Preventing Drug Abuse among Sexual-Minority Youth

摘要 在这项赠款申请中提出的随机对照试验解决了 在美国，性少数青少年的吸毒率高得不成比例。性方面的- 少数族裔青少年是指自我认同为男同性恋、女同性恋、双性恋或对自己的性取向不确定的青少年。 在这份申请中，我们的性少数群体青年样本也将包括那些认为自己是变性人或 不确定自己的性别认同。我们建议开发和测试一个量身定做的、基于网络的程序来预防毒品 在性少数群体青年中使用和推迟药物使用开始。到目前为止，还没有这样的程序存在。 研究参与者将是从Facebook招募的15至17岁的年轻人。作为规模最大、规模最大的 在美国流行的社交网站Facebook在美国注册了约380万人。 用户，年龄在15到17岁之间。国家数据显示，大约7.5%的年轻人认为自己是性爱- 作为少数群体成员，Facebook为这一难以接触到的人群提供了无与伦比的访问途径。 为期10天的干预将在网上进行。会议将安装在可定制的 首页有年轻人寻找的功能：时事、娱乐和体育新闻、健身和 时尚小贴士，热门游戏和社交网站的链接，以及与健康相关的资源。 解决对所有青少年来说突出的吸毒风险因素--即管理同伴和社会 影响-会议内容将为年轻人提供获得、尝试、接收反馈的机会，并 掌握与以下方面相关的认知行为技能：目标设定、解决问题、拒绝服药、自信和 规范性信念。与现有程序不同，这些会话将在表面上定制(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 性少数派青年。解决性少数群体青少年吸毒的具体危险因素--即压力 与内在化的同性恋恐惧症、来自同龄人的骚扰和管理家庭拒绝有关--额外 课程内容将集中在：增强自我价值、应对策略、建立社会支持和管理 消极的情绪。 这项随机对照试验将包括890名来自美国的性少数族裔青年。全是年轻人 将在线完成预测措施。干预-ARM青少年随后将与为期10节的计划互动； 控制臂中的年轻人将可以访问一个关注安慰剂网站。所有的青少年都将完成后测 措施和1年、2年和3年的后续措施。跨后测和年度跟踪测量 在某些情况下，数据分析将检查研究部门之间30天的药物使用率和药物使用开始率。 我们还将检查对与药物使用有关的中介变量的干预效果，并评估 中介变量的变化在多大程度上解释了武器之间药物使用的差异。

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.