This is a competitive renewal of a stakeholder-engaged study across 28 college campuses focused on tailored harm reduction interventions to reduce risk for sexual violence (SV) among undergraduate college students receiving care from college health and counseling centers (CHCs). “Reducing Alcohol Involved Sexual vio- lence in higher Education (RAISE)” is a longitudinal study that builds on a previous cluster-randomized con- trolled trial on college campuses in Pennsylvania and West Virginia (R01 AA023260). We aim to reach stu- dents at elevated risk for SV and hazardous drinking: students with history of SV, students who identify as sex- ual/gender minority, and students who have disabilities (65% of our previous sample). SV, particularly alcohol- involved SV, remains highly prevalent on college campuses. Our previous study found that a large proportion of students seeking care in CHCs have experienced SV victimization (n=2291, 64% of women, 32% of men report lifetime SV) which is associated with binge drinking. Students identifying as sexual or gender minority or endorsing a disability (i.e., physical, emotional, sensory, neurologic, and learning impairments) report particu- larly high lifetime prevalence of SV that is associated with greater odds of binge drinking compared to students not exposed to SV. The previous RCT involved training CHC staff to deliver a brief educational intervention to reduce SV risk, titled “Giving Information for Trauma Support and Safety” (GIFTSS), to all students seeking care. Implementation varied across CHCs. Among students who received GIFTSS as intended, we found sig- nificant increases in self-efficacy to use harm reduction strategies and SV-related services. Students with his- tory of SV had greater than four-fold increase in odds of disclosing this history to providers. We identified pro- vider-, clinic-and campus-level changes needed to improve intervention delivery. To more directly target use of harm reduction strategies among students at elevated risk for SV and hazardous drinking, we also propose to integrate a safety decision aid (myPlan app for use on smartphone or computer) which increases harm reduc- tion behaviors among college women experiencing partner violence. The focus of this renewal is to 1) test strategies to improve implementation of GIFTSS, 2) offer support for students at elevated risk for SV and haz- ardous drinking with tailored harm reduction strategies delivered via the myPlan app after the clinic visit, and 3) strengthen campus policies to promote access to SV services and reduce hazardous drinking. A 2x2 cluster randomized controlled trial will compare two implementation strategies for GIFTSS in CHCs (provider scripts vs. learning collaborative) focusing on undergraduate students ages 18-24 (N= 2400 across 28 campuses) with follow-up at 4 months and 12 months (Aim 1). We will evaluate the effectiveness of myPlan in increasing uptake of tailored harm reduction strategies for those at elevated risk for SV and hazardous drinking (Aim 2). Finally, we will assess for alcohol and SV policy changes on each campus that may increase access to and uptake of confidential services among students at elevated risk for hazardous drinking and SV (Aim 3).

This is a competitive renewal that builds on a previous stakeholder-engaged cluster-randomized controlled trial across 28 college campuses and that focuses on undergraduate college students at elevated risk for sexual violence and hazardous drinking (i.e., students with prior history of sexual violence, students who are sexual or gender minority, and students with disabilities). “Reducing Alcohol Involved Sexual violence in higher Education (RAISE)” is a longitudinal study that will test research-informed strategies to improve implementation of a prevention intervention in college health and counseling centers, integrate a safety decision aid (via computer or mobile device) to more directly target harm reduction among students particularly vulnerable to hazardous drinking and SV, and evaluate campus policies that increase accessibility and uptake of confidential services for students. This is the first study to situate a sexual violence prevention intervention in college health and counseling centers to address two significant public health concerns -- alcohol-involved sexual violence and hazardous drinking on college campuses.