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Fostering College Students' Responsibility as Prosocial Bystanders to Sexual Violence Prevention: A Meta-Analysis of the Bringing in the Bystander Program

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Title: Fostering College Students' Responsibility as Prosocial Bystanders to Sexual Violence Prevention: A Meta-Analysis of the Bringing in the Bystander Program
Language: English
Authors: Jessica Bouchard, Jennifer S. Wong (ORCID 0000-0001-7523-7430), Chelsey Lee
Source: Journal of American College Health. 2024 72(9):3410-3422.
Availability: Taylor & Francis. Available from: Taylor & Francis, Ltd. 530 Walnut Street Suite 850, Philadelphia, PA 19106. Tel: 800-354-1420; Tel: 215-625-8900; Fax: 215-207-0050; Web site: http://www.tandf.co.uk/journals
Peer Reviewed: Y
Page Count: 13
Publication Date: 2024
Document Type: Journal Articles
Reports - Research
Education Level: Higher Education
Postsecondary Education
Descriptors: Student Responsibility, Prosocial Behavior, Sexual Abuse, Prevention, College Students, Student Attitudes, Behavior
DOI: 10.1080/07448481.2022.2162825
ISSN: 0744-8481
1940-3208
Abstract: Objective: To synthesize research examining the effectiveness of the sexual violence bystander program "Bringing in the Bystander" ("BitB"). Participants: The analytic sample included 2083 youth in the treatment group and 969 in the comparison group. Method: A search strategy that included a total of 45 search terms was applied to 28 electronic databases. Results: The systematic search yielded a final analytic sample of 14 evaluations, with 38 independent effect sizes calculated across four outcome measures: rape myth attitudes (n = 11), bystander efficacy (n = 11), bystander intentions (n = 11), and bystander behavior (n = 5). The "BitB" program produced significant, positive pooled effects on measures of rape-supportive attitudes, bystander efficacy, and bystander intentions. Conclusions: The overall results are promising and suggest that the "BitB" education program may be an effective tool for targeting sexual violence on campuses.
Abstractor: As Provided
Entry Date: 2024
Accession Number: EJ1451899
Database: ERIC
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  Value: <anid>AN0181109498;acl01dec.24;2024Nov28.03:47;v2.2.500</anid> <title id="AN0181109498-1">Fostering college students' responsibility as prosocial bystanders to sexual violence prevention: A meta-analysis of the Bringing in the Bystander program </title> <p>Objective: To synthesize research examining the effectiveness of the sexual violence bystander program Bringing in the Bystander (BitB). Participants: The analytic sample included 2083 youth in the treatment group and 969 in the comparison group. Method: A search strategy that included a total of 45 search terms was applied to 28 electronic databases. Results: The systematic search yielded a final analytic sample of 14 evaluations, with 38 independent effect sizes calculated across four outcome measures: rape myth attitudes (n = 11), bystander efficacy (n = 11), bystander intentions (n = 11), and bystander behavior (n = 5). The BitB program produced significant, positive pooled effects on measures of rape-supportive attitudes, bystander efficacy, and bystander intentions. Conclusions: The overall results are promising and suggest that the BitB education program may be an effective tool for targeting sexual violence on campuses.</p> <p>Keywords: Bringing in the Bystander; bystander intervention; meta-analysis; sexual violence prevention; systematic review</p> <hd id="AN0181109498-2">Introduction</hd> <p>Despite the introduction of the Campus Sexual Violence Elimination (SaVE) Act in 2013 (which requires that all Title IX schools implement sexual violence prevention education programming for incoming students),[<reflink idref="bib1" id="ref1">1</reflink>] rates of sexual violence victimization on college campuses continue to be problematic. Findings from the 2019 Association of American Universities (AAU) Campus Climate Survey on Sexual Assault and Misconduct, a nationally representative survey which represents 181,752 students from a broad mix of institutions, indicate that one in four undergraduate college women in the United States (26%) have experienced sexual violence; an increase of 3 percentage points from the 2015 AAU survey.[<reflink idref="bib2" id="ref2">2</reflink>] The high prevalence of sexual violence among college women is concerning considering the continued evidence of the expansive and long-term negative impacts on victims' mental health (eg, suicidal thoughts, anxiety, depression, PTSD),[<reflink idref="bib3" id="ref3">3</reflink>],[<reflink idref="bib4" id="ref4">4</reflink>] social/interpersonal functioning (eg, social withdrawal, emotional distancing),[<reflink idref="bib5" id="ref5">5</reflink>],[<reflink idref="bib6" id="ref6">6</reflink>] and academic/educational attainment (eg, waning attendance, loss of motivation to participate in class, decreased GPA).[[<reflink idref="bib7" id="ref7">7</reflink>], [<reflink idref="bib9" id="ref8">9</reflink>]]</p> <p>The implementation of legislation requiring U.S. colleges to administer sexual violence prevention programs on campus has undoubtedly contributed to the proliferation of sexual violence prevention strategies and programming. Despite the prominence of such programs across campuses, however, evidence concerning the effectiveness of sexual violence prevention programs is mixed – particularly with respect to their ability to reduce rates of sexual assault.[[<reflink idref="bib10" id="ref9">10</reflink>], [<reflink idref="bib12" id="ref10">12</reflink>]]</p> <hd id="AN0181109498-3">Sexual violence prevention programs on college campuses</hd> <p>Broadly, college-based sexual violence prevention programs aim to change students' knowledge, attitudes, and behaviors toward sexual violence. A wide variety of strategies exist to achieve these aims, including awareness campaigns (eg, raising campus-wide awareness of sexual violence as a problem), educational programs (eg, changing knowledge and attitudes toward issues surrounding sexual violence such as consent, social norms, and rape myths), sexual assault risk reduction programs (eg, teaching women skills (such as self-defense) to reduce their risk of sexual assault victimization), and bystander programs (eg, teaching students skills to intervene when witnessing incidents of potential sexual violence).[<reflink idref="bib13" id="ref11">13</reflink>]</p> <p>Of these strategies, bystander programs have received significant traction and have been widely adopted across U.S. college campuses. One noteworthy limitation of primary sexual violence prevention strategies (to which their lack of clear effectiveness is sometimes attributed) is that they typically take a narrow approach to prevention by framing men as perpetrators of sexual violence and women as victims.[<reflink idref="bib14" id="ref12">14</reflink>],[<reflink idref="bib15" id="ref13">15</reflink>] Bystander interventions were designed to address this limitation by taking a broader approach to prevention. That is, rather than framing sexual violence as solely a perpetrator issue or a victim/survivor concern, bystander education programs emphasize the role of the campus community and encourage all members to challenge perpetrator behavior and assist in preventing sexual violence.[<reflink idref="bib13" id="ref14">13</reflink>] This innovative approach to sexual violence prevention led to the mandated inclusion in the Campus SaVE Act of a bystander intervention component in all sexual violence prevention programs implemented on college campuses.[<reflink idref="bib1" id="ref15">1</reflink>]</p> <hd id="AN0181109498-4">Bystander intervention programs on college campuses</hd> <p>The bystander intervention model of sexual violence prevention emphasizes that everyone has a role to play in shifting social norms toward violence against women and ending sexual violence.[<reflink idref="bib16" id="ref16">16</reflink>] Programs are designed to counteract the "bystander effect" (ie, the reduced likelihood of intervening in the presence of others due to the assumption that others will respond to the situation) by encouraging participants to intervene when they witness warning signs or incidents of sexual violence.[<reflink idref="bib17" id="ref17">17</reflink>] In particular, the five-step model to bystander intervention is used as a theoretical foundation for bystander education programs and teaches participants to become active prosocial bystanders by learning how to (<reflink idref="bib1" id="ref18">1</reflink>) notice the warning signs that an incident of sexual violence may occur (or has already occurred), (<reflink idref="bib2" id="ref19">2</reflink>) identify the situation as high risk, (<reflink idref="bib3" id="ref20">3</reflink>) feel a sense of responsibility as a bystander and decide to intervene, (<reflink idref="bib4" id="ref21">4</reflink>) determine they have the skills to diffuse the situation, and (<reflink idref="bib5" id="ref22">5</reflink>) intervene safely and effectively, and/or support victims when incidents of sexual violence are disclosed.