An Online Family-based Program to Prevent Alcohol Use and Dating and Sexual Violence among Sexual and Gender Minority Youth

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Project Summary Research documents concerning rates of alcohol use (AU) and dating violence (DV) among sexual and gender minority youth (SGMY), likely related to a combination of population-specific risk factors (e.g., caregiver rejection, internalized homo/bi/transphobia), universal risk factors (e.g., deficits in social emotional skills and alcohol refusal skills, inaccurate perceptions of alcohol norms) and lack of protective factors (e.g., parenting and family relational skills). To date, however, we know very little about how to concurrently prevent AU and DV among SGMY. We propose to develop and evaluate an online family-based program (Healthy Families Bright Future program [HFBFP]) to prevent AU and DV among SGMY ages 15 to 18. The HFBFP will be a group-based intervention that includes seven weekly separate caregiver and youth sessions. Programming for caregivers will focus on fostering acceptance and support for SGMY and enhancing relevant caregiving skills. Programming for SGMY will focus on reducing internalized homo/bi/transphobia and enhancing social- emotional skills, increasing accurate perceptions of alcohol and dating violence norms, and increasing alcohol refusal skills. SGMY and caregiver programming will be designed to be complementary in content to enhance the potency of programming components, and program skills will be practiced as a family between sessions. The program will be co-facilitated by an SGM young adult and SGMY caregiver. The interdisciplinary team of investigators will work alongside 10 SGMY on a Youth Advisory Board (YAB), 10 caregivers to SGMY on a Caregiver Advisory Board (CAB), and an Expert Advisory Board (EAB) on all phases of the project. During the Adaptation and Planning Phase, we will finalize the HFBFP via ongoing feedback from the Youth, Caregiver, and Expert Advisory Boards (Aim 1a) as well as conduct an open pilot trial of the HFBFP with fourteen families to further refine the HFBFP content and evaluate the feasibility of research procedures and program implementation (Aim 1b). During the Pilot Evaluation Phase, we will via a randomized controlled trial of caregiver–SGMY dyads (50 dyads assigned to the HFBFP and 50 dyads to a waitlist), assess the acceptability and feasibility of the HFBFP (Aim 2a) via program observations, post-session surveys (n = 100), and exit interviews (n = 28) with SGMY and their caregiver(s). We will test the HFBFP’s efficacy in improving relevant family/caregiver outcomes (e.g., acceptance of SGMY, family communication skills, parenting self-efficacy) as well as relevant SGMY outcomes (e.g., minority stress, alcohol use intentions/willingness, DV/alcohol use norms, communication self-efficacy) (Aim 2b) via surveys completed at baseline, immediate post-test, and 3- month follow-up. We will recruit SGMY and their caregivers (100 dyads) with elevated minority stress from across the U.S. via social media and from LGBTQ+ organizations. We will oversample families of color and families living in rural areas.