the fact that most sexual aggression is perpetrated by men against women, but they also ignore the fact that people of any gender can be perpetrators and that anyone can be a victim. This fits with dominant gendered discourses that portray men as sexual agents and women as sexual regulators while ignoring the experiences of anybody whose identity or experience does not fit a heteronormative binary.

In the conclusion of their synthesis of systematic reviews, Kovalenko et al. (2022) recommend that sexual assault prevention programs account for gendered patterns of violence. They specifically note the importance of implementing both mixed-gender and gender-specific programming to target men and women’s differential risks of perpetration and victimization. Yet, they do not provide guidance on whether separate gender-specific programs should be implemented with TGQN students—or if TGQN students should be incorporated into programs targeting (presumably cisgender) men and women.

Regardless, this recommendation may be premature as findings from past systematic reviews and meta-analyses have produced inconsistent findings regarding the comparative benefits of each of these approaches, with some indicating more favorable program effects for gender-specific programs (Anderson & Whiston, 2005; Kettrey et al., 2023) and others indicating non-significant differences between the effects of gender-specific and mixed-gender programs (Jouriles et al., 2018; Kettrey et al., 2019). Importantly, none of these reviews investigated the content of sexual assault prevention programs that target gender-specific groups, nor examined differences in the content and outcomes between programs that target specific genders.

To date, the only meta-analysis of research examining gender-specific prevention programming focuses on programs implemented with men. It found significant, favorable effects on some attitudes/intentions and non-significant effects on perpetration (Wright et al., 2020). Yet, this meta-analysis did not report information on the content of men’s programs, and it did not address TGQN students at all. Thus, the purpose of this systematic review and meta-analysis was to examine differences in content and outcomes between gender-specific campus sexual assault prevention programming implemented with different gender groups. We specifically examined differences in the tactics that are promoted to prevent violence as well as behavioral outcomes that are measured between genders. This is especially important considering that there are clear gendered patterns in the ways that campus sexual assault prevention programs are implemented in the United States.

Gendered Patterns in Content of U.S. Campus Sexual Assault Prevention Programs

The U.S. Campus Sexual Assault Violence Elimination (SaVE) Act of 2013 mandates that all higher education institutions receiving federal funds must offer primary prevention and awareness programming addressing sexual violence to incoming college students (Violence Against Women Reauthorization Act, 2013). According to the World Health Organization, effective violence prevention programming should recognize the multifaceted nature of violence by targeting interactions between the individual, social relationships (e.g., peers, intimate partners, and family members), community factors (e.g., schools, workplaces, and neighborhoods), and societal factors (e.g., cultural norms and attitudes) (Krug et al., 2002). The mandates of the Campus SaVE Act largely focus on individuals (e.g., individual knowledge and skill acquisition) and social relationships (e.g., bystander intervention).

Among other requirements, the Campus SaVE Act specifies that prevention programming must define sexual consent and violence (i.e., domestic violence, dating violence, sexual assault, and stalking) and must include a statement indicating that the institution of higher education prohibits the aforementioned forms of violence. It also specifies that primary prevention programs must include content on bystander intervention and risk reduction. Although this legislation does not use gendered language when referring to prevention program participants, perpetrators of assault, or victims, there are apparent gendered patterns in the ways that programs with bystander and risk reduction content were traditionally designed and implemented. Traditionally, bystander programs were largely implemented with men and risk reduction content was largely implemented with women.

Bystander programs encourage young people to intervene when witnessing incidents or warning signs of sexual assault (Banyard, 2011; Banyard et al., 2004; Burn, 2009; McMahon & Banyard, 2012). By treating young people as potential allies in preventing sexual assault, bystander programs have the capacity to be less threatening than traditional sexual assault prevention programs, which typically address young people as either potential perpetrators or victims (Burn, 2009; Katz, 1995; Messner, 2016). The earliest bystander programs tended to portray victims as women and bystanders as men who have the potential to stop other men from perpetrating sexual assault. These include programs such as Mentors in Violence Prevention (Katz, 1995) and The Men’s Program (Foubert, 2000). More recently, bystander programs such as Bringing in the Bystander and Green Dot have begun to use a gender-neutral approach to build a sense of responsibility among all students to intervene on behalf of all potential victims of sexual assault (Banyard et al., 2007, 2009; Coker et al., 2011). Currently, both types of bystander programs, those targeting men and those that are gender-neutral, are actively implemented with college students (Jouriles et al., 2018; Kettrey et al., 2019).

The U.S. Campus SaVE Act defines risk reduction content as information that encourages students to “recognize warning signs of abusive behavior and how to avoid potential attacks” (Violence Against Women Reauthorization Act, 2013). Risk reduction programs focus on actions college students may take to decrease their personal risk of victimization. They teach participants how to avoid or thwart an assault by “helping potential victims learn to use verbal and/or physical self-protection strategies” (Holtzman & Menning, 2019, p. 7). Such programs have a gendered history, as they were a popular second-wave feminist approach to empowering women and increasing their confidence in their ability to resist sexual assault (Hollander, 2018a; Messner, 2016). Contemporary risk reduction programs maintain a gendered lens by focusing on women’s resistance to sexual victimization (Gidycz & Dardis, 2014; Hollander, 2018b).