[<reflink idref="bib18" id="ref23">18</reflink>],[<reflink idref="bib19" id="ref24">19</reflink>]</p> <p>Several sexual violence bystander education programs that target college students have emerged in recent years. The programs most frequently discussed in the academic literature include <emph>Bringing in the Bystander</emph>,[<reflink idref="bib13" id="ref25">13</reflink>]<emph>Green Dot</emph>,[<reflink idref="bib20" id="ref26">20</reflink>]<emph>TakeCARE</emph>,[<reflink idref="bib21" id="ref27">21</reflink>]<emph>Mentors in Violence Prevention (MVP)</emph>,[<reflink idref="bib22" id="ref28">22</reflink>] and <emph>The Men's Program</emph>.[<reflink idref="bib23" id="ref29">23</reflink>] Although the ways in which these programs approach bystander training vary, they have common aims represented by curriculum topics such as awareness of sexual violence as a problem, changing norms around sexual violence by promoting prosocial bystander attitudes and behaviors, promoting individual responsibility to act as a bystander, and teaching skills to intervene safely and effectively.</p> <hd id="AN0181109498-5">The effectiveness of bystander interventions</hd> <p>There is no shortage of reviews that examine the overall impacts of sexual violence bystander programs; in recent years, five systematic reviews and five meta-analyses on the topic of sexual violence bystander interventions have been published.[[<reflink idref="bib24" id="ref30">24</reflink>], [<reflink idref="bib26" id="ref31">26</reflink>], [<reflink idref="bib28" id="ref32">28</reflink>], [<reflink idref="bib30" id="ref33">30</reflink>], [<reflink idref="bib32" id="ref34">32</reflink>]] Overall, meta-analytic findings suggest that bystander training has a positive and statistically significant impact on participants' attitudes/beliefs toward sexual violence,[<reflink idref="bib29" id="ref35">29</reflink>],[<reflink idref="bib30" id="ref36">30</reflink>] identifying a situation as appropriate for intervention,[<reflink idref="bib33" id="ref37">33</reflink>] bystander efficacy,[<reflink idref="bib30" id="ref38">30</reflink>],[<reflink idref="bib32" id="ref39">32</reflink>] bystander intentions,[<reflink idref="bib30" id="ref40">30</reflink>],[<reflink idref="bib32" id="ref41">32</reflink>] and bystander behaviors.[[<reflink idref="bib29" id="ref42">29</reflink>], [<reflink idref="bib31" id="ref43">31</reflink>], [<reflink idref="bib33" id="ref44">33</reflink>]]</p> <p>While synthesized findings overwhelmingly suggest that bystander interventions produce positive impacts for college students, existing meta-analyses also indicate varying impacts across individual studies and programs. Despite the fact that popular programs such as <emph>Green Dot</emph> and <emph>Bringing in the Bystander</emph> have been implemented across multiple college campuses, to our knowledge, no meta-analytic studies have focused on the impacts of any <emph>specific</emph> bystander sexual violence prevention program. The need for synthesized research that focuses on specific programs is important to increase the evidence base available to decisionmakers and program implementers. Having access to summative evidence on a specific program may be of use to college administrators and sexual violence office staff when faced with the task of implementing a sexual violence prevention program on campus. Searching and screening the literature for potentially appropriate programs, including evidence-based programs, is a time-consuming task that requires expertise in research methodology to understand the nuances of individual studies; having ready access to summative research on a given program may help simplify the decision-making process.</p> <hd id="AN0181109498-6">Current study</hd> <p>Across several of the recent systematic reviews and meta-analyses on sexual violence bystander programs, the <emph>Bringing in the Bystander</emph> (<emph>BitB</emph>) program developed by Victoria Banyard, Mary Moynihan, and colleagues stands out as the program most frequently evaluated and replicated in empirical studies. While primary studies for the most suggest positive effects of the program, the magnitude of effects range across studies and findings are not statistically significant across all outcome categories examined. The purpose of the current study is to meta-analyze the effects of the <emph>BitB</emph> program on changing sexual violence- and bystander-related outcomes among college students, and attempt to identify important moderators of program success such as variations to program content and delivery.</p> <hd id="AN0181109498-7">The Bringing in the Bystander program for college students</hd> <p>The <emph>BitB</emph> program was developed at the University of New Hampshire and is grounded in the theoretical foundations of the bystander framework.[<reflink idref="bib13" id="ref45">13</reflink>] The program aims to prevent sexual violence by promoting knowledge, attitudinal, and behavioral changes toward sexual violence by (<reflink idref="bib1" id="ref46">1</reflink>) engaging the campus community as prosocial bystanders and fostering a sense of community responsibility to act as a bystander, (<reflink idref="bib2" id="ref47">2</reflink>) developing empathy for victims of sexual violence, and (<reflink idref="bib3" id="ref48">3</reflink>) equipping students with skills to intervene safely and effectively before, during, and after an incident of sexual violence occurs.[<reflink idref="bib13" id="ref49">13</reflink>],[<reflink idref="bib34" id="ref50">34</reflink>]</p> <p> <emph>BitB</emph> is an in-person educational workshop delivered to undergraduate students by a two-person team of trained facilitators (typically one man and one woman).[<reflink idref="bib13" id="ref51">13</reflink>] In adherence to suggested best practices for sexual violence prevention interventions, the program was originally designed to be provided to single-sex groups of men and women.[<reflink idref="bib13" id="ref52">13</reflink>] The program is primarily delivered in one of two formats: a single-session (90 minute) program, and a multi-session program (three 90-minute sessions totaling 4.5 hours).[<reflink idref="bib16" id="ref53">16</reflink>] Several iterations of the program exist with durations ranging from one to eight hours.[<reflink idref="bib35" id="ref54">35</reflink>],[<reflink idref="bib36" id="ref55">36</reflink>]</p> <p> <emph>BitB</emph> program components include interactive group discussions on topics such as bystander responsibility, contextual factors that influence bystander behavior (eg, social norms), awareness of sexual violence (for example, behaviors that constitute sexual violence, the prevalence of sexual violence, the negative consequences of sexual violence for victims), legal and/or university policies toward sexual violence, and bystander intervention strategies and skills. The session(s) also include a variety of active learning exercises such as role-playing scenarios to practice intervention skills (with a key emphasis on the person's own safety). The <emph>BitB</emph> program may also include a 30-minute booster session, which is delivered two months after program implementation to remind participants of key aspects of the prevention program messaging. See Banyard et al[<reflink idref="bib13" id="ref56">13</reflink>] for a comprehensive overview of discussion topics delivered in each session of the program, as well as key differences between the content of the abbreviated single-session version of the program and the multi-session version.</p> <hd id="AN0181109498-8">Methods</hd> <p></p> <hd id="AN0181109498-9">Systematic literature review</hd> <p>To develop key terms for use in the systematic literature search for empirical evaluations of the <emph>BitB</emph> program, a comprehensive and exhaustive list of terms was identified by consulting the relevant literature for synonyms and interchangeable phrases; see Kugley et al.[<reflink idref="bib37" id="ref57">37</reflink>] Using an iterative process of trial and error and with multiple rounds of testing, four constructs which encompassed a total of 45 search terms were developed. Boolean operators and wildcard markers were used to broaden the search. The final search terms for each of the four constructs are shown in Table 1.</p> <p>Table 1. Search constructs and key terms.