scholarly journals An Avatar-Led Digital Smoking Cessation Program for Sexual and Gender Minority Young Adults: Intervention Development and Results of a Single-Arm Pilot Trial (Preprint)

2021 ◽  
Author(s):  
Jaimee L Heffner ◽  
Noreen L Watson ◽  
Edit Serfozo ◽  
Megan M Kelly ◽  
Erin D Reilly ◽  
...  
Keyword(s):  
Young Adults ◽  
Pilot Trial ◽  
Intervention Development ◽  
Targeted Interventions ◽  
Gender Minority ◽  
Tobacco Treatment ◽  
Acceptance And Commitment ◽  
Sexual And Gender Minority ◽  
Biochemical Testing ◽  
And Gender

BACKGROUND Sexual and gender minority young adults have a high prevalence of smoking and unique barriers to accessing tobacco treatment. OBJECTIVE To address these challenges as well as their preferences for sexual and gender minority–targeted interventions and digital programs, we developed and evaluated the acceptability, preliminary efficacy, and impact on theory-based change processes of an acceptance and commitment therapy–based digital program called Empowered, Queer, Quitting, and Living (EQQUAL). METHODS Participants (n=22) of a single-arm trial conducted to evaluate the program were young adults, age 18 to 30 years, who self-identified as sexual and gender minority individuals and smoked at least one cigarette per day. All participants received access to the EQQUAL program. Participants completed web-based surveys at baseline and at a follow-up 2 months after enrollment. We verified self-reported smoking abstinence with biochemical testing; missing data were counted as smoking or using tobacco. RESULTS For young adults who logged in at least once (n=18), the mean number of log-ins was 5.5 (SD 3.6), mean number of sessions completed was 3.1 (SD 2.6), and 39% (7/18) completed all 6 sessions. Overall, 93% of participants (14/15) were satisfied with the EQQUAL program, 100% (15/15) found it easy to use, and 100% (15/15) said it helped them be clearer about how to quit. Abstinence from smoking or using tobacco was confirmed with biochemical testing for 23% of participants (5/22). Both quantitative and qualitative results suggested a positive overall response to the avatar guide, with areas for future improvement largely centered on the avatar’s appearance and movements. CONCLUSIONS Treatment acceptability of EQQUAL was very promising. The rate of abstinence, which was biochemically confirmed, was 3 times higher than that of the only other digital program to date that has targeted sexual and gender minority young adults and 6 to 13 times higher than those of nontargeted digital smoking interventions among sexual and gender minority young adults. Planned improvements for the next iteration of the program include making the avatar’s movements more natural; offering multiple avatar guides with different on characteristics such as race, ethnicity, and gender identity from which to choose; and providing a support forum for users to connect anonymously with peers.

scholarly journals An Avatar-Led Digital Smoking Cessation Program for Sexual and Gender Minority Young Adults: Intervention Development and Results of a Single-Arm Pilot Trial

10.2196/30241 ◽  
2021 ◽  
Vol 5 (7) ◽  
pp. e30241
Author(s):  
Jaimee L Heffner ◽  
Noreen L Watson ◽  
Edit Serfozo ◽  
Megan M Kelly ◽  
Erin D Reilly ◽  
...  
Keyword(s):  
Young Adults ◽  
Pilot Trial ◽  
Intervention Development ◽  
Targeted Interventions ◽  
Gender Minority ◽  
Tobacco Treatment ◽  
Acceptance And Commitment ◽  
Sexual And Gender Minority ◽  
Biochemical Testing ◽  
And Gender

Background Sexual and gender minority young adults have a high prevalence of smoking and unique barriers to accessing tobacco treatment. Objective To address these challenges as well as their preferences for sexual and gender minority–targeted interventions and digital programs, we developed and evaluated the acceptability, preliminary efficacy, and impact on theory-based change processes of an acceptance and commitment therapy–based digital program called Empowered, Queer, Quitting, and Living (EQQUAL). Methods Participants (n=22) of a single-arm trial conducted to evaluate the program were young adults, age 18 to 30 years, who self-identified as sexual and gender minority individuals and smoked at least one cigarette per day. All participants received access to the EQQUAL program. Participants completed web-based surveys at baseline and at a follow-up 2 months after enrollment. We verified self-reported smoking abstinence with biochemical testing; missing data were counted as smoking or using tobacco. Results For young adults who logged in at least once (n=18), the mean number of log-ins was 5.5 (SD 3.6), mean number of sessions completed was 3.1 (SD 2.6), and 39% (7/18) completed all 6 sessions. Overall, 93% of participants (14/15) were satisfied with the EQQUAL program, 100% (15/15) found it easy to use, and 100% (15/15) said it helped them be clearer about how to quit. Abstinence from smoking or using tobacco was confirmed with biochemical testing for 23% of participants (5/22). Both quantitative and qualitative results suggested a positive overall response to the avatar guide, with areas for future improvement largely centered on the avatar’s appearance and movements. Conclusions Treatment acceptability of EQQUAL was very promising. The rate of abstinence, which was biochemically confirmed, was 3 times higher than that of the only other digital program to date that has targeted sexual and gender minority young adults and 6 to 13 times higher than those of nontargeted digital smoking interventions among sexual and gender minority young adults. Planned improvements for the next iteration of the program include making the avatar’s movements more natural; offering multiple avatar guides with different on characteristics such as race, ethnicity, and gender identity from which to choose; and providing a support forum for users to connect anonymously with peers.