Messner (2016) points to advantages and disadvantages of gendered patterns in the implementation of bystander and risk-reduction content. Focusing on men’s violence against women, as risk reduction programs typically do, can draw attention to patriarchal roots of violence against women. Yet, it largely ignores the fact that anyone can be a victim of sexual violence. On the other hand, the bystander approach is likely to be less threatening to men than other approaches because it treats men as allies rather than potential perpetrators. However, as Messner argues, the potential cost is that men who participate in bystander programs may see themselves as “good guys” who need to stop “bad guys” from committing violence against women, essentially discouraging them from reflecting on their own behaviors that may contribute to or may constitute sexual violence. There is empirical evidence demonstrating this purported cost, as a systematic review and meta-analysis of studies evaluating the effects of bystander programs found that these programs are successful at increasing bystander intervention to stop violence committed by others, but the programs have no significant effect on participants’ own sexually violent behavior (Kettrey et al., 2019).

Gender-specific prevention programs have the potential to emphasize that anyone can be a perpetrator or victim of sexual assault, albeit with different levels of risk. Yet, the gendered roots of mandated forms of prevention content suggest that this may be unlikely. Studies that evaluate programs implemented with specific gender groups provide the opportunity to examine differences in program content and outcomes based on participant gender. They specifically permit the evaluation of gendered patterns in the tactics promoted to different gender groups, and outcomes that are targeted/measured when programs are implemented with different genders.

In our meta-analysis of research assessing outcomes of campus sexual assault prevention programs, approximately two-thirds of the included studies evaluated programs that were implemented in settings that consisted solely of either (presumably cisgender) men or women (Kettrey et al., 2023). Thus, the present review is a sub-analysis of our larger meta-analysis, and it focuses on the subsample of studies implemented solely with men or women. No studies were implemented with TGQN samples and there was no indication of whether TGQN students were included in men’s or women’s programs. We limit our sub-analysis to studies that target either men or women and exclude studies that evaluate a single program implemented consistently with different groups in gender-segregated settings. This is so that we can examine differences in program content selected by researchers/practitioners to be implemented with specific genders.

Method

This analysis is part of a larger systematic review and meta-analysis evaluating the effects of U.S. campus prevention programming on sexual assault outcomes. The larger project was pre-registered with PROSPERO and full methodological details can be found in the registration protocol (PROSPERO protocol number CRD42020191392). We have reported meta-analytic findings from the aggregate sample of eligible studies elsewhere (Kettrey et al., 2023).

Inclusion Criteria

Studies that were eligible for the aggregate meta-analysis had to evaluate a campus sexual assault prevention program implemented with college students in the United States. Research reports for eligible studies could be disseminated in any year up through the date we conducted our search, but had to be written in English. Eligible studies also had to meet the criteria outlined below pertinent to intervention program, study outcomes, participants/setting, and research design.

Eligible Intervention Programs

Eligible studies included in the aggregate meta-analysis must have evaluated a sexual assault prevention program implemented with college students in the U.S. Eligible programs may have addressed sexual assault exclusively or in conjunction with other topics (e.g., intimate partner violence, and sexual health). Studies that reported one or more eligible outcomes, but did not explicitly state that the program contained sexual assault content, were not eligible for inclusion. To be included in this sub-analysis, studies had to evaluate a program that was implemented with a specific gender group. No studies in our aggregate analysis evaluated programs that were implemented solely with TGQN students. Thus, studies that were eligible for this sub-analysis evaluated programs that were implemented solely with men or women (with no clear indication of whether these included TGQN students). Since we were interested in examining gender-specific programs, we excluded studies that evaluated a program that was uniformly implemented with different gender groups in gender-segregated settings.

Eligible Study Outcomes

To be included in the aggregate meta-analysis, and in this sub-analysis, eligible studies must have reported one or more outcomes in one of the following domains: sexual assault attitudes/knowledge, sexual assault victimization, sexual assault perpetration, and bystander-related outcomes. We used these same inclusion criteria for this sub-analysis and reported on study characteristics and program content from the sample of all studies that met this inclusion criterion. However, since the number of men’s program evaluations and women’s program evaluations that, respectively, reported each attitude/knowledge outcome were small, we only report victimization, perpetration, and bystander behavior outcomes.

Sexual assault victimization included experiences of any unwanted sexual contact. Similarly, perpetration included measures of the commission of any unwelcome sexual acts. It included self-reports and official reports, but it must have represented actual behavior, rather than intentions to commit assault. Bystander behavior included actions that participants took to prevent sexual assault or aid a survivor of sexual assault.