</p> <p> <ephtml> <table><thead><tr><td>Construct</td><td>Key terms</td></tr></thead><tbody valign="top"><tr><td>University/college</td><td>(universit* or colleg* or "higher education" or campus* or undergrad*)</td></tr><tr><td>Bringing in the Bystander</td><td>("bringing in the bystander" or BITB or "know your power" or "intimate partner violence" or "partner violence" or IPV or "partner abus*" or "dating violence" or "relationship violence" or "dating abuse" or "dating aggression" or "relationship aggression" or "sexual* violen*" or "sexual* aggressi*" or "sexual* abus*" or "sexual assault" or rape or "date rape" or "acquaintance rape" or "bystander*" or "Red Flag" or "Intervention Initiative")</td></tr><tr><td>Prevention program</td><td>(strateg* or interven* or prevent* or program* or treatment* or campaign* or training or workshop or education or online or poster or "social marketing")</td></tr><tr><td>Evaluation</td><td>(eval* or impact* or outcome* or assess* or effect* or efficacy)</td></tr></tbody></table> </ephtml> </p> <p>The search strategy was applied to 28 electronic databases (eg, <emph>Criminal Justice Abstracts</emph>, <emph>PsycINFO</emph>) and the key terms were searched in the abstract and title fields. Additionally, the grey literature was explored for unpublished works such as theses and dissertations, conference presentations, technical reports, and independent projects. Grey literature sources included Google and Google Scholar, 16 websites of relevant organizations (eg, <emph>Department of Justice</emph>, <emph>National Resource Center on Domestic Violence</emph>, <emph>Public Safety Canada</emph>), 16 journals that often publish articles on sexual violence prevention (eg, <emph>Journal of Interpersonal Violence</emph>; <emph>Aggression and Violent Behavior</emph>), and the curriculum vitae of eight prominent researchers in the field (eg, <emph>V. Banyard</emph>, <emph>A. Cares</emph>, <emph>M. Moynihan</emph>, and <emph>S. Potter</emph>). Further, the reference lists of identified meta-analyses or systematic literature reviews focused on sexual violence prevention or bystander education programs were also searched to identify additional studies.</p> <hd id="AN0181109498-10">Selection criteria</hd> <p>Studies were required to meet several <emph>a priori</emph> criteria to be eligible for inclusion in the pooled analysis: (<reflink idref="bib1" id="ref58">1</reflink>) Evaluates the <emph>Bringing in the Bystander</emph> program on a college campus; (<reflink idref="bib2" id="ref59">2</reflink>) Reports on at least one bystander- or sexual violence-related outcome (eg, bystander attitudes, bystander behaviors, endorsement of rape myths, sexual assault victimization); (<reflink idref="bib3" id="ref60">3</reflink>) Provides sufficient numerical or graphical data to allow for the computation of an effect size; (<reflink idref="bib4" id="ref61">4</reflink>) Has a minimum analytic sample size of 20 subjects in the treatment group; (<reflink idref="bib5" id="ref62">5</reflink>) Uses a pretest/post-test design or a comparison group design; (<reflink idref="bib6" id="ref63">6</reflink>) Was published in English or French; and (<reflink idref="bib7" id="ref64">7</reflink>) Was published between January 2005 and January 2022. Studies were excluded if they examined the effects of additional programs in such a way that precluded isolation of the effects of <emph>BitB</emph>.</p> <hd id="AN0181109498-11">Study collection</hd> <p>After the initial literature search was completed, studies deemed potentially eligible were screened by two independent reviewers. Inclusion criteria were applied to the abstracts and titles to determine those studies that should be retrieved for further review. After retrieval, the same two reviewers applied the inclusion and exclusion criteria to identify those studies to be retained for full coding and effect size calculation. Discrepancies in reviewer decisions were discussed until an agreement was reached.</p> <hd id="AN0181109498-12">Analytic approach</hd> <p></p> <hd id="AN0181109498-13">Coding</hd> <p>All studies selected for inclusion were coded by two reviewers using Microsoft Excel on a series of 67 variables. These variables included intervention characteristics (eg, number of sessions and contact hours, who delivered the program material, whether the program was delivered to groups of single-sex or mixed-sex groups), study characteristics (eg, research design, type of comparison group; score on the Maryland Scale of Scientific Methods), sample characteristics (eg, sample size, sample ethnicity mix), nature of outcome measures (eg, outcome category [eg, bystander attitudes, bystander behavior], type of data [eg, mean scores/standard deviations on a validated scale], timing of post-test), and treatment and control group outcomes (eg, scores on measurement scales at pretest and post-test). Following data extraction, two reviewers calculated 38 effect sizes assessing the effectiveness of the <emph>BitB</emph> program.</p> <hd id="AN0181109498-14">Outcome measures</hd> <p>Four categories of outcome measures were included in the final set of analyses.</p> <hd id="AN0181109498-15">Rape myth attitudes</hd> <p>Rape myth attitudes involved measuring participant endorsement of myths about sexual violence. For example, "Women tend to exaggerate how much rape affects them," and "Men don't usually intend to force sex on a woman, but sometimes they get too sexually carried away"; Illinois Rape Myth Acceptance Scale.[<reflink idref="bib38" id="ref65">38</reflink>]</p> <hd id="AN0181109498-16">Bystander efficacy</hd> <p>Bystander confidence with respect to intervening in situations of (potential) sexual violence were typically measured using the Bystander Efficacy Scale.[<reflink idref="bib16" id="ref66">16</reflink>] Items included how confident respondents would feel that they could perform a behavior such as asking a friend if they need to be walked home from a party, determining if someone who is in an abusive relationship is in immediate danger, and making sure their friends leave a party with the same people they arrived with.</p> <hd id="AN0181109498-17">Bystander intentions</hd> <p>Bystander likelihood of helping others in situations involving sexual violence were typically assessed using the Bystander Intention to Help Scale.[<reflink idref="bib35" id="ref67">35</reflink>] Items include, for example, "Think through the pros and cons of different ways I might help if I see an instance of sexual violence," "indicate my displeasure when I hear a sexist joke being made," and "I express disagreement with someone I don't know who says having sex with someone who is passed out or very intoxicated is okay."</p> <hd id="AN0181109498-18">Bystander behavior</hd> <p>Last, measures of bystander behavior assessed self-reported instances of engaging in behaviors such as interrupting risky situations, speaking up when rape myths are perpetuated, calling for professional help, or telling a peer to stop hitting their partner.[<reflink idref="bib39" id="ref68">39</reflink>] Example items include "I confronted a friend who made excuses for the abusive behaviors of others"; "I approached a friend when I thought they were in an abusive relationship and let them know I'm here to help"; "I walked a friend home from a party who has had too much to drink," and "I asked for verbal consent when I was intimate with my partner, even though we are in a long-term relationship."</p> <hd id="AN0181109498-19">Effect size types</hd> <p>A standardized mean difference was used as the primary effect size type, and effect sizes were calculated based on three types of reported outcome data: (<reflink idref="bib1" id="ref69">1</reflink>) pretest and post-test means with standard deviations for a treatment and control group (<emph>n</emph> = 18); (<reflink idref="bib2" id="ref70">2</reflink>) pretest and post-test means, standard deviations, and either an <emph>F</emph>-test or <emph>t-</emph>test for a single treatment group (<emph>n</emph> = 17); and (<reflink idref="bib3" id="ref71">3</reflink>) <emph>F</emph>-test with unequal post-test sample sizes for a treatment and control group (<emph>n</emph> = 3). Notably, the analytic sample included studies using two-group designs and single-group designs. There is mixed support in the literature for pooling effect sizes from two-group and single-group designs[<reflink idref="bib40" id="ref72">40</reflink>],[<reflink idref="bib41" id="ref73">41</reflink>]; however, some authors argue that effect sizes from these designs can be appropriately pooled with certain statistical adjustments and the assurance that they estimate the same treatment effect.[<reflink idref="bib42" id="ref74">42</reflink>] When working with student populations, single-group research designs are often the most feasible and/or the only option through which to conduct research and as such, are common within educational settings. The exclusion of these designs would prevent the consideration of a substantial portion of the existing research and would not provide a comprehensive overview of the treatment effect of interest.[<reflink idref="bib43" id="ref75">43</reflink>],[<reflink idref="bib44" id="ref76">44</reflink>] Following current analytical suggestions,[<reflink idref="bib45" id="ref77">45</reflink>] studies using a single-group design were included in the analysis after first being transformed into a raw score metric.</p> <hd id="AN0181109498-20">Decision rules</hd> <p>Additionally, as the calculation of a pooled effect assumes that all effect sizes are independent, the following set of decision rules was used to ensure the independence of effect sizes both between and within studies.