At a glance

Intervention Interventions focus on educating male students about sexual violence, with an aim to build empathy for victims and survivors, raise awareness about the influence of gender socialisation and social norms, dispel rape myths, and challenge sexual violence-supportive attitudes

Key populations Male university students who have not necessarily perpetrated sexual violence

Outcomes studied Gender-based violence; behaviours; knowledge, beliefs and attitudes; lived experience; relationships; wellbeing and emotions

Impact of the intervention Of the 32 primary studies, seven outcomes received an effectiveness rating on our Effectiveness Estimate Tool

Australian Evidence None of the studies presented findings from Australia

Risk of bias Of the studies with available quantitative data, we rated 2 as very low or low, 0 as moderate, and 15 as high or very high risk of bias on the Risk of Bias tool

Intervention description

What are the key characteristics of the intervention?

Didactic sexual violence educational interventions for male university students seek to build men's empathy for victims and survivors, raise awareness about the influence of gender socialisation and social norms, dispel rape myths and challenge sexual violence-supportive attitudes. The overarching aim is to prevent young men from potentially perpetrating sexual violence, particularly sexual assault.

The educational nature of these interventions means participants learn about key statistics on the prevalence of sexual violence and its legal definitions, consent and sexual communication, and rape myths. Other topics cover attitudes towards rape, sexually aggressive behaviours and dispelling myths and misperceptions of sexual violence. These interventions generally involve the presentation of educational materials (often shown in a video format), followed by activities like hypothetical scenarios or vignettes of sexual violence and facilitated small group discussions.

These interventions are generally underscored by three main approaches:

• Empathy-based approaches seek to elicit empathy towards victims and survivors of sexual violence. These interventions can involve listening to or watching testimonials of women who have experienced sexual violence followed by discussions and empathy-based behavioural tasks centred on imagining the effects of sexual violence on the victim and survivor and how they would feel, and in turn the feelings of the participants themselves. While the content and characteristics of the intervention are primarily heteronormative in focus, some interventions also feature material about a male-on-male sexual violence incident. The aim of this portrayal of sexual violence is to elicit empathy by drawing parallels to common experiences of female victim-survivors.
• Gender socialisation approaches seek to improve understandings of masculine and feminine socialisation. These interventions can involve discussing traditional conceptions of masculinity and femininity, sexual aggression and positive roles men can play in ending violence against women.
• Social norms approaches seek to challenge dominant views relating to men, women and sex. These interventions can involve discussing gender role scripts and power relations that promote a rape-supportive environment and the consequences of sexual violence.



What does the intervention involve?

Where is the intervention set? Tertiary education settings, including universities and colleges

How is the intervention delivered? Primarily delivered by male peer educators or trained facilitators. It is delivered face-to-face in groups, often with a video presentation shown in person. One intervention was a self-directed online format

How frequently is the intervention delivered? These interventions are brief and often delivered in single sessions (n=29, 90%), ranging from 22 minutes to 2 hours in length

What resources and costs are involved? None of the included studies commented on the costs

Theory of change

How is the intervention designed or theorised to work?

Many of the primary studies did not describe the theory of change behind the interventions (14 of 32 studies). These interventions hypothesised that teaching cohorts of male students about sexual violence will induce empathy for victims and survivors’ of sexual violence, will, in turn, alter rape-supportive attitudes and ultimately aid in the cessation of sexual violence on campus

For studies that described a theoretical basis, the interventions were primarily based on existing models such as:

• the Elaboration Likelihood Model which suggests that participants have an increased likelihood of attitude and behaviour change when they are motivated and can thoughtfully evaluate information that is presented as personally relevant (Foubert & McEwan, 1998; Foubert & Perry, 2007). These conditions lead to central route processing, a type of thinking whereby listeners actively process the program content being presented (Foubert & McEwan, 1998; Foubert & Perry, 2007). Specifically, The Men’s Program (see the Included Studies table) is based upon the Elaboration Likelihood Model.
• Belief Systems Theory which suggests that interventions can produce attitudinal change by approaching participants as “potential helpers” rather than “potential perpetrators” of sexual violence, thereby avoiding defensiveness and encouraging cooperation (Hudspith et al., 2021).
• Cognitive Dissonance Theory, which suggests that people experience discomfort when they hold conflicting beliefs, or their beliefs contradict their behaviour and, to resolve this discomfort, they are likely change their beliefs or behaviour. For example, participants who hold rape supportive beliefs may change these beliefs when tasked with an activity requiring them to explain why such beliefs are problematic (Raymond, 2011).