Eligible Participants and Settings

To be included in the sub-analysis, eligible studies must have evaluated programs that were implemented with a single-gender sample of college students attending colleges/universities in the United States. This included studies reporting on broad samples of college students as well as those using specialized samples such as those focusing on athletes or fraternity/sorority members. Those studies that reported findings from breakout groups (e.g., reporting findings separately for fraternity members and non-members) were only eligible if findings were reported such that breakout groups could be combined aggregated to calculate aggregate effect sizes. To ensure our findings were representative of program effects among traditional college students, the mean age of study samples could be no greater than 25. However, in our screening process, we excluded no studies based on this age criterion alone.

Eligible Research Designs

Eligible studies must have used the individual as the unit of analysis (e.g., measured individual-level attitudes/knowledge or behavior) and must have used an experimental or controlled quasi-experimental research design to compare an eligible intervention group (i.e., students assigned to an eligible program) with a comparison group (e.g., students not assigned to an eligible program). We specifically included the following research designs: randomized controlled trials (i.e., RCTs using individual or cluster assignment), quasi-RCTs, and controlled quasi-experimental designs (QEDs, i.e., those using a comparison group not assigned randomly or quasi-randomly). Eligible QED designs included regression discontinuity designs and matching, as well as studies that reported enough statistical information to allow estimation of pretest effect sizes (treatment/comparison group equivalence) for at least one eligible outcome measure.

Search Strategy

We conducted an initial search for literature in January 2020 and conducted an updated search in June 2021. To minimize omission of eligible studies and obtain a sample that was representative of published studies (i.e., those appearing in books or peer-reviewed journals) as well as unpublished studies (i.e., dissertations/theses, conference proceedings, working papers, forthcoming articles), we conducted a comprehensive search of the literature following strategies outlined by Cooper (2010). This included conducting searches in electronic databases as well as conducting gray literature searches for unpublished studies.

Electronic Databases

We searched electronic databases that included bibliographic information for reports from a wide range of disciplines that are relevant to campus sexual assault. These disciplines included health, sociology, psychology, education, and criminology. We specifically searched PsycINFO, PsycARTICLES, Education Resources Information Central, Sociological Index, SocIndex, Criminal Justice Abstracts, ProQuest (including dissertations/theses), PubMed, Cochrane Central Register of Controlled Trials, and Cochrane Database of Systematic Reviews. We used search terms that we expected to capture the target population and terms expected to capture sexual violence. We also used more general terms that had the potential to identify studies addressing physical and/or sexual violence. Our specific search terms were as follows:

[(“intervention” OR “prevention” OR “program” OR “education” OR “training” OR “curriculum”) AND (“college” OR “university” OR “higher education”) AND (“sexual violence” OR “sexual assault” OR “sexual coercion” OR “sexual consent” OR “unwanted sex” OR “undesired sex” OR “forced sex” OR “forced intercourse” OR “rape” OR “sexual victimization” OR “sexual violence perpetration” OR “sexual perpetration” OR “intimate partner violence” OR “IPV” OR “dating violence” OR “dating aggression” OR “dating abuse” OR “partner abuse” OR “bystander” OR “gender violence” OR “gendered violence” OR “gender based violence” OR “gender-based violence”)]

Gray Literature Search

To limit the influence of publication bias (i.e., the greater tendency for studies with significant effects to be published compared to studies with non-significant effects), we conducted a search for gray (unpublished) literature. To identify gray literature, we searched sources that we believed were likely to produce unpublished research and/or ongoing studies that were likely to be completed before our coding process was finished. We specifically searched and/or reviewed clincaltrials.gov, grant award listings from the National Institute of Justice, National Institutes of Health, and conference proceedings from pertinent organizations (i.e., American Society of Criminology, American Psychological Association, American Sociological Association, and Society for the Scientific Study of Sexuality). Additionally, we reviewed reference lists of extant review articles and all reports that we deemed eligible for inclusion. We also contacted authors of pertinent studies to request drafts of unpublished (e.g., forthcoming) studies, and reviewed tables of contents of journals relevant to sexual assault.

Eligibility Screening

After completing our search for literature, we double-screened abstracts of all candidate reports to identify and drop any clearly ineligible studies (e.g., those that did not evaluate a campus sexual assault prevention program, studies conducted outside the United States, and studies using single group pretest-posttest designs). We then retrieved full-text reports of all remaining candidate reports. We based our final eligibility decisions on readings of the full-text reports. To ensure reliability, two team members double-screened each report while adhering to a codebook.

Study Coding

Coding was deductive and entailed classifying each study into a-priori categories for each variable that appeared in the meta codebook. We coded all eligible studies for moderator variables that had the potential to influence program effects in the areas of study design (e.g., randomization, follow-up timing), program implementation (e.g., group size, frequency of treatment contact, and delivery format), and participant characteristics (e.g., average age and proportion of athletes). We also coded specific categories of program content (e.g., variables pertinent to risk reduction programs and bystander intervention training programs).

