In response to the call for research on bioethical issues to guide health-related, behavioral science research (NOT-OD-24-031), this administrative supplement will focus on processes to support co-creation of multi-level interventions for students with disabilities (SWD) to address the nexus of sexual violence (SV) exposure and heavy drinking. The alcohol misuse common on American college campuses is particularly harmful for SWD, putting them at even higher risk for intimate partner violence (IPV) and SV victimization than other students. From our team’s prior work, over a quarter of students seeking care in college health and counseling centers (CHC) endorsed having at least one disability, and of those students, over three quarters had experienced IPV or SV in their lifetime. Yet no interventions exist that address the specific and unique needs of SWD and that offer harm reduction strategies to reduce risk for violence exposure and alcohol misuse (i.e., heavy episodic drinking and excessive alcohol use). Particularly challenging for research and intervention development is the continued ‘invisibility’ of disabilities, the stigma associated with disabilities, intersections with other forms of marginalization such as racism, homophobia, and transphobia, and limited patient and community engagement in alcohol research. Thus, the bioethical issues to be addressed in this proposal are: 1) development of a shared framework for conducting research with college SWD designed with SWD and other constituents, and 2) identifying accessible human-centered design strategies to ensure full inclusion of SWD in co-creating prevention interventions. This study leverages the parent study, a cluster randomized controlled trial of an SV prevention program across 20+ college campuses in the U.S. (R01 AA023260, PI Miller). The parent study supports a community of practice across these diverse campuses with campus administrators, those responsible for accessibility services, diversity and inclusion, student safety, sexual assault prevention, alcohol and drug counseling, student health services including counseling, and learning supports. Additionally, through connections with student health and counseling centers, the parent study will facilitate recruitment of this harder-to-reach population as well as campus personnel with expertise in serving students with disability to participate in proposed study procedures. We will identify key ethical considerations for conducting research with college SWD to guide college campus behavioral health research (Aim 1). We will implement accessible human-centered design sessions with key constituents to co-create multi-level prevention interventions focused on healing-centered supports for SWD (Aim 2). These aims are expected to contribute to research on bioethical issues. First, the listening sessions will yield a toolkit to guide inclusive research practices that center SWD. Second, the interventions that are co-created will be c...