Daily stressors and diurnal cortisol among sexual and gender minority young adults.

2020 ◽  
Author(s):  
Wilson S. Figueroa ◽  
Peggy M. Zoccola ◽  
Andrew W. Manigault ◽  
Katrina R. Hamilton ◽  
Matt C. Scanlin ◽  
...  
Keyword(s):  
Young Adults ◽  
Daily Stressors ◽  
Diurnal Cortisol ◽  
Gender Minority ◽  
Sexual And Gender Minority ◽  
And Gender

scholarly journals Smoking cessation intervention trial outcomes for sexual and gender minority young adults.

2019 ◽  
Vol 38 (1) ◽  
pp. 12-20 ◽  
Author(s):  
Erin A. Vogel ◽  
Johannes Thrul ◽  
Gary L. Humfleet ◽  
Kevin L. Delucchi ◽  
Danielle E. Ramo
Keyword(s):  
Smoking Cessation ◽  
Young Adults ◽  
Smoking Cessation Intervention ◽  
Intervention Trial ◽  
Gender Minority ◽  
Cessation Intervention ◽  
Trial Outcomes ◽  
Sexual And Gender Minority ◽  
And Gender

scholarly journals The Put It Out Project (POP) Facebook Intervention for Young Sexual and Gender Minority Smokers: Outcomes of a Pilot, Randomized, Controlled Trial

2019 ◽  
Vol 22 (9) ◽  
pp. 1614-1621 ◽  
Author(s):  
Erin A Vogel ◽  
Danielle E Ramo ◽  
Meredith C Meacham ◽  
Judith J Prochaska ◽  
Kevin L Delucchi ◽  
...  
Keyword(s):  
Smoking Cessation ◽  
Controlled Trial ◽  
Pilot Trial ◽  
Smoking Cessation Intervention ◽  
Smoking Abstinence ◽  
Gender Minority ◽  
Culturally Tailored ◽  
Cessation Intervention ◽  
Sexual And Gender Minority ◽  
And Gender

Abstract Introduction This trial investigated whether a Facebook smoking cessation intervention culturally tailored to young sexual and gender minority (SGM) smokers (versus non-tailored) would increase smoking abstinence. Methods Participants were 165 SGM young adult US smokers (age 18–25) recruited from Facebook in April 2018 and randomized to an SGM-tailored (POP; N = 84) or non-tailored (TSP-SGM; N = 81) intervention. Interventions delivered weekly live counseling sessions and 90 daily Facebook posts to participants in Facebook groups. Primary analyses compared POP and TSP-SGM on biochemically verified smoking abstinence (yes/no; primary outcome), self-reported 7-day point prevalence abstinence (yes/no), reduction in cigarettes per week by 50+% from baseline (yes/no), making a quit attempt during treatment (yes/no), and stage of change (precontemplation/contemplation vs. preparation/action). Supplemental analyses compared POP to two historical control groups. Results POP participants were more likely than TSP-SGM participants to report smoking abstinence at 3 (23.8% vs. 12.3%; OR = 2.50; p = .03) and 6 months (34.5% vs. 12.3%; OR = 4.06; p < .001) and reduction in smoking at 3 months (52.4% vs. 39.5%; OR = 2.11; p = .03). Biochemically verified smoking abstinence did not significantly differ between POP and TSP-SGM at 3 (OR = 2.00; p = .33) or 6 months (OR = 3.12; p = .08), potentially due to challenges with remote biochemical verification. In supplemental analyses, POP participants were more likely to report abstinence at 3 (OR = 6.82, p = .01) and 6 (OR = 2.75, p = .03) months and reduced smoking at 3 months (OR = 2.72, p = .01) than participants who received a referral to Smokefree.gov. Conclusions This pilot study provides preliminary support for the effectiveness of a Facebook smoking cessation intervention tailored to SGM young adults. Implications SGM individuals have disproportionately high smoking prevalence. It is unclear whether smoking cessation interventions culturally tailored to the SGM community are more effective than non-tailored interventions. This pilot trial found preliminary evidence that an SGM-tailored Facebook smoking cessation intervention increased reported abstinence from smoking, compared to a non-tailored intervention. Trial Registration NCT03259360.