Eligible studies were double-coded by two independent coders who were trained to adhere to a detailed codebook. Coders entered data directly into a database and coding results were compared for discrepancies that were resolved by further discussion among the four-member research team. Throughout the coding process, we made all reasonable attempts to collect complete data on variables that were listed in the codebook. When we could not extract key variables of interest from study reports, we contacted primary study authors to request this information. To minimize risk of bias, research team members recused themselves from screening/coding any reports that they had authored or co-authored.

Calculation of Effect Sizes

To calculate effect sizes, we extracted relevant summary statistics from research reports (e.g., means/standard deviations, proportions, observed sample sizes). We reported continuous measures of outcomes using a standardized mean difference (SMD) effect size metric with a small-sample correction (i.e., Hedges’ g). When binary outcome measures were reported, we converted log odds ratio effect sizes (available from binary measures) into SMD effect sizes by entering the observed proportions and sample sizes into Wilson’s (2013) online effect size calculator. We coded all SMD effect sizes such that positive values (i.e., >0) indicated a favorable outcome for the intervention group and negative values (i.e., <0) indicated an unfavorable outcome.

The individual (i.e., individual-level attitudes/knowledge and behaviors) was our unit of analysis. However, some eligible studies used cluster randomization in which participants were randomized into intervention and comparison conditions at the group level (e.g., entire classes/ athletic teams assigned to a condition), yet the authors made inferences at the individual level. To correct for this, we followed procedures outlined in the Cochrane Handbook (Higgins & Green, 2011) to inflate the standard errors of effect sizes by multiplying them by the square root of the design effect [1 + (M − 1) ICC], where M is the average cluster size for a given study and ICC is the intracluster correlation coefficient for a given outcome. In cases where study authors did not report ICCs, we used a liberal assumed value of .10. This value has been used in past meta-analyses that synthesize attitude and behavioral outcomes of dating/sexual violence prevention programs (De La Rue et al., 2014; Kettrey et al., 2019) and is supported by Hedges and Hedberg’s (2007) research on ICCs in cluster RCTs conducted in educational settings.

Data Analysis

Our final sample included dependent effect sizes (e.g., effects from multiple follow-up waves or multiple treatment arms within a single study). Thus, we used the robust variance estimation (RVE) meta-analytic method. This method allows researchers to estimate meta-regression models with dependent effect sizes; however, when used with small samples, it can produce narrow confidence intervals and, thus, increase the chances of a type I error (Hedges et al., 2010; Tanner-Smith & Tipton, 2014; Tipton, 2013). To address this, Tipton (2015) developed a method for conducting RVE with a small-sample correction, which can be implemented with the Robumeta package in R (Fisher & Tipton, 2015). In our analysis, we used the Robumeta package to conduct RVE correlated effects modeling using inverse variance weighting and Tipton’s small-sample adjustment.

To minimize bias in our results due to effect size outliers, we Winsorized all effect sizes falling more than two standard deviations away from the mean of the effect size distribution. We did this by replacing outliers with the value that fell exactly two standard deviations from the mean of the distribution of effect sizes (Lipsey & Wilson, 2001). We conducted separate meta-analyses for every individual outcome, assessed heterogeneity using the I² and τ² statistics, and conducted bivariate moderator analyses by implementing meta-regression using small-sample RVE estimators for those candidate-moderators that were reported by a minimum of 10 studies for a specific outcome. Our reason for conducting bivariate moderator analyses was that many of the outcomes in our meta-analyses were reported by an insufficient number of studies to allow multivariate moderator analysis.

Results

Literature Search Results

The flow of studies through the search and screening process for both the aggregate analysis and sub-analysis is outlined in the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) diagram in Figure 1. Specific details concerning the flow of reports through the screening process for the aggregate analysis (N = 80) are discussed elsewhere (see Kettrey et al., 2023). Of the studies included in the aggregate analysis, 38 used gender-specific samples and were included in the sub-analysis. Specifically, 22 used samples of women, and 16 used samples of men. It is generally unclear whether TGQN students were included in these samples, and no studies specifically focused on TGQN students or reported information about TGQN students. Table 1 summarizes characteristics of the 38 studies included in this sub-analysis, broken down into women’s and men’s program studies.

Figure 1.

PRISMA diagram documenting flow of reports through systematic review.

Table 1.

Characteristics of Studies Included in the Meta-Analytic Sample.

