An affirmative coping skills intervention to improve the mental and sexual health of sexual and gender minority youth (Project Youth AFFIRM): Protocol for an implementation study

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dc.contributor.authorEaton, Andrew
dc.date.accessioned2022-04-29T15:39:38Z
dc.date.available2022-04-29T15:39:38Z
dc.date.issued2019-06-06
dc.description©Shelley L Craig, Lauren B McInroy, Andrew David Eaton, Gio Iacono, Vivian WY Leung, Ashley Austin, Cheryl Dobinson. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 06.06.2019. This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Research Protocols, is properly cited. The complete bibliographic information, a link to the original publication on http://www.researchprotocols.org, as well as this copyright and license information must be included.en_US
dc.description.abstractBackground: Sexual and gender minority youth (SGMY, aged 14-29 years) face increased risks to their well-being, including rejection by family, exclusion from society, depression, substance use, elevated suicidality, and harassment, when compared with their cisgender, heterosexual peers. These perils and a lack of targeted programs for SGMY exacerbate their risk for HIV and other sexually transmitted infections. Cognitive behavioral therapy (CBT) interventions support clients by generating alternative ways of interpreting their problems and beliefs about themselves. CBT, tailored to the experiences of SGMY, may help SGMY improve their mood and coping skills by teaching them how to identify, challenge, and change maladaptive thoughts, beliefs, and behaviors. Based on the promising results of a pilot study, a CBT-informed group intervention, AFFIRM, is being tested in a pragmatic trial to assess its implementation potential. Objective: The aim of this study is to scale-up implementation and delivery of AFFIRM, an 8-session manualized group coping skills intervention focused on reducing sexual risk behaviors and psychosocial distress among SGMY. Our secondary aim is to decrease sexual risk taking, poor mental health, and internalized homophobia and to increase levels of sexual self-efficacy and proactive coping among SGMY. Methods: SGMY are recruited via flyers at community agencies and organizations, as well as through Web-based advertising. Potential participants are assessed for suitability for the group intervention via Web-based screening and are allocated in a 2:1 fashion to the AFFIRM intervention or a wait-listed control in a stepped wedge wait-list crossover design. The intervention groups are hosted by collaborating community agency sites (CCASs; eg, community health centers and family health teams) across Ontario, Canada. Participants are assessed at prewait (if applicable), preintervention, postintervention, 6-month follow-up, and 12-month follow-up for sexual health self-efficacy and capacity, mental health indicators, internalized homophobia, stress appraisal, proactive and active coping, and hope. Web-based data collection occurs either independently or at CCASs using tablets. Participants in crisis are assessed using an established distress protocol. Results: Data collection is ongoing; the target sample is 300 participants. It is anticipated that data analyses will use effect size estimates, paired sample t tests, and repeated measures linear mixed modeling in SPSS to test for differences pre- and postintervention. Descriptive analyses will summarize data and profile all variables, including internal consistency estimates. Distributional assumptions and univariate and multivariate normality of variables will be assessed. Conclusions: AFFIRM is a potentially scalable intervention. Many existing community programs provide safe spaces for SGMY but do not provide skills-based training to deal with the increasingly complex lives of youth. This pragmatic trial could make a significant contribution to the field of intervention research by simultaneously moving AFFIRM into practice and evaluating its impact.en_US
dc.description.authorstatusFacultyen_US
dc.description.peerreviewyesen_US
dc.description.sponsorshipSLC is the Canada Research Chair in Sexual and Gender Minority Youth. This project is funded by a Partnership Grant from the Social Sciences and Humanities Research Council of Canada (SSHRC #895-2018-1000) with funding for evaluation activities from the Public Health Agency of Canada (PHAC #1718-HQ-000697). ADE is supported by a salary award from the Ontario HIV Treatment Network. The authors would like to thank Bonnie Lao for her assistance with this article.en_US
dc.identifier.citationCraig S, McInroy L, Eaton A, Iacono G, Leung V, Austin A, Dobinson C An Affirmative Coping Skills Intervention to Improve the Mental and Sexual Health of Sexual and Gender Minority Youth (Project Youth AFFIRM): Protocol for an Implementation Study JMIR Res Protoc 2019;8(6):e13462 URL: https://www.researchprotocols.org/2019/6/e13462 DOI: 10.2196/13462en_US
dc.identifier.doihttps://www.researchprotocols.org/2019/6/e13462
dc.identifier.urihttps://hdl.handle.net/10294/14841
dc.language.isoenen_US
dc.publisherJMIR Research Protocolsen_US
dc.rightsAttribution License 4.0*
dc.rights.uritps://creativecommons.org/licenses/by/4.0/*
dc.subjectsexual and gender minorities (9); youth (48); coping behavior (1); pragmatic clinical trial (1); cognitive behavioral therapy (41); implementation science (52)en_US
dc.titleAn affirmative coping skills intervention to improve the mental and sexual health of sexual and gender minority youth (Project Youth AFFIRM): Protocol for an implementation studyen_US
dc.typeArticleen_US
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