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NCT Number: NCT06101056

Code of Respect (X-CoRe): Trial of a Multi-level Sexual Assault and Sexual Harassment Prevention Intervention for Active Duty Airmen

The purpose of this study is to examine the efficacy of Code of Respect (X-CoRe) multi-level sexual assault (SA) and harassment (SH) prevention program in improving psychosocial determinants (e.g., knowledge, skills, self-efficacy, attitudes) related to respectful/disrespectful relationships, to examine the efficacy of X-CoRe in reducing SA and sexual harassment SH victimization and to examine the efficacy of X-CoRe increasing bystander behavior and improving unit cohesion and mission readiness by decreasing secondary risk and harmful behaviors (e.g., alcohol misuse, intimate partner violence, suicide ideation). The study will be conducted at at Joint Base McGuire Dix-Lakehurst (JBMDL) located in Burlington County, New Jersey, and participants will be cluster-randomized at the level of the squadron to one of two conditions: the X-CoRe program or a control condition.

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Key information

Conditions

Sexual Assault Behavior Sexual Behavior Sexual Harassment Social Behavior

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Active Duty, stationed at JBMDL
  • assigned to one of the 26 Air Force squadrons within the three Air Force Wings at JBMDL (87 Air Base Wing (ABW), 305 Air Mobility Wing (ABM), and 621 Contingency Response Wing (CRW))
  • English speaking
  • access to an electronic device with internet capabilities

Exclusion criteria

  • being in service branches other than Air Force (e.g., Army or Navy)
  • Airmen not ranked E1-E4 at JBMDL

Treatment and study plan

Junior Enlisted Component

Behavioral

Junior Enlisted Airmen (E4 and below) will complete 10 online modules designed to train them on recognizing SH and SA, healthy and unhealthy relationships, and situations that may increase risk for SH and SA. Participants will adopt and practice a lifestyle paradigm of select-detect-protect, in which service members select their personal rule to have only healthy (non-abusive) relationships with their peers and romantic partners, detect signs and situations that might threaten their rules, and protect their rules using communication, management, and avoidance skills. They will be instructed to adopt a zero-tolerance approach to SH and SA and will receive skills training related to communication and conflict resolution for healthy relationships, reduction of SH and SA perpetration, consent communication, reporting incidents of SH and SA, and bystander intervention. Participants who have experienced SH or SA are encouraged to use the "Get Help Now" feature to access support 24/7.

Leadership Component

Behavioral

Mid- and advanced-level leaders (E5 and above) will complete 10 online modules designed to train them to recognize forms of SH and SA, how to respond to an incident of SH or SA, and how to create a safe work environment free of SH and SA. Leaders will also adopt and practice the paradigm select-detect-protect. Leaders will select their personal rule to enforce a healthy work environment (free of SH and SA), detect signs and situations that might threaten their rule (e.g., displaying inappropriate pictures on the computer), and protect their rules using communication and management skills. Leaders will also be given background material on SH and SA in the military (e.g., extent of the problem, DoD definitions, and policies) and installation resources for reporting incidents. As with the Junior Enlisted component, Leaders who may have experienced SH or SA are encouraged to use our "Get Help Now" feature to access support 24/7.

Social Marketing Campaign

Behavioral

All participating Airmen (including Junior Enlisted Airmen and Leaders) will be exposed to X-CoRe's social marketing campaign, which includes posters, flyers, postcards, and digital content for social media. Messages are designed to increase awareness of consent and foster Wing-wide norms that are supportive of healthy relationships. Resources for Service members to receive support if they have experienced SH or SA will also be provided through the social marketing materials. Social marketing materials, such as posters, will be distributed at "hot spots" for SA (e.g., dorms).

