The purpose of this study is to examine the efficacy of Code of Respect (X-CoRe) multi-level sexual assault (SA) and harassment (SH) prevention program in improving psychosocial determinants (e.g., knowledge, skills, self-efficacy, attitudes) related to respectful/disrespectful relationships, to examine the efficacy of X-CoRe in reducing SA and sexual harassment SH victimization and to examine the efficacy of X-CoRe increasing bystander behavior and improving unit cohesion and mission readiness by decreasing secondary risk and harmful behaviors (e.g., alcohol misuse, intimate partner violence, suicide ideation). The study will be conducted at at Joint Base McGuire Dix-Lakehurst (JBMDL) located in Burlington County, New Jersey, and participants will be cluster-randomized at the level of the squadron to one of two conditions: the X-CoRe program or a control condition.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
NONE
Enrollment
1,200
Junior Enlisted Airmen (E4 and below) will complete 10 online modules designed to train them on recognizing SH and SA, healthy and unhealthy relationships, and situations that may increase risk for SH and SA. Participants will adopt and practice a lifestyle paradigm of select-detect-protect, in which service members select their personal rule to have only healthy (non-abusive) relationships with their peers and romantic partners, detect signs and situations that might threaten their rules, and protect their rules using communication, management, and avoidance skills. They will be instructed to adopt a zero-tolerance approach to SH and SA and will receive skills training related to communication and conflict resolution for healthy relationships, reduction of SH and SA perpetration, consent communication, reporting incidents of SH and SA, and bystander intervention. Participants who have experienced SH or SA are encouraged to use the "Get Help Now" feature to access support 24/7.
Mid- and advanced-level leaders (E5 and above) will complete 10 online modules designed to train them to recognize forms of SH and SA, how to respond to an incident of SH or SA, and how to create a safe work environment free of SH and SA. Leaders will also adopt and practice the paradigm select-detect-protect. Leaders will select their personal rule to enforce a healthy work environment (free of SH and SA), detect signs and situations that might threaten their rule (e.g., displaying inappropriate pictures on the computer), and protect their rules using communication and management skills. Leaders will also be given background material on SH and SA in the military (e.g., extent of the problem, DoD definitions, and policies) and installation resources for reporting incidents. As with the Junior Enlisted component, Leaders who may have experienced SH or SA are encouraged to use our "Get Help Now" feature to access support 24/7.
All participating Airmen (including Junior Enlisted Airmen and Leaders) will be exposed to X-CoRe's social marketing campaign, which includes posters, flyers, postcards, and digital content for social media. Messages are designed to increase awareness of consent and foster Wing-wide norms that are supportive of healthy relationships. Resources for Service members to receive support if they have experienced SH or SA will also be provided through the social marketing materials. Social marketing materials, such as posters, will be distributed at "hot spots" for SA (e.g., dorms).
The University of Texas Health Science Center at Houston
Houston, Texas, United States
RECRUITINGChange in SA victimization as assessed by the Sexual Experiences Survey
This is a 10 item questionnaire and each is scored on a 4 point scale from 0-3 or more higher number indicating worse outcome
Time frame: baseline,6 months follow up, 12 months follow up
Change in SH victimization as assessed by the (Sexual Experience Questionnaire (SEQ-DoD)
This is a 23 item questionnaire and each is scored on a 5 point scale from 0, 1-2,3-5,6-9 or more, higher number indicating worse
Time frame: baseline, 6 months follow up, 12 months follow up
Change in knowledge of Sexual Harassment and Assault as assessed by the Knowledge of Sexual Harassment and Assault Scale
This is a 6 item questionnaire and each question is answered as true or false
Time frame: baseline,6 months follow up, 12 months follow up
Change in Rape Myth Acceptance as assessed by the Illinois Rape Myth Acceptance Scale -Short Form
This is a 20 item questionnaire and each is scored on a 7 point scale from not at all agree-very much agree a higher number indicating worse outcome
Time frame: baseline,6 months follow up, 12 months follow up
Change in Gender Role Beliefs as assessed by the Hypergender Ideology Scale -Short Form
This is a 19 item questionnaire and each is scored on a 6 point scale from strongly disagree to strongly agree, higher number indicating worse outcome
Time frame: baseline,6 months follow up, 12 months follow up
Change in attitudes towards Sexual Harassment as assessed by the Sexual Harassment Attitude Scale
This is a 17 item questionnaire and each is scored on a 5 point scale from strongly disagree-strongly agree, higher number indicating worse outcome
Time frame: baseline,6 months follow up, 12 months follow up
Change in Attitudes towards Relationship Violence as assessed by the Acceptance of Couple Violence Scale
This is a 17 item questionnaire and each is scored on a 4 point scale from strongly disagree-strongly agree , higher number indicating worse outcome