[<reflink idref="bib43" id="ref78">43</reflink>] First, when multiple publications containing the same sample were identified (ie, overlapping samples), only one report was used. Second, if a study included multiple treatment groups and only one control group, only one treatment group was selected (ie, the group that was most commensurate with other programs).</p> <hd id="AN0181109498-21">Meta-analyses</hd> <p>DerSimonian and Laird random effects models were used for the analyses; these models assume that between-study variability is related to factors other than random sampling error.[<reflink idref="bib46" id="ref79">46</reflink>] Heterogeneity in the pooled sets of effect sizes was assessed using <emph>Q</emph>-statistics and <emph>I<sups>2</sups></emph>statistics (where <emph>I<sups>2</sups></emph> is based on tau-squared). Potential publication bias and small study effects were assessed through the use of funnel plots (which plot standard error against effect size) and Egger's test for funnel plot asymmetry.[<reflink idref="bib47" id="ref80">47</reflink>],[<reflink idref="bib48" id="ref81">48</reflink>] Influence analyses were used as a robustness check for each of the models to determine whether any individual study exerted an extreme impact on the overall pooled treatment effect.[<reflink idref="bib49" id="ref82">49</reflink>]</p> <hd id="AN0181109498-22">Results</hd> <p></p> <hd id="AN0181109498-23">Systematic search results</hd> <p>The search of the 28 electronic databases identified a total of 11,018 studies for review, of which 229 were selected for initial inclusion. Two reviewers independently read through the abstracts of the selected studies to determine relevance, which resulted in the retention of 199 studies to be retrieved for full-text review. Due to restrictions in applying the full search strategy to the grey literature sources (eg, organization websites), a more limited set of key terms was used for the grey search, and the first 100 hits in each source were reviewed. As such, the specific number of grey literature records identified and reviewed was not tracked; in total an additional 16 studies were selected for full-text review from the grey literature sources. During this phase of the search, the reviewers erred on the side of caution and included any study that could have potentially contained an evaluation of <emph>BitB.</emph> The same two reviewers applied the selection criteria in full, resulting in a set of 25 <emph>BitB</emph> empirical evaluations selected for preliminary inclusion. After data extraction, coding, and the application of decision rules, 14 studies (contributing 38 independent effect sizes) were included in the final set of studies for analysis. Table 2 presents the specific number of hits selected in each successive step of the search strategy.</p> <p>Table 2. Systematic search results.</p> <p> <ephtml> <table><thead><tr><td>Step</td><td>Classification</td><td>Number of hits</td></tr></thead><tbody valign="top"><tr><td>1</td><td>Total number of records identified through the electronic database search<xref ref-type="table-fn" rid="tfn1">a</xref></td><td char=".">11,018</td></tr><tr><td char=".">2</td><td>Total number of records deemed potentially eligible for inclusion (after duplicates across databases were removed)</td><td char=".">229</td></tr><tr><td>Number of grey literature records deemed potentially eligible for inclusion</td><td char=".">16</td></tr><tr><td>3</td><td>Number of studies retained to be retrieved for full-text review</td><td char=".">199</td></tr><tr><td>4</td><td>Number of full-text articles retrieved and assessed for eligibility<xref ref-type="table-fn" rid="tfn2">b</xref>,<xref ref-type="table-fn" rid="tfn3">c</xref></td><td char=".">186</td></tr><tr><td>5</td><td>Number of articles identified for initial inclusion<xref ref-type="table-fn" rid="tfn4">d</xref></td><td char=".">25</td></tr><tr><td char=".">6</td><td>Number of articles coded in full and included in final set of studies for analysis</td><td char=".">14</td></tr><tr><td>Number of independent effect sizes included in the final analytic sample</td><td char=".">38</td></tr></tbody></table> </ephtml> </p> <p>1 <sups>a</sups>Due to restrictions in applying the full search strategy to the grey literature sources, select key terms were searched and the first 100 hits were reviewed. As such, the specific number of grey literature records identified and reviewed is not reported.</p> <ulist> <item>2 <sups>b</sups>We were successful in retrieving the full-text articles for all but 13 studies.</item> <item>3 <sups>c</sups>During the application of the selection criteria, 166 studies were excluded because they did not evaluate a <emph>BitB</emph> program that was implemented on a college campus.</item> <item>4 <sups>d</sups>During the data extraction and coding processes, an additional 11 studies were excluded for the following reasons: (<reflink idref="bib1" id="ref83">1</reflink>) the intervention being evaluated was not exclusively <emph>BitB</emph>, (<reflink idref="bib2" id="ref84">2</reflink>) missing data or an inability to calculate effect sizes (eg, missing standard deviations, reporting a statistical test not amenable to calculating an effect size), (<reflink idref="bib3" id="ref85">3</reflink>) sample size below the minimum of 20 in the treatment group, (<reflink idref="bib4" id="ref86">4</reflink>) overlapping sample with another study in the set, and (<reflink idref="bib5" id="ref87">5</reflink>) inappropriate comparison group (eg, another program or group that had extensive baseline differences compared to the treatment group).</item> </ulist> <hd id="AN0181109498-24">Characteristics of included studies</hd> <p>The majority of the studies (<emph>n</emph> = 8; 57%) were published between 2015 and 2021, and the year of program implementation ranged from 2003 to 2018 with most programs delivered after 2007 (64%; see Table 3). All but one of the studies were found in peer-reviewed journals (93%; the remaining study was an unpublished thesis), and almost all programs were implemented in the United States (<emph>n</emph> = 11; 79%). Studies varied in terms of research design and methodological rigor; five studies used a randomized control design (36%), three used a quasi-experimental design with a weakly matched comparison group (21%), and six used a single-group pretest-post-test design (43%). Correspondingly, 64% of the studies (<emph>n</emph> = 9) were rated as moderately rigorous on the Maryland Scale of Scientific Methods (SMS) with scores of 2 or 3, and 36% were rated as strong on the SMS with a score of 4 or 5 (<emph>n</emph> = 5).[<reflink idref="bib50" id="ref88">50</reflink>]</p> <p>Table 3. Study characteristics (<emph>N</emph> = 14).</p> <p> <ephtml> <table><thead><tr><td>General study characteristics</td><td><italic>N</italic> (%)</td></tr></thead><tbody valign="top"><tr><td>Program implementation year</td><td /></tr><tr><td> Before 2012</td><td char=".">7 (50.00)</td></tr><tr><td> After 2012</td><td char=".">7 (50.00)</td></tr><tr><td>Geographic location</td><td /></tr><tr><td> United States</td><td char=".">11 (78.57)</td></tr><tr><td> Canada</td><td char=".">2 (14.29)</td></tr><tr><td> New Zealand</td><td char=".">1 (7.14)</td></tr><tr><td>Research design</td><td /></tr><tr><td> Randomized control trial</td><td char=".">5 (35.71)</td></tr><tr><td> Quasi-experiment with weakly matched comparison group</td><td char=".">3 (21.43)</td></tr><tr><td> Single group pretest posttest</td><td char=".">6 (42.86)</td></tr><tr><td>Sample characteristics</td><td><italic>N</italic> (%)</td></tr><tr><td>Program participants</td><td /></tr><tr><td> General undergraduate student body</td><td char=".">9 (64.29)</td></tr><tr><td> Specific undergraduate students (Greek system, athletes, student leaders)</td><td char=".">5 (35.71)</td></tr><tr><td>Gender of participant sample</td><td /></tr><tr><td> All female (90%+)</td><td char=".">1 (7.14)</td></tr><tr><td> Mostly female (70–89%)</td><td char=".">3 (21.43)</td></tr><tr><td> Mixed (31–69% male/female)</td><td char=".">9 (64.29)</td></tr><tr><td> All male (90%+)</td><td char=".">1 (7.14)</td></tr><tr><td>Race/ethnicity of participant sample</td><td /></tr><tr><td> All/mostly white (70%+ white)</td><td char=".">8 (57.14)</td></tr><tr><td> Mixed/mostly minority (<70% white)</td><td char=".">6 (42.86)</td></tr><tr><td>Program characteristics</td><td><italic>N</italic> (%)</td></tr><tr><td>Number of sessions</td><td /></tr><tr><td> 1</td><td char=".">11 (78.57)</td></tr><tr><td> 2</td><td char=".">2 (14.29)</td></tr><tr><td> Missing</td><td char=".">1 (7.14)</td></tr><tr><td>Program length (hours)</td><td /></tr><tr><td> 1 hour</td><td char=".">2 (14.29)</td></tr><tr><td> 1.5 hours</td><td char=".">6 (42.86)</td></tr><tr><td> 3 hours</td><td char=".">2 (14.29)</td></tr><tr><td> 4.5 hours</td><td char=".">3 (21.43)</td></tr><tr><td> Missing</td><td char=".">1 (7.14)</td></tr><tr><td>Type