	Women’s Studies (N = 22)		Men’s Studies (N = 16)
Moderator Variables	Percent or Mean (SD)	Valid (N)	Percent or Mean (SD)	Valid (N)
Study characteristics
Peer-reviewed	72.73	22	75.00	16
Year of dissemination^a	2009	22	2008	16
Study design
RCT—Individual	77.27	22	68.75	16
RCT—Cluster	9.09	22	25.00	16
QED	13.64	22	5.25	16
Study attrition
Mean % attrition at first follow-up	14.90 (13.11)	21	19.00 (16.62)	13
Mean % attrition at last follow-up	33.43 (16.73)	7	37.18 (25.71)	11
Posttest timing in weeks^b	11.31 (13.87)	67	10.50 (10.26)	94
Participant and setting characteristics
Campus setting
Community or technical college	0.00	19	0.00	15
HBCU	0.00	19	0.00	15
Public university (non-HBCU)	94.74	19	93.33	15
Private university (non-HBCU)	5.26	19	6.67	15
Mean % White in sample	83.80 (11.24)	20	85.00 (27.15)	15
Mean % TGQN or LGBTQ+ in sample	4.64 (4.7)	11	3.67 (3.27)	6
Mean age of sample	19.95 (1.28)	15	20.11 (0.84)	14
Mean % Greek members in sample	62.62 (40.40)	8	61.38 (38.90)	13
Mean % athletes in sample	NA	0	41.67 (50.64)	3
Risk reduction program content
Personal safety	63.64	22	0.00	16
Sexual refusal	47.62	21	0.00	16
Sexual consent	27.27	22	50.00	16
Self-defense	27.27	22	0.00	16
Alcohol	68.18	22	56.25	16
Communication skills	50.00	22	37.50	16
Bystander training program content
Bystander intervention	13.64	22	85.71	14
Study outcomes
Sexual victimization	63.64	22	0.00	16
Sexual perpetration	0.00	22	56.25	16
Bystander intervention	4.55	22	37.50	16

Note. RCT = randomized controlled trial; QED = quasi-experimental design; HBCU = historically Black college or university; TGQN = transgender, genderqueer/questioning, and nonbinary; SD = standard deviation.

Median is reported for year (1993–2021 for women’s studies and 1996–2021 for men’s studies).

N for posttest timing equals number of effect sizes. All other Ns represent number of studies.

Study and Sample Characteristics

As depicted in Table 1, most studies were RCTs and were disseminated through peer-reviewed outlets. The median/midpoint year of dissemination was 2009 for studies of programs implemented with women and 2008 for programs implemented with men (range 1996–2021). Participant samples of the included studies were not particularly diverse. The overwhelming majority of studies were conducted with samples from non-HBCU public universities (M_women = 94.74% and M_men = 93.33%). The majority of participants were White (M_women = 83.80% and M_men = 85.00%). A small minority of participants were TGQN or LGBTQ+ (M_women = 4.64% and M_men = 3.67%). However, only 11 of 22 studies in the women’s program subsample and 6 of 16 studies in the men’s program subsample reported gender identity beyond a gender binary measure or reported sexual orientation at all.

Program Content

Programs implemented with women contained more risk reduction content than those implemented with men. No programs implemented with men included content on personal safety (e.g., steps that participants may take to ensure safety, such as not leaving drinks unattended), sexual refusal (e.g., ways to decline sexual advances), or self-defense (e.g., physical/logistical tactics for thwarting a sexual assault). The percentages of programs implemented with women that included such content were 63.64%, 47.62%, and 27.27%. Yet, similar proportions of programs implemented with men and women included content on the ways that alcohol may contribute to sexual assault (χ²[1, N = 36] = 0.57, p > .05). Additionally, similar proportions of programs implemented with men and those implemented with women included content on communication (χ²[1, N = 36] = 0.56, p > .05) and consent (χ²[1, N = 36] = 2.06, p > .05). A significantly greater proportion of programs implemented with men (85.71%), compared to those implemented with women (13.64%), included content on ways that bystanders may take responsibility/action for preventing sexual assault (χ²[1, N = 36] = 18.29, p < .001).

Meta-Analysis Results

We ran separate meta-analyses for the following violence and behavioral outcomes: sexual victimization, sexual perpetration, and bystander intervention. Results are presented separately below, broken apart for the subsamples of studies evaluating programs implemented with men and those implemented with women.

Sexual Victimization

Fourteen studies evaluating programs implemented with women reported a total of 27 victimization effects (see Figure 2). The average intervention effect was small but significant and favorable (g = 0.19, 95% CI [0.06, 0.32]). Specifically, treatment group reports of victimization were 0.19 standard deviations lower than comparison group reports of victimization. There was no evidence of substantial heterogeneity (I² = 0.00%, τ² = 0.00). A sensitivity analysis to determine whether the average effect size differed when assuming a .00, .20, .40, .60, or .80 correlation between within-study effect sizes revealed that the average effect size was the same for each of these assumed correlations (g = 0.19). No studies of programs implemented with men reported sexual victimization as an outcome (Figures 3 and 4).

Figure 2.

Forest plot of effects of women’s campus sexual assault prevention programs on sexual assault victimization.

Figure 3.

Forest plot of effects of men’s campus sexual assault prevention programs on sexual assault perpetration.

Figure 4.

Forest plot of effects of men’s campus sexual assault prevention programs on bystander intervention behavior.

