Development and Preliminary Trial of a Brief, Portable Health Intervention for Rural Sexual Minority Emerging Adults
Condition: Depression; Suicidality; Substance Abuse; HIV; Minority Stress
MeSH terms: Substance-Related Disorders
Study type: Interventional

Summary: 
      The purpose of this study is to test the feasibility of writing interventions specifically
      designed for lesbian, gay, and bisexual (LGB) emerging adults (ages 18-29) that are aimed at
      improving the outcomes: depression, suicidality, substance abuse and HIV risk behaviors.
    

Detailed description: 
      This study is considered the third part ("Phase 3") of a larger study where parts one and two
      were designed to utilize elicitation focus groups to develop effective intervention materials
      (Phase 1) and then refine the developed materials through structured interviews (Phase 2).
      Phase 3 will test feasibility and assess early signs of efficacy of writing interventions. To
      do this, participants will be randomized to one of three arms (one arm will serve as
      control). Those that choose to participate will be asked to complete outcome measures
      (depressive symptoms, suicidality, use of alcohol and illicit drugs, HIV risk behavior) and
      measures of proposed mediators (self-reported and biological stress, behavioral and emotional
      self-regulation) and moderators (e.g., social support, identity centrality) at baseline,
      post-intervention, and three-month follow-up. In addition, structured interviews with 15
      intervention participants will be used to refine study procedures as the investigators scale
      up this intervention for a future randomized controlled trial (RCT).
    

Intervention name(s): Expressive Writing (EW) Intervention; Self-Affirmation (SA) Intervention; Control
Intervention type(s): Behavioral; Behavioral; Other
Intervention description(s): The EW intervention will utilize the procedures piloted earlier with gay and bisexual male college students in urban and rural regions of the US. In this condition, participants will be instructed to write for 20 minutes across three consecutive days in a free-form manner about the most stressful or traumatic LGB-related event that they have encountered.; The SA intervention will ask participants to read a brief description, over the course of 3 consecutive days, of a (hypothetical) LGB youth who is facing minority stress. Each day's description will contain a different LGB youth facing a different stigma-related stressor derived from Phase 1 and 2 interviews. Participants will then be asked to write a letter for 20 minutes to advise the LGB youth how best to cope with minority stress drawing on their personal experiences.; Participants randomly assigned to the control condition will be asked to write about what they have done since waking up that morning for 20 minutes across 3 consecutive days. This control matches the time and activity of the EW and SA arms and has been implemented across dozens of EW and SA studies.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Double (Investigator, Outcomes Assessor)
Primary purpose: Prevention
Keywords: Expressive Writing; Minority Stress; Lesbian Gay Bisexual