Primary outcomes

  1. Change in SA victimization as assessed by the Sexual Experiences Survey

    Time frame: baseline,6 months follow up, 12 months follow up

    This is a 10 item questionnaire and each is scored on a 4 point scale from 0-3 or more higher number indicating worse outcome

  2. Change in SH victimization as assessed by the (Sexual Experience Questionnaire (SEQ-DoD)

    Time frame: baseline, 6 months follow up, 12 months follow up

    This is a 23 item questionnaire and each is scored on a 5 point scale from 0, 1-2,3-5,6-9 or more, higher number indicating worse

Secondary outcomes

  1. Change in knowledge of Sexual Harassment and Assault as assessed by the Knowledge of Sexual Harassment and Assault Scale

    Time frame: baseline,6 months follow up, 12 months follow up

    This is a 6 item questionnaire and each question is answered as true or false

  2. Change in Rape Myth Acceptance as assessed by the Illinois Rape Myth Acceptance Scale -Short Form

    Time frame: baseline,6 months follow up, 12 months follow up

    This is a 20 item questionnaire and each is scored on a 7 point scale from not at all agree-very much agree a higher number indicating worse outcome

  3. Change in Gender Role Beliefs as assessed by the Hypergender Ideology Scale -Short Form

    Time frame: baseline,6 months follow up, 12 months follow up

    This is a 19 item questionnaire and each is scored on a 6 point scale from strongly disagree to strongly agree, higher number indicating worse outcome

  4. Change in attitudes towards Sexual Harassment as assessed by the Sexual Harassment Attitude Scale

    Time frame: baseline,6 months follow up, 12 months follow up

    This is a 17 item questionnaire and each is scored on a 5 point scale from strongly disagree-strongly agree, higher number indicating worse outcome

  5. Change in Attitudes towards Relationship Violence as assessed by the Acceptance of Couple Violence Scale

    Time frame: baseline,6 months follow up, 12 months follow up

    This is a 17 item questionnaire and each is scored on a 4 point scale from strongly disagree-strongly agree , higher number indicating worse outcome

  6. Change in Relationships Skills Self-Efficacy as assessed by the Interpersonal competence Questionnaire - Negative assertion subscale

    Time frame: baseline,6 months follow up, 12 months follow up

    This is an 8 item questionnaire and each is scored on a 5 point scale from I am poor at this-I am extremely good at this, lower number indicating worse outcome

  7. Change in Attitudes towards Preventing Sexual Harassment and Assault as assessed by the Attitudes Toward Preventing Dating Violence Subscale

    Time frame: baseline,6 months follow up, 12 months follow up

    This is a 3 item questionnaire and each is scored on a 4 point scale from strongly disagree to strongly agree, higher number indicating better outcome

  8. Change in Attitudes towards Cyberbullying as assessed by the Harmful Cyberbullying Attitudes Scale

    Time frame: baseline,6 months follow up, 12 months follow up

    This is a 5 item questionnaire and each is scored on a 5 point scale from strongly disagree to strongly agree

    , higher number indicating worse outcome

  9. Change in attitudes towards Alcohol Use as assessed by the Drinking Values Scale

    Time frame: baseline,6 months follow up, 12 months follow up

    This is a 10 item questionnaire and each is scored on a 5 point scale from strongly disagree to strongly agree, higher number indicating worse outcome

  10. Change in Bystander Self-Efficacy as assessed by the Bystander Efficacy Scale

    Time frame: baseline,6 months follow up, 12 months follow up

    This is an 18 item questionnaire and each is scored from 0(can't do) to 100(very certain) higher number indicating better outcome

  11. Change in Barriers to Sexual Assault Intervention as assessed by the Barriers to Sexual Assault Bystander Intervention Scale

    Time frame: baseline,6 months follow up, 12 months follow up

    This is a 23 item questionnaire and each is scored on a 7 point scale from strongly disagree-strongly agree a higher number indicating worse outcome

  12. Change in Conflict Communication Skills as assessed by the Conflict Communication Scale - Confrontation Subscale

    Time frame: baseline,6 months follow up, 12 months follow up

    This is a 15 item questionnaire and each is scored on a 6 point scale from strongly disagree-strongly agree a higher number indicating worse outcome