Time frame: baseline,6 months follow up, 12 months follow up
Change in Relationships Skills Self-Efficacy as assessed by the Interpersonal competence Questionnaire - Negative assertion subscale
This is an 8 item questionnaire and each is scored on a 5 point scale from I am poor at this-I am extremely good at this, lower number indicating worse outcome
Time frame: baseline,6 months follow up, 12 months follow up
Change in Attitudes towards Preventing Sexual Harassment and Assault as assessed by the Attitudes Toward Preventing Dating Violence Subscale
This is a 3 item questionnaire and each is scored on a 4 point scale from strongly disagree to strongly agree, higher number indicating better outcome
Time frame: baseline,6 months follow up, 12 months follow up
Change in Attitudes towards Cyberbullying as assessed by the Harmful Cyberbullying Attitudes Scale
This is a 5 item questionnaire and each is scored on a 5 point scale from strongly disagree to strongly agree , higher number indicating worse outcome
Time frame: baseline,6 months follow up, 12 months follow up
Change in attitudes towards Alcohol Use as assessed by the Drinking Values Scale
This is a 10 item questionnaire and each is scored on a 5 point scale from strongly disagree to strongly agree, higher number indicating worse outcome
Time frame: baseline,6 months follow up, 12 months follow up
Change in Bystander Self-Efficacy as assessed by the Bystander Efficacy Scale
This is an 18 item questionnaire and each is scored from 0(can't do) to 100(very certain) higher number indicating better outcome
Time frame: baseline,6 months follow up, 12 months follow up
Change in Barriers to Sexual Assault Intervention as assessed by the Barriers to Sexual Assault Bystander Intervention Scale
This is a 23 item questionnaire and each is scored on a 7 point scale from strongly disagree-strongly agree a higher number indicating worse outcome
Time frame: baseline,6 months follow up, 12 months follow up
Change in Conflict Communication Skills as assessed by the Conflict Communication Scale - Confrontation Subscale
This is a 15 item questionnaire and each is scored on a 6 point scale from strongly disagree-strongly agree a higher number indicating worse outcome
Time frame: baseline,6 months follow up, 12 months follow up
Change in Bystander Behavior as assessed by the Bystander Behavior Scale - Risky Situations and Party Safety Subscale
This is a 25 item questionnaire and each is scored on a 4 point scale categorically from 0, 1, 2,3 or more times a higher number indicating better outcome
Time frame: baseline,6 months follow up, 12 months follow up
Change in Horizontal Unit Cohesion as assessed by the Horizontal Cohesion Scale
This is a 6 item questionnaire and each is scored on a 5 point scale from strongly disagree-strongly agree a higher number indicating better outcome
Time frame: baseline,6 months follow up, 12 months follow up
Change in Vertical Unit Cohesion as assessed by the Vertical cohesion Scale
This is a11 item questionnaire and each is scored on a 5 point scale from strongly disagree-strongly agree a higher number indicating better outcome
Time frame: baseline,6 months follow up, 12 months follow up
Change in Intimate Partner Violence as assessed by the Composite Abuse Scale (Revised) - Short Form
This is a 15 item questionnaire and each is scored on a 5 point scale from not in the past 12 months to daily/almost daily a higher number indicating worse outcome
Time frame: baseline,6 months follow up, 12 months follow up
Change in Alcohol Use as assessed by the Alcohol 30-day Quantity and Frequency
Participants are asked the following two questions: one regarding the frequency of consumption (number of days), and a second regarding the usual quantity of consumption (number of drinks) on drinking days, higher number indicating more alcohol use
Time frame: baseline,6 months follow up, 12 months follow up
Change in Suicide Ideation as assessed by the Columbia -Suicide Severity Rating Scale - Severity of Suicidal Ideation Subscale
This is a 5 item questionnaire and each is scored on a 5 point scale from wish to be dead-suicidal intent with plan a higher number indicating worse outcome
Time frame: baseline,6 months follow up, 12 months follow up
Change in Anxiety as assessed by the Generalized Anxiety Disorder Screener
This is a 7 item questionnaire and each is scored on a 4 point scale from not at all-nearly every day a higher number indicating worse outcome
Time frame: baseline,6 months follow up, 12 months follow up
Change in Depression as assessed by the Patient Health Questionnaire 9 (PHQ-9)
This is a 9 item questionnaire and each is scored on a 4 point scale from not at all-nearly every day a higher number indicating worse outcome
Time frame: baseline,6 months follow up, 12 months follow up
Change in PTSD as assessed by the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) Cross Cutting Symptom Measure
This is a 23 item questionnaire and each is scored on a 5 point scale from not at all-nearly every day a higher number indicating worse outcome
Time frame: baseline,6 months follow up, 12 months follow up
Change in Overall Health Functioning as assessed by the World Health Organization Disability Assessment Schedule (WHODAS) 2.0) - Short Form
This is a 12 item questionnaire and each is scored on a 5 point scale from none-extreme or cannot do a higher number indicating worse outcome
Time frame: baseline,6 months follow up, 12 months follow up
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