Effect of Bystander-Based Violence Intervention Training on Development of Alcohol Use Disorder in a Prospective Cohort: Dual Efficacy?

Purpose: Bystander interventions show promise to reduce interpersonal violence. Because risky situations often involve alcohol use, bystander interventions may also reduce the risk of problem alcohol use. Methods: Using a prospective cohort study, based on an existing cluster-randomized controlled trial (RCT), we evaluated the longer-term efficacy of Green Dot bystander training to reduce DSM-5 defined alcohol use disorder (AUD). High school seniors (n = 3,377) recruited from RCT intervention and control schools completed a baseline survey during their senior year. Follow up data were then examined at a 12-month and final follow-up survey 24–48 months later once participants were no longer in high school. Results: At 12-month follow up (n = 2,077), AUD rates were lower among those who attended intervention (6.8%) versus control (9.2%) schools (adjusted rate ratio (aRR) = 0.73; 95% confidence interval (CI): 0.57–0.94). This reduction in AUD was most evident among those went on to attend 4-yr colleges after the baseline survey (n = 1,197; aRR = 0.70; 95% CI: 0.54–0.91) and males (n = 634; aRR = 0.63; 95% CI: 0.45–0.88). At 12-month follow up, report of receiving bystander training both in high school and after high school (vs. no training or only training in high school or after high school) was associated with the lowest rates of AUD, but only among those who did not attend 4-yr colleges. No differences were found at final follow up. Conclusions: As implemented in a cluster-RCT, Green Dot bystander training was associated with significantly lower AUD rates 12-months after leaving high school. Bystander training to reduce interpersonal violence may have a dual effect on reducing AUD.