REDUCING ALCOHOL-INVOLVED SEXUAL ASSAULT THROUGH INTEGRATED PREVENTION EDUCATION AT UNIVERSITY OF OREGON by HANNAH ARGENTO-McCURDY A THESIS Presented to the Department of Public Policy, Planning, and Management and the Robert D. Clark Honors College in partial fulfillment of the requirements for the degree of Bachelor of Arts June 2020 An Abstract of the Thesis of Hannah Argento-McCurdy for the degree of Bachelor of Arts in the Department of Public Policy, Planning, and Management to be taken June 2020 Title: Reducing Alcohol-Involved Sexual Assault Through Integrated Prevention Education at University of Oregon Approved: Nicole Ngo Primary Thesis Advisor This paper examines the existing prevention education at the University of Oregon and how it can better prevent alcohol-involved sexual violence through comprehensive and integrated education surrounding substance abuse and misuse. Through a literature review and interview with the Director of Prevention Services and Substance Abuse Prevention Education (SAPE) Coordinator at the University of Oregon this paper identifies several areas in prevention education that could be improved. High-risk drinking behaviors among college students increases the risk for sexual violence, thus requiring a more coordinated and integrated approach to prevention education. In addition to the existing educational intervention for incoming students, I recommend that two other events receive targeted educational intervention due to increases in alcohol use: the transition between on-campus and off-campus living and students’ 21st birthdays. Second, I suggest a period of reflection for personal normative feedback on individual alcohol consumption and beliefs about consent and gender norms. This must be followed by guided discussion that could decrease high-risk drinking behavior and rape myth. Third, I recommend empathy interventions to discuss ii how rape myths and hypermasculinity can decrease barriers to action in bystander interventions. Finally, I find that employing harm reduction strategies already used in substance abuse prevention could be applied to sexual violence prevention by promoting sexual assertiveness. These additional interventions could help reduce sexual violence and alcohol consumption at the University of Oregon. iii Acknowledgements The process of completing this thesis has been one of the most rewarding and difficult academic experience in my life thus far and would not have been possible without the support of many people. The desire to write this thesis resulted from my own alcohol-involved sexual assault. I found the research process to be healing and bring some closure to these events in my life. Several people I thank below directly supported me in the aftermath of the incident both personally and academically and without their support and guidance I would not be graduating this term. I would like to first thank my thesis committee: Associate Professor with Tenure Dr. Nicole Ngo of Public Policy, Planning and Management, Professor of Biology Dr. Nathan Tublitz, and Clark Honors College Associate Dean of Undergraduate Studies Dr. Daphne Gallagher for their continued support during this process. Professor Ngo, I was inspired by your class on healthcare policy and am deeply grateful for your thorough feedback all year. Your expertise in public policy and guidance throughout this arduous but gratifying process has been integral to finishing my thesis. I am especially grateful to you for continuing your advisement over your maternity leave. Professor Tublitz, thank you for joining my committee and offering guidance during the winter term and your willingness to support myself and my work. I thoroughly enjoyed your class this past winter and am grateful that my final in-person honors college class was engaging, fun, and thought-provoking. Professor Gallagher, thank you for not only serving as my CHC academic advisor this past year and ensuring I graduated, but also for your flexibility and graciousness to serve on my committee. I appreciate your ongoing support over the last year and a half. iv Thank you to Miriam Jordan for your tireless work throughout this thesis process and throughout my four years at the Clark Honors College. I would next like to thank Professor David Frank for his continued support over the last two years. Your critical support at a time when I needed it most kept me academically and personally motivated to finish school. Next, I am grateful for Alexis Drakatos and Kerry Frazee not only for their invaluable participation in my research but as integral sources of support and relief, and for serving as personal role models for me. The SAPE program has been a second home for me on campus. I am deeply grateful for the support and compassion you both instilled in the program. Alexis has been my supervisor as a peer-educator for the last two years and I would like to thank her especially for her flexibility these last several months as my workload academically and professionally increased. I am also deeply grateful and lucky to for my large family who supported me in many ways. Thank you particularly to Annie and Oliver for spending so much time providing thoughtful, helpful feedback and critique for this thesis. Your love and support in a myriad of ways has kept me motivated and driven to finish school. Thank you to my mom and dad and my siblings, Sara and James, for being my fiercest advocates and pillars of guidance and unconditional love. Lastly, I would like to thank Jessica Haymaker and Kasia Mylnski. Kasia, thank you for helping me find justice in the aftermath of my assault. Jessica, thank you for your continued kindness, advocacy, and support during these last two years. Both of your work inspired me to become involved in and research sexual violence prevention. v Table of Contents Executive Summary viii Introduction 1 Section 2: Literature Review and Background 5 2.1 Rape Myths 5 2.2 Alcohol and Sexual Assault 6 2.3 Risk Factors for Sexual Assault and Alcohol Consumption Among College Students 9 2.4 Alcohol Consumption and College Students 9 2.5 Alcohol and sexual assault at the University of Oregon 11 2.6 Relationship between sexual assault and alcohol use 13 2.7 Bystander intervention training 13 2.8 Socio-ecological Model 15 2.9 Social Norming Theory 16 2.10 Harm Reduction Theory 19 Section 3: Methods 21 Section 4: Results 23 4.1 Interview: Kerry Frazee, Director of Prevention Services at University of Oregon 23 4.1.1 Misconceptions about college 23 4.1.2 Institutional barriers: Decentralization and funding 24 4.1.3 Socio-ecological model for SVPE and SAPE 26 4.1.4 Progress in programming efforts 27 4.2 Interview: Alexis Drakatos, Substance Abuse Prevention Education Coordinator at University of Oregon 28 4.2.1 Challenges and Successes of SAPE 29 4.2.2 New Programming Efforts 30 4.2.3 Substance Abuse and Sexual Assault 31 Section 5: Discussion of Prevention Strategies and Policy Recommendations 32 5.1 Promote community efforts 32 5.1.1 Moving from on-campus to off-campus housing 33 5.1.2 21st Birthdays 33 vi 5.1.3 Community level sexual violence reduction efforts 35 5.2 Applying Social Norming Theory to prevention efforts 36 5.3 Incorporating Empathy Interventions into Bystander Intervention Training 37 5.4 Applying Harm Reduction Theory to sexual violence prevention programs 39 Conclusions 41 Appendix A - Interviewee Questions 44 Appendix B - Interview Outline 45 Bibliography 46 List of Figures Figure 1. Four levels in the socio-ecological model 16 List of Tables Table 1. American Students Perceived vs. Actual Alcohol Consumption 10 Table 2. College Student Alcohol Consumption by Number of Drinks 11 Table 3. University of Oregon Alcohol Consumption 2012 12 Table 4. Bystander Interventions and Barriers 14 vii Executive Summary The summary below outlines a complete list of recommendations made in this thesis to implement at University of Oregon to improve sexual violence and substance abuse education prevention efforts. 1. Requiring multiple education interventions that coincide with transitioning from on-campus to off-campus housing and students’ 21st birthdays. 2. Developing strategies to integrate social norming practices by challenging student perceptions about their peers’ behaviors coupled with personalized normative feedback to reflect on personal use and behavior. 3. Integrating empathy interventions to reduce rape myths and increase active bystander participation. 