Efficacy of a Multi-level School Intervention for LGBTQ Youth

项目摘要 这项研究的目的是测试理论上知情的、以学校为基础的性健康干预的有效性。 少数性别群体(SGM，例如女同性恋、男同性恋、双性恋、变性人)青少年，骄傲和赋权(P&E)。 研究发现，SGM学生在学校遭受伤害的可能性是 异性恋者，变性人青年中的比例更高。这种基于偏见的受害行为，其中一部分是 通常被称为少数民族应激，已被认为是实质性行为健康的参与因素 与异性恋同龄人相比，SGM面临着诸如抑郁、焦虑、自我伤害、 以及自杀的念头和企图。与类似的受害者相比，这些差异是SGM独有的 非SGM同龄人，受害的SGM青少年自杀率明显更高。当学校缺乏 SGM欺凌政策，SGM学生比学校同龄人更有可能报告自杀行为 政策。研究还表明，在缺乏保护性政策的学校中，SGM受害更常见 和资源，如性别和性行为联盟(GSA)、SGM特定的反欺凌指南、教师和 员工培训，以及公开支持的盟友。因此，很明显，对SGM青年的任何干预都必须 同时(A)帮助SGM青年应对少数族裔压力的影响和(B)努力减少这种可能性 通过解决学校层面的因素，防止未来成为受害者。P&E干预旨在解决这些结果 通过一种新颖的多层次校本干预。由包括美国国立卫生研究院在内的九年研究支持- 支持在四所学校(1R21MD013971)进行的可行性研究，我们将确定干预措施 通过完成三个特定目标来实现有效性：1)确定随机对照试验中干预措施的参与者级别的有效性 有24所学校。2)确定在全校范围内对(A)报告少数民族压力和 所有SGM学生的行为健康结果和(B)对学校氛围的看法(即，规范、态度、 信念、对SGMA的欺凌行为、政策)。3)检查可能影响的因素 干预成功(例如，实施的忠诚度、实施的障碍或促进者、学校或学生 特点)，为今后的传播做好干预准备。在完成全部十个P&E之后 在各届会议上，学校层面的因素将通过学生主导的环境变化来解决 学校的策略侧重于学校氛围的关键领域：安全、人际关系、教与学、 和制度环境。这一创新的R01应用程序汇集了一支全国公认的 少数民族压力和预防科学专家，并回应国家确立的公共卫生需求 来自美国国家医学科学院、美国国立卫生研究院(NOT-MD-19-001)和 国家同性恋特别工作组。

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.