Among the studies of programs implemented with women, we ran a series of moderator analyses to determine the effect of program content on sexual victimization. The only content category that significantly moderated program effects on victimization was consent, and this effect was moderate in size (b = 0.40, 95% CI [0.27, 0.53]). Programs that included content on consent had more favorable effects on victimization (by 0.40 standard deviations) than programs that did not include content on consent. No significant moderating effects were found for personal safety (b = 0.02, 95% CI [−0.30, 0.33]), refusal (b = 0.14, 95% CI [−0.18, 0.47]), self-defense (b = −0.02, 95% CI [−0.42, 0.37]), alcohol (b = −0.18, 95% CI [−0.70, 0.33]), or communication (b = −0.00, 95% CI [−0.29, 0.28]). None of the studies that reported victimization as an outcome included bystander content, precluding its analysis as a moderator. Additionally, there was insufficient variation in perpetrator and victim gender to analyze these moderators.

Sexual Perpetration

None of the studies evaluating programs implemented with women reported sexual perpetration as an outcome. Nine studies evaluating programs implemented with men reported a total of 12 perpetration effects. The average intervention effect was non-significant (g = 0.18, 95% CI [−0.12, 0.48]) with no evidence of substantial heterogeneity (I² = 0.00%, τ² = 0.00). A sensitivity analysis to determine whether the average effect size differed when assuming a .00, .20, .40, .60, or .80 correlation between within-study effect sizes revealed that the average effect size was the same for each of these assumed correlations (g = 0.18). Since a small number of studies reported perpetration effects, we did not conduct moderator analyses for this outcome.

Bystander Intervention

Only one study of programs implemented with women reported program effects on bystander intervention behavior, which precluded data synthesis. Six studies of programs implemented with men reported a total of 17 bystander intervention effects. The average intervention effect was non-significant (g = 0.32, 95% CI [−0.32, 0.96]) with evidence of moderate heterogeneity (I² = 64.76%, τ² = 0.34). A sensitivity analysis to determine whether the average effect size differed when assuming a .00, .20, .40, .60, or .80 correlation between within-study effect sizes revealed that the average effect size was the same for each of these assumed correlations (g = 0.32). Since a small number of studies reported bystander intervention effects, we did not conduct moderator analyses for this outcome.

Discussion

Our analysis suggests that gender-specific programming is a fairly common approach to campus sexual assault prevention, as our subsample of gender-specific studies constitutes almost half of the 80 studies included in our aggregate meta-analysis. In general, programs implemented with men and those implemented with women both tend to apply a heteronormative, traditionally gendered lens to sexual assault prevention by portraying assault as something that men perpetrate against women. This is evident in both the gendered tactics that programs contain as well as the behavioral outcomes measured in evaluations of men’s programs versus women’s programs (see Table 2 for a summary of critical findings).

Table 2.

Summary of Critical Findings.

• Gender-specific campus sexual assault prevention programs overwhelmingly portray violence as something that men perpetrate against women.• TGQN/LGBTQ+ students are largely absent from gender-specific programs.• Women’s programs typically teach participants how they can reduce their personal risk of victimization.• Men’s programs teach participants how they may serve as bystanders who intervene to prevent other men’s violence.• Women’s programs have a small but significant effect on victimization (g = 0.19, 95% CI [0.06, 0.32]) but evaluations of these programs do not report effects on perpetration.• Men’s programs have a non-significant effect on perpetration (g = 0.18, 95% CI [−0.12, 0.48]) and evaluations of these programs do not report effects on victimization.

Note. TGQN = transgender, genderqueer/questioning, and nonbinary.

The tendency of campus sexual assault prevention programs to portray violence as something that men commit against women was evident in the tactics promoted by men’s and women’s programs. Programs implemented with women tended to include more risk reduction content than those implemented with men, suggesting that women, but not men, need to reduce their risk of being assaulted. Large proportions of programs implemented with women included prevention content on personal safety, sexual refusal, and self-defense tactics. No programs implemented with men included this content. This may not be surprising, as it suggests women are taught to avoid sexual assault (by implementing safety measures, effectively refusing unwanted sex, and fighting off perpetrators) and men are not. This may reinforce patriarchal notions that a woman is to be blamed if she is sexually assaulted, as it depicts sexual assault as something that women can avoid if they take precautions. It also has the potential to render men’s victimization invisible, such that men who experience assault may view their experience as anomalous and be disinclined to seek support. Ultimately, the tendency to teach women, and only women, to protect themselves from sexual assault can be invalidating for a range of victims.

Gender-specific programming also overwhelmingly presents bystander content to men. This is consistent with the roots of the bystander approach, which encouraged men to take action to prevent other men from perpetrating sexual assault (Foubert, 2000; Katz, 1995). Yet, it is interesting considering that past reviews of the research on bystander programs indicate that many of these programs are implemented in mixed-gender settings (Kettrey et al., 2019). This may indicate that program developers consider bystander intervention content important for the general populace (i.e., in mixed-gender settings), but not necessary to include when only women are in the audience. It could also indicate that mixed-gender bystander programming may actually treat men as the primary audience for their content. The exclusion of bystander content in programs implemented with women is especially surprising and concerning, as past research suggests women are a great source of bystander support to victims (Banyard, 2008; Bennett et al., 2017; Brown et al., 2014; Edwards et al., 2015; Kettrey & Thompson, 2023; McMahon, 2010). That is, women are promising allies in preventing sexual assault and, thus, bystander programs targeted toward women may benefit from harnessing this existing source of support.

