Study Limitations and Strengths
’s behavior
SECONDARY
This study had some limitations. First, the study sites were limited to 2 urban universities to accommodate program adaptation, production, and testing. Therefore, the findings cannot be generalized to all university men in Vietnam. However, the 2 study universities represented public and private institutions of higher education, diverse faculties of study, and diverse student bodies from urban and provincial Vietnam. Second, behavioral outcomes were self-reported and may have been subject to social desirability bias. To mitigate this limitation, the team relied on a validated instrument to measure sexual violence and self-administration, which enhances privacy and may enhance honest disclosures. Third, we did not interview women on campus about changes in behavior, as reported by men, owing to resource constraints and the ethical and logistical challenges of linking women’s reports of men’s behavior at the individual level. Fourth, some nonsignificant differences in behavior and attenuation of behavior change at 12 months suggest the need for booster training after the 3-hour program period. Fifth, the 12-month follow-up period allowed for a short-term impact assessment of GlobalConsent. However, the follow-up period in this study exceeded that in most similar studies. Long-term follow-up of participants would be beneficial to assess the impact of GlobalConsent on behavioral outcomes throughout men’s time at university and beyond. Sixth, similar to other web-based interventions, the content of GlobalConsent may become outdated, and updating or future adaptations to GlobalConsent may incur new costs. To mitigate this limitation, the team adapted a program script and content to ensure maximum durability. Seventh, participants in the GlobalConsent group may have become unblinded to their treatment assignment. Although a possibility, having an attention-control condition in which adolescent-focused health content is provided should reduce the likelihood of unblinding because health-related content is provided in both arms, and participants were not informed about the specific theoretical knowledge-, attitudinal-, and empathy-related pathways by which the GlobalConsent programing was expected to operate. Finally, some loss to follow-up was observed in both study arms. However, in absolute terms and relative to similar intervention studies [Recognizing these potential limitations, the strengths of this study were many. They included a randomized controlled design, customized attention-control condition, web-based delivery of GlobalConsent and attention-control programs to computers and smartphones, a large sample of participating university men, outstanding participation and retention, and refined measurement of primary behavioral outcomes and secondary (mediating) outcomes at 3 months and 9 months after intervention. Ours is among the few RCTs in the field, especially in LMICs, to assess impacts on 2 behaviors and to assess the impact on behavior at 2 time points after intervention.