PROJECT SUMMARY/ABSTRACT Alcohol misuse, sexual assault, and psychological distress (anxiety, depression) are significant interconnected problems among bisexual women. Heavy drinking is a primary risk factor for sexual victimization and increases risk for revictimization. Bisexual women report higher rates of heavy episodic drinking compared to heterosexual women, as well as higher rates of sexual assault compared to heterosexual or lesbian women. Bisexual women also report higher levels of minority stress, lower levels of connection to the LGBTQ+ community, and greater psychological distress (anxiety, depression) compared to lesbian women. Taken together, there is a strong need to target alcohol use, sexual assault, and psychological distress among bisexual women. Problematically, existing integrated alcohol and sexual assault interventions do not consider the unique stressors (minority stress, disconnection from the LGBTQ+ community) faced by bisexual women. Bisexual women also report less benefit from existing prevention approaches interventions. An integrated alcohol and sexual assault prevention program specifically tailored to bisexual women is therefore warranted. The proposed research will develop an intervention targeted toward bisexual college women between the ages of 18 – 30 with a history of sexual victimization who report heavy episodic drinking, a particularly high-risk group. The intervention will integrate (a) evidence-based motivational interviewing with personalized feedback to address risky alcohol use, (b) mindfulness skills training to reduce psychological distress, and (c) sexual assault risk reduction and resistance education as well as bystander intervention skills training with the goal of decreasing revictimization. Following a Stage 1A and 1B treatment development model, in Stage 1A information from informant interviews (N = 10), three focus groups (N = 30), stakeholder interviews (N = 6), and a campus advisory board will guide the development of the integrated intervention. The integrated intervention will be tested in an open trial (N = 20) in which interview and self-report methods will be utilized to gather information regarding the feasibility and acceptability of the intervention. The intervention will be revised and then evaluated in a Stage 1B randomized pilot trial involving 90 women assigned to the proposed intervention or a wait list control group. Women will be followed at 2- and 4- months post-baseline. In the Revision Phase, we will conduct exit interviews and revise the intervention to prepare for a larger clinical trial. Results of this research are expected to inform the development of interventions that not only target the intersection of alcohol use and sexual assault among bisexual college women, but also promote the overall wellbeing of bisexual women. This integrated approach represents a shift in how these public health problems are typically addressed and has the potential for significant impact across several cross-cutting outcomes.

PROJECT NARRATIVE Public Health Relevance Heavy drinking, sexual assault, and psychological distress are significant, co-occurring problems for young adult bisexual women. Psychological distress is a common aftereffect of trauma and intersects with minority stress and drinking to cope with psychological distress can increase risk for sexual revictimization. This study will involve developing and piloting an integrated intervention that designed to reduce alcohol use, sexual revictimization, and psychological distress among a particularly high-risk group – young adult bisexual women with a history of sexual victimization and who report heavy episodic drinking.