4. Applying Harm Reduction Theory to promote sexual assertiveness and increase student comfortability with sexual communication. viii Introduction At the University of Oregon, approximately 1 in 5 women will be assaulted in college (Westat 2019). The University of Oregon Prevention Services seeks to educate students on substance abuse and sexual violence to help reduce these occurrences (Westat 2019). Sexual assault is defined as “sexual contact or behavior that occurs without explicit consent of the victim,” including but not limited to attempted rape, penetration of the body, fondling or unwanted sexual touching, or forcing a victim to perform sexual acts, such as oral sex. (RAINN 2020). Despite the high frequency of sexual assault at University of Oregon, most students only receive sexual violence curriculum as incoming freshmen and transfers. This thesis raises concerns that these one-time or ad hoc trainings insufficiently provide a strong foundation for students to learn about these topics throughout their college education. Similarly, Substance Abuse Prevention Education (SAPE) targets student groups but is not taught consistently nor mandated throughout the university. A survey among University of Oregon students found that 43.8% of women who reported incidents of non-consensual touching also reported drugs or alcohol were involved (Westat 2019). The prevalence and the link between sexual assault and substance abuse on campus demands that prevention programming surrounding both issues is taught concurrently. While alcohol is not a cause or an excuse for sexual assault, it is an important risk factor that should be integrated into sexual assault prevention programs. During the first several weeks of school, incoming freshman and transfer students undergo a series of educational programs surrounding sexual violence and substance abuse. Two mandatory online courses and “Get Explicit”1 seminars followed by the “red zone”2 campaign outside the Knight library saturate culture in the fall. Prevention programs are developed in the Office of the Dean of Students, implemented by students, and overseen by faculty and staff. The bulk of University of Oregon’s Sexual Violence Prevention Education’s (SVPE) resources are spent educating freshman during their first month in college. Substance Abuse Prevention Education (SAPE) spreads out its resources over four years but does not have any compulsory in- person training or workshops. Both education teams fall under the direction of the Office of the Dean of Students, but do not often collaborate on projects or curriculum development. It is also important to note that while SVPE and SAPE are two separate programs with different goals, there is a documented linkage between sexual assault and substance abuse [ CITATION Abbey01 \l 1033 ]. Because sexual assault is a highly underreported violent crime, statistics on it cannot be accurately determined. However, about one half of violent crimes involve the perpetrator under the influence of alcohol and this statistic can be applied to sexual violence as well [ CITATION Abbey01 \l 1033 ]. Consequently, addressing substance abuse on campus through education from freshman through senior year would help mitigate sexual violence. Cultures involving heavy drinking lead to circumstances where sexual assault is more likely to occur. This thesis explores the effectiveness of University of Oregon sexual violence and substance abuse prevention programs and makes recommendations on how these 1 “Get Explicit” refers to the mandatory sexual violence seminar delivered by trained peer educators in the fall for incoming students. 2 The red zone campaign located on the Knight library lawn at the end of October is a display of small red flags to represent the 3,250 students that will experience sexual violence this year. Aptly named, the “red zone” refers to the first few weeks of college where the rate of sexual assault is the highest. 2 programs could be improved. First, implementing educational programming throughout a student’s tenure around these issues is critical given that sexual violence can occur at any point during college. Second, a more effective way of mitigating sexual violence on campus is to integrate programs with substance abuse education. It is reasonable that a majority of substance abuse and sexual violence programming takes place during fall term freshman year since the largest percentage of sexual violence incidents occur during this period, which is commonly referred to as “the red zone.” These first couple months in college are also when many students first experiment with substances bot licit and illicit. Investing the bulk of Prevention Services’ capacity and resources in these initial months to incoming and often younger incoming students makes sense because it is the most effective way to reach on the most vulnerable populations on campus. However, sexual assaults and substance abuse can occur during any point in college. In fact, aside from the “red zone”, there are other significant spikes in heavy drinking during college including the transition from on-campus residences to off-campus housing and around a student’s 21st birthday. Thus, it is important to address sexual violence and substance abuse throughout college and not only during the first weeks of being a new student at UO. This thesis seeks to evaluate current prevention programming on campus, provide an overview of the prevalence of sexual violence and substance abuse nationally and at University of Oregon, and recommend alternative educational programming. These recommendations are based on a literature review, evidence-based research methods used to inform prevention efforts, and interviews with University of Oregon Prevention Services employees. This research addresses the processes, 3 approaches, and barriers to successful policy creation and implementation that best prevent sexual violence. It also investigates the methods and research that inform University of Oregon’s sexual violence and substance abuse prevention efforts to assess existing programs that align with evidence-based research. 4 Section 2: Literature Review and Background The purpose of this literature review is to examine published literature that investigates the relationship between substance abuse and sexual violence. This study focuses on the most common gender breakdown of sexual assault involving a male perpetrator and female victim. The National Sexual Violence Resource Center found in their 2015 study that approximately 21.3% of women and 2.6% of men are victims of attempted or completed rape (NSVRC 2015). Sexual assault occurs among people of all genders, victims and perpetrators can be male, female, and beyond the gender binary. The results of this research evaluating the relationship between sexual assault and alcohol could be applied to sexual violence scenarios between different perpetrator/victim gender identities. Also, there are differences in sexual assault when victims and perpetrators are different gender identities that this paper does not investigate, but that must be acknowledged. 2.1 Rape Myths Rape myths can be defined as widely and persistently held attitudes and typically false beliefs about rape that deny and justify male sexual aggression against women (Lonsway, Fitzgerald 1994). There are a myriad of rape myths that vary among different social settings, but most consistently rape myths include victim blaming, disbelief in rape claims, perpetrator exoneration, and claims that only certain types of women are raped (Grubb, Turner 2012). Two theories that inform rape myths are sexual social exchange theory and dating script theory. Sexual social exchange theory suggests that female sexuality has an exchange value wherein men feel they are “owed” 5 something and thus a man’s sexual coercion is understandable if he has “given” something such as paying for dinner or giving a gift (Bastow, Minieri 2010). Dating script theory affirms the gender norms that men are more sexually aggressive, and women should offer tokenized resistance to sexual advances before giving in (Bastow, Minieri 2010). Rape myths acceptance can lead to sexual assault because they are used to justify perpetrator actions and sexual assault by placing blame on the victim. Crime victims are often seen has being responsible for their own fate, contributing to the “victim blaming” phenomenon that plagues victims of sexual assault (Grubb, Turner 2012). There are many variables which contribute to victim blaming, including judgements made against victims for what they wear, any substance use, and previous relationships with the perpetrator. Social exchange theory further explains victim blaming because the exchange value assigned to female sexuality suggests that women “owe” aspects of their sexuality and when they do not deliver, male action is justified. Men and women both believe in rape myths, but belief tends to persist among men at a greater rate than women (Burn 2009). Men have consistently been found to be less supportive of rape victims (Ward 1988) and more likely to believe that a rape was consensual sex desired by the victim (Lonsway, Fitzgerald 1994). 