of program facilitator</td><td /></tr><tr><td> Program staff</td><td char=".">2 (14.29)</td></tr><tr><td> University students</td><td char=".">8 (57.14)</td></tr><tr><td> University staff + university students</td><td char=".">1 (7.14)</td></tr><tr><td> Does not specify</td><td char=".">3 (21.43)</td></tr><tr><td>Delivered to single-sex group</td><td /></tr><tr><td> Yes</td><td char=".">9 (64.29)</td></tr><tr><td> No</td><td char=".">3 (21.43)</td></tr><tr><td> Missing</td><td char=".">2 (14.29)</td></tr><tr><td>Significant modifications to original curriculum</td><td /></tr><tr><td> Yes</td><td char=".">5 (35.71)</td></tr><tr><td> No</td><td char=".">9 (64.29)</td></tr></tbody></table> </ephtml> </p> <p>At pretest, the treatment group sample size ranged from 36 to 369 participants (<emph>M</emph> = 169.4, <emph>SD</emph> = 108.5), and the control group sample size ranged from 20 to 298 participants (<emph>M</emph> = 137.1, <emph>SD</emph> = 94.5). Most of the programs targeted an audience of general undergraduate students (<emph>n</emph> = 9; 64%), while five studies targeted specific undergraduate students such as those in fraternities/sororities, intercollegiate athletes, and/or student leaders (36%). Males and females were fairly equally represented across the sample; in the majority of studies (<emph>n</emph> = 9) the gender composition of participants was mixed (31 to 69% male/female). With respect to ethnicity, Caucasian students were more highly represented across the study samples; in eight studies (57%) the participants were at least 70% white, while six studies (43%) had mixed samples of Caucasian students and students with ethnic minority backgrounds.</p> <p>All of the <emph>BitB</emph> programs were delivered face-to-face to small groups of participants. Additionally, the programs were primarily implemented in a single session (<emph>n</emph> = 11; 79%) by university students who served as peer mentors (57%). Overall, the duration of the interventions varied (1 hour to 4.5 hours; average duration 2.3 hours [SD = 1.4]), and only one program reported using a booster session (7%). The programs were most commonly delivered to single-sex groups of students (<emph>n</emph> = 9; 64%). Finally, while many studies reported making some alterations to the curriculum (eg, using examples and statistics that were specific to the campus and local community), five studies (36%) reported making significant modifications/adaptations to the original curriculum (eg, adding content to discuss other forms of sexual/domestic violence, including scenarios relevant to minorities such 2SLGBTQ + and racialized students). Appendix A provides a detailed study-level description of each study.</p> <hd id="AN0181109498-25">Meta-analytic results</hd> <p>Next, we present pooled estimates for a set of commensurate <emph>BitB</emph> program outcomes. While several outcome measures were reported in each study, only three outcomes were reported consistently enough across the sample of studies to allow for a sufficiently large sample for meta-analytic pooling: rape myth acceptance (<emph>n</emph> = 11), bystander efficacy (<emph>n</emph> = 11), and bystander intentions (<emph>n</emph> = 11). Due to the small sample of studies reporting on treatment impacts on bystander behaviors (<emph>n</emph> = 5), a pooled analysis is not provided. Instead, preliminary analyses are presented narratively for this outcome measure.</p> <hd id="AN0181109498-26">Rape myth acceptance (n = 11)</hd> <p>Eleven studies reported on outcomes examining the impact of the <emph>BitB</emph> program on participants' endorsement of rape myths. The model yielded a pooled estimate of 0.274 (95% CI 0.137 to 0.411; <emph>z</emph> = 3.93, <emph>p</emph> <.001), which is a positive and statistically significant result. This finding suggests that, overall, <emph>BitB</emph> is effective at decreasing student acceptance/endorsement of rape myths. Figure 1 presents a forest plot of the effects of <emph>BitB</emph> programs on attitudes toward rape myths; all but one study produced a positive effect size and six of the effect sizes were statistically significant.</p> <p>PHOTO (COLOR): Figure 1. Forest plot for the meta-analysis on rape myth acceptance (n = 11).</p> <p>The model resulted in a significant <emph>Q</emph>-statistic of 85.05 (<emph>df</emph> = 10, <emph>p</emph> <.001) and an <emph>I<sups>2</sups></emph> value of 88.2%, suggesting heterogeneity within the sample that can largely be attributed to factors beyond sampling error. The presence of bias was assessed through a visual inspection of a funnel plot; the plot was mostly symmetrical, with one study[<reflink idref="bib51" id="ref89">51</reflink>] flagged as potentially concerning as it fell markedly outside the pseudo 95% confidence interval. The sensitivity analysis suggests that this study was not overly influential on the pooled estimate, and that the omission of the study would not change the direction or statistical significance of the pooled effect. Egger's test of small study effects provides no indication of bias with a coefficient of 1.08 (<emph>SE</emph> = 1.77, <emph>t</emph> = 0.61). Overall, the results suggest that the positive and statistically significant effect of <emph>BitB</emph> on college students' rape myth acceptance is robust.</p> <hd id="AN0181109498-27">Bystander efficacy (n = 11)</hd> <p>The overall pooled effect of studies that measured bystander efficacy was positive and significant at 0.403 (95% CI 0.273 to 0.534, <emph>z</emph> = 6.06, <emph>p</emph> <.001), suggesting that <emph>BitB</emph> significantly and positively impacts participants' confidence to act as bystanders. As shown in the forest plot in Figure 2, all of the effect sizes are positive, and nine of the 11 studies produced statistically significant effects.</p> <p>PHOTO (COLOR): Figure 2. Forest plot for the meta-analysis on bystander efficacy (n = 11).</p> <p>The random effects model had a statistically significant heterogeneity statistic (<emph>Q</emph> = 44.38, <emph>df</emph> = 10, <emph>p</emph> <.001), with an accompanying <emph>I</emph><sups>2</sups> value of 77.5%, which again suggests that heterogeneity can be attributed to factors other than sampling error. Egger's bias coefficient was not significant (1.66, <emph>SE</emph> = 1.47, <emph>t</emph> = 1.13), and no serious concerns of publication bias, small study effects, or influential studies were uncovered. Although one study was flagged as potentially concerning (as it fell far outside the pseudo confidence interval),[<reflink idref="bib51" id="ref90">51</reflink>] the influence analysis suggests that its removal would reduce the overall pooled estimate to.324 which would remain a statistically significant finding.</p> <hd id="AN0181109498-28">Bystander intentions (n = 11)</hd> <p>The pooled treatment effect on outcome measures of bystander intentions yielded an effect size of 0.459 (95% CI 0.327 to 0.592; <emph>z</emph> = 6.793, <emph>p</emph> <.001). This result suggests that, overall, the <emph>BitB</emph> program is effective at increasing intentions to intervene as a bystander. The forest plot in Figure 3 shows that all studies produced positive effects, and all but one effect size was statistically significant.</p> <p>PHOTO (COLOR): Figure 3. Forest plot for the meta-analysis on bystander intentions (n = 11).</p> <p>Substantial heterogeneity was present in the model (<emph>Q =</emph> 53.89, <emph>df</emph> = 10, <emph>p</emph> <.001; <emph>I</emph><sups>2</sups> = 81.4%). Egger's bias coefficient was not significant (1.463, <emph>SE</emph> = 1.74, <emph>t</emph> = 0.84), and the influence analysis found a robust effect.</p> <hd id="AN0181109498-29">Bystander behaviors (n = 5)</hd> <p>Five studies presented outcome measures of bystander behaviors. An initial examination indicated substantial variability in the effect size produced by each study. More specifically, three studies had positive and statistically significant effects, one had a positive but non-significant impact, and one study resulted in a negative but non-significant finding.</p> <p>A preliminary meta-analysis of the five studies reported a positive but non-significant pooled effect, however, influence analyses suggest that the pooled estimate is not robust as the omission of a single study would shift the direction, magnitude, and statistical significance of the pooled effect. The volatile effect and small sample of studies measuring bystander behaviors precludes us from drawing definitive conclusions about the effects of <emph>BitB</emph> on this outcome, the results presented here should be considered preliminary evidence of program effect.</p> <hd id="AN0181109498-30">Discussion</hd> <p>The present study examined the effectiveness of the <emph>Bringing in the Bystander</emph> program on changing sexual violence- and bystander-related outcomes among college students. The systematic search identified 11,018 studies for review, resulting in the review of 186 articles. After applying the selection criteria and decision rules, 14 studies producing 38 independent effect sizes were included in the meta-analysis.