Impacts of GlobalConsent, a Web-Based Social Norms Edutainment Program, on Sexually Violent Behavior and Bystander Behavior Among University Men in Vietnam: Randomized Controlled Trial

"This project adds to the limited evidence from LMICs [low- and middle-income countries] on efficacious strategies to prevent sexual violence and promote prosocial bystander behaviors in university men."

Reviews of sexual violence prevention programmes have described the importance of bystander interventions and approaches that engage men as women's allies. However, young men are often difficult to reach and may resist participation in prevention programmes. RealConsent is an evidence-based web-delivered intervention tested among university men in the United States that uses didactic presentation of material via integrated audio, video, and infographics, along with educational entertainment. This randomised controlled trial (RCT) tested the impact of GlobalConsent, which is an adaptation of RealConsent, on sexually violent behaviour and prosocial bystander behaviour among university men in Vietnam, where sexual violence persists despite the legal reforms to address it.

RealConsent is based on formative research, social cognitive theory, social norms theory, and the bystander education model. Sexually violent behaviour is theorised to arise from the interplay of sociocontextual factors, personal factors, and behaviour. To operationalise this theory of change, programmatic features of RealConsent include gender-specific content and diverse behaviour change techniques, such as providing information and instruction on obtaining effective consent for sex and intervening safely, modeling communication and intervening behaviours, showing positive outcomes for obtaining consent, and intervening plus negative outcomes for perpetrating and not intervening, and reinforcing with positive feedback.

To adapt RealConsent for delivery to a new context, the research team followed the Centers for Disease Control and Prevention (CDC)'s 5-step process. The result was GlobalConsent, a 6-module web-based intervention whose 30-minute modules covered 6 topics: consent for sex, rape-myth beliefs and norms regarding gender roles, effective communication, alcohol and rape, victim empathy, and bystander intervention. Each module included didactic activities, interactivity, and episodes of an adapted, locally produced serial drama that modeled positive behaviours with cismale peers and cisfemale sex partners.

The researchers used a double-blind, parallel intervention versus control group design with 1:1 randomisation at 2 universities in Hanoi. A total of 793 consenting heterosexual or bisexual men aged 18-24 years who matriculated in September 2019 were enrolled and assigned randomly to GlobalConsent or a 6-module attention-control adolescent health education (AHEAD) programme. Both the programmes were delivered to computers and smartphones over 12 weeks. Self-reported sexually violent behaviours toward women in the prior 6 months and prosocial bystander behaviours in the prior year were measured at 0, 6, and 12 months.

More than 92.7% (735/793) of men in both study arms completed at least 1 programme module, and >90.2% (715/793) of men completed all 6 modules. At baseline, a notable percentage of men reported any sexually violent behaviour (GlobalConsent: 123/396, 31.1%; AHEAD: 103/397, 25.9%) in the prior 6 months. Among men receiving GlobalConsent, the odds of reporting a high level (at least 2 acts) of sexually violent behaviour at the endline were 1.3 times the odds at baseline. Among men receiving AHEAD, the corresponding odds ratio was higher, at 2.7. The odds of reporting any bystander behaviour at endline were 0.7 times the odds at baseline for GlobalConsent, and the corresponding odds ratio for AHEAD was lower, at 0.5.

Thus, this study "provides empirical support for the efficacy of a web-based edutainment approach for sexual violence prevention delivered to the computers and smartphones of students on college campuses, which may be more appealing and feasible in resource-constrained LMICs....The web-based platform and GlobalConsent delivered to computers and smartphones make wide-scale implementation with higher fidelity more feasible than in-person programs."

In conclusion: "Given the high rates of sexual violence against women, growing numbers of young men and women attaining postsecondary education, and rapid increases in access to the internet and smartphones globally, universities are ideal settings to provide novel sexual violence prevention programs during this critical developmental window, when young men are leaving home and are at increasing risk of sexually violent behavior. Evidence-based sexual violence prevention programs such as GlobalConsent, which are cost-effective, easily implemented by universities, and appealing to a diverse student population, are needed globally."