Some interventions also relied on a combination of other underlying behavioural theories such as:

• Social learning theory which suggests that people can learn by observing and imitating others.
• Protection-motivation theory which suggests that fear may facilitate attitude change as people are motivated to react in self-protective ways.
• Theory of planned behaviour which suggests that behavioural intent is shaped by a person’s attitude towards the behaviour, subjective norms, and perceived behavioural control.

Impact

This section speaks to the effectiveness of the studies.

The included studies measured a large range of outcomes across the categories of behaviour (e.g., bystander or consensual behaviours), gender-based violence (e.g., intent to rape or sexual assault), knowledge, beliefs and attitudes (e.g., attitudes towards consent or knowledge of how to help victims/survivors), relationships (e.g., communication or social connectedness), wellness and emotions (e.g., emotional skills or empathy), and perceptions of the intervention.

Studies were critically appraised for their risk of bias on the ANROWS-IRIS tool. Of the 20 studies with available data, two received a rating of low risk of bias, 14 received a rating of moderate-high risk of bias, and one received a rating of high risk of bias. Three meta-analyses were also critically appraised on the AMSTAR 2 rating tool, of which one received a rating of moderate confidence and two received a rating of critically low confidence.

Although many of the critically appraised studies were randomised controlled trials, they tended to be rated as a high or moderate risk of bias on the ANROWS-IRIS domains of selection bias and confounders. In terms of selection bias, some studies did not report their target population, or sampled participants from biased sources. For example, an intervention targeting college men may be biased if the participants are from fraternities, because men who are not fraternity members are unrepresented, making the findings ungeneralisable for all college men. Studies tended to have a higher risk of bias on the domain confounders because many did not assess equivalence between the intervention and control groups.

Findings in the impact table below draw two primary studies that received a low risk of bias on the ANROWS-IRIS tool and one meta-analysis of moderate confidence on the AMSTAR 2.

✅ = Most systematic reviews and studies show effectiveness
🟢 = Most studies show effectiveness
🟨= Most systematic reviews and studies show no effect
🟡 = Most studies show no effect
⛔= Potentially harmful
🔵 = Mixed evidence
✖ = Insufficient causal evidence
🕓 = Not yet rated

Effectiveness rating

Outcome

Description

Rape myth acceptance

Rape myth acceptance was measured in one meta-analysis of moderate confidence, and two primary studies with low risk of bias.

A meta-analysis of five studies specifically for male fraternity members indicated a moderate and significant effect size. The authors concluded that these interventions successfully reduced participants’ rape myth acceptance.

In one primary study, results indicated no effect on rape myth acceptance at 7 months following the intervention. The second study examined two versions of an empathy-based intervention. It found that the program with an additional module on bystander intervention had a significantly lower rape myth acceptance than those in the control group, while an intervention with an additional module on consent did not have a statistically significant difference at immediate follow-up.

Likelihood of perpetrating sexual assault

One study found that two versions of an empathy-based intervention (one with an additional module on consent and another on bystander intervention) had significantly less likelihood of perpetrating sexual assault than those in the control group, measured immediately after the intervention.

IPV

Most studies (n = 2) show reduced intimate partner violence, and report that the intervention was effective for reducing PTSD at the six-month mark post-intervention.