</p> <p>Our findings suggest that <emph>BitB</emph> has positive and statistically significant impacts on college students' attitudes toward rape myths/sexual violence and bystander-related outcomes. Specifically, the positive and statistically significant effect for rape myth acceptance suggests that, overall, <emph>BitB</emph> is effective at reducing students' rape-supportive attitudes. This finding is important as empirical evidence suggests that individuals who endorse rape myths are more likely to commit acts of sexual violence.[[<reflink idref="bib52" id="ref91">52</reflink>], [<reflink idref="bib54" id="ref92">54</reflink>]] Additionally, the heightened risk of sexual assault among college students is often at least partially attributed to social norms within certain campus environments that foster rape culture (eg, Greek system, intercollegiate athletes).[<reflink idref="bib56" id="ref93">56</reflink>] As such, changing students' attitudes toward rape myths, and providing them with the knowledge to confidently challenge social norms that foster rape culture can make campuses safer by addressing a key underlying factor that contributes to the perpetuation of sexual violence.</p> <p>Second, as active and prosocial bystanders play an important role in the intervention in situations of sexual violence, the increase in participants' bystander efficacy and bystander intentions is a positive indication of important program impacts. With respect to bystander efficacy, our findings suggest that participation in the program contributed to an increased confidence for performing bystander behaviors. Similarly, participation in the program contributed to an increased willingness to help as a bystander and attempt to prevent sexual assaults from happening. Overall, these findings are encouraging as they suggest that participants are able to identify high-risk situations and have the confidence to diffuse a situation. Moreover, the findings indicate that participants would feel inclined to intervene if a situation warranted intervention. These findings are particularly important with respect to countering the "bystander effect," as individuals may be less likely to diffuse the responsibility to act if they feel a sense of duty to intervene and are confident in their skills to effectively intercede. While an individual's expressed confidence and/or intention to prevent sexual violence does not necessarily indicate that they will in fact intervene in a situation where action is required, possessing the skills and the confidence to successfully apply those skills increases the likelihood that students will be able to effectively provide assistance to victims and prevent violent situations.</p> <p>Last, while the small sample of studies that report on bystander behavior outcomes precluded a pooled analysis, preliminary analyses suggest mixed evidence for the effectiveness of <emph>BitB</emph> on increasing bystander behaviors. As there are several challenges associated with measuring bystander behavior (eg, timeline of the evaluation, limited opportunity for participants to engage in bystander behavior), it is possible that at the time of post-test some participants may not have been presented with a situation in which they had the opportunity to act as a bystander (ie, a potential situation involving sexual violence). To the extent that this was true in the <emph>BitB</emph> evaluations included in the current study, the lack of increased bystander behaviors may not be an accurate reflection of program impact. More studies that report on the impact of <emph>BitB</emph> on bystander behavior are required before strong claims can be made concerning the program's ability to create behavioral change. Longer follow-up data collection points may be helpful in allowing sufficient time for participants to experience scenarios in which they can implement skills learned and demonstrate an increase in their bystander behaviors.</p> <p>Altogether, our findings suggest that the <emph>BitB</emph> program has a positive impact on changing sexual violence- and bystander-related outcomes among college students. Although there is limited evidence to assess whether the program increases actual bystander behaviors, the findings are nonetheless encouraging as the program successfully changes several behaviors that are often associated with inhibiting bystander action (eg, failure to recognize sexual violence, lack of awareness of high-risk situations, limited sense of responsibility to intervene, and lack of skills).[<reflink idref="bib18" id="ref94">18</reflink>],[<reflink idref="bib57" id="ref95">57</reflink>] In particular, these findings are promising as the knowledge and skills gained from participating in <emph>BitB</emph> represent steps 1 through 4 of Latane and Darley's[<reflink idref="bib18" id="ref96">18</reflink>] five-step bystander intervention model (see above); indicating that actual behavioral change (step 5 of the model) may be possible if those skills are practiced, reinforced, and maintained over time. Additional research is needed, as it is possible that supplementary instruction is required to affect long-term/actual behavioral change. For example, perhaps longer program sessions and/or exposure to booster sessions are essential for developing robust bystander skills, and recurring skills maintenance may reinforce participants' confidence and further enhance the motivation for and likelihood of safe and effective bystander action.</p> <p>Future research on <emph>BitB</emph> should explore variations in program implementation and the associated impacts on program outcomes. Program duration is an obvious contender for research focus, as determining whether the 60 minute and 4.5-hour program versions have comparable outcomes would be useful information for college administrators. Similarly, assessing the utility of single versus multi-session <emph>BitB</emph> programs, the impacts of booster sessions, and whether delivering the program in single sex groups – particularly in light of current movements toward gender inclusivity – are all relevant considerations for future program evaluations. Additionally, as recent research suggests that victims of sexual violence are less likely to intervene as bystanders,[<reflink idref="bib58" id="ref97">58</reflink>] future research should further examine the relationship between sexual violence victimization and the impacts of bystander education programs on bystander-related outcomes.</p> <hd id="AN0181109498-31">Limitations</hd> <p>While a sample of 14 studies is sufficient for meta-analytic pooling, there are several limitations associated with the number of included studies. The sample of 14 studies is small, and the sets of studies looking at the three separate outcomes categories are even smaller (ie, 11 effect sizes per pooled set). Further, we note that all outcomes were assessed via self-report and as such are subject to standard self-reporting limitations such as response bias. In part due to the small sample size of existing evaluations, the set of included <emph>BitB</emph> studies is not strongly representative of all existing variations of the program. While the findings herein concerning program impacts are positive and significant, they cannot necessarily be generalized to all versions of <emph>BitB</emph>, such as multi-session programs, programs using booster sessions, and programs delivered by non-peer educators. The lack of variation in the sample of 14 studies across these programmatic variables precluded the use of moderator analyses to assess the importance of such characteristics. In addition, 79% of the set of studies were conducted in the U.S., and generalizing findings to universities in other countries should be undertaken cautiously as American college campuses may differ in important ways (such as a heavy emphasis on a culture of college sports and fraternities/sororities). Further, most of the studies used participant samples predominantly made up of Caucasian participants; whether the curriculum content of <emph>BitB</emph> translates effectively to minority student populations is not clear.</p> <p>Another limitation is with respect to methodological rigor. Of the 14 studies in the sample, almost half used a single group pretest post-test design. While the challenges of implementing comparison group designs can be prohibitive in some contexts, increasing the methodological rigor of program evaluations would serve to better inform the field. Last, only three categories of program outcomes contained sufficient data for meta-analytic pooling and there were too few studies measuring participant reports of actual bystander behaviors to allow for a rigorous assessment of program impact with respect to this outcome. In addition, several other non-bystander program outcomes were reported in some studies, which may also be important indicators of <emph>BitB</emph> program impacts.