Shelley L Craig1, Andrew D Eaton2, Vivian W Y Leung3, Gio Iacono4, Nelson Pang3, Frank Dillon5, Ashley Austin6, Rachael Pascoe3, Cheryl Dobinson7. 1. Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor St. W., Toronto, ON, M5S1V4, Canada. shelley.craig@utoronto.ca. 2. Faculty of Social Work, University of Regina - Saskatoon Campus, Saskatoon, SK, Canada. 3. Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor St. W., Toronto, ON, M5S1V4, Canada. 4. School of Social Work, University of Connecticut, Hartford, CT, USA. 5. College of Integrative Sciences and Arts, Arizona State University, Tempe, AZ, USA. 6. Ellen Whiteside-McDonnell School of Social Work, Barry University, Miami, FL, USA. 7. Planned Parenthood Toronto, Toronto, ON, USA.
Abstract
OBJECTIVE: This study tested the efficacy of AFFIRM, a brief affirmative cognitive-behavioural group intervention tailored to reduce psychosocial distress and improve coping among sexual and gender minority adolescents and young adults (SGMY). METHOD: SGMY (n = 138; M age = 22.44) were allocated to immediate 8-week AFFIRM intervention delivered at 12 community-based organisations or an 8-week waitlisted control. At baseline, post-intervention or post-waitlist, participants completed self-reported assessments of depression, hope, coping, and stress appraisal. Implementation outcomes of feasibility and acceptability were also assessed. RESULTS: Compared to waitlist, SGMY in the intervention condition significantly reduced their depressive symptoms (b = - 5.79, p = .001) as well as increased reports of hope (agency: b = 0.84, p = .001; pathway: b = 0.79, p = .001), and coping by emotional support (b = 0.59, p < .001), instrumental support (b = 0.67, p < .001), positive framing (b = 0.59, p < .001), humour (b = 0.36, p = .014), planning (b = 0.49, p < .001) as well as reflective coping (b = 0.27, p = .009). Intervention participants were also less likely to perceive stress as a threat (b = - 0.43, p = .001), and more likely to perceive stress as challenge (b = 0.67, p < .001) and have the resources to deal with that stress (b = 0.38, p = .016) in comparison to waitlisted control participants. All outcomes had medium to large effect sizes. AFFIRM participants reported low attrition (8.5%) and high levels of engagement and acceptability (e.g. 99% agreed intervention was relevant to their lives). Over 63% of the community organizations that participated in the training hosted AFFIRM at least once during the study. CONCLUSIONS: Results demonstrate efficacy for the community-based implementation of an affirmative clinical intervention designed for SGMY to address depression and foster coping with universal and minority stressors.
RCT Entities:
OBJECTIVE: This study tested the efficacy of AFFIRM, a brief affirmative cognitive-behavioural group intervention tailored to reduce psychosocial distress and improve coping among sexual and gender minority adolescents and young adults (SGMY). METHOD: SGMY (n = 138; M age = 22.44) were allocated to immediate 8-week AFFIRM intervention delivered at 12 community-based organisations or an 8-week waitlisted control. At baseline, post-intervention or post-waitlist, participants completed self-reported assessments of depression, hope, coping, and stress appraisal. Implementation outcomes of feasibility and acceptability were also assessed. RESULTS: Compared to waitlist, SGMY in the intervention condition significantly reduced their depressive symptoms (b = - 5.79, p = .001) as well as increased reports of hope (agency: b = 0.84, p = .001; pathway: b = 0.79, p = .001), and coping by emotional support (b = 0.59, p < .001), instrumental support (b = 0.67, p < .001), positive framing (b = 0.59, p < .001), humour (b = 0.36, p = .014), planning (b = 0.49, p < .001) as well as reflective coping (b = 0.27, p = .009). Intervention participants were also less likely to perceive stress as a threat (b = - 0.43, p = .001), and more likely to perceive stress as challenge (b = 0.67, p < .001) and have the resources to deal with that stress (b = 0.38, p = .016) in comparison to waitlisted control participants. All outcomes had medium to large effect sizes. AFFIRM participants reported low attrition (8.5%) and high levels of engagement and acceptability (e.g. 99% agreed intervention was relevant to their lives). Over 63% of the community organizations that participated in the training hosted AFFIRM at least once during the study. CONCLUSIONS: Results demonstrate efficacy for the community-based implementation of an affirmative clinical intervention designed for SGMY to address depression and foster coping with universal and minority stressors.
Entities:
Keywords:
Cognitive behavioural therapy; Community intervention; Coping; Depression; Sexual and gender minorities; Stress appraisal
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