Evaluating Cross-Cutting Prevention at the U.S. Air Force Academy

Evaluating Cross-Cutting Sexual Assault and Alcohol Misuse Prevention Programming at the U.S. Air Force Academy

Sexual assault and alcohol misuse are interrelated, persist at high rates in military populations, and carry negative consequences for military units and personnel. Combining tailored efforts to prevent sexual assault and alcohol misuse is critical for developing a more effective Force. This study will test the cross-cutting immediate and long-term outcomes of two programs, the Sexual Communication and Consent (SCC) sexual assault prevention program and the eCHECKUP TO GO alcohol misuse prevention program, delivered separately and in combination, with Cadets at the United States Air Force Academy. Anonymous Cadet self-report data will be collected before training (pre-test), immediately after training (post-test), 3 months after training (Fall semester follow-up), and 9 months after training (Spring semester follow-up).

Study Overview

• Status: Completed
• Conditions: Alcohol Misuse; Sexual Assault
• Intervention / Treatment: Behavioral: Training as usual (TAU); Behavioral: Alcohol eCHECKUP TO GO (eCHECKUP TO GO); Behavioral: Sexual Communication and Consent (SCC)

Detailed Description

Sexual assault and alcohol misuse both persist at high rates among military populations. These behaviors interfere with readiness, unit cohesion, mission objectives, and personnel performance and retention. There are demonstrated associations between sexual assault and alcohol misuse for both perpetrators and victims of sexual assault. Therefore, combining efforts to prevent sexual assault and alcohol misuse is critical for more effective and efficient programming. Moreover, tailored prevention programming that addresses individual risks and experiences related to sexual assault and alcohol misuse is likely to be the most effective programming. Unfortunately, to date, no evidence-based cross-cutting interventions have been developed and evaluated for impacts on both sexual assault and alcohol misuse among military populations. Several challenges impede this effort. Sexual assault prevention and alcohol misuse prevention are typically managed in different organizations within military settings, including within Military Service Academies. Training settings face many competing demands for trainees' time and instructor capacity, and instructors' ability to provide both sexual assault-related and alcohol-related training varies widely. Despite the promise of tailored training, individualized programming also presents feasibility challenges in group education settings common to military training. In alignment with the Fiscal Years 2021-2025 Department of Defense (DoD) Sexual Assault Prevention and Response (SAPR) Research Agenda and DoD's desire to have cross-cutting prevention programs that reduce risk for multiple harmful behaviors, the long-term goal of the proposed work is to address these challenges and provide the military with flexible, engaging, tailored prevention programming that reduces sexual assault and alcohol misuse while minimizing burden on Service members and training settings. To that end, the basic objective of this study is to test the cross-cutting immediate and long-term outcomes of two programs, the Sexual Communication and Consent (SCC) sexual assault prevention program and the eCHECKUP TO GO alcohol misuse prevention program, delivered separately and in combination, with Cadets at the United States Air Force Academy. Anonymous Cadet self-report data will be collected before training (pre-test), immediately after training (post-test), 3 months after training (Fall semester follow-up), and 9 months after training (Spring semester follow-up).

• Study Type: Interventional
• Enrollment (Actual): 2041
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • Colorado
    • Air Force Academy, Colorado, United States, 80840
      • United States Air Force Academy

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child; Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• U.S. Air Force Academy Basic Cadet enrolled in 2022 or 2023 Basic Cadet Training

Exclusion Criteria:

• Unable or unwilling to provide informed consent

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Prevention
• Allocation: Non-Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

4

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Active Comparator: Training as usual (TAU); TAU without SCC or eCHECKUP TO GO	Behavioral: Training as usual (TAU); TAU involves universal classroom instruction focused on developing knowledge, attitudes, and skills to promote personal resilience, increase potential for success, and develop healthy and rewarding personal relationships.
Experimental: TAU plus eCHECKUP TO GO; TAU with eCHECKUP TO GO (without SCC)	Behavioral: Training as usual (TAU); TAU involves universal classroom instruction focused on developing knowledge, attitudes, and skills to promote personal resilience, increase potential for success, and develop healthy and rewarding personal relationships.; Behavioral: Alcohol eCHECKUP TO GO (eCHECKUP TO GO); eCHECKUP TO GO is a personalized, online intervention designed to reduce cognitive risk factors for alcohol misuse. eCHECKUP TO GO is brief, self-guided, and provides individualized feedback based on a user's self-reported alcohol use patterns and consequences.
Experimental: SCC; SCC without TAU or eCHECKUP TO GO	Behavioral: Sexual Communication and Consent (SCC); SCC combines universal classroom instruction with tailored web-based content. Based on sociodemographic characteristics and prior sexual assault experiences, Cadets receive tailored content that addresses either primary victimization prevention, revictimization prevention, or healthy relationships and bystander intervention promotion.
Experimental: SCC plus eCHECKUP TO GO; SCC with eCHECKUP TO GO (without TAU)	Behavioral: Alcohol eCHECKUP TO GO (eCHECKUP TO GO); eCHECKUP TO GO is a personalized, online intervention designed to reduce cognitive risk factors for alcohol misuse. eCHECKUP TO GO is brief, self-guided, and provides individualized feedback based on a user's self-reported alcohol use patterns and consequences.; Behavioral: Sexual Communication and Consent (SCC); SCC combines universal classroom instruction with tailored web-based content. Based on sociodemographic characteristics and prior sexual assault experiences, Cadets receive tailored content that addresses either primary victimization prevention, revictimization prevention, or healthy relationships and bystander intervention promotion.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Self-reported Sexual Assault Victimization	Participants self-report whether they experienced any type of unwanted sexual contact between Basic Cadet Training and the Spring semester follow-up using a modified version of the Sexual Experiences Survey.	From pre-test to Spring semester follow-up, an average of 10 months
Self-reported Sexual Assault Perpetration	Participants self-report whether they perpetrated any type of unwanted sexual contact between Basic Cadet Training and the Spring semester follow-up using a modified version of the Sexual Experiences Survey.	From pre-test to Spring semester follow-up, an average of 10 months
Self-reported Alcohol Use	Participants self-report the approximate number of alcoholic drinks they consumed each day of the week during a typical week over the past month (assessed at both the Fall and Spring semester follow-up assessments). Participants who respond with any weekly value greater than 0 alcoholic drinks at either the Fall or Spring semester follow-up are coded as positive for any alcohol use.	From pre-test to Spring semester follow-up, an average of 10 months

