Combining alcohol misuse and sexual assault prevention enhances training outcomes in a U.S. military service academy

Abstract

OBJECTIVE: Alcohol misuse and sexual assault are prevalent in the U.S. military, including in military service academies. As these behaviors frequently co-occur, there is an urgent need to develop and test prevention programs that address risk factors for both and that are also appropriately tailored for military cadets. The purpose of this study was to compare the efficacy of a combined alcohol misuse and sexual assault prevention program to those of an alcohol misuse prevention program plus a healthy skills program, a stand-alone sexual assault prevention program, and a stand-alone healthy skills program.

METHOD: A four-arm quasi-experimental study was conducted at the U.S. Air Force Academy with two incoming classes of cadets (N = 1,985). Participants completed pre- and posttest surveys to assess alcohol misuse- and sexual assault-related knowledge and attitudes. Mixed-effects multilevel models tested changes over time by condition; interactions were examined to determine whether program effects were moderated by sex or prior alcohol use.

RESULTS: Several significant differences between conditions in pre- to posttest changes were observed, with most results indicating greater improvements for the combined condition than for other conditions. Alcohol readiness to change improved in the combined program compared to the alcohol misuse prevention and healthy skills program (p < 0.05); knowledge regarding sexual assault and self-efficacy to resist unwanted sexual advances increased significantly more in the combined program than in all others (p < 0.05).

CONCLUSIONS: This study provides initial evidence to support combined, tailored alcohol misuse and sexual assault training in military academy settings.