You will be presented with a collection of medical randomized controlled trial (RCT) reports addressing a shared clinical question -- for instance, the efficacy of a medical intervention on a disease or condition. Given the titles and abstracts of these reports, your task is to generate the conclusion of the systematic review article synthesizing the key findings. Your conclusion should be a few sentences long. In your response, include only the conclusion and no other text. The RCT reports are below.



Title 1:
An Online Bystander Intervention Program for the Prevention of Sexual Violence.
Abstract 1:
OBJECTIVE Because of its high prevalence and serious consequences for victims , sexual violence is a significant problem on college campuses . Sexual assault prevention programs based on the byst and er intervention model have been shown to be effective ; however , current programs are limited in terms of ease of distribution . To address this issue , we developed and evaluated " Take Care , " an online byst and er intervention program . To our knowledge , this is the first empirical evaluation of an online byst and er intervention program design ed to prevent sexual violence . METHOD Ninety-three participants ( 80.6 % female , 19.4 % male ) recruited from social psychology classes at a mid-size university were r and omly assigned to view one of two online programs : Take Care or a control program on study skills . Before viewing the programs , participants completed measures of byst and er behaviors and feelings of efficacy for performing such behaviors . Measures were administered again post-intervention and at a two-month follow-up assessment . RESULTS Participants who viewed Take Care reported greater efficacy for engaging in byst and er behaviors at post-treatment and two months following treatment , compared to those who viewed the control program . In addition , participants who viewed Take Care reported performing relatively more byst and er behaviors for friends at the two-month follow-up assessment , compared to participants who viewed the control program . CONCLUSIONS These results suggest that sexual violence prevention programs may be effectively adapted to an online format


Title 2:
A Web-Based Sexual Violence Bystander Intervention for Male College Students: Randomized Controlled Trial
Abstract 2:
Background Byst and er intervention approaches offer promise for reducing rates of sexual violence on college campuses . Most interventions are in-person small-group formats , which limit their reach and reduce their overall public health impact . Objective This study evaluated the efficacy of RealConsent , a Web-based byst and er approach to sexual violence prevention , in enhancing prosocial intervening behaviors and preventing sexual violence perpetration . Methods A r and om probability sample of 743 male undergraduate students ( aged 18 to 24 years ) attending a large , urban university located in the southeastern United States was recruited online and r and omized to either RealConsent ( n=376 ) or a Web-based general health promotion program ( n=367 ) . Participants were surveyed online at baseline , postintervention , and 6-months postintervention . RealConsent was delivered via a password-protected Web portal that contained six 30-minute media-based and interactive modules covering knowledge of informed consent , communication skills regarding sex , the role of alcohol and male socialization in sexual violence , empathy for rape victims , and byst and er education . Primary outcomes were self-reported prosocial intervening behaviors and sexual violence perpetration . Secondary outcomes were theoretical mediators ( eg , knowledge , attitudes ) . Results At 6-month follow-up RealConsent participants intervened more often ( P=.04 ) and engaged in less sexual violence perpetration ( P=.04 ) compared to controls . In addition , RealConsent participants reported greater legal knowledge of sexual assault ( P<.001 ) , greater knowledge of effective consent ( P<.001 ) , less rape myths ( P<.001 ) , greater empathy for rape victims ( P<.001 ) , less negative date rape attitudes ( P<.001 ) , less hostility toward women ( P=.01 ) , greater intentions to intervene ( P=.04 ) , less hyper-gender ideology ( P<.001 ) , less positive outcome expectancies for nonconsensual sex ( P=.03 ) , more positive outcome expectancies for intervening ( P<.001 ) , and less comfort with other men ’s inappropriate behaviors ( P<.001 ) . Conclusions Our results support the efficacy of RealConsent . Due to its Web-based format , RealConsent has potential for broad-based dissemination thereby increasing its overall public health impact on sexual violence . Trial Registration Clinical trials.gov : NCT01903876 ; http:// clinical trials.gov/show/NCT01903876 ( Archived by WebCite at http://www.webcitation.org/6S1PXxWKt )