scholarly journals Risk, Resilience, and Smoking in a National, Probability Sample of Sexual and Gender Minority Adults, 2017, USA

2020 ◽  
Vol 47 (2) ◽  
pp. 272-283 ◽  
Author(s):  
Joseph G. L. Lee ◽  
Bonnie E. Shook-Sa ◽  
Jeffrey Gilbert ◽  
Leah M. Ranney ◽  
Adam O. Goldstein ◽  
...  
Keyword(s):  
Substance Use ◽  
Protective Factors ◽  
Smoking Status ◽  
Risk And Resilience ◽  
Theoretical Frameworks ◽  
Targeted Interventions ◽  
Gender Minority ◽  
Sexual And Gender Minority ◽  
Advertising Skepticism ◽  
And Gender

Background. There are well-documented inequities in smoking between sexual and gender minority (SGM; e.g., lesbian, gay, bisexual, and transgender [LGBT]) and straight and cisgender people. However, there is less information about risk for and resilience against smoking among SGM people. Such information is critical for understanding etiology and developing interventions. Aims. To conduct a within-group assessment of risks and resiliencies relating to smoking status. Method. In 2017, we conducted a cross-sectional telephone survey with a national, probability-based sample of SGM adults ( N = 453). We assessed theory-informed risks (adverse childhood events, substance use–oriented social environment, mental distress, stigma, discrimination, social isolation, and identity concealment) and resiliencies (advertising skepticism, identity centrality, social support, and SGM community participation). We applied survey weights, standardized predictor variables, and fit logistic regression models predicting smoking status. We stratified by age and SGM identity. Results. Patterns of risk and resilience differ by age and identity. Effects were consistently in the same direction for all groups for participating in substance use–oriented social environments, pointing to a potential risk factor for all groups. Advertising skepticism and having people you can talk to about being LGBTQ were potential protective factors. Discussion. Intervention development should address risk and resilience that differs by SGM identity. Additionally, our findings suggest interventionists should consider theoretical frameworks beyond minority stress. Conclusion. While much of the literature has focused on the role of stress from stigma and discrimination in tobacco use, addressing social norms and bolstering protective factors may also be important in SGM-targeted interventions.

scholarly journals Efficacy of affirmative cognitive behavioural group therapy for sexual and gender minority adolescents and young adults in community settings in Ontario, Canada

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Shelley L. Craig ◽  
Andrew D. Eaton ◽  
Vivian W. Y. Leung ◽  
Gio Iacono ◽  
Nelson Pang ◽  
...  
Keyword(s):  
Young Adults ◽  
Adolescents And Young Adults ◽  
Post Intervention ◽  
Community Based ◽  
Stress Appraisal ◽  
Gender Minority ◽  
Minority Adolescents ◽  
Cognitive Behavioural ◽  
Sexual And Gender Minority ◽  
And Gender

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.

scholarly journals Sexual and Gender Minority Caregivers of People With Dementia and Their Care Recipients

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 697-697
Author(s):  
Joel Anderson ◽  
Jason Flatt ◽  
Jennifer Jabson Tree ◽  
Alden Gross ◽  
Karen Rose
Keyword(s):  
Activities Of Daily Living ◽  
Daily Living ◽  
Care Recipient ◽  
Electronic Survey ◽  
Targeted Interventions ◽  
Gender Minority ◽  
Care Recipients ◽  
People With Dementia ◽  
Sexual And Gender Minority ◽  
And Gender

Abstract Little is known about the unique experiences of sexual and gender minority (SGM) caregivers of people with dementia or their care recipients. We used an electronic survey to assess psychosocial measures within this caregiving population, including measures related to the care recipient. The majority of caregivers (N=285) were gay men (62%). Most respondents were white (80%), with a quarter identifying as Latinx. The majority of caregivers were a spouse/partner (59.3%) and were providing care for someone who identified as LGB (70%), with 20% caring for someone transgender. Half of care recipients did not have an advance directive. The majority of care recipients needed assistance with ≥5 instrumental activities of daily living (83%) and ≥1basic activities of daily living (74%). This study is the first to provide data regarding the unique needs of SGM caregivers of someone with dementia and will support the development of targeted interventions for this population.

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