Efficacy of a Multi-level School Intervention for LGBTQ Youth

项目摘要 本研究的目的是测试一种理论上知情的、以学校为基础的干预措施对性和 性别少数群体（SGM，例如，女同性恋、男同性恋、双性恋、变性者）青少年，自豪和赋权（P&E）。 研究发现，SGM学生在学校遭受伤害的可能性是普通学生的8到10倍， 异性恋者，变性青年的比例甚至更高。这种基于偏见的受害，其中一部分是 通常被称为少数民族的压力，已被引用为参与因素，在实质性的行为健康 与异性恋者相比，SGM面临的差异，如抑郁，焦虑，自我伤害， 自杀意念和企图这些差异是SGM所独有的，与类似受害者相比， 非SGM同龄人，受害SGM青少年报告自杀率显着较高。当学校缺乏 SGM欺凌政策，SGM学生更有可能报告自杀比同龄人在学校的保护 施政纲要而研究还表明，SGM受害者在缺乏保护政策的学校更常见 和资源，如性别和性行为联盟（GSA），SGM具体的反欺凌指导方针，教师和 员工培训和公开支持的盟友因此，很明显，对SGM青年的任何干预都必须 同时（a）帮助SGM青年科普少数民族压力的影响，（B）努力减少 通过解决学校层面的因素来预防未来的受害。P&E干预旨在解决这些结果 通过新颖的多层次校本干预。在九年的研究支持下，包括NIH- 支持在四所学校进行的可行性研究（1 R21 MD 013971），我们将确定干预措施 通过完成三个具体目标来确定有效性：1）确定RCT中干预措施的参与者水平有效性 24所学校。2)确定全校范围内的干预措施对（a）少数民族压力的报告， 所有SGM学生的行为健康结果和（B）对学校气氛的感知（即，规范，态度， 信仰，对SGMA的欺凌行为，政策）在所有学生。3)检查可能影响的因素 干预成功（例如，实施的忠实度、实施的障碍或促进因素、学校或学生 特征），为将来的传播做好准备。在完成所有10个P&E之后， 会议，学校层面的因素将由学生主导的环境变化的实施解决 学校的战略集中在学校气氛的关键领域：安全，关系，教学， 和制度环境。这个创新的R 01应用程序汇集了一个国家认可的团队， 少数民族压力和预防科学专家，并响应国家建立的公共卫生需要， 美国国家医学院、美国国立卫生研究院（NOT-MD-19-001）和 全国同性恋工作组。

Project Summary The goal of this study is to test the efficacy of a theoretically informed, school-based intervention for sexual and gender minority (SGM, e.g., lesbian, gay, bisexual, transgender) adolescents, Proud & Empowered (P&E). Studies found that SGM students are 8 to 10 times more likely to experience victimization in schools than heterosexuals, with rates even higher among transgender youth. This bias-based victimization, part of which is commonly known as minority stress, has been cited as a participating factor in the substantial behavioral health disparities SGM face when compared to their heterosexual counterparts, such as depression, anxiety, self-harm, and suicidal ideation and attempt. These disparities are unique to SGM, as when compared to similarly victimized non-SGM peers, victimized SGM adolescents report significantly higher rates of suicide. When schools lack SGM bullying policies, SGM students are more likely to report suicidality than peers in schools with protective policies. Studies also indicate that SGM victimization is more common in schools that lack protective policies and resources such as gender and sexuality alliances (GSAs), SGM-specific antibullying guidelines, teacher and staff training, and openly supportive allies. Therefore, it is clear that any intervention for SGM youth must simultaneously (a) help SGM youth cope with the effects of minority stress and (b) work to reduce the likelihood of future victimization by addressing school-level factors. The P&E intervention seeks to address these outcomes through a novel multi-level school-based intervention. Supported by nine years of research including an NIH- supported feasibility study conducted at four schools (1R21MD013971), we will determine the interventions' efficacy by completing three specific aims: 1) Determine participant-level efficacy of the intervention in an RCT with 24 schools. 2) Determine the schoolwide intervention effects on (a) reporting of minority stress and behavioral health outcomes among all SGM students and (b) perceptions of school climate (i.e., norms, attitudes, beliefs, bullying behavior toward SGMA, policies) among all students. 3) Examine factors that may affect intervention success (e.g., fidelity of implementation, barriers or facilitators to implementation, school or student characteristics) to prepare the intervention for future dissemination. Following the completion of all ten P&E sessions, school-level factors will be addressed by student-led implementation of environmental change strategies at the school focused on key domains of school climate: safety, relationships, teaching and learning, and institutional environment. This innovative R01 application brings together a team of nationally recognized minority stress and prevention science experts and responds to a nationally established public health need for research from the National Academy of Medicine, the National Institutes of Health (NOT-MD-19-001), and the National Gay and Lesbian Task Force.