These aforementioned gender patterns in program content were also pronounced in the behavioral outcomes that studies of gender-specific programs reported. Almost two-thirds of studies evaluating women’s programs reported victimization as an outcome whereas no studies evaluating men’s programs reported victimization. Additionally, over half of studies evaluating men’s programs reported perpetration as an outcome whereas no studies evaluating women’s programs reported this outcome. A significantly greater proportion of studies evaluating men’s programs than those evaluating women’s programs reported bystander intervention behavior as an outcome (only one evaluation of a women’s program reported this outcome).

Altogether, this means that we do not really know the effects of gender-specific campus sexual assault prevention programming on women’s perpetration, men’s victimization, or women’s bystander intervention behavior. We also do not know where TGQN students fit into gender-specific programming. As a result of the lack of TGQN-specific studies, and the fact that very few studies in our sample reported the gender identity of participants beyond a binary, we do not know (1) how TGQN students might be affected by programming targeted to their specific (non-cisgender) identities or (2) how TGQN students have been affected by gender-specific programs targeting (presumably) cisgender men and women. In order to make recommendations for practice for TGQN students, more research is needed on the effects of new and existing programs among various TGQN groups. This is an important goal, and there is currently a general dearth of research in this area (Blackburn et al., 2024).

What does all of this mean for practice? In the conclusion of their synthesis of systematic reviews, Kovalenko et al. (2022) recommend that sexual assault prevention should include both mixed-gender and gender-specific programming. Findings from our meta-analysis suggest that gender-specific programs portray women as victims and men as perpetrators or bystanders. When implemented alone, effects are statistically small (i.e., women’s victimization) or null (i.e., men’s perpetration and bystander intervention). However, it is possible that, when implemented in conjunction with mixed-gender programming, gender-specific programming may provide meaningful benefits in terms of sexual assault prevention. Future research should examine the effects of programming that includes both gender-specific and mixed-gender components, with specific attention to TGQN students. Until such research is conducted, it is difficult to ascertain the practical utility of Kovalenko et al.’s (2022) recommendation.

Limitations

Findings from this systematic review and meta-analysis should be interpreted within the confines of some important limitations. First, our sample is representative of evaluations of programs that practitioners/researchers selected to be implemented with specific gender groups, with no clear attention to TGQN participants. It does not include studies that evaluated a single program that was implemented with more than one gender in gender-specific settings (this excluded four studies in our aggregate meta-analysis sample). Thus, it is important to remember that findings are specific to gender-specific content rather than content that was simply implemented in gender-segregated groups. Additionally, this sub-analysis came from a meta-analysis of studies assessing campus sexual assault prevention programs implemented in the United States and the study samples were largely conducted at public non-HBCU campuses with largely White samples. As a result, findings may not generalize to other contexts or other demographic groups.

Finally, findings from our review represent effects demonstrated in studies meeting eligibility criteria that were disseminated between 1996 and 2021 (a 25-year period). In our aggregate analysis, we found that year of dissemination was not a significant moderator of program effects (Kettrey et al., 2023), meaning that the earlier studies and later studies in our analysis produced similar findings. However, it is important to note that our findings do not necessarily represent characteristics or effects of programs that have been evaluated outside of this timeframe, nor do they represent programs that are currently being implemented but have not yet been rigorously evaluated. Thus, it will be important for researchers to evaluate newly emerging approaches to campus sexual assault prevention.

Conclusion

Campus sexual assault is a problem that overwhelmingly affects cisgender women and TGQN students, yet any student may be a perpetrator or victim of sexual assault (Cantor et al., 2020). For this reason, scholars have recommended that campus sexual assault prevention programs adopt mixed-gender and gender-specific approaches that incorporate a range of scenarios wherein different genders are perpetrators and victims (Kovalenko et al., 2022). Yet, the comparative potential of mixed-gender and gender-specific approaches is unclear as past meta-analyses have produced mixed results regarding whether gender-specific and mixed-gender implementations of campus sexual assault prevention programming have differential effects (Anderson & Whiston, 2005; Jouriles et al., 2018; Kettrey et al., 2019; 2023). Importantly, these past analyses examined differences between programs implemented in single-gender versus mixed-gender settings but did not analyze differences in content of programs that target a specific gender.

Our sub-analysis suggests that gender-specific programming largely misses the opportunity to acknowledge the differential risks of perpetration and victimization among different gender groups. Specifically, both women’s and men’s programs overwhelmingly portray women as victims, men as perpetrators, and bystanders as men. Both largely ignore the experiences of TGQN students. Although cisgender women and TGQN students are overwhelmingly the victims of campus sexual assault (Cantor et al., 2020), neither women’s nor men’s programs clearly acknowledge that people of any gender may be victims or perpetrators.