Empathy towards victims/survivors

Empathy towards victims and survivors was measured in two low risk of bias primary studies. In one study, results indicated that there was no effect of the intervention on empathy towards victims and survivors at 7 months follow-up. The second study examined two versions of an empathy-based intervention and found that the program with an additional module on bystander intervention had significantly more empathy towards victims and survivors than those in the control group, while an intervention with an additional module on consent did not have a statistically significant difference, at immediate follow-up.

Intention to rape

Intention or likelihood to rape was measured in two low risk of bias studies. In one study, there was no statistically significant difference between the behavioural intent to rape in two empathy-based interventions (each with an additional module on either consent or bystander intervention) and the control group, at immediate follow up. In another study, there was not a statistically significant effect on self-reported intent to rape at 7 months follow-up.

Sexual aggression

One study found no statistically significant effect on self-reported sexually aggressive behaviour at 7 months following the intervention.

Socially desirable responding

One study found that there was not a statistically significant effect on social conformity at 7 months following the intervention.

General empathy

One study found statistically significant effects in favour of the control group with a greater decrease in general empathy at 7-month follow-up. The authors emphasise the presence of measurement effects which may limit the conclusions of the paper. That is, administering a survey asking about empathy before receiving the intervention may have affected participants’ post-survey responses.

Key Populations

Has the impact of this intervention been tested with certain key populations?

This Intervention Review assessed the impact of sexual violence prevention education for male students in tertiary education settings. These interventions were delivered to cohorts of male-only university or college students. Participants were mostly undergraduate-level students based in United States fraternities who were aged 18 to 25 years. The interventions were not designed for any specific cultural or ethnic groups, people with physical or mental disabilities, or health conditions. Many of the interventions were delivered to students who were young, white and single, meaning the impact of the interventions have not been tested with certain key populations.

The table below gives an overview of whether or not the intervention was examined with some key populations. The inclusion of these populations was guided by the National Plan to End Violence against Women and Children 2022-2032 and the Australian National Research Agenda to End Violence against Women and Children: 2023-2028.

Population	What do we know about this group?	Degree of knowledge
Aboriginal and Torres Strait Islander communities	0 studies. The appropriateness of this intervention with this population has not yet been established. Therefore, we cannot confirm the applicability of this intervention to this population
Sexuality and gender diverse / LGBTIQA+	0 studies. The appropriateness of this intervention with this population has not yet been established. Therefore, we cannot confirm the applicability of this intervention to this population
Specific age groups (including older people, children and young people)	All studies examined the effectiveness of the intervention with young men aged 18 to 25 years.
Culturally and linguistically diverse (CALD) groups	0 studies. The appropriateness of this intervention with this population has not yet been established. Therefore, we cannot confirm the applicability of this intervention to this population
Migrants and refugees	0 studies. The appropriateness of this intervention with this population has not yet been established. Therefore, we cannot confirm the applicability of this intervention to this population
People with disability	0 studies. The appropriateness of this intervention with this population has not yet been established. Therefore, we cannot confirm the applicability of this intervention to this population

Key considerations

This section summarises factors that may contribute to study results, factors that may be considered to facilitate better outcomes, and the transferability of the intervention to an Australian context.

What do we know about the intervention in Australia?

• Absence of Australian research: None of the studies were conducted in Australia. All studies, except for one Canadian study, were based in the United States.

• College culture in the United States: In one-third of the studies (n = 11), the participants were fraternity members, which may not translate to the Australian context. Fraternities and “Greek” culture are major elements of a male student’s experience at United States colleges and are generally hyper-masculine settings. While Australia and the United States share similar university cultures in relation to high levels of reports of sexual violence, particularly in residential college settings, and widespread discontent with institutional responses, further research is required to determine how transferable or acceptable these interventions are for Australian tertiary education settings.

What should Australian stakeholders consider?