2.2 Alcohol and Sexual Assault Existing literature shows a strong a link between the consumption of alcohol and sexual assault. In a summary report produced by the National Institute of Health, researchers assert that 50% of violent crimes involve the victim, perpetrator, or both parties consuming alcohol (Collins and Messerschmidt 1993). Sexual violence is classified as a violent crime and thus the statistics are held true for sexual violence 6 incidents. One study using data from the National Crime and Victimization Survey (NCVS) found that an estimated 25% of violent crime perpetrators consumed alcohol [ CITATION Col93 \l 1033 ]. Victims of violent crime who are under the influence of alcohol are never responsible for what happened, however alcohol diminishes awareness and ability, thus heightening many risk factors. Perpetrators, while always responsible for their actions, may not make the same choices or appropriately read a situation when inebriated. Many perpetrators of sexual assault misread non-verbal cues because alcohol diminishes cognitive function. Alcohol contributes to the misperception of the woman’s cues often resulting in men perceiving women as more encouraging than she really is because of alcohol’s effect on his cognitive functioning (Abbey, Zawacki and Buck, et al. 2001). Alcohol is also often used as an excuse for irregular or perceived bad behavior. Thus, male perpetrators may consume alcohol before committing a premeditated sexual assault, thereby giving them an excuse for their behavior. Research funded by the National Institute on Alcohol Abuse and Alcoholism conducted by Dr. Antonia Abbey and her team of researchers evaluated laboratory studies on how alcohol effects human behavior. The project surveys perpetrators and victims to identify factors that contribute to alcohol-involved sexual assault and examine the relationship between alcohol and sexual assault. The research found that “general, heavy alcohol consumption” and “heavy drinkers who are likely to spend more time at bars and parties” were found to be factors in both perpetrators and victims that increase the likelihood of sexual assault (Abbey, Zawacki and Buck, et al. 2001). One study conducted on incarcerated rapists and college students revealed that men who 7 reported drinking heavily are more likely to commit sexual assault because they are frequently in spaces where assault occurs (bars and social events), they may use their intoxication as an excuse for any socially deviant behavior, and they exhibit specific characteristics (impulsivity and anti-social behavior) that may increase their tendency to consume more alcohol (Abbey, Zawacki and Buck, et al. 2001). Additionally, gender norms, such as expecting men to initiate sexual or romantic advances, heightens some male’s inclination when consuming alcohol to act on certain impulses after their cognitive ability diminishes. When men drink the expectation is that they will feel more aggressive, powerful, and disinhibited (Abbey, Zawacki and Buck, et al. 2001). Men are also more likely to focus on sexual intent during conversations than women and “this focus on the implicit sexual meaning of women's actions can lead an interested man to make errors and assume that friendly behavior has a sexual intent.” [ CITATION Abb00 \l 1033 ] Alcohol has long held a reputation for acting as an aphrodisiac and an outlet for “letting loose,” or unwinding. Thus, when men become intoxicated, they are more likely to misinterpret signals and perceive women to be more sexually interested than they actually are (Abbey, Zawacki and McAuslan 2000). Coupled with the societal perception that women who drink alcohol are more sexually available, women who drink alcohol are thus more likely to experience unwanted sexual advances that can result in attempted or completed rape [CITATION Placeholder1 \l 1033 ] Thus, the circumstances under which alcohol-involved sexual assault occurs puts college students, many of whom have never lived away from home prior, at a heightened risk for sexual assault. 8 2.3 Risk Factors for Sexual Assault and Alcohol Consumption Among College Students The college culture and rules surrounding the relationship between men and alcohol versus women and alcohol further contributes to environments where sexual assault is more likely to occur. For example, fraternities are allowed to consume alcohol in their chapter houses, whereas sororities cannot (National Panhellenic Counsel, 2014). This difference further reinforces concerns over fraternity culture encouraging heavy drinking, which could be associated with more exploitative relationships with women. Members of Greek organizations are more likely to engage in high-risk drinking behavior including binge drinking (consuming 5 or more drinks for men and 4 or more drinks for women during a single drinking occasion), and experience negative consequences from drinking (blackout, hangover, academic problems, unplanned sexual assault) (Turrisi, Mallett, Mastroleo 2008). Sexual assault involving alcohol is more likely to occur between people who do not know each other well, are acquaintances rather than partners or spouses, and at parties, social events, and bars (Abbey, Zawacki and Buck, et al. 2001). College students are more likely to be in these types of social situations and for many students college is the first time they are exposed to social situations involving alcohol with little to no supervision. 2.4 Alcohol Consumption and College Students According to the American College Health Association (AHCA) National College Health Undergraduate survey, 60% of college students report some alcohol use in the last 30 days. 9 Table 1. American Students Perceived vs. Actual Alcohol Consumption (American College Health Association 2012) According to Table 1, women’s actual alcohol use is higher in categories establishing use in 9 days or less, but men report a higher percentage of use from 10-30 days (American College Health Association 2012). Men can typically consume more alcohol and while maintaining lower blood alcohol levels, however men report greater rates of binge drinking defined as drinking more than 4 drinks in women and 5 or more drinks in men [ CITATION Cen18 \l 1033 ]. Also, the perceived use of alcohol in college is much higher than actual use. This perception is increasingly dangerous regarding the relationship between sexual assault and alcohol because students are more likely to believe heavy drinking patterns and behaviors are common and thus participate in binge drinking as a social norm (American College Health Association 2012). This can result in individual events where students binge drink because their perceived use among their peers is higher, but not necessarily a consistent pattern in binge drinking. As a result, college students are more likely to drink at social events and in bars because of the perception that everyone else is doing so. Episodes of binge drinking puts college students at a higher risk for alcohol involved sexual assault. On average, at least 50% of college students’ sexual assaults are associated with alcohol use and in 81% of alcohol related sexual assaults both the victim and perpetrator are drinking (Abbey 2002). 10 Table 2. College Student Alcohol Consumption by Number of Drinks (American College Health Association 2012) Binge drinking is also more prevalent in college, and men report a higher rate of binge drinking than women (American College Health Association 2012). However, women reach a higher blood alcohol content (BAC) with fewer drinks due to body/fat distribution, hormones, height, and weight. Due to the frequency and amount of alcohol use among college students, college students are at heightened risk for sexual violence. 2.5 Alcohol and sexual assault at the University of Oregon The Presidential Task Force from the University of Oregon evaluated alcohol and drug use and prevention programs on campus in March 2013. The figure below compares survey results of University of Oregon students compared to the National Group from a survey conducted by the American Health College Association. University of Oregon students report a higher rate of binge drinking than the national average and a higher rate of any alcohol use. In a separate survey, University of Oregon students were surveyed in 2019 through the American Association of Universities Campus Climate Survey regarding the prevalence of sexual violence among students. It revealed that 20.8 percent of women experienced nonconsensual sexual contact by 11 physical force (defined on the survey as: someone holding you down with his or her body weight, pinning your arms, hitting or kicking you, or using or threatening to use a weapon against you) or inability to consent (defined on the survey as: when you were unable to consent or stop what was happening because you were passed out, asleep, or incapacitated due to drugs or alcohol) (Westat 2019). Table 3. University of Oregon Alcohol Consumption 2012 (University of Oregon 2013) The survey also revealed that undergraduate women who reported at least one victimization (unwanted sexual contact, verbally coerced sex, rape or attempted rape) was 13.5 percent of first- year students, 15.0 percent of second-year students, 22.5 percent of third-year students, and 28.6 percent of students in their fourth year or higher (Westat 2019). Estimates for the group of students in their fourth year or higher represent the cumulative risk of victimization students experience over the entire span of their college career (Westat 2019). While undergraduate first year students are typically considered to be the most at risk, collegiate Oregon women experience sexual violence throughout their 4 years at school. Additionally, sexual violence is a highly underreported crime. It is estimated that three out of four incidents of sexual assault go unreported and among female college students only 20% of sexual assault incidents are reported (Rape, Abuse and Incest National Network 2020). 12 2.6 Relationship between sexual assault and alcohol use While alcohol use and sexual assault often occur concurrently, this does not mean that alcohol is a cause of sexual assault. This paper does not investigate the causes of sexual assault however it is clear that alcohol heightens risk factors. High risk drinking behavior is pervasive in college, particularly among Greek members (Turrisi, Mallett, Mastroleo 2008). Perceived notions about college drinking among college students lead students to believe that there is a higher rate of drinking than actual use. Sexual assault among college students occurs more than half the time when one or both parties use alcohol, which demands that education surrounding sexual assault on college campuses include comprehensive programs surrounding this intersection. 