  13. Change in Bystander Behavior as assessed by the Bystander Behavior Scale - Risky Situations and Party Safety Subscale

    Time frame: baseline,6 months follow up, 12 months follow up

    This is a 25 item questionnaire and each is scored on a 4 point scale categorically from 0, 1, 2,3 or more times a higher number indicating better outcome

  14. Change in Horizontal Unit Cohesion as assessed by the Horizontal Cohesion Scale

    Time frame: baseline,6 months follow up, 12 months follow up

    This is a 6 item questionnaire and each is scored on a 5 point scale from strongly disagree-strongly agree a higher number indicating better outcome

  15. Change in Vertical Unit Cohesion as assessed by the Vertical cohesion Scale

    Time frame: baseline,6 months follow up, 12 months follow up

    This is a11 item questionnaire and each is scored on a 5 point scale from strongly disagree-strongly agree a higher number indicating better outcome

  16. Change in Intimate Partner Violence as assessed by the Composite Abuse Scale (Revised) - Short Form

    Time frame: baseline,6 months follow up, 12 months follow up

    This is a 15 item questionnaire and each is scored on a 5 point scale from not in the past 12 months to daily/almost daily a higher number indicating worse outcome

  17. Change in Alcohol Use as assessed by the Alcohol 30-day Quantity and Frequency

    Time frame: baseline,6 months follow up, 12 months follow up

    Participants are asked the following two questions: one regarding the frequency of consumption (number of days), and a second regarding the usual quantity of consumption (number of drinks) on drinking days, higher number indicating more alcohol use

  18. Change in Suicide Ideation as assessed by the Columbia -Suicide Severity Rating Scale - Severity of Suicidal Ideation Subscale

    Time frame: baseline,6 months follow up, 12 months follow up

    This is a 5 item questionnaire and each is scored on a 5 point scale from wish to be dead-suicidal intent with plan a higher number indicating worse outcome

  19. Change in Anxiety as assessed by the Generalized Anxiety Disorder Screener

    Time frame: baseline,6 months follow up, 12 months follow up

    This is a 7 item questionnaire and each is scored on a 4 point scale from not at all-nearly every day a higher number indicating worse outcome

  20. Change in Depression as assessed by the Patient Health Questionnaire 9 (PHQ-9)

    Time frame: baseline,6 months follow up, 12 months follow up

    This is a 9 item questionnaire and each is scored on a 4 point scale from not at all-nearly every day a higher number indicating worse outcome

  21. Change in PTSD as assessed by the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) Cross Cutting Symptom Measure

    Time frame: baseline,6 months follow up, 12 months follow up

    This is a 23 item questionnaire and each is scored on a 5 point scale from not at all-nearly every day a higher number indicating worse outcome

  22. Change in Overall Health Functioning as assessed by the World Health Organization Disability Assessment Schedule (WHODAS) 2.0) - Short Form

    Time frame: baseline,6 months follow up, 12 months follow up

    This is a 12 item questionnaire and each is scored on a 5 point scale from none-extreme or cannot do a higher number indicating worse outcome

Study contacts

Contact information is provided by the study sponsor or research team.

Belinda Hernandez, PhD, MPH

CONTACT

[email protected]

(210) 276-9021

Laura Thormaehlen

CONTACT

[email protected]

(713) 500-9655

Sponsors and collaborators

Lead sponsor

The University of Texas Health Science Center, Houston

Other

Collaborators

  • United States Department of Defense

Registry information

Official study title

Code of Respect (X-CoRe): a Randomized Controlled Trial of a Multi-level Sexual Assault and Sexual Harassment Prevention Intervention for Active Duty Airmen

Important dates

Study start
2024
Primary completion
2027
Study completion
2027
First posted
Oct 25, 2023
Registry last updated
Jan 28, 2025

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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