The nature of the available evidence:

• Older body of evidence: Nearly half of the included studies were conducted between the late 1990s and early 2000s (n=15). It is therefore possible the curriculum may no longer be considered current. Implementors could consider revisions based on recent empirical research, theoretical frameworks and best practice standards.
• Outcomes measured: According to the intervention’s theory of change, a complete cessation of sexual violence is the desired outcome from these interventions, however, many of the quantitative impact evaluations did not measure gender-based violence or behaviour changes. Most studies measured the attitude changes with short follow-up periods after the intervention was implemented, meaning it remains unclear whether the attitude changes go on to render behaviour changes in the participants. Future research should seek to measure the intention and actual perpetration of sexual violence.
• Lack of research on diverse populations: Many of the included studies focused on young white men, often in college fraternities. There are gaps in knowledge regarding the effect of the intervention on groups such as mature-aged and/or postgraduate, racially and ethnically diverse, and disabled students. Due to the inherent nature of the intervention being designed for tertiary education settings, it is unclear whether the intervention could be transferred to other settings (for example, high schools or workplaces).

Implementation considerations:

• Intervention delivery: Interventions were delivered by peer educators who received training from professional facilitators or professionally trained facilitators with experience presenting the material. Peer educators may be considered more relatable to their fellow students, while professional facilitators may be regarded with more credibility.
• Intervention intensity: Generally, lessons were delivered in single sessions, meaning this intervention is not time intensive. Implementors should consider the dosage of the intervention to balance time commitment with positive outcomes.
• Intervention duration: Given the brevity of most of the interventions (between 22 minutes and 2 hours), future studies may test the impact of implementing multiple sessions to determine the effectiveness of longer exposure to sexual violence prevention education for college and university male student populations.
• Resourcing: This intervention involves the recruitment and training of peer educators or facilitators, as well as the development or provision of audiovisual or printed materials. It was not possible to determine the cost effectiveness, given none of the studies reported on the costs associated with implementation.

Included studies

Characteristics of primary studies included in the Intervention Review

References and further reading

Included Studies

• Barone, R. P., Wolgemuth, J. R., & Linder, C. (2007). Preventing sexual assault through engaging college men.Journal of College Student Development, 48(5), 585-594. https://doi.org/10.1353/csd.2007.0045


• Berg, D. R., Lonsway, K. A., & Fitzgerald, L. F. (1999). Rape prevention education for men: The effectiveness of empathy-induction techniques. Journal of College Student Development, 40(3), 219-234.https://psycnet.apa.org/record/1999-05202-002K


• Berliant, J. (2012). Sexual assault prevention: Changing explicit and implicit cognitions of university men [Doctoral dissertation, Carlton University]. Carlton University Institutional Repository.https://repository.library.carleton.ca/concern/etds/hx11xf70n


• Boulter, C. (1998). Effects of an acquaintance rape prevention program on male college students' endorsements of rape myth beliefs and sexually coercive behaviors [Doctoral dissertation, Washington State University]. Dissertation Abstracts International: Section B: The Sciences and Engineering, 59(3-B), 1411.


• Caver, K. (2012). Masculine ideology and college men's reactions to a sexual assault prevention program [Doctoral dissertation, Texas A&M University].https://hdl.handle.net/1969.1/ETD-TAMU-2012-08-11555


• Choate, L. H. (2003). Sexual assault prevention programs for college men: An exploratory evaluation of the men against violence model. Journal of College Counseling, 6(2), 166-176. https://doi.org/10.1002/j.2161-1882.2003.tb00237.x


• Darlington, E. (2014). Decreasing misperceptions of sexual violence to increase bystander intervention: A social norms intervention [Doctoral dissertation, University of Oregon]. ProQuest LLC.


• Davis, T. L. (1997). The effectiveness of a sex role socialization-focused date rape prevention program in reducing rape-supportive attitudes in college fraternity men [Doctoral dissertation, University of Iowa]. ProQuest Dissertations & Theses Global. https://www.proquest.com/dissertations-theses/effectiveness-sex-role-socialization-focused-date/docview/304343237/se-2


• Davis, T. L., & Liddell, D. L. (2002). Getting inside the house: The effectiveness of a rape prevention program for college fraternity men. Journal of College Student Development, 43(1), 35-50.