2.7 Bystander intervention training One popular approach toward prevention across university campuses is bystander intervention training, which engages peers in reducing sexual violence. The central tenants of bystander intervention are: 1) recognizing a potentially harmful situation; 2) feeling empowered to act; 3) making a safe and effective action to prevent harm (Lehigh University 2020). Activating peers as bystanders is considered a positive method of sexual violence prevention because it frames people as potential allies rather than victims or perpetrators, and reduces the burden often put on victims for reducing sexual violence (Burn 2009). Examples of bystander intervention can be different for men and women. Some examples of techniques aimed at a female bystander are refusing to leave a friend alone at a party of bar or preventing a female from accompanying a male to a private location (Burn 2009). 13 The bystander intervention model has been widely used at colleges and universities as a way to reduce sexual violence and is employed in the mandatory “Get Explicit” training at University of Oregon. The bystander intervention model most widely used in universities asserts there are five steps to intervention and at each stage there is a barrier to action. Successful bystander intervention training seeks to address each barrier to action and empower students to be active bystanders. Intervention Stage Barrier to Action Notice the event Failure to notice the event due to distraction at social event Interpret the situation as high risk Failure to identify from lack of for sexual assault knowledge of high-risk factors Assume intervention Failure to take responsibility due responsibility to diffusion of responsibility, relationships, attributions of worthiness Decide how to act Not knowing what to do or say Choose to act Fear of social retribution, perceived social norms Table 4. Bystander Interventions and Barriers (Latané, Darley 1970 and Burn 2009) Successful bystander intervention training seeks to address each barrier to action and empower students to be active bystanders. 2.8 Socio-ecological Model Both Sexual Violence Prevention Education (SVPE) and Substance Abuse Prevention Education (SAPE) use the four-level socio-ecological model to drive their prevention efforts. The model addresses that how individual, relationship, community, 14 and societal factors contribute to putting people at risk from experiencing or perpetrating violence or participating in high risk behaviors (Center for Disease Control 2020). At the individual level, factors influencing behavior include gender, sexual orientation, religion, personal goals and values, character, health and economic status, ethnicity, and race (NASPA 2004). Prevention strategies at the individual level include motivational interviewing, a technique employed by SAPE wherein peer educators discuss with interested students constructive ways to make a behavior change, such as a strategy to quit using vape or tobacco products. Examples of enacting change on a relationship level is encouraging bystander intervention and working with individuals to spread information or resources to their immediate friends. Addressing a shift on the community and societal levels can be done through larger, campus-wide efforts, such as media campaigns and required trainings. Figure 1. Four levels in the socio-ecological model (Center for Disease Control, 2020) In the diagram above, the overlap between each circle suggests how each level impacts each other; the societal level has an overarching influence across the other three. The American College Health Association suggests that institutions of higher education which use the socio-ecological model should focus primarily on transforming the campus and community environments through population-level initiatives (American 15 College Health Association 2012). The Get Explicit program delivered by SVPE’s peer educators addresses community level behavioral change. Employing a socio-ecological model ensures that prevention efforts address the different levels at which targeted behavior change outreach must occur. This model asserts that addressing societal, community and relationship levels will influence individual behavioral change (NASPA 2004). The interaction between the individual, environment, and community is integral to the socio-ecological model. 2.9 Social Norming Theory Social Norming Theory recognizes that individuals, particularly young adults, tend to overestimate their peers’ alcohol consumption and these perceptions often lead them to drink more heavily themselves than they would otherwise would (McAlaney, Bewick, et al. 2011). Social norms campaigns typically include a marketing component to align students’ perceived use with the actual use. These campaigns are often utilized on college campuses, including the University of Oregon. The premise of applying social norming theory to substance abuse prevention is that if individual perceptions are corrected to reflect actual use, then social pressure to engage in high-risk, perceived use will decrease (McAlaney, Bewick, et al. 2011) There are mixed results regarding effectiveness of social norming theory in changing individual behavior. For example, one study found that college students exposed to alcohol abuse prevention education intervention that included a social norms component saw a decrease in the student’s perception of use, but not a decrease in self- reported alcohol consumption (Stamper, Smith, et al. 2004). This suggests that social 16 norming may not be effective on its own and must be coupled with other prevention strategies. A study published by the Journal of Consulting and Clinical Psychology found that comparing young people’s personal use to the social normative use was successful in reducing individual alcohol consumption (Neighbors, Lewis, et al. 2016). Personal normative feedback compares individual use to the norm and was found to be effective in reducing individual alcohol consumption by continuing the educational programming over a six-month period. This indicates that longer term programming and including personal normative feedback increases the efficacy of social norming and changes individual behavior long term. Social norming can also be applied to mitigating sexual violence. Data from one study reveals that men underestimate how important sexual consent is to other men. Men’s perception of their peer’s norms heavily influences their adherence to sexual consent and found that presenting accurate data about social norms can catalyze men into allies against sexual assault (Fabiano, Perkins, et al. 2003). Men who commit sexual assault or have sexually aggressive tendencies also tend to overestimate their peer’s involvement in sexually aggressive activities (Orchowski 2019). Changing behavior to prevent sexual violence through social norming can be done by delivering personalized normative feedback about how male perceptions about sexual behavior differs from their peers. Interactive small groups where information comparing an individual’s perception to the group presented in real time and active social marketing campaigns using media, posters, and materials can galvanize behavior change 17 (Orchowski 2019). These strategies aim to address students at an individual, group and collective level, echoing the socio-ecological model. One successful program for first year collegiate men that changed self-reported sexually aggressive behavior used social norming to dispel myths about bystander intervention, norms correction, consent discussions, and invoke empathy for victims of sexual assault (Berkowitz, Gidycz, et al. 2011). The integrated model for sexual assault used to inform this study proposed that a perpetrator’s attitudes, beliefs, socialization, and peer-group relationships determine the conditions in which he would be willing to perpetrate or justify a sexual assault (Perkins, Berkowitz 2003). This program included a “booster session” four months later to revisit topics discussed in the first session (Berkowitz, Gidycz, et al. 2011). The empathy component of this program strengthened this community on a relational level. Students in the program had the opportunity to share their discomfort with notions of toxic masculinity and discus their personal experiences in an effort to “undermine traditional conceptions of masculinity” that are linked to high-risk sexual behavior (Berkowitz, Gidycz, et al. 2011). 2.10 Harm Reduction Theory The goal of harm reduction is to lower high-risk behavior without encouraging abstinence. Harm reduction programs have successfully reduced the risk of unwanted pregnancy and transmission of sexually transmitted disease through sexual health education programs among teens (Canadian Paediatric Society 2008). When applied to substance abuse prevention, the principal of harm reduction is to accept that a certain continued level of use will exist and prioritizes reducing high-risk behavior rather than discouraging all behavior (Canadian Paediatric Society 2008). SAPE employs this 18 strategy throughout all of its programming. Rather than encourage students to abstain from substance use, the mission of SAPE is to decrease risks associated with substance abuse and engage the campus community in conversations around substance abuse and misuse. Harm reduction includes the transtheoretical model of change. This model suggests that people move through several stages (outlined below) when making a serious behavioral change. SAPE peer educators use this model during motivational interviewing to gauge how willing and able a student is to change a behavior. These stages include (MacMaster 2004):  Precontemplation: No intention to change, often due to lack of awareness  Contemplation: Awareness of the problem, and individual is considering a change  Preparation: A combination of intention to change and making plans to do so  Action: Currently implementing plan to make a change  Maintenance: Ensuring there is no relapse in behavior Harm reduction aims to meet people in their current circumstance and work with them, wherever they are in the stages of change. For application at a university, this means accepting that substance use will occur on some level regardless of any policy prohibiting use or programs that discourage it. SAPE programming uses a community- based harm reduction approach grounded in peer education. 