An Affirmative Coping Skills Intervention to Improve Mental and Sexual Health of Sexual and Gender Minority Youth
- Conditions
- Coping SkillsMental Health IssueHivStigma, Social
- Interventions
- Behavioral: AFFIRM
- Registration Number
- NCT04318769
- Lead Sponsor
- University of Toronto
- Brief Summary
AFFIRM is an 8-session manualized group coping skills intervention focused on reducing sexual risk behaviours and psychosocial distress among SGMY. AFFIRM is delivered by two facilitators (primarily social workers and peers) through a combination of education and rehearsal (i.e., simulation of real-life experiences) in a manner that affirms participants' sexual and gender minority identities and experiences. AFFIRM is being tested in a five-year trial using a stepped wedge waitlist crossover design, where all participants receive the intervention in clusters.
- Detailed Description
Session 1 focus
Introduction to cognitive behavioral therapy (CBT), exploring lesbian, gay, bisexual, transgender, and queer (LGBTQ)+ identities, and understanding minority stress.
Session 1 activities
Introductions
Discussing the theory and purpose of CBT approaches
Exploring stress and minority stress
Understanding the causes of stress in our lives
Session 2 focus
Understanding the impact of anti-LGBTQ attitudes and behaviors on stress.
Session 2 activities
Check in and review
Examining homophobia, heterosexism, and transphobia at the individual, institutional, and cultural level
Identifying how these experiences impact thoughts, feelings, and behaviors
Fostering strategies for both coping with and combating anti-LGBTQ discrimination at all levels
Session 3 focus
Understanding how thoughts impact feelings.
Session 3 activities
Check in and review
Distinguishing between thoughts and feelings
Exploring how thoughts influence feelings and behaviors
Identifying counterproductive thinking patterns
Recognizing negative self-talk and feelings of hopelessness
Learning thought stopping
Session 4 focus
Using thoughts to change feelings.
Session 4 activities
Check in and review
Increasing positive thinking and feelings of hope
Changing negative thoughts to positive thoughts
Challenging negative thinking and internalized homophobia/negative feelings through the ABCD (activating event, belief, consequence, and debate) method
Session 5 focus
Exploring how activities impact feelings.
Session 5 activities
Check in and review
Examining the impact of various activities on feelings
Identifying supportive and identity-affirming activities
The impact of LGBTQ-affirming activities on feelings
Session 6 focus
Planning to overcome counterproductive thoughts and negative feelings.
Session 6 activities
Check in and review
Distinguishing between clear and unclear goals
Identifying short, mid-, and long-term goals
Creating a sexual health plan
Fostering hope for the future
Session 7 focus
Understanding the impact of minority stress and anti-LGBTQ attitudes or behaviors on social relationships.
Session 7 activities
Check in and review
Anti-LGBTQ discrimination can lead to feelings of discomfort around others
Responding to discrimination or harassment in social situations
Learning to be assertive
Session 8 focus
Putting it all together: developing safe, supportive, and identity-affirming social networks.
Session 8 activities
Check in and review
Maintaining a healthy social network: attending to thoughts, expectations, feelings, and behaviors within relationships
Identifying a plan for building a supportive network
Recruitment & Eligibility
- Status
- ACTIVE_NOT_RECRUITING
- Sex
- All
- Target Recruitment
- 300
- Aged 14 to 29 years at time of screening
- Identifies as a sexual and/or gender minority
- Reads, writes, and speaks fluent English
- Is interested in participating in the 8-session AFFIRM intervention
- Assessed to be in crisis (i.e., high risk of suicidality)
- Warrenting a more intensive intervention
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- CROSSOVER
- Arm && Interventions
Group Intervention Description AFFIRM AFFIRM AFFIRM is an 8-session psychoeducational weekly group intervention
- Primary Outcome Measures
Name Time Method Acceptability - participant satisfaction with group sessions week 56 Participants will complete a satisfaction questionnaire.
Feasibility - participant attendance at group sessions week 56 Proportions of participants that enroll, commence, and complete the intervention.
- Secondary Outcome Measures
Name Time Method Intervention fidelity - how closely facilitators adhere to intervention model Study period sessions 1-8 (weeks 1-8) Independent coders will complete a checklist questionnaire of AFFIRM intervention items, based on the manual, to determine how closely intervention facilitators adhered to the model
Trial Locations
- Locations (7)
The 519 Church Street Community Centre
🇨🇦Toronto, Ontario, Canada
Centre for Addiction and Mental Health (CAMH)
🇨🇦Toronto, Ontario, Canada
COMPASS Health
🇨🇦Hamilton, Ontario, Canada
Reach Out Centre for Kids - Positive Space Network
🇨🇦Oakville, Ontario, Canada
Hamilton Family Health Team
🇨🇦Hamilton, Ontario, Canada
Sherbourne Health Centre
🇨🇦Toronto, Ontario, Canada
Asian Community AIDS Services (ACAS)
🇨🇦Toronto, Ontario, Canada