</p> <hd id="AN0181109498-32">Conclusion</hd> <p>Addressing the prevalence of sexual violence victimization on college campuses has become a higher priority for many schools across the US, in part a result of the introduction of the Campus SaVE Act in 2013.[<reflink idref="bib1" id="ref98">1</reflink>] As such, there has been an increase in the implementation of sexual violence prevention programming, including those programs targeting bystander behaviors such as the <emph>BitB</emph> program. The findings from the current study are promising and suggest that <emph>BitB</emph> is generally effective at reducing levels of rape myth acceptance and increasing levels of bystander efficacy and intentions among college students. Program effectiveness at changing bystander behaviors remains unclear. Future research on the program should consider other indicators of program impact and further investigate behavioral outcomes. Future evaluators of <emph>BitB</emph> programs should also seek to address the methodological limitations of previous studies; in particular, through working to overcome barriers to implementing randomized control group or comparison group designs, as well as reporting important moderator variables (such as those listed in Table 3) so that moderator analyses can be conducted to understand whether program effects are related to intervention characteristics such as program characteristics (eg, length, delivery) or sample characteristics (eg, participant gender). Although more research will be beneficial, the positive impacts on several bystander related outcomes offer support for the continued use of the <emph>BitB</emph> program by those colleges and universities seeking change in their campus culture toward sexual violence.</p> <hd id="AN0181109498-33">Conflict of interest disclosure</hd> <p>The authors have no conflicts of interest to report. The authors confirm that the research presented in this article met the ethical guidelines, including adherence to the legal requirements of Canada.</p> <p>*Studies included in the meta-analysis are denoted by an asterisk (*)</p> <hd id="AN0181109498-34">Appendix A. Detailed study-level characteristics.</hd> <p></p> <p> <ephtml> <table><thead><tr><td>Author (Date)</td><td>Participants</td><td>Program length</td><td>Program modifications</td><td>Program delivery (facilitator; group gender composition)</td><td>Research design</td><td>Maryland scale rating</td><td>Sample characteristics (gender distrib.; ethnic composition)</td><td>Analytic sample size</td><td>Outcomes</td><td>Effect size (standard error)</td></tr><tr><td>TX group</td><td>CTL group</td></tr></thead><tbody valign="top"><tr><td>Amar et al (2012)<xref ref-type="bibr" rid="bibr59">59</xref></td><td>Under-graduate students</td><td>Not reported</td><td>Modified to include campus specific examples and content</td><td>Trained program facilitators<xref ref-type="table-fn" rid="tfn8">d</xref></td><td>Single-group pretest- post-test</td><td char=".">2<xref ref-type="table-fn" rid="tfn5">a</xref></td><td char=".">70% female; 67% Caucasian</td><td char=".">142</td><td>N/A</td><td>Rape Myth Acceptance</td><td char=".">0.594 (0.073)</td></tr><tr><td char=".">153</td><td>Bystander Intentions</td><td char=".">0.708 (0.078)</td></tr><tr><td>Banyard et al (2007)<xref ref-type="bibr" rid="bibr16">16</xref></td><td>Under-graduate students</td><td>Single 90-minute session</td><td>N/A</td><td>Trained peer facilitators (male/female pair); single sex delivery</td><td>RCT</td><td char=".">5<xref ref-type="table-fn" rid="tfn7">c</xref></td><td char=".">56% female; 90% Caucasian</td><td char=".">129</td><td char=".">115</td><td>Rape Myth Acceptance</td><td char=".">0.210 (0.127)</td></tr><tr><td>Bystander Intentions</td><td char=".">0.542 (0.129)</td></tr><tr><td>Bystander Efficacy</td><td char=".">0.486 (0.128)</td></tr><tr><td>Bystander Behavior</td><td char=".">0.355 (0.128)</td></tr><tr><td>Banyard et al (2009)<xref ref-type="bibr" rid="bibr60">60</xref></td><td>Resident advisors & student staff</td><td>Single 90-minute session</td><td>N/A</td><td>Trained peer facilitators; single sex delivery</td><td>Single-group pretest- post-test</td><td char=".">2</td><td char=".">60% female; predominantly Caucasian<sup>e</sup></td><td char=".">193</td><td>N/A</td><td>Rape Myth Acceptance</td><td char=".">0.312 (0.054)</td></tr><tr><td>Bystander Intentions</td><td char=".">0.420 (0.068)</td></tr><tr><td>Bystander Efficacy</td><td char=".">0.321 (0.055)</td></tr><tr><td>Cares et al (2015)<xref ref-type="bibr" rid="bibr15">15</xref></td><td>First-year undergraduate students</td><td char=".">2 sessions, 4.5 hours in total</td><td>Modified to include campus specific examples and content</td><td>Trained peer facilitators; single sex delivery</td><td>RCT</td><td char=".">5</td><td char=".">52% female; 85% Caucasian</td><td char=".">291</td><td char=".">298</td><td>Rape Myth Acceptance</td><td char=".">0.172 (0.083)</td></tr><tr><td>Bystander Intentions</td><td char=".">0.419 (0.083)</td></tr><tr><td>Bystander Efficacy</td><td char=".">0.413 (0.083)</td></tr><tr><td>Elias-Lambert and Black (2016)<xref ref-type="bibr" rid="bibr61">61</xref></td><td>Under-graduate fraternity members</td><td>Single 90-minute session</td><td>N/A</td><td>Trained peer facilitators; single sex delivery</td><td>RCT</td><td char=".">5</td><td>All male; 52% Caucasian</td><td char=".">79</td><td char=".">63</td><td>Rape Myth Acceptance</td><td char=".">0.001 (0.169)</td></tr><tr><td>Bystander Intentions</td><td char=".">0.213 (0.169)</td></tr><tr><td>Bystander Behavior</td><td char=".">−.240 (0.170)</td></tr><tr><td>Hines and Palm Reed (2017)<xref ref-type="bibr" rid="bibr36">36</xref></td><td>First-year students</td><td>Single one-hour session</td><td>Shortened the 2-hour program to be 1 hour</td><td>Trained facilitators (students and university faculty/staff); single sex delivery</td><td>Single-group pretest- post-test</td><td char=".">2</td><td char=".">62% female; 73% Caucasian</td><td char=".">324</td><td>N/A</td><td>Rape Myth Acceptance</td><td char=".">0.169 (0.031)</td></tr><tr><td>Bystander Intentions</td><td char=".">0.317 (0.051)</td></tr><tr><td>Inman et al (2018)<xref ref-type="bibr" rid="bibr62">62</xref></td><td>First-year undergraduate students</td><td>Single one-hour session</td><td>Modified the delivery to be in mixed-sex groups</td><td>Trained peer facilitators; mixed sex delivery</td><td>Single-group pretest- post-test</td><td char=".">2</td><td char=".">57% female; 75% Caucasian</td><td char=".">169</td><td>N/A</td><td>Rape Myth Acceptance</td><td char=".">0.162 (0.058)</td></tr><tr><td>Bystander Efficacy</td><td char=".">0.316 (0.068)</td></tr><tr><td>Moynihan and Banyard (2008)<xref ref-type="bibr" rid="bibr63">63</xref></td><td>Under-graduate student athletes and Greek system members</td><td>Single 90-minute session</td><td>N/A</td><td>Trained peer faciliators (male/female pair); single sex delivery</td><td>Single-group pretest- post-test</td><td char=".">2</td><td char=".">50% female; predominantly Caucasian<sup>e</sup></td><td char=".">106</td><td>N/A</td><td>Rape Myth Acceptance</td><td char=".">−0.119 (0.110)</td></tr><tr><td>Bystander Intentions</td><td char=".">0.230 (0.074)</td></tr><tr><td>Bystander Efficacy</td><td char=".">0.188 (0.073)</td></tr><tr><td>Moynihan et al (2010)<xref ref-type="bibr" rid="bibr64">64</xref></td><td>Intercollegiate athletes</td><td>Single 4.5-hour session</td><td>N/A</td><td>Trained program facilitators (male/female pair); single sex delivery</td><td>RCT</td><td char=".">5</td><td char=".">43% female; predominantly Caucasian<sup>e</sup></td><td char=".">36</td><td char=".">62</td><td>Rape Myth Acceptance</td><td char=".">0.361 (0.211)</td></tr><tr><td>Bystander Intentions</td><td char=".">0.422 (0.212)</td></tr><tr><td>Bystander Efficacy</td><td char=".">0.466 (0.212)</td></tr><tr><td>Bystander Behavior</td><td char=".">0.201 (0.215)</td></tr><tr><td>Moynihan et al (2011)<xref ref-type="bibr" rid="bibr65">65</xref></td><td>Undergraduate sorority members</td><td>Single 90-minute session</td><td>N/A</td><td>Trained program facilitators (male/female pair); single sex delivery</td><td>RCT</td><td char=".">5</td><td>All female; predominantly Caucasian<sup>e</sup></td><td char=".">28</td><td char=".">18</td><td>Bystander Intentions</td><td char=".">0.743 (0.312)</td></tr><tr><td>Bystander Efficacy</td><td char=".">0.920 (0.317)</td></tr><tr><td>Bystander Behavior</td><td char=".">0.743 (0.312)</td></tr><tr><td>Peterson et al (2018)<xref ref-type="bibr" rid="bibr51">51</xref></td><td>Under-graduate students</td><td>Single 90-minute session</td><td>Modified to include campus specific content and additional forms of violence</td><td>Trained peer facilitators (male/female pair); single sex delivery</td><td>Quasi-experiment w/weakly matched comparison group</td><td char=".">3<xref ref-type="table-fn" rid="tfn6">b</xref></td><td char=".">50% female; 70% Caucasian</td><td char=".">232</td><td char=".">176</td><td>Rape Myth Acceptance</td><td char=".">0.893 (0.105)</td></tr><tr><td>Bystander