• Echols, K. L. (1998). Dating relationships and sexual victimization: an intervention program with college freshman males [Doctoral dissertation, University of Alabama]. UMI Company.


• Foubert, J. D. (2000). The longitudinal effects of a rape-prevention program on fraternity men's attitudes, behavioral intent, and behavior. Journal of American College Health, 48(4), 158-163. https://doi.org/10.1080/07448480009595691


• Foubert, J. D., & Marriott, K. A. (1997). Effects of a sexual assault peer education program on men’s belief in rape myths. Sex Roles, 36(3-4), 259-268. https://doi.org/10.1007/BF02766271


• Foubert, J. D., & McEwen, M. K. (1998). An all-male rape prevention peer education program: Decreasing fraternity men's behavioral intent to rape. Journal of College Student Development, 39(6), 548-556. https://psycnet.apa.org/record/1998-11416-002


• Foubert, J. D., & Newberry, J. T. (2006). Effects of two versions of an empathy-based rape prevention program on fraternity men's survivor empathy, attitudes, and behavioral intent to commit rape or sexual assault. Journal of College Student Development, 47(2), 133-148. http://dx.doi.org/10.1353/csd.2006.0016


• Foubert, J. D., Godin, E. E., & Tatum, J. L. (2010). In their own words: Sophomore college men describe attitude and behavior changes resulting from a rape prevention program 2 years after their participation. Journal of Interpersonal Violence, 25(12), 2237-2257. https://doi.org/10.1177/0886260509354881


• Gidycz, C. A., Orchowski, L. M., & Berkowitz, A. D. (2011). Preventing sexual aggression among college men: An evaluation of a social norms and bystander intervention program. Violence Against Women, 17 (6), 720-742. https://doi.org/10.1177/1077801211409727


• Hatcher, A. P. (2009). An evaluation of a sexual assault education program [Doctoral dissertation, Western Michigan University]. ProQuest Dissertations & Theses Global. https://www.proquest.com/dissertations-theses/evaluation-sexual-assault-education-program/docview/305031970/se-2


• Holz, K. B., Fischer, A. R., & Daood, C. J. (2018). The role of men’s beliefs in shaping their response to a sexual violence prevention program. Psychology of Men & Masculinity, 19(2), 308-313. https://doi.org/10.1037/men0000091


• Johansson-Love, J. & Geer, J. H. (2003). Investigation of attitude change in a rape prevention program. Journal of Interpersonal Violence, 18(1), 84-99. https://doi.org/10.1177/0886260502238542


• Liu, E. (2010). A study of a university-based men-only prevention program (men care): Effect on attitudes and behaviors related to sexual violence [Doctoral dissertation, University of Southern California] ProQuest Dissertations & Theses Global. https://www.proquest.com/dissertations-theses/study-university-based-men-only-prevention/docview/748223021/se-2


• Lobo, T. R. (2005). Evaluation of a sexual assault prevention program for college men: Effects on self-reported sexually aggressive behavior, social perceptions, and attitudes [Doctoral dissertation, Ohio University].


• Northam, E. J. (1998). The evaluation of a university-based acquaintance rape prevention program [Doctoral dissertation, University of Oklahoma]. UMI Company.


• O'Donohue, W., Yeater, E. A., & Fanetti, M. (2003). Rape prevention with college males: The role of rape myth acceptance, victim empathy, and outcome expectancies. Journal of Interpersonal Violence, 18(5), 513-531. https://doi.org//10.1177/0886260503251070


• Phipps, K. A. (2004). Evaluating an empathy-based model of sexual assault prevention [Doctoral dissertation, Central Michigan University]. ProQuest Information and Learning Company.


• Raymond, E. M. (2011). A sexual assault prevention program for men based on cognitive dissonance theory [Doctoral dissertation, University of Wyoming]. ProQuest LLC.