Title 3:
Encouraging Responses in Sexual and Relationship Violence Prevention
Abstract 3:
Colleges and universities are high-risk setting s for sexual and relationship violence . To address these problems , institutions of higher education have implemented prevention programs , many of which train students as potential byst and ers who can step in to help diffuse risky situations , identify and challenge perpetrators , and assist victims . The impact of byst and er sexual and relationship violence prevention programs on long-term behavior of byst and ers has remained a key unanswered question for those who seek to offer the most effective programs as well as for policy makers . In this study , the research ers experimentally evaluated the effectiveness of the Bringing in the Byst and er ® in-person program . Participants were 948 1st-year college students of whom 47.8 % were women and 85.2 % identified as White ( 15 % also identified as Hispanic in a separate question ) between the ages of 18 and 24 at two universities ( one a rural , primarily residential campus and the other an urban , highly commuter campus ) in the northeastern United States . To date , this is the first study to have found positive behavior changes as long-lasting as 1 year following an educational workshop focusing on engaging byst and ers in preventing sexual and relationship violence . Even so , many questions remain to be answered about prevention and intervention of this type . More prospect i ve research is needed on  byst and er-focused prevention of these forms of violence to help underst and and better predict the complicated relationships both between and among the attitudes and behaviors related to preventing sexual and relationship violence . In this regard , we make specific recommendations for design ing and evaluating programs based on our findings relating to the importance of moderators , especially two key understudied ones , readiness to help and opportunity to intervene


Title 4:
Evaluation of Green Dot: An Active Bystander Intervention to Reduce Sexual Violence on College Campuses
Abstract 4:
Using a cross-sectional survey of a r and om sample of 7,945 college undergraduates , we report on the association between having received Green Dot active byst and er behavior training and the frequency of actual and observed self-reported active byst and er behaviors as well as violence acceptance norms . Of 2,504 students aged 18 to 26 who completed the survey , 46 % had heard a Green Dot speech on campus , and 14 % had received active byst and er training during the past 2 years . Trained students had significantly lower rape myth acceptance scores than did students with no training . Trained students also reported engaging in significantly more byst and er behaviors and observing more self-reported active byst and er behaviors when compared with nontrained students . When comparing self-reported active byst and er behavior scores of students trained with students hearing a Green Dot speech alone , the training was associated with significantly higher active byst and er behavior scores . Those receiving byst and er training appeared to report more active byst and er behaviors than those simply hearing a Green Dot speech , and both intervention groups reported more observed and active byst and er behaviors than nonexposed students


Title 5:
ACT Internet-based vs face-to-face? A randomized controlled trial of two ways to deliver Acceptance and Commitment Therapy for depressive symptoms: an 18-month follow-up.
Abstract 5:
The aim of the present study was to investigate two interventions based on Acceptance and Commitment Therapy ( ACT ) for depressive symptoms : A face-to-face treatment ( ACT group ) was compared to a guided self-help treatment delivered via the Internet consisting of two assessment sessions ( pre and post ) and an ACT-based Internet program ( iACT ) .  Out patients experiencing at least mild depressive symptoms were r and omized to either approach . The iACT treatment group received access to an ACT-based Internet program and supportive web-based contact over a period of 6 weeks . The face-to-face group received ACT-based treatment once a week over the same period of time . In both groups , the results showed a significant effect on depression symptomatology , and general wellbeing after treatment and at the 18-month follow-up . However , the data indicated that the iACT group changed differently regarding depressive symptoms and wellbeing as compared to the face-to face ACT group . Results showed large pre-treatment to 18-month follow-up within-group effect sizes for all symptom measures in the iACT treatment group ( 1.59 - 2.08 ) , and for most outcome measures in the face-to-face ACT group ( 1.12 - 1.37 ) . This non-inferiority study provides evidence that guided Internet-delivered ACT intervention can be as effective as ACT-based face-to-face treatment for out patients reporting depressive symptoms , and it may offer some advantages over a face-to-face intervention


Title 6:
Friends Helping Friends: a nonrandomized control trial of a peer-based response to dating violence.
Abstract 6:
Dating violence is a significant problem for older adolescents with implication s for the survivor 's health . Survivors disclose the violence to friends who are often ill equipped to help them manage the consequences . The purpose of this pilot study was to evaluate the effectiveness and feasibility of Friends Helping Friends , a community-level education program to teach older adolescents to recognize and intervene in dating violence . A convenience sample of 101 students aged 18 to 22 years were nonr and omly allocated to a treatment or control group and completed pre- and post-test measures . Compared with the control group , treatment group participants reported increased perceived responsibility to help , skills to act as a byst and er , and intention to help and decreased rape myth acceptance .  Friends Helping Friends shows promise as an effective strategy for older adolescent females in the prevention and response to dating violence


