Retraining Alcohol and Condom Tendencies (ReACT) intervention among women with a history of rape: A secondary analysis of a proof-of-principle study

Abstract

Women who have experienced rape are more likely to engage in heavy alcohol use and condom nonuse. In this secondary analysis, we examined whether rape history moderated the effects of Retraining Alcohol and Condom Tendencies, a brief integrated approach bias modification intervention for reducing alcohol use and increasing condom use. Sixty women between 18 and 24 (M = 19.88, SD = 1.50) reporting heavy alcohol use and unprotected sex with casual partners were randomly assigned to a training condition (n = 31; 42% experienced rape) or a sham-control condition (n = 29; 34% experienced rape). Participants in the training condition were trained to make avoidance movements away from alcohol stimuli and approach movements toward condom stimuli over four training sessions. Among women who experienced rape, there were large effects between treatment and control conditions on all outcomes (alcohol use d_pp2 = -0.87, condom use d_pp2 = 0.63, and negative condom attitudes d_pp2 = -1.02). Significant Time × Condition interactions were found for alcohol approach bias, condom approach bias, and condom use, with women in the training condition showing reduced alcohol approach bias, increased condom approach bias, increased condom use, and improved condom attitudes relative to controls (ps < .05). A significant three-way interaction (Time × Condition × Rape History) indicated that women with a history of rape in the treatment condition exhibited the largest reductions in alcohol consumption. Effects on condom use and attitudes did not differ by rape history. Retraining Alcohol and Condom Tendencies effectively reduced alcohol use and improved condom use behaviors among high-risk college women, with particularly strong effects on alcohol use for women with a history of rape. (PsycInfo Database Record (c) 2026 APA, all rights reserved).