TY - JOUR
T1 - Pilot testing the feasibility of a game intervention aimed at improving help seeking and coping among sexual and gender minority youth: protocol for a randomized controlled trial
AU - Coulter, Robert W.S.
AU - Sang, Jordan M.
AU - Louth-Marquez, William
AU - Henderson, Emmett R.
AU - Espelage, Dorothy
AU - Hunter, Simon C.
AU - DeLucas, Matthew
AU - Abebe, Kaleab Z.
AU - Miller, Elizabeth
AU - Morrill, Brooke A.
AU - Hieftje, Kimberly
AU - Friedman, Mark S.
AU - Egan, James E.
N1 - Acceptance from webpage
OA article
Applied Gold exception - immediate OA in OA journal. ET 9/6/20
PY - 2019/2/15
Y1 - 2019/2/15
N2 - Background:
Sexual and gender minority youth (SGMY; eg, lesbian, gay, bisexual, and
transgender youth) experience myriad substance use and mental health
disparities compared with their cisgender (nontransgender) heterosexual peers.
Despite much research showing these disparities are driven by experiences of
bullying and cyberbullying victimization, few interventions have aimed to
improve the health of bullied SGMY. One possible way to improve the health of
bullied SGMY is via a Web-accessible game intervention. Nevertheless, little
research has examined the feasibility of using a Web-accessible game
intervention with SGMY.Objective:
This study aimed to describe the protocol for a randomized controlled trial
(RCT) pilot, testing the feasibility and limited efficacy of a game-based
intervention for increasing help-seeking–related knowledge, intentions,
self-efficacy, behaviors, productive coping skills use, and coping flexibility
and reducing health risk factors and behaviors among SGMY.
Methods:
We enrolled 240 SGMY aged 14 to 18 years residing in the United States into a
2-arm prospective RCT. The intervention is a theory-based, community-informed,
computer-based, role playing game with 3 primary components: encouraging
help-seeking behaviors, encouraging use of productive coping, and raising
awareness of Web-based resources. SGMY randomized to both the intervention and
control conditions will receive a list of SGMY-inclusive resources, covering a
variety of health-related topics. Control condition participants received only
the list of resources. Notably, all study procedures are conducted via the
internet. We conveniently sampled SGMY using Web-based advertisements. Study
assessments occur at enrollment, 1 month after enrollment, and 2 months after
enrollment. The primary outcomes of this feasibility study include
implementation procedures, game demand, and game acceptability. Secondary
outcomes include help-seeking intentions, self-efficacy, and behaviors;
productive coping strategies and coping flexibility; and knowledge and use of
Web-based resources. Tertiary outcomes include bullying and cyberbullying
victimization, loneliness, mental health issues, substance use, and
internalized sexual and gender minority stigma.
Results:
From April to July 2018, 240 participants were enrolled and randomized. Half of
the enrolled participants (n=120) were randomized into the intervention
condition and half (n=120) into the control condition. At baseline, 52.1%
(125/240) of the participants identified as gay or lesbian, 26.7% (64/240) as
bisexual, 24.2% (58/240) as queer, and 11.7% (28/240) as another
nonheterosexual identity. Nearly half (113/240) of participants were a gender
minority: 36.7% (88/240) were cisgender boys, and 16.3% (39/240) were cisgender
girls. There were no differences in demographic characteristics between
intervention and control condition participants.
Conclusions:
Web-accessible game interventions overcome common impediments of face-to-face
interventions and present a unique opportunity to reach SGMY and improve their
health. This trial will provide data on feasibility and limited efficacy that
can inform future Web-based studies and a larger RCT aimed at improving health
equity for SGMY.Trial
Registration: ClinicalTrials.gov NCT03501264;
https://clinicaltrials.gov/ct2/show/NCT03501264 (Archived by WebCite at
http://www.webcitation.org/72HpafarW)
AB - Background:
Sexual and gender minority youth (SGMY; eg, lesbian, gay, bisexual, and
transgender youth) experience myriad substance use and mental health
disparities compared with their cisgender (nontransgender) heterosexual peers.
Despite much research showing these disparities are driven by experiences of
bullying and cyberbullying victimization, few interventions have aimed to
improve the health of bullied SGMY. One possible way to improve the health of
bullied SGMY is via a Web-accessible game intervention. Nevertheless, little
research has examined the feasibility of using a Web-accessible game
intervention with SGMY.Objective:
This study aimed to describe the protocol for a randomized controlled trial
(RCT) pilot, testing the feasibility and limited efficacy of a game-based
intervention for increasing help-seeking–related knowledge, intentions,
self-efficacy, behaviors, productive coping skills use, and coping flexibility
and reducing health risk factors and behaviors among SGMY.
Methods:
We enrolled 240 SGMY aged 14 to 18 years residing in the United States into a
2-arm prospective RCT. The intervention is a theory-based, community-informed,
computer-based, role playing game with 3 primary components: encouraging
help-seeking behaviors, encouraging use of productive coping, and raising
awareness of Web-based resources. SGMY randomized to both the intervention and
control conditions will receive a list of SGMY-inclusive resources, covering a
variety of health-related topics. Control condition participants received only
the list of resources. Notably, all study procedures are conducted via the
internet. We conveniently sampled SGMY using Web-based advertisements. Study
assessments occur at enrollment, 1 month after enrollment, and 2 months after
enrollment. The primary outcomes of this feasibility study include
implementation procedures, game demand, and game acceptability. Secondary
outcomes include help-seeking intentions, self-efficacy, and behaviors;
productive coping strategies and coping flexibility; and knowledge and use of
Web-based resources. Tertiary outcomes include bullying and cyberbullying
victimization, loneliness, mental health issues, substance use, and
internalized sexual and gender minority stigma.
Results:
From April to July 2018, 240 participants were enrolled and randomized. Half of
the enrolled participants (n=120) were randomized into the intervention
condition and half (n=120) into the control condition. At baseline, 52.1%
(125/240) of the participants identified as gay or lesbian, 26.7% (64/240) as
bisexual, 24.2% (58/240) as queer, and 11.7% (28/240) as another
nonheterosexual identity. Nearly half (113/240) of participants were a gender
minority: 36.7% (88/240) were cisgender boys, and 16.3% (39/240) were cisgender
girls. There were no differences in demographic characteristics between
intervention and control condition participants.
Conclusions:
Web-accessible game interventions overcome common impediments of face-to-face
interventions and present a unique opportunity to reach SGMY and improve their
health. This trial will provide data on feasibility and limited efficacy that
can inform future Web-based studies and a larger RCT aimed at improving health
equity for SGMY.Trial
Registration: ClinicalTrials.gov NCT03501264;
https://clinicaltrials.gov/ct2/show/NCT03501264 (Archived by WebCite at
http://www.webcitation.org/72HpafarW)
KW - sexual and gender minorities
KW - adolescent
KW - video games
KW - feasibility studies
KW - help-seeking behavior
KW - adaptation
KW - psychological
KW - alcohol drinking
KW - cigarette smoking
KW - vaping
KW - mental health
KW - randomized controlled trial
U2 - 10.2196/12164
DO - 10.2196/12164
M3 - Article
VL - 8
JO - JMIR Research Protocols
JF - JMIR Research Protocols
SN - 1929-0748
IS - 2
M1 - e12164
ER -