19 Section 3: Methods When researching sexual violence and substance abuse, people tend to be reluctant to talk about their own experiences. Thus, it is very common to use anonymous surveys to collect and interview specialists on the topic. For this research, publicly available data collected from University of Oregon surveys on sexual violence and substance was used to compare statistics on use and violence, specifically the Campus Climate Survey from 2019 and 2015 in addition to interviews with staff from University of Oregon Prevention Programs. The purpose of these interviews was to understand the current atmosphere in the Prevention Education office and gauge the challenges and successful outcomes from both programs. Employees discussed how the nationwide phenomena described in section 2 have been incorporated at the University of Oregon, putting the national discussion in a local context. Specific questions were asked regarding funding, a common issue among prevention programs at university campuses as well as the relationship between substance abuse and sexual violence on campus. Interviewees include Alexis Drakatos, Substance Abuse Prevention Coordinator, and Kerry Frazee, Director of Prevention Services. The University of Oregon Institutional Review Board (IRB) for Human Subject Research approved this project. Questions posed to interviewees are in Appendix A. The interviews were conducted in person at the respective offices of Alexis Drakatos and Kerry Frazee in Oregon Hall at the University of Oregon. The interview with Alexis Drakatos was approximately 27 minutes and the interview with Kerry Frazee lasted approximately 39 minutes. Interviews were recorded 20 on iPhone and transcribed in a Microsoft Word document. The outline for the interview process can be found in Appendix B. This paper presents the results from the interviews in a narrative summary. Answers to the questions posed to the interviewees were analyzed to consider themes that were consistently mentioned during the interview. The discussion in section 5 evaluates the evidence-based body of research Frazee and Drakatos cite to inform the University of Oregon Prevention Programming that was also discussed in section 2. 21 Section 4: Results 4.1 Interview: Kerry Frazee, Director of Prevention Services at University of Oregon February 27, 2020 Kerry Frazee serves as the Director of Prevention Services at the Office of the Dean of Students at the University of Oregon where she oversees the SVPE and SAPE programs. She has held this position for the past three years. Frazee began working on the University of Oregon Prevention Services team as the SVPE Director in 2014. After organizational restructuring and an expansion of duty she became the Director of Prevention Services and oversees areas of high-risk behavior, including sexual violence and substance abuse and misuse. 4.1.1 Misconceptions about college One of the challenges Frazee finds is that many students have not received any training around sexual assault, consent, or substance abuse or misuse until college. She notes that students have already adopted habits surrounding substance use and starting a behavior change in late adolescence or early adulthood is challenging. She claims that to create a foundation of building prevention efforts, programs have to go back to the basics of education and awareness. While she finds that large movements, such as “Me Too” has shifted entry level awareness, Kerry states that, “there is a lot of work that has to reconstruct the cultures and ideologies that students come to college with to progress and move forward.” 22 She also notes that one of the largest challenges regarding substance abuse and misuse is related to social norms when students enter college. The media does not help. Movies often glorify college environments and convey experiences with substance abuse, misuse, and hookup culture. She finds that when students come in with preconceived notions, there is a difference between their perception of the social norm and the real norm. Thus, students are more likely to engage in high risk behaviors to fit in within this perception. As a result, University of Oregon Prevention Services work is rooted in addressing social norms and infusing harm reduction with students and starting these conversations when students are already in college. Kerry asserts she most commonly sees two areas of motivations for students engaging in substance use: a sense of belonging (expectations and perceptions of how to fit in) and using substances as a coping mechanism. A desire to fit in often leads to drinking alcohol because of the high perceived use. Students who use alcohol to cope perceive that substances relieve or minimize stress. As a result, they are more likely to see it as a resource for stress reduction and coping. Kerry says the media encourages substance misuse: “I deserve this, I need this, I’ve had a hard day, using it to cope,” and suggests, “students see it in those circumstances and it leads to those motivating reasons.” 4.1.2 Institutional barriers: Decentralization and funding Two institutional barriers Frazee discusses are the decentralization of prevention efforts across campus and funding. Frazee views barriers as opportunities—not for the students but for the administration. There are pockets of campus doing substance abuse prevention and sexual violence prevention, but there is an unmet opportunity to, “collect 23 forces and work smarter, not harder.” Various departments and organizations across University of Oregon, including the Women’s Center, the Men’s Center, Fraternity and Sorority Life (FSL), University of Oregon Police Department, Domestic Violence Clinic, University Health Center, University Counseling Center, Residence Life, Orientation Programs, UO Athletics, Safe Ride, Organization Against Sexual Assault (OASA), and the Collegiate Recovery Center all offer resources and conduct programming around prevention education. While many organizations work together in various capacities, there is no administrative centralization to combine forces. Funding for SVPE and SAPE varies from several different sources and this also serves as a challenge. SVPE is funded through grants, donations, foundation funding (money from private donors) and general (institutional, public money) funding. SAPE uses general funds for one full time employee (SAPE Coordinator) and the rest of the programming is through donations. General and foundational funds are nearly certain but grants and donations must be procured each year. “Get Explicit” and 3rd Millennium are funded by the University of Oregon Foundation and Frazee expects that these programs will transition to be funded by the General Fund in the future. Funding for SVPE is mostly allocated to Get Explicit, an in-person peer led intervention that occurs in the fall for all incoming students. Prevention Services and SVPE conducted research in developing the program and ensured it met all of the five primary principle components for effective programming on college campuses: using social norms, peer education, multi-method delivery approaches, appropriately timed (intentionally in the red zone), and community specific follow up. A graduate educator position was created to intentionally include all of those components. Their research 24 found that bystander intervention is the leading promising practice in reducing sexual violence among peers, and thus “Get Explicit” trains students on being active bystanders and intervening safely in a situation that may lead to sexual assault. SAPE funding is procured exclusively through donations (with the exception of one full time employee) and the Communiversity program. Communiversity is a partnership between University of Oregon and outside student housing vendors who pay to have their housing advertised at University of Oregon. Each Spring the SAPE team puts on a housing fair and secures vendor contracts to secure funding for their programming. A majority of SAPE funds are put towards peer educators to deliver prevention education materials through various programming. SAPE peer educators increase education and awareness and partner with environmental components (stress less, other student organizations committed to overall health and wellness) so that substance use is infused into these larger conversations. 