Title 7:
TakeCARE, a Video Bystander Program to Help Prevent Sexual Violence on College Campuses: Results of Two Randomized, Controlled Trials.
Abstract 7:
OBJECTIVE The present research reports on two r and omized controlled trials evaluating TakeCARE , a video byst and er program design ed to help prevent sexual violence on college campuses . METHOD In Study 1 , students were recruited from psychology courses at two universities . In Study 2 , first-year students were recruited from a required course at one university . In both studies , students were r and omly assigned to view one of two videos : TakeCARE or a control video on study skills . Just before viewing the videos , students completed measures of byst and er behavior toward friends and ratings of self-efficacy for performing such behaviors . The efficacy measure was administered again after the video , and both the byst and er behavior measure and the efficacy measure were administered at either one ( Study 1 ) or two ( Study 2 ) months later . RESULTS In both studies , students who viewed TakeCARE , compared to students who viewed the control video , reported engaging in more byst and er behavior toward friends and greater feelings of efficacy for performing such behavior . In Study 1 , feelings of efficacy mediated effects of TakeCARE on byst and er behavior ; this result did not emerge in Study 2 . CONCLUSIONS This research demonstrates that TakeCARE , a video byst and er program , can positively influence byst and er behavior toward friends . Given its potential to be easily distributed to an entire campus community , TakeCARE might be an effective addition to campus efforts to prevent sexual violence


Title 8:
The Longitudinal Effects of a Rape-prevention Program on Fraternity Men's Attitudes, Behavioral Intent, and Behavior
Abstract 8:
Abstract Rape myth acceptance , likelihood of raping , and sexually coercive behavior of 145 fraternity men r and omly assigned to a control group or a rape-prevention program  were surveyed . One third of 23 fraternities on a mid-Atlantic public university campus volunteered to participate in the study . The rape-prevention intervention consisted of “ the men 's program , ” a victim empathy-based presentation titled “ How to help a sexual assault survivor : What men can do . ” Although no evidence of change in sexually coercive behavior was found , significant 7-month declines in rape myth acceptance and the likelihood of committing rape were shown among program participants . In the case of rape myth acceptance , the 7-month decrement remained lower in the participant group than in the control group . Implication s of using these initial findings from the men 's program for rape-prevention programming are discussed


Title 9:
Comparison of face-to-face and internet interventions for body image and eating problems in adult women: an RCT.
Abstract 9:
OBJECTIVE The aim of this study was to compare the outcomes following an eight-session , small group , therapist-led , intervention for  body dissatisfaction , and disordered eating in adult women , delivered either in face-to-face or synchronous , internet mode . METHOD Community women with high body dissatisfaction and internet access were r and omly assigned to either face-to-face delivery ( N = 42 ) , internet delivery ( N = 37 ) , or delayed treatment control ( N = 37 ) . All groups were assessed at baseline and 8 - 9 weeks later . The intervention groups were reassessed at 6-months follow-up . RESULTS Both intervention groups showed large improvements in body dissatisfaction compared with the delayed treatment control and these improvements were maintained at follow-up . However , posttreatment improvements were greater in the face-to-face than internet intervention . CONCLUSION In adult women , it is desirable to deliver the body image intervention in a face-to-face mode , but the internet mode is effective and has the potential to increase access to therapy


Title 10:
A randomized controlled trial of a multi-dose bystander intervention program using peer education theater.
Abstract 10:
This article reports findings from a longitudinal , experimental evaluation of a peer education theater program , Students Challenging Realities and Educating Against Myths ( SCREAM ) Theater . This study examines the impact of SCREAM Theater on a range of byst and er-related outcomes ( i.e. byst and er intentions , byst and er efficacy , perception of friend norms and byst and er behaviors ) in situations involving sexual violence and whether there was a differential impact of the program by participant sex . First-year college students completed three waves of surveys ( pretest , first post-test and second post-test ) . All participants received one dose of the intervention during summer orientation after the pretest . After the first post-test , participants were r and omly assigned to receive two additional doses , or to a control condition , in which they received no additional doses . Students in both one- and three-dose groups reported a number of positive increases . Overall , an intent-to-treat analysis ( n = 1390 ) indicated three doses of the intervention during the first semester of college result ed in better outcomes than the one-time intervention during summer orientation alone . Although both male and female students ' scores increased during the study period , female students consistently scored higher than male students on each outcome . The findings suggest that peer education theater holds promise for byst and er intervention education on college campuses
Results : Students who participated in a byst and er program , compared to those who had not , had more pro-social attitudes/beliefs about sexual violence and intervening to prevent it , and engaged in more byst and er behavior .
Program effects diminished over time , but meaningful changes persisted for at least three months following program delivery .
Longer programs had greater effects than shorter programs on attitudes/beliefs .
Conclusions : Byst and er programs can be a valuable addition to colleges ' violence prevention efforts