• Schewe, P. A. & O'Donohue, W. (1996). Rape prevention with high-risk males: Short-term outcome of two interventions. Archives of Sexual Behavior, 25(5), 455-471. https://dx.doi.org/10.1007/BF0243754


• Stephens, K. A. (2008). Rape prevention with Asian /Pacific Islander and Caucasian college men: The roles of culture and risk status [Doctoral dissertation, University of Washington]. ProQuest Dissertations & Theses Global. https://www.proquest.com/dissertations-theses/rape-prevention-with-asian-pacific-islander/docview/304440606/se-2


• Stephens, K. A., & George, W. H. (2004). Effects of anti-rape video content on sexually coercive and noncoercive college men's attitudes and alcohol expectancies. Journal of Applied Social Psychology, 34(2), 402-416. https://doi.org/10.1111/j.1559-1816.2004.tb02554.x


• Stephens, K. A., & George, W. H. (2009). Rape prevention with college men: Evaluating risk status. Journal of Interpersonal Violence, 24(6), 996-1013. https://doi.org/10.1177/0886260508319366


• Stewart, A. L. (2014). The men’s project: A sexual assault prevention program targeting college men. Psychology of Men & Masculinity, 15(4), 481-485. https://doi.org/10.1037/a0033947


• Tarrant, J. M. (1999). Rape education for men: A comparison of two interventions [Doctoral dissertation, University of Missouri-Columbia]. UMI Company.


• Wong, Y. J. McDermott, R. C. Zounlome, N. O. O. Klann, E. M. & Peterson, Z. D. (2020). Self-persuasion: An experimental evaluation of a sexual aggression preventive intervention for U.S. college men. Journal of Interpersonal Violence, 37(5-6), 2037-2061. https://doi.org/10.1177/0886260520936369

• DeGue, S., Valle, L. A., Holt, M. K., Massetti, G. M., Matjasko, J. L., & Tharp, A. T. (2014). A systematic review of primary prevention strategies for sexual violence perpetration. Aggression and Violent Behavior, 19(4), 346-362. https://doi.org/https://doi.org/10.1016/j.avb.2014.05.004


• Fellmeth G. L. T., Heernan, C., Nurse, J., Habibula, S., & Sethi, D. (2013). Educational and skills-based interventions for preventing relationship and dating violence in adolescents and young adults. Cochrane Database of Systematic Reviews, 6. CD004534. https://doi.org/10.1002/14651858.CD004534.pub3


• Graham, L. M., Embry, V., Young, B.-R., Macy, R. J., Moracco, K. E., Reyes, H. L. M., & Martin, S. L. (2021). Evaluations of prevention programs for sexual, dating, and intimate partner violence for boys and men: A systematic review. Trauma, Violence, & Abuse, 0(0), 1-27. https://doi.org/10.1177/1524838019851158


• Hudspith, L. F., Wager, N., Willmott, D., & Gallagher, B. (2021). Forty years of rape myth acceptance interventions: A systematic review of what works in naturalistic institutional settings and how this can be applied to educational guidance for jurors. Trauma, Violence, & Abuse, 24(2), 981-1000. https://doi.org/10.1177/15248380211050575


• Ruvalcaba, Y., Rodriguez, A. L., Eaton, A. A., Stephens, D. P., & Madhivanan, P. (2022). The effectiveness of American college sexual assault interventions in highly masculine settings: A systematic review and meta-analysis. Aggression and Violent Behavior, 65, 101760. https://doi.org/10.1016/j.avb.2022.101760


• Wright, L. (2017). The effectiveness of male-targeted sexual assault prevention programs: a meta-analysis. [Doctoral dissertation, Indiana University]. Indiana University.


• Wright, L. A., Zounlome, N. O. O., & Whiston, S. C. (2020). The effectiveness of male-targeted sexual assault prevention programs: A meta-analysis. Trauma, Violence & Abuse, 21(5), 859–869. https://doi.org/10.1177/1524838018801330

• Vladutiu, C J., Martin, S. L. & Macy, R. J. (2011). College- or university-based sexual assault prevention programs: A review of program outcomes, characteristics, and recommendations Trauma, Violence & Abuse, 12(2), 67-86. https://dx.doi.org/10.1177/1524838010390708