Preventing Drug Abuse among Sexual-Minority Youth

摘要 在这项拨款申请中提出的随机对照试验解决了以下问题： 在美国，性少数青少年的药物使用率不成比例地高。性- 少数群体青少年是自我认同为男同性恋、女同性恋、双性恋或不确定自己性取向的青年。 在这个应用程序中，我们的性少数青年样本还将包括那些认为自己是变性人或变性人的青年。 不确定自己的性别身份。我们建议开发和测试一个量身定制的，基于网络的程序，以防止毒品 在性少数青年中使用和推迟开始使用毒品。迄今为止，还没有这样的方案。 研究参与者将是从Facebook招募的15至17岁的年轻人。作为世界上最大、 作为美国最受欢迎的社交网站，Facebook在美国拥有约380万注册用户。 15至17岁的用户。国家数据显示，大约7.5%的青年认为自己是性- 作为少数群体成员，Facebook为这一难以接触的人群提供了无与伦比的访问权限。 第10节干预将在线提供。会议将被安置在一个可定制的 主页的特点青年寻求：饲料的当前事件，娱乐和体育新闻，健身和 时尚小贴士，流行游戏和社交网站的链接，以及健康相关的资源。 针对所有青少年都面临的吸毒风险因素，即如何管理同伴和社会关系， 影响力会议内容将为年轻人提供机会，以获得，尝试，接受反馈， 掌握与以下方面相关的认知行为技能：目标设定，解决问题，拒绝药物，自信， 规范性信念与现有的计划不同，这些会议将在表面上定制（例如，字符， 设计元素、词汇）和结构层次（例如，场景，角色扮演），以反映日常现实， 性少数青年解决性少数青年吸毒的特定风险因素，即压力， 与内化的同性恋恐惧症，来自同龄人的骚扰，以及管理家庭拒绝-额外 会议内容将集中在：提高自我价值，应对策略，建立社会支持，管理 消极情绪 这项随机对照试验将包括来自美国的890名性少数青年。所有青年 将在线完成预测试措施。然后，干预组青年将与10节课程进行互动; 对照组的青少年将可以访问一个注意力安慰剂网站。所有青少年将完成后测 措施以及1年、2年和3年的后续措施。在测试后和年度随访测量中 在某些情况下，数据分析将检查研究组之间的30天药物使用率和药物使用开始率。 我们还将研究干预对与药物使用相关的中介变量的影响，并评估 中介变量的变化在多大程度上解释了两组药物使用的差异。

ABSTRACT The randomized controlled trial proposed in this grant application addresses the problem of disproportionately high rates of drug use among sexual-minority adolescents in the United States. Sexual- minority adolescents are youth who self-identify as gay, lesbian, bisexual, or unsure of their sexual orientation. In this application, our sample of sexual-minority youth will also include youth who identify as transgender or unsure of their gender identity. We propose to develop and test a tailored, web-based program to prevent drug use and delay drug use initiation among sexual-minority youth. To date, no such program exists. Study participants will be 15- to 17-year-old youth recruited from Facebook. As the largest and most popular social networking site in the United States, Facebook has approximately 3.8 million registered U.S. users, aged 15 to 17 years. With national data indicating that approximately 7.5% of youth identify as a sexual- minority group member, Facebook provides unparalleled access to this difficult to reach population. The 10-session intervention will be delivered online. The sessions will be housed on a customizable homepage with features youth seek: feeds to current events, entertainment and sports news, fitness and fashion tips, links to popular gaming and social-networking sites, and health-related resources. To address the risk factors for drug use that are salient for all youth—namely managing peer and social influences—session content will provide youth with opportunities to acquire, try out, receive feedback on, and master cognitive-behavioral skills related to: goal setting, problem solving, drug refusal, assertiveness, and normative beliefs. Unlike extant programs, these sessions will be tailored at the surface (e.g., characters, elements of design, lexicon) and structural levels (e.g., scenarios, role-plays) to reflect the everyday realities of sexual-minority youth. To address sexual-minority youths’ specific risk factors for drug use—namely the stress associated with internalized homophobia, harassment from peers, and managing family rejection—additional session content will focus on: enhancing self-worth, coping strategies, building social supports, and managing negative moods. The randomized controlled trial will include 890 sexual-minority youth from the United States. All youth will complete pretest measures online. Intervention-arm youth will then interact with the 10-session program; youth in the control arm will have access to an attention-placebo website. All youth will then complete posttest measures and 1-, 2-, and 3-year follow-up measures. Across posttest and annual follow-up measurement occasions, data analyses will examine rates of 30-day drug use and drug use initiation between study arms. We will also examine intervention effects on mediator variables associated with drug use and assess the extent to which changes in mediator variables explain differences in drug use between arms.