4.1.3 Socio-ecological model for SVPE and SAPE SAPE and SVPE use evidence-based strategies to prevent abuse, misuse, and violence founded on the socio-ecological model, a four-level model that considers the complex interplay between individual, relationship, community, and societal factors (Center for Disease Control 2020). Motivational interviewing (peer led interviews to initiate change on an individual level) combined with social norming (based on the premise that perceptions of peer drinking norms have a causal influence on an individual's own drinking) drives SAPE programming to create behavior change on an individual and community level (Stamper, Smith, Gant, Bogle 2004). SVPE uses the socio-ecological model as well. However, a challenge of focusing prevention efforts 25 addressing sexual violence at the individual level is that most perpetrators do not typically plan on inflicting sexual violence in advance. Thus, SVPE does targeted community outreach and includes bystander intervention education to engage communal and societal factors. 4.1.4 Progress in programming efforts Regarding sexual violence, Frazee is most proud of how the National and Campus Climate Survey from 2015 and 2019 have documented success in University of Oregon sexual assault programming. Sexual violence is difficult to measure because it is highly underreported. An increase in reports typically indicates that students know and trust resources and know that what happened to them is not okay. The surveys have been informative and served as a benchmark across the nation. An increase in bystander behavior and intention to engage in bystander behavior and consent and has also been positive. As the pervasiveness of sexual violence further permeates the public lexicon, organic student initiatives in the last few years on campus continue to increase, compared to when Frazee first started at the University of Oregon. Additionally, changes to the reporting policy to be more survivor and student centered, updated faculty and student relationship policy have also contributed to recent successes. Regarding substance abuse prevention, Frazee is most proud of the program’s growth and outreach. Social norming and outreach have greatly increased where students are more comfortable talking about substance abuse and misuse. SAPE partnered with recovery programs and increased late night programming. Every Thursday each term “Ducks After Dark” shows new movies on campus that is free for students. This stemmed from SAPE programming. The climate and how students and 26 the University of Oregon community talks about substances has shifted and Frazee hopes to continue that and focus on harm reduction involving high risk and binge drinking behaviors to encourage more healthy experiences for students. Prevention services acknowledges the intersection between sexual violence and substance use and Frazee asserts there are components of substance abuse that need to be incorporated in discussions around sexual violence. Regarding specific student groups requesting presentations or information about the intersection between sexual violence and alcohol, the sober monitor policy often comes up on the sexual violence prevention leadership board in Fraternity and Sorority Life (FSL) office at University of Oregon. Sober monitoring is required by FSL at all official fraternity or sorority events. It is common for harm reduction strategies related to SVPE to include recommendations for the structures of Greek member events. There is a push towards helpful collaboration with social policy and sober monitors to decrease risk factors for social events in the Greek system. 4.2 Interview: Alexis Drakatos, Substance Abuse Prevention Education Coordinator at University of Oregon February 11, 2020 Alexis Drakatos is the Coordinator for Substance Abuse Prevention at Office of the Dean of Students at University of Oregon. The interview was structured in a series of planned questions, with follow up as needed. 27 4.2.1 Challenges and Successes of SAPE The first series of questions focused on the challenges and successes of her current position. Regarding alcohol consumption among college students, the largest barrier Drakatos deals with is normalization of unhealthy drinking behaviors in the community. Drinking culture that permeates student life, and to an extent among faculty and staff, normalizes binge drinking especially among students. She thinks that “even the language [of some faculty and staff] and [assumption] that students will show up to class on Friday mornings hungover,” further contributes to this normalization. Drakatos asserts that these accepted behaviors are more difficult to change because the expectation is that this is normal and permissible. According to Drakatos, students often overestimate how many of their peers engage in high-risk drinking behaviors and this misperception further, “normalizes binge-drinking behaviors.” The University of Oregon also perpetuates stereotypes of a party school. For example, tailgating hours were recently extended and the “culture and community of our school with such a big emphasis on athletics can contribute” to normalizing binge-drinking behaviors, making it difficult to encourage a healthier relationship with substances. She discussed the difficulty of applying prevention efforts where students enter with a range of experiences with substances. Most models are, “one size fits all,” when in reality students have a wide range of backgrounds in relation to substance use and misuse. Especially being on a medium sized campus, Drakatos asserts that using the “one size fits all” model is hard because, “there are many different communities and students with different experiences [and] having the capacity to meet those groups 28 where they are at is tough because of how big the size of campus is compared to the ratio of our staff.” The greatest institutional barrier to SAPE work is a lack of funding. Perhaps the most shocking revelation from this interview is that the University allocates no general or foundation funding to SAPE outside of Drakatos’ salary and purchasing 3rd Millennium3 online courses for incoming students. The SAPE office hires and trains student peer educators to do conduct all substance abuse prevention programming that occurs after mandatory online courses. This programming includes informational handouts made by peer educators, tabling events, presentations to student groups, among other special events. Funds to pay peer educators and SAPE programming comes from the Communiversity program. Communiversity contracts are highly lucrative. However, because these contracts are frequently renegotiated and dependent on outside sources, substance abuse programming is not as stable as their SVPE counterpart. 4.2.2 New Programming Efforts The SAPE program was restructured and revitalized under Drakatos over the last year and a half. There has been no change in the data regarding substance use on campus because new, increased efforts to reduce substance abuse and misuse have been only recently implemented. Drakatos instead looks at what information and impressions students take with them after presentations and outreach. The feedback SAPE receives has been very positive. Some of the successes Drakatos has seen include successful 3 3rd Millennium is the mandatory online prevention course students must take during their first term at University of Oregon. It covers consent, alcohol and cannabis use and misuse, and bystander intervention. 29 medical amnesty campaigns that include information on how to save a life when someone is overdosing on alcohol. SAPE has received positive feedback about how these campaigns have shifted the dialogue so that students feel more comfortable getting help when someone is in serious danger. For example, medical amnesty laws in Oregon protect underage people from receiving a citation known as a Minor in Possession (MIP) for both the person who makes the call to medical authorities and law enforcement and for the person who is at risk of overdosing. SAPE campaigns work to publicize this information and to reduce alcohol-related deaths. In the fall term, SAPE reached over 1,000 students through community specific presentations tailored to individual requests. SAPE aims to reach every student twice during their academic career. 4.2.3 Substance Abuse and Sexual Assault Drakatos sees the intersection between sexual violence and substance abuse most often when student organizations request presentations about both alcohol and sexual assault. Drakatos asserts that knowledge about rape culture and how alcohol is used to perpetuate sexual assault has permeated public knowledge in recent years. Drakatos claims that many organizations on campus at University of Oregon request that SAPE deliver presentations that includes both alcohol misuse and abuse and sexual violence prevention. Drakatos has attended the National Association of Student Personnel Administrators (NASPA) conference for the last three years. In the first two years there were very few dialogues on the intersection between sexual assault and substance use, however at the most recent 2020 conference there were numerous options at NASPA prevention strategies that targeted this intersection. 30 Section 5: Discussion of Prevention Strategies and Policy Recommendations Several recommendations outlined in this discussion build on the interviews in section 4 and the literature reviewed in section 2. These recommendations include: 1) requiring multiple required education intervention programs to coincide with common transitional events among students on a community level; 2) Developing strategies to best integrate social norming practices into these prevention efforts; 3) Integrating empathy interventions to reduce rape myths and increase active bystander participation; 4) Applying Harm Reduction Theory to promote sexual assertiveness. These recommendations seek to reduce alcohol-involved sexual assault through multi-faceted educational interventions. 