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Knowledge of Sexual Assault	The percentage of correct participant responses to 8 true-or-false questions about sexual assault.	From pre-test to post-test, an average of 1 month
Knowledge of Effective Consent	The percentage of correct participant responses to 7 true-or-false questions about effective sexual consent.	From pre-test to post-test, an average of 1 month
Self-efficacy to Resist Unwanted Sexual Advances	A subset of participants rate their degree of confidence in their ability to use certain protective strategies in 6 specific high-risk situations. Scale scores range 6 to 42, with higher scores indicating greater self-efficacy.	From pre-test to post-test, an average of 1 month
Normative Perceptions of Peer Alcohol Use	Participants report how many days in the week they estimate the average Cadet of their same age and gender drinks and how many drinks the average Cadet of their same age and gender consumes per day using a modified version of the Quantity/Frequency/Peak questionnaire. The average number of estimated drinks consumed per drinking day is computed from this data and has a possible score range of 0 drinks to 6 drinks.	From pre-test to post-test, an average of 1 month
Readiness to Change Alcohol Use Behavior	Participants self-report their readiness to change their drinking behavior using a single item. The possible item score ranges 0 to 4, with higher scores indicating greater readiness to change.	From pre-test to post-test, an average of 1 month
Dating-related Protective Strategy Use	Participants self-report the degree to which they engaged in behavioral strategies to reduce sexual assault risk using the Dating Self-Protection Against Rape Scale. Scores range 0 to 70, with higher scores indicating greater engagement in dating-related protective behavioral strategies.	From pre-test to Spring semester follow-up, an average of 10 months
Alcohol-related Protective Strategy Use	Participants self-report the degree to which they engaged in behavioral strategies to reduce alcohol-related harms using an adapted version of the Protective Behavioral Strategies Survey. Scores range 0 to 100, with higher scores indicating greater engagement in alcohol-related protective strategies.	From pre-test to Spring semester follow-up, an average of 10 months

Collaborators and Investigators

• Sponsor: RTI International
• Collaborators: San Diego State University; United States Department of Defense; University of Florida; U.S. Army Medical Research and Development Command; U.S. Army Medical Research Acquisition Activity
• Investigators: Principal Investigator: Marni L Kan, PhD, RTI International; Principal Investigator: Nichole M Scaglione, PhD, University of Florida; Principal Investigator: Emily A Schmied, PhD, San Diego State University

Publications and helpful links

General Publications

• Eckhoff R, Boyce M, Watkins RL, Kan M, Scaglione N, Pound L, Root M. Examining the Use of Mobile Technology to Deliver Tailored Sexual Assault Prevention in a Classroom Environment in the Military: Development and Usability Study. JMIR Mhealth Uhealth. 2022 Nov 16;10(11):e41455. doi: 10.2196/41455.
• Kan ML, Scaglione NM, Buben A, Morgan JK, Grimes KEL, Watson CJ, Charm S, Lowe AN, Eckhoff RP, Lane M, Root MK, Pound LB. Feasibility and acceptability of tailored sexual assault prevention in the US Air Force. Pilot Feasibility Stud. 2024 Nov 21;10(1):145. doi: 10.1186/s40814-024-01565-6.
• Goldstein SJ, Scaglione NM, Kan ML, Grimes KEL, Lane ME, Morgan JK, Martin SL. Accuracy, Acceptability, and Burden of an Integrated Screening Approach to Facilitate the Delivery of Tailored Sexual Assault Prevention in the U.S. Air Force. J Child Sex Abus. 2025 Jul-Aug;34(5-6):661-681. doi: 10.1080/10538712.2024.2364792. Epub 2024 Jun 14.

Study record dates

Study Major Dates

• Study Start (Actual): June 27, 2022
• Primary Completion (Actual): May 1, 2024
• Study Completion (Actual): May 1, 2024

Study Registration Dates

• First Submitted: March 3, 2025
• First Submitted That Met QC Criteria: March 7, 2025
• First Posted (Actual): March 13, 2025

Study Record Updates

• Last Update Posted (Actual): November 25, 2025
• Last Update Submitted That Met QC Criteria: November 21, 2025
• Last Verified: November 1, 2025

More Information

Terms related to this study

• Keywords: Alcohol misuse prevention; Sexual assault prevention; Sexual Communication and Consent; eCHECKUP TO GO
• Additional Relevant MeSH Terms: Organization and Administration; Health Services Administration; Health Care Quality, Access, and Evaluation; Organic Chemicals; Data Collection; Health Care Evaluation Mechanisms; Quality of Health Care; Health Care Economics and Organizations; Alcohols; Records; Jurisprudence; Social Control, Formal; Informed Consent; Ethanol; Consent Forms
• Other Study ID Numbers: 0218275.001.001.003; W81XWH-21-9-0011.012 (Other Grant/Funding Number: U.S. Army Medical Research and Development Command); W81XWH-20-2-0014 (Other Grant/Funding Number: The Department of Defense's Office of Congressionally Directed Medical Research Programs)

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No