Sexual assault (SA) affects more than half of women in the United States and is associated with elevated risk for impairing posttraumatic stress symptoms as well as increased risk for substance misuse, particularly opioid misuse. Intervening in the acute period after a sexual assault may reduce the likelihood of symptom onset or escalation. Brief, scalable interventions that can be delivered at the point of care and reinforced remotely could address early needs and improve outcomes for survivors.
The primary objective was to evaluate the acceptability and feasibility of two brief interventions delivered in the acute post-SA period: a 17-minute Skills Training in Affective Recovery (STAR) video shown at the Sexual Assault Medical Forensic Exam (SAMFE), and a 21-day text message program (TextSTAR) delivered after the SAMFE to reinforce coping strategies and psychoeducation. The interventions aim to prevent the onset or worsening of posttraumatic stress symptoms and substance misuse.
This was a Sequential Multiple Assignment Randomized Trial (SMART) enrolling 50 women aged 18 years or older who presented for a SAMFE within seven days of a sexual assault. At the SAMFE visit participants were randomized to either view the STAR video (n = 25) or receive no video (n = 25). One week after the SAMFE, participants completed online questionnaires assessing substance use and posttraumatic stress. Those who met or exceeded pre-specified thresholds for acute stress or opioid use (n = 36) were randomized a second time to receive the 21-day TextSTAR program (n = 18) or no text messaging (n = 18). Participants completed weekly online surveys for 2–4 weeks post-SAMFE that included symptom assessments and measures of text program acceptability.
The STAR video is a 17-minute brief intervention that provides trauma-focused psychoeducation and actionable skills. Content areas included information about trauma reactions, strategies to reduce fear and avoidance, recommendations to enhance social support, and coping approaches to address substance use. The TextSTAR program extended these aims via a 21-day sequence of text messages designed to reinforce the video content, prompt use of coping strategies, and provide brief supportive reminders during the acute recovery period.
Acceptability of the STAR video was assessed immediately after viewing at the SAMFE. At 1 week post-SAMFE, online questionnaires measured posttraumatic stress symptoms and substance use, which determined eligibility for randomization to TextSTAR. Participants who received TextSTAR provided acceptability ratings at weekly surveys delivered 2–4 weeks after the SAMFE. Feasibility was evaluated by ability to enroll the target sample and retention rates at 1 and 4 weeks.
Participants reported favorable acceptability for both interventions. Among those who received the STAR video, 80% rated it as extremely acceptable immediately after viewing. For TextSTAR, acceptability at follow-up ranged from 60% to 90% of recipients reporting at least moderate acceptability, depending on the timepoint assessed. These findings indicate that both the brief video and the text message program were generally well received by recent sexual assault survivors.
Enrollment and short-term retention supported feasibility for this acute-post-SA intervention approach. The study enrolled 50 participants and achieved retention rates of 94% at the 1-week follow-up and 90% at the 4-week follow-up. These rates suggest that delivering a brief video at the SAMFE and supplementing with a text messaging program is practical in this population and study setting.
In this pilot SMART trial, the 17-minute STAR video and the 21-day TextSTAR text messaging program were found to be acceptable and feasible when delivered in the acute period following sexual assault. Both interventions targeted psychoeducation, reduction of fear and avoidance, enhancement of social support, and coping strategies for substance use. The trial is registered at ClinicalTrials.gov under identifier NCT06456190.
The abstract and plain language summary report acceptability and feasibility outcomes but do not provide detailed demographic breakdowns, specific symptom measure scores, statistical comparisons, or longer-term efficacy results. Those details were not reported in the supplied source excerpt.