5.1 Promote community efforts Drakatos and Frazee each state that both SVPE and SAPE use the socio- ecological model to inform prevention programming efforts. This includes motivational interviewing techniques that address behavioral change at an individual level and “Get Explicit” approaches that encourage behavioral change at a communal level. To comprehensively address this intersection, policy must address each level. The University of Oregon should concentrate their resources on targeting behavioral change at the community level based on recommendations from the American College Heath Association and NASPA to influence the individual and relationship levels, on a population-wide scale. Current “Get Explicit” programming seeks to do this, however due to limited funding SVPE concentrates their efforts on delivering information to 31 incoming students during the red zone. As students move throughout college, their environment, relationships, personal goals, and character will almost certainly change, making it critical to reach them at multiple points during their time as a student at the University of Oregon. 5.1.1 Moving from on-campus to off-campus housing An important juncture during a student’s time on campus is transitioning from living on-campus to off-campus. This typically occurs after their first year on campus. Previous work found that students who live off-campus without their parents, either alone or with peers, consume alcohol more frequently, at greater quantities, and with a higher number of alcohol-related consequences than students living on-campus (Benz, DiBello et al. 2017). Additionally, moving off-campus distances students from on- campus resources. Trained residence staff and assistants are no longer in proximity, diminishing student resources for concerns or help regarding sexual assault or substance use. Yet, there is a no mandated university programming that prepares students for off- campus living. A mandatory educational intervention occurring at the end of Spring quarter to revisits information from “Get Explicit” and 3rd Millennium and increases population-wide knowledge about substance abuse and misuse, and sexual violence prevention is suggested. This programming should be modeled after “Get Explicit” to address behavioral change on a community level. 5.1.2 21st Birthdays Another significant milestone that warrants community-wide educational intervention is surrounding 21st birthdays. Many studies show higher level of alcohol 32 consumption on 21st birthdays from college students. For example, a University of Missouri study found that 83% of college students consumed alcohol on their 21st birthday at a greater amount, 12% of drinkers reported consuming 21 drinks, and about half of drinkers exceeded the amount of drinks they initially planned to consume (Rutledge, Park, Sher 2008). The 21st birthday typically occurs during the third year of college for traditional students, or the second year of living off campus for many University of Oregon students. Since this event occurs at different times throughout the year, and thus a community-wide intervention, such as Get Explicit, would not be as effective. Instead, addressing the 21st birthday phenomenon at a relational and individual level may result in successful behavioral changes. One example of an effective policy strategy is Virginia Tech’s “21st Birthday Project,” where individuals turning 21 can visit a peer-educator to undergo a motivational interview and make a plan for their birthday; participants of the program in turn receive a coupon-book for non-alcohol related activities, food, and drinks (Virginia Tech 2020). This type of program engages students at an individual and relational level. Motivational interviewing techniques encourage students to not only think about their own behavior but engage with their friends in a behavior change as well. The coupon book serves as an incentive for individuals to participate and advertises the program to their friends and smaller communities, thus engaging students at a relational level. The socio-ecological model suggests that the overlapping levels influence one another, and thus making large-scale changes on an individual and relational scale will impact the communal and societal levels as well. The University of Oregon could consider such a program by centralizing efforts from Fraternity and Sorority Life (FSL) and SAPE. The 33 FSL office has a considerable amount of control over requirements for members of Greek organizations. Thus, if FSL would require sorority and fraternity members to complete the 21st birthday programming delivered by SAPE, a large portion of body would participate in this programming. Over time as more students participate in the program, the coupon book would advertise among students not required to participate and increase involvement outside of FSL. 5.1.3 Community level sexual violence reduction efforts Integrating sexual violence curriculum into these programs is essential for preventing sexual assault throughout college. As students move off-campus, there is more distance between campus resources, such as Resident Advisors and Residence Staff who are responsible for checking in on students and offering resources. Moving off-campus demands further discussion and education surrounding the intersection between sexual violence and alcohol because students are more likely to drink more. Many of the scenarios and strategies given to incoming students are based on dorm environments. Off-campus housing environments are vastly different and thus students need different skills and techniques in bystander intervention. Bystander intervention looks different in other environments, such as apartments, houses, and bars. Similarly, when students turn 21, they are more likely to consume alcohol in a bar. Sexual assault can look very different when students spend time at bars. Targeted, community specific education throughout college is imperative in mitigating sexual violence. As drinking culture shifts as students move through college, different education interventions must be implemented at all levels of the socio-ecological model. 34 5.2 Applying Social Norming Theory to prevention efforts Across all of the successful social norm programs discussed in the literature review, several consistent themes appear to indicate success in changing high-risk behavior. Educational intervention programs that occur over a long period of time increases the likelihood of causing a behavior change. Programs using personal normative feedback saw a reduction in high-risk drinking behavior over a six-month period. Four suggestions to better integrate social norming theory into prevention programming are made here. First, programming should include a period of reflection for students to look at their own relationship with substances, specifically how much and how often individuals consume alcohol. This should be done at the beginning of motivational interviewing for 21st birthday individual programming and for programming around the housing transition at the beginning of student’s second year at University of Oregon. Following individual reflection, peer educators should then reveal actual use of alcohol on campus before proceeding with the rest of the program. Second, this research finds that an empathy intervention implemented within existing sexual violence prevention programs may reduce sexual assaults. A second period of reflection should occur at a point when the programming begins initial discussions of sexual violence for students to think about their own values, morals, and expectations around consent and gender norms. Guided group discussion surrounding why students have these values should follow. The guided group discussion serves to compare student’s personal norms surrounding their opinions of consent and gender roles in comparison to their peers. 35 Third, there must be a mandatory survey conducted at all required trainings for students to anonymously submit their self-recorded alcohol use and perceptions of consent. For these program suggestions to be evaluated for efficacy, there must be metrics for the University of Oregon Prevention Programs to measure the success of these programs. These surveys must be required at all mandatory trainings to encapsulate the most accurate body of data. Lastly, successful social norming programs should occur over a sustained, long period of time. University of Oregon should invest funding in SAPE so that ongoing programming is feasible. Implementing social norming theory into educational interventions at the transition to off-campus housing and for 21st birthdays will likely cause a cultural and communal shift in the perceptions around alcohol use. If consistent programming and interaction with students can occur, the likelihood of reducing high risk drinking behavior is greater. 5.3 Incorporating Empathy Interventions into Bystander Intervention Training Some barriers to bystander participation in sexual assault prevention are more difficult to overcome than others. For example, failure to assume intervention responsibility is a greater barrier for men than for women (Burn 2009). Men are more likely to accept rape myths which translates into a decreased likelihood to take action by assuming responsibility under the bystander intervention model (Burn 2009). It is thus necessary to combat belief in rape myths in order to increase bystander participation. Research on social norming theory suggests that rape myths can be reduced through increasing empathy driven education interventions, thus increasing the likelihood of men engaging in bystander interventions. 