Supporting Parents in Affirming Their Children's Experiences of Stigma
- Conditions
- Parent-Child Relations
- Interventions
- Behavioral: Brief online writing interventionOther: Control condition
- Registration Number
- NCT05919849
- Lead Sponsor
- Yale University
- Brief Summary
The purpose of this study is to develop and test two brief online writing interventions to improve parental acceptance of sexual and gender minority youth (SGMY) in the Southeast United States.
- Detailed Description
The purpose of this study is to develop and test the acceptability, feasibility, and preliminary efficacy of two brief online writing interventions to improve parental acceptance of sexual and gender minority youth (SGMY) in the Southeast United States. Parental support represents the strongest predictor of sexual and gender minority youth's (SGMY) mental health. However, many parents react to their SGMY's disclosure with rejection. Even relatively accepting parents can experience discomfort, while SGMY often report lingering unmet needs from their parents into adulthood. Few interventions exist to help parents support their SGMY child and none has been tested in a randomized trial with efficacy for decreasing parental rejection and increasing support of their SGMY. This proposal will develop and test the efficacy of two theory-based interventions that aim to address this gap. Results will identify mechanisms contributing to parental rejection and develop scalable approaches to reduce these mechanisms to shrink the substantial mental health disparities affecting SGMY. If efficacious, these interventions can be scaled up through online platforms capable of bypassing barriers to parental support of SGMY across high-stigma regions.
The focus of this registration is the randomized controlled trial.
Recruitment & Eligibility
- Status
- RECRUITING
- Sex
- All
- Target Recruitment
- 129
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Parents are eligible if they meet the following criteria:
- Be a parent, grandparent, or any other family member who considers themselves a guardian of an SGMY between 15-29 years old,
- Live in the Southeast United States (Louisiana, Mississippi, Alabama, Georgia, South Carolina, North Carolina, Tennessee, Arkansas, Kentucky, Florida),
- Identify as heterosexual and cisgender, and
- Report non-acceptance of their SGMY.
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SGMY are eligible if they meet the following criteria:
- Self-identify as SGM,
- Are 15-29 years old,
- Live in the Southeast United States, and
- Have a parent enrolled in the trial
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Any individual who meets any of the following criteria will be excluded from participation in this study:
- Active mania, psychosis, or suicidality, and
- Unable to provide informed consent.
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- CROSSOVER
- Arm && Interventions
Group Intervention Description Attachment-Based Writing Brief online writing intervention Participants in the attachment-based writing (ABW) condition will respond to distinct prompts created for the condition based on components of attachment-based family therapy (ABFT). Expressive Writing Brief online writing intervention Participants in the expressive writing (EW) condition will be instructed to write in a free-form manner about the most stressful aspects of being a parent of an SGMY, following standard EW procedures. Neutral Writing Control condition Participants in the control condition will be asked to write about what they have done since waking up that morning.
- Primary Outcome Measures
Name Time Method Change in Parents' Rejecting and Supportive Behaviors Measured By the Parent Non-Acceptance Scale Baseline, 5 Days Post-Baseline, and 3 Months Post-Baseline The 10-item Parent Non-Acceptance Scale is a self-reported instrument assessing positive and negative indicators of parental acceptance of their SGMY. Parents report level of agreement on a scale from 1 (Strongly Disagree) to 6 (Strongly Agree), with a higher score on negative indicators representing a higher level of non-acceptance and a higher score on positive indicators representing a lower level of non-acceptance.
- Secondary Outcome Measures
Name Time Method Change in Secondary Parental Acceptance and Rejection Measured By the Five-Minute Speech Sample Baseline, 5 Days Post-Baseline, and 3 Months Post-Baseline The Five-Minute Speech Sample (FMSS) is a measure of parent-child dynamics where parents talk for 5 minutes about their thoughts and feelings about their SGMY. The qualitative interview is coded and scored appropriately to measure parental behavior towards their SGMY
Change in Parent Perceived Stress Using the Perceived Stress Scale Baseline, 5 Days Post-Baseline, and 3 Months Post-Baseline The 10-item Perceived Stress Scale assesses parents' perceived stress by asking about frequency of thoughts and feelings during the past month on a scale from 0 (never) to 4 (very often), where a higher score indicates a higher level of perceived stress.
Change in Parent Report of Child Depression and Anxiety Using the PROMIS Depression and Anxiety Scales Baseline, 5 Days Post-Baseline, and 3 Months Post-Baseline The 15-item proxy-report PROMIS Depression and Anxiety Scales measures parent report of their SGM child's depression and anxiety symptoms by asking frequency of the SGMY's symptoms over the past 7 days on a scale from 1 (never) to 5 (always), where higher scores indicate a greater severity of parent-reported symptoms.
Change in Secondary Parental Acceptance and Rejection Measured By the the Parental Acceptance/Rejection Questionnaire Baseline, 5 Days Post-Baseline, and 3 Months Post-Baseline The 24-item Parental Acceptance/Rejection Questionnaire describes the way parents act towards their children. Parents report how true each statement is on a scale from 1 (almost always true of me) to 4 (almost never true of me) where a higher score indicates a higher level of rejection.
Change in Parent Negative Emotion Using a Modified Positive and Negative Affect Schedule (PANAS) Baseline, 5 Days Post-Baseline, and 3 Months Post-Baseline The 20-item Positive and Negative Affect Schedule (PANAS) inquires about parents' positive and negative affect towards their SGMY. Participants indicate how often they have felt either positive or negative indicators on a scale of 1 (very slightly or not at all) to 5 (extremely). A high score on positive affect indicators indicates a higher positive affect towards the SGMY, while a high score on negative affect indicates a higher negative affect towards the SGMY.