Moving forward, it is advisable that gender-specific campus sexual assault prevention programming begin to reflect the risks of perpetration and victimization that are tailored to the target audience and, importantly, the effects of this program content should be rigorously evaluated (see recommendations in Table 3). This includes measuring program effects on perpetration and victimization among various genders. For programming that is implemented in mixed-gender settings, it is also vital that perpetrators, victims, and bystanders are depicted as realistically as possible, meaning that all genders are shown to take on all three roles, with clear indication of the prevailing gendered patterns of assault. Without the application and evaluation of these gender-specific approaches, researchers and practitioners will not know whether programming efforts are protecting the most at-risk gender groups (e.g., cisgender women and TGQN students) while also ensuring the safety of lower-risk groups (e.g., cisgender men).

Table 3.

Implications for Practice, Policy, and Research.

Practice	• The content of gender-specific campus sexual assault prevention programs should acknowledge that people of any gender may be perpetrators or victims of violence, and the effects of this content should be evaluated.• The content of gender-specific campus sexual assault prevention programs should be inclusive of TGQN/LGBTQ+ students’ experiences, and the effects of this content should be evaluated.• The content of women’s campus sexual assault prevention programs should emphasize the role that women may play in preventing sexual assault as active bystanders, and the effects of this content should be evaluated.
Policy	• Decision makers should determine the advantages and disadvantages of gender-specific versus mixed-gender programs as they pertain to behavioral outcomes, and use this information to make implementation recommendations to practitioners.
Research	• Evaluations of gender-specific campus sexual assault prevention programs should measure perpetration outcomes among women and victimization outcomes among men.• Evaluations of gender-specific and mixed-gender campus sexual assault prevention programs should examine the effects of programming on preventing violence against TGQN/LGBTQ+ students.• Evaluations should focus on programming that combines both gender-specific and mixed-gender approaches.

Note. TGQN = transgender, genderqueer/questioning, and nonbinary.

Thinking broadly, it is important to note that the studies included in our meta-analysis largely focused on individual-level and relationship-level strategies and outcomes, and explored the question of whether these are effective when implemented in gender-specific groups. Targeting individuals and relationships is the predominant approach to campus sexual assault prevention programming (Bonar et al., 2022). However, by itself, this is incomplete. The World Health Organization emphasizes the importance of viewing violence from an ecological perspective (Krug et al., 2002). Such a perspective entails recognizing the multifaceted nature of violence as a product of interactions between the individual, social relationships (e.g., peers, intimate partners, and family members), community factors (e.g., schools, workplaces, and neighborhoods), and societal factors (e.g., cultural norms and attitudes).

In line with this approach, experts in campus sexual assault prevention recommend a comprehensive strategy that engages with multiple levels of the social environment including students, faculty/staff, parents/significant adults, institutional leadership, and community partnerships (McMahon et al., 2021). Applying an ecological perspective directly to TGQN students, scholars have recommended that programming targeting TGQN students should include content inclusive of TGQN experiences (individual), ensure bystander training recognizes violence between TGQN people (social relationships), address oppression and create safe environments for TGQN people (community), and implement/enforce policies that protect TGQN people from harm while challenging those policies that create hostile environments for TGQN people (Blackburn et al., 2024). Thus, it is important to remember that gender-specific programs that target individuals and relationships, such as the ones evaluated in this meta-analysis, are just one small part of a comprehensive approach to sexual assault prevention.

Footnotes

Acknowledgements

The authors would like to thank Mary P. Koss for her expert consultation during the early phases of this project.

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 project was supported by Grant No. 2019-SI-AX-0004 awarded by the Office on Violence Against Women, U.S. Department of Justice. The opinions, findings, conclusions, and recommendations expressed in this publication are those of the authors and do not necessarily reflect the views of the U.S. Department of Justice. This systematic review and meta-analysis was registered with PROSPERO (CRD42020191392).

ORCID iD

Heather Hensman Kettrey

Author Biographies

Heather Hensman Kettrey, PhD, is an associate professor in the Department of Sociology, Anthropology and Criminal Justice and Director of the Center for Criminal Justice and Social Research at Clemson University. Her research focuses on gender and sexuality, violence, youth and emerging adulthood, and prevention programming.

Martie P. Thompson, PhD, is the Blue Cross North Carolina Distinguished/Endowed Professor in the Department of Public Health and Exercise Science at Appalachian State University. Her research focuses on risk factors and consequences of violence, as well as risk factors for suicidal behavior.

Robert A. Marx, PhD, is an assistant professor in the Department of Child and Adolescent Development at San Jose State University. Their research focuses on queer and trans youth development, as well as sexual violence prevention programming.

Alyssa J. Davis, MS, is a PhD student in the Department of Sociology at Vanderbilt University. Her research focuses on gender and sexuality, violence, masculinity, and online social movements.

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