Intentions</td><td char=".">0.929 (0.105)</td></tr><tr><td>Bystander Efficacy</td><td char=".">0.915 (0.105)</td></tr><tr><td>Rudzinski (2019)<xref ref-type="bibr" rid="bibr66">66</xref></td><td>Under-graduate students</td><td>Single 3-hour session</td><td>Modified to include additional content for LGBTQ + and racialized students</td><td>Not reported</td><td>Single-group pretest- post-test</td><td char=".">3</td><td char=".">79% female; 59% Caucasian</td><td char=".">70</td><td>N/A</td><td>Rape Myth Acceptance</td><td char=".">0.213 (0.135)</td></tr><tr><td>Bystander Efficacy</td><td char=".">0.079 (0.126)</td></tr><tr><td>Senn and Forest (2016)<xref ref-type="bibr" rid="bibr67">67</xref></td><td>Under-graduate students</td><td>Single 3-hour session</td><td>Integrated the program into undergraduate courses</td><td>Trained peer facilitators (male/female pair); single sex delivery</td><td>Quasi-experiment w/weakly matched comparison group</td><td char=".">3</td><td char=".">52% female; 69% Caucasian</td><td char=".">248</td><td char=".">196</td><td>Bystander Intentions</td><td char=".">0.268 (0.096)</td></tr><tr><td>Bystander Efficacy</td><td char=".">0.331 (0.096)</td></tr><tr><td>Bystander Behavior</td><td char=".">0.224 (0.096)</td></tr><tr><td>Stojanov et al (2021)<xref ref-type="bibr" rid="bibr68">68</xref></td><td>Undergraduate students</td><td char=".">2 sessions, 4.5 hours in total</td><td>Modified to fit campus culture/context in NZ</td><td>Not reported; mixed sex delivery</td><td>Quasi-experiment w/weakly matched comparison group</td><td char=".">3</td><td char=".">78% female; 49% Caucasian</td><td char=".">25</td><td char=".">41</td><td>Bystander Efficacy</td><td char=".">0.442 (0.257)</td></tr></tbody></table> </ephtml> </p> <ulist> <item>5 <sups>a</sups>Level 2. Temporal sequence between the program and the crime or risk outcome clearly observed, or the presence of a comparison group without demonstrated comparability to the treatment group.[<reflink idref="bib50" id="ref99">50</reflink>]<sups>(p.4)</sups></item> <item>6 <sups>b</sups>Level 3. A comparison between two or more comparable units of analysis, one with and one without the program.[<reflink idref="bib50" id="ref100">50</reflink>]<sups>(p.4)</sups></item> <item>7 <sups>c</sups>Level 5. Random assignment and analysis of comparable units to program and comparison groups.[<reflink idref="bib50" id="ref101">50</reflink>]<sups>(p.5)</sups></item> <item>8 <sups>d</sups>Group gender composition for program delivery not reported.</item> <item>9 <sups>e</sups>Researchers did not collect detailed information on race/ethnicity because the campus where the program took place was over 90% Caucasian and did not want to make participants potentially identifiable.</item> </ulist> <ref id="AN0181109498-35"> <title> References </title> <blist> <bibl id="bib1" idref="ref1" type="bt">1</bibl> <bibtext> Rape, Abuse, & Incest National Network [RAINN]. Campus SaVE Act. https://<ulink href="http://www.rainn.org/articles/campus-save-act">www.rainn.org/articles/campus-save-act</ulink>. Published January 2021. Accessed January 2021.</bibtext> </blist> <blist> <bibl id="bib2" idref="ref2" type="bt">2</bibl> <bibtext> Cantor D, Fisher B, Chibnall S, et al. 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Header DbId: eric
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An: EJ1451899
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PubType: Academic Journal
PubTypeId: academicJournal
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Items – Name: Title
  Label: Title
  Group: Ti
  Data: Fostering College Students' Responsibility as Prosocial Bystanders to Sexual Violence Prevention: A Meta-Analysis of the Bringing in the Bystander Program
– Name: Language
  Label: Language
  Group: Lang
  Data: English
– Name: Author
  Label: Authors
  Group: Au
  Data: <searchLink fieldCode="AR" term="%22Jessica+Bouchard%22">Jessica Bouchard</searchLink><br /><searchLink fieldCode="AR" term="%22Jennifer+S%2E+Wong%22">Jennifer S. Wong</searchLink> (ORCID <externalLink term="https://orcid.org/0000-0001-7523-7430">0000-0001-7523-7430</externalLink>)<br /><searchLink fieldCode="AR" term="%22Chelsey+Lee%22">Chelsey Lee</searchLink>
– Name: TitleSource
  Label: Source
  Group: Src
  Data: <searchLink fieldCode="SO" term="%22Journal+of+American+College+Health%22"><i>Journal of American College Health</i></searchLink>. 2024 72(9):3410-3422.
– Name: Avail
  Label: Availability
  Group: Avail
  Data: Taylor & Francis. Available from: Taylor & Francis, Ltd. 530 Walnut Street Suite 850, Philadelphia, PA 19106. Tel: 800-354-1420; Tel: 215-625-8900; Fax: 215-207-0050; Web site: http://www.tandf.co.uk/journals
– Name: PeerReviewed
  Label: Peer Reviewed
  Group: SrcInfo
  Data: Y
– Name: Pages
  Label: Page Count
  Group: Src
  Data: 13
– Name: DatePubCY
  Label: Publication Date
  Group: Date
  Data: 2024
– Name: TypeDocument
  Label: Document Type
  Group: TypDoc
  Data: Journal Articles<br />Reports - Research
– Name: Audience
  Label: Education Level
  Group: Audnce
  Data: <searchLink fieldCode="EL" term="%22Higher+Education%22">Higher Education</searchLink><br /><searchLink fieldCode="EL" term="%22Postsecondary+Education%22">Postsecondary Education</searchLink>
– Name: Subject
  Label: Descriptors
  Group: Su
  Data: <searchLink fieldCode="DE" term="%22Student+Responsibility%22">Student Responsibility</searchLink><br /><searchLink fieldCode="DE" term="%22Prosocial+Behavior%22">Prosocial Behavior</searchLink><br /><searchLink fieldCode="DE" term="%22Sexual+Abuse%22">Sexual Abuse</searchLink><br /><searchLink fieldCode="DE" term="%22Prevention%22">Prevention</searchLink><br /><searchLink fieldCode="DE" term="%22College+Students%22">College Students</searchLink><br /><searchLink fieldCode="DE" term="%22Student+Attitudes%22">Student Attitudes</searchLink><br /><searchLink fieldCode="DE" term="%22Behavior%22">Behavior</searchLink>
– Name: DOI
  Label: DOI
  Group: ID
  Data: 10.1080/07448481.2022.2162825
– Name: ISSN
  Label: ISSN
  Group: ISSN
  Data: 0744-8481<br />1940-3208
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Objective: To synthesize research examining the effectiveness of the sexual violence bystander program "Bringing in the Bystander" ("BitB"). Participants: The analytic sample included 2083 youth in the treatment group and 969 in the comparison group. Method: A search strategy that included a total of 45 search terms was applied to 28 electronic databases. Results: The systematic search yielded a final analytic sample of 14 evaluations, with 38 independent effect sizes calculated across four outcome measures: rape myth attitudes (n = 11), bystander efficacy (n = 11), bystander intentions (n = 11), and bystander behavior (n = 5). The "BitB" program produced significant, positive pooled effects on measures of rape-supportive attitudes, bystander efficacy, and bystander intentions. Conclusions: The overall results are promising and suggest that the "BitB" education program may be an effective tool for targeting sexual violence on campuses.
– Name: AbstractInfo
  Label: Abstractor
  Group: Ab
  Data: As Provided
– Name: DateEntry
  Label: Entry Date
  Group: Date
  Data: 2024
– Name: AN
  Label: Accession Number
  Group: ID
  Data: EJ1451899
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=eric&AN=EJ1451899
RecordInfo BibRecord:
  BibEntity:
    Identifiers:
      – Type: doi
        Value: 10.1080/07448481.2022.2162825
    Languages:
      – Text: English
    PhysicalDescription:
      Pagination:
        PageCount: 13
        StartPage: 3410
    Subjects:
      – SubjectFull: Student Responsibility
        Type: general
      – SubjectFull: Prosocial Behavior
        Type: general
      – SubjectFull: Sexual Abuse
        Type: general
      – SubjectFull: Prevention
        Type: general
      – SubjectFull: College Students
        Type: general
      – SubjectFull: Student Attitudes
        Type: general
      – SubjectFull: Behavior
        Type: general
    Titles:
      – TitleFull: Fostering College Students' Responsibility as Prosocial Bystanders to Sexual Violence Prevention: A Meta-Analysis of the Bringing in the Bystander Program
        Type: main
  BibRelationships:
    HasContributorRelationships:
      – PersonEntity:
          Name:
            NameFull: Jessica Bouchard
      – PersonEntity:
          Name:
            NameFull: Jennifer S. Wong
      – PersonEntity:
          Name:
            NameFull: Chelsey Lee
    IsPartOfRelationships:
      – BibEntity:
          Dates:
            – D: 01
              M: 01
              Type: published
              Y: 2024
          Identifiers:
            – Type: issn-print
              Value: 0744-8481
            – Type: issn-electronic
              Value: 1940-3208
          Numbering:
            – Type: volume
              Value: 72
            – Type: issue
              Value: 9
          Titles:
            – TitleFull: Journal of American College Health
              Type: main
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