Change in Secondary Parental Acceptance and Rejection Measured By the Children's Report of Parent Behavior Inventory Baseline, 5 Days Post-Baseline, and 3 Months Post-Baseline The Children's Report of Parent Behavior Inventory (CRPBI) is a 10-item rejection/support subscale assessing level of rejection/support. Parents report how much each statement describes the way they acted towards their SGMY ranging from 1 (not like you) to 3 (a lot like you), where Acceptance and Psychological Control scores are the totals of the individual items in the respective sub-scales, and Firm Control score is obtained by taking the sum of the Firm Control + subscale, adding 24, and by then subtracting the total of the Firm Control -- subscale.
Change in Parent Anti-SGM Bias Assessed Using the Social Distance Scale Baseline, 5 Days Post-Baseline, and 3 Months Post-Baseline The Social Distance Scale assesses anti-LGBTQ (Lesbian, Gay, Bisexual, Trans, Queer) stigma by assessing parents' responses to different scenarios from 0 (definitely unwilling or completely uncomfortable) to 3 (definitely willing or completely comfortable), where a lower score indicates stronger anti-LGBTQ stigma.
Change in Parent Anti-SGM Bias Assessed Using the Lesbian, Gay, Bisexual Affiliate Stigma Measure Baseline, 5 Days Post-Baseline, and 3 Months Post-Baseline The Lesbian, Gay, Bisexual Affiliate Stigma Measure (LGB-ASM) measures affiliate stigma faced by heterosexual family and friends of sexual minority people. Parents rate how much they agree with each statement on a scale from 1 (strongly disagree) to 6 (strongly agree), with the option to claim "not applicable." A higher score indicates stronger affiliate stigma.
Change in Parent-Child Relationship Quality and Stress Assessed by the McMaster Family Assessment Device General Functioning Subscale Baseline, 5 Days Post-Baseline, and 3 Months Post-Baseline The 12-item McMaster Family Assessment Device General Functioning Subscale further assesses perceived parent-child relationship quality and stress on a scale of "strongly agree" (1) to "strongly disagree" (4), where a higher score indicates lower general family functioning.
Change in Parent-Child Relationship Quality and Stress Assessed by the Parental Environment Questionnaire Conflict, Involvement, and Regard for Child Subscales Baseline, 5 Days Post-Baseline, and 3 Months Post-Baseline The Parental Environment Questionnaire Conflict (12-item), Involvement (12-item), and Regard for Child (5-item) Subscales assess perceptions of parent-child relationship quality. Parents rate how true each statement is on a scale from 1 (definitely true) to 5 (definitely false), where a high score on the conflict scale indicates greater parental conflict, a high score on the involvement scale indicates less parental involvement, and a high score on the regard for child scale indicates high regard for child.
Change in Parent Depression and Anxiety Using the PROMIS (Patient-Reported Outcomes Measurement Information System®) Depression, Anxiety, and Anger Scales Baseline, 5 Days Post-Baseline, and 3 Months Post-Baseline The 63-item PROMIS Depression, Anxiety, and Anger questionnaires measure parent-reported frequency of depression, anxiety, and anger symptoms over the past 7 days on a scale from 1 (never) to 5 (always), where higher scores indicate higher severity of symptoms.
Intervention Acceptability Measured By the Client Satisfaction Questionnaire 3-Month-Post-Baseline The Client Satisfaction Questionnaire is an 8-item measurement of perceived helpfulness, likelihood of recommending, and positive experience. Participants rate statements on a scale of 1 (most negative) to 4 (most positive), with a high score representing a higher level of satisfaction.
Change in Parent-Child Unresolved Conflict Measured Using the Unfinished Business Scale Baseline, 5 Days Post-Baseline, and 3 Months Post-Baseline The 11-item Unfinished Business Scale was adapted by Principal Investigator Pachankis with strong psychometric properties to measure parents' unresolved negative thoughts and feelings towards their SGMY. Parents rate statements about their SGM child on a scale from 1 (not at all) to 5 (very much), where a higher score represents greater unresolved parent-child conflict.
Change in Parent Empathy Measured By the Questionnaire of Cognitive and Affective Empathy Baseline, 5 Days Post-Baseline, and 3 Months Post-Baseline The 31-item Questionnaire of Cognitive and Affective Empathy (QCAE) measures parent empathy toward their SGMY. Parents rate how much a statement relates to them on a scale of 1 (strongly disagree) to 4 (strongly agree), where a high score indicates a high level of empathy toward the SGMY.
Intervention Acceptability Measured By the Treatment Acceptability Survey 3-Month-Post-Baseline The 17-item Treatment Acceptability Survey assesses perceived helpfulness, likelihood of recommending, and positive experience of the interventions. Participants rate statements on a scale of 1(strongly disagree) to 4 (strongly agree), with a higher score representing a higher level of acceptability.
Intervention Feasibility Measured By Percentage of Fully Engaged Sessions Measured Throughout Intervention (Up to 2 Weeks) Intervention feasibility will be partially measured by the percentage of fully engaged sessions, defined as the number of writing sessions that included at least 313 words.
Intervention Feasibility Measured By Percentage of Intervention Sessions Completed Measured Throughout Intervention (Up to 2 Weeks) Intervention feasibility will be partially measured by the percentage of intervention sessions participants complete.
Intervention Feasibility Measured By Number of Platform Technical/Accessibility Issues Measured Throughout Intervention (Up to 2 Weeks) Intervention feasibility will partially be tracked by the number of platform technical or accessibility issues noted throughout the intervention.
Trial Locations
- Locations (4)
Vanderbilt University
🇺🇸Nashville, Tennessee, United States
Ben-Gurion University
🇮🇱Be'er Sheva, Israel
University of Maryland
🇺🇸College Park, Maryland, United States
Yale University
🇺🇸New Haven, Connecticut, United States