36 Discussions that target eliciting empathetic responses towards victims of sexual violence and existing gender norms lead to successful behavior changes (Fabiano, Perkins 2003). A common characteristic of men who have commit sexual assault is a lower level of empathy than men who have not (Abbey, Zawacki and Buck, et al. 2001). Thus, including programming to elicit empathy can serve as a preventative measure. Gender norms surrounding drinking create environments that lend themselves to heightened risk for sexual assault. Conversations regarding gender norms in the context of sexual assault and alcohol use are important because women who come forward about sexual assault often face criticism, backlash, and social isolation. Given that over 40% of sexual assaults at University of Oregon involve alcohol or another substance, integrating conversations about sexism and gender roles into bystander intervention training is critical (Westat 2019). Bystander intervention training should include an empathy intervention event designed to decrease the persistence of rape myths on college campus. It is especially critical to do so among men. Hypermasculinity increases the likelihood of believing in rape myth and several studies have found that facilitated discussions allowing men to discuss among each other how toxic masculinity plays a role in their life exhibits an increase in empathy toward sexual assault victims (Shafer, Ortiz et al. 2018). To reduce sexual violence on campus at University of Oregon, Prevention Programs must include mandatory educational conversations during mandatory educational interventions that focus on how gender norms contribute to rape myth concerning victim blaming and the implications of toxic masculinity. While initial discussions should be integrated into mandatory prevention trainings, this is also an 37 opportunity for the Men’s Center, Fraternity and Sorority Life (FSL), and Prevention Services to collaborate on elective programming to target men who wish to further participate in bystander intervention and combat sexual assault. A training in conjunction with the identified campus partners to invite willing men to converse on toxic masculinity and then train them to move into their own communities and spread knowledge among their peers on a relational level is recommended. 5.4 Applying Harm Reduction Theory to sexual violence prevention programs Several elements of harm reduction strategy can be useful in mitigating sexual assault on college campuses. First, continued harm reduction approaches to substance abuse can decrease high risk drinking behavior, which in turn can reduce the risk of alcohol-involved sexual assault. Second, harm reduction employs a peer-based model, which increases the credibility and trust of the programs because college students are more likely to listen and trust their peers (Castro, Foy 2002). SVPE uses peer educators during “Get Explicit,” and this practice should be continued across the recommendations made above for ongoing community education and engagement throughout students’ tenures. To improve upon the current model, students should be given the tools to be sexually assertive. This includes open communication about individual sexual desires and the ability to recognize unhealthy sexual circumstances (Shafer, Ortiz et. al 2018). Sexual assertiveness training assumes that students will be sexually active and need the communication skills to discuss their sexual preferences and consent. Peer led programming about consent should seek to empower students about the control they have over their own bodies and better communicate with sexual partners about their 38 sexual preferences. Studies have found that sexual assertiveness rather than sexual aggression is linked to positive sexual interactions (Shafer, Ortiz et. al 2018). However, alcohol consumption impacts individual’s ability to respond appropriately to social communication, and thus trainings on sexual assertiveness must be coupled with alcohol misuse and abuse education. 39 Conclusions This research found that the University of Oregon Prevention Team have used these evidence-based strategies to the best extent given their limited capacity. To best reduce alcohol-involved sexual assault using the recommendations from this work, there must be increased and secured funding to Prevention Services. Funding for a majority of SAPE programming is contingent on securing vendor applications from housing contracts through the Communiversity program, making it difficult to participate campus-wide at the individual, relationship, and communal level to bring about societal change in behavior and culture. The lack of funding for SVPE and SAPE limits the capacity of these programs to reach each student in meaningful, effective ways throughout their tenure at University of Oregon. Research into the evidenced based strategies that inform SAPE and SVPE programs suggest the need to revisit information multiple times to promote behavior change. Currently, limited funding capacity restricts all mandatory sexual violence and substance abuse prevention programs to the first term of college for all incoming students and existing educational programs do not delve deeply into the intersection between sexual assault and alcohol. Sexual assault and binge drinking on college campuses are independent, yet overlapping crises. The statistics of sexual assault are alarmingly high and behind each number is someone’s life profoundly altered. The intersection between sexual assault and alcohol, particularly in college when adolescents are away from home for the first time and experimenting with new phenomena, demands integrated, comprehensive, evidenced-based and consistent education. This paper recommends several policy 40 changes based on conclusions drawn from the literary review and from analysis on the theories and models that inform SVPE and SAPE programs. There are many groups, organizations, and programs on campus that deliver education interventions about safe alcohol use and sexual assault prevention. However, there is a lack of organization to centralize efforts and reach a wider population of students. Structured coordination across these existing programs to capitalize and make better use of existing resources would strengthen campus-wide efforts to reduce sexual violence. The rate of alcohol-involved sexual assault and the social structure of college campuses that lends itself to high-risk drinking behavior warrants integrated education surrounding alcohol and sexual assault. The socio-ecological model considers how the individual, relationship, community, and societal factors contribute to the risk of experiencing violence or participating in high risk behaviors. Addressing alcohol- involved sexual assault through the socio-ecological model should be primarily addressed at the communal level by continuing mandatory trainings modeled after “Get Explicit” and individual and relational interventions. These trainings should address the common students experiences: transitioning from residence halls to off-campus housing and 21st birthdays. Sexual assault looks different at different stages of college as people transition their housing and common locations where alcohol is consumed. Social norming theory asserts that young adults overestimate their peers’ alcohol consumption and consequently drink more heavily than they would otherwise. Challenging students’ perceptions of their peers behavior over a long period of time in peer-lead trainings or workshops that include personal normative feedback has 41 evidenced success in reducing individual high-risk behavior. Programs that revisit information through multiple trainings have demonstrated success in changing behavior. Thus, I argue for increasing funding for SAPE and SVPE programs so that it is possible to implement programs that occur throughout college life from first year to last. Implementing social norming to specifically address sexual violence should also include discussions to illicit empathetic responses from participants towards victims and conversation around the perceptions of bystander intervention efforts. SAPE takes a harm reduction approach to reducing high-risk behavior from substance use. Applying harm reduction in the context of reducing high-risk drinking behavior and encouraging sexual assertiveness may decrease the risk of sexual assault. Employing and continuing the peer-based model across education intervention efforts increases the credibility of the program and can increase the engagement and retention of bystander intervention, “Get Explicit,” and 21st birthday programming. 42 Appendix A - Interviewee Questions 1. How long have you worked in your current role? 2. What are some of the challenges you’ve faced in addressing substance abuse and sexual violence on campus? 3. Are there institutional barriers to implementing prevention programs? 4. What methods are the prevention programs based on? 5. What are some of the successful outcomes regarding the effectiveness of programming you’ve experienced on the job? 6. Over the course of the school year, how do you allocate program funding? a. What programs use the bulk of your resources? b. 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