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      Internet-based interventions to promote help-seeking for mental health in LGBTQ+ young adults: Protocol for a randomized controlled trial

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          Abstract

          Background

          Compared to its cis-heterosexual counterpart, the sexual and gender minority (SGM) population is disproportionately susceptible to mental health problems, including depression, anxiety, and minority stress. They are also facing unique help-seeking barriers when in need of support. Past research has shown promising results in using interventions to promote help-seeking intentions and attitudes of the cis-heterosexual population. However, there were no known help-seeking interventions targeting the SGM population. This protocol illustrates a study design to test the efficacy of a newly-developed internet-based program aimed to promote help-seeking for mental health in LGBTQ+ young adults.

          Methods

          This study is a randomized controlled trial that aims to promote and improve the SGM young adults' help-seeking by integrating animated psychoeducational videos, group discussion, and the SGM youth help-seeking brochure. Primary outcomes, including help-seeking intentions and attitudes, will be measured at baseline, post-intervention, one-month post-intervention, and three-month post-intervention. The secondary outcomes, including help-seeking stigma, help-seeking literacy, mental health literacy, and help-seeking behaviors, will be measured at the same time points.

          Discussion

          This is an internet-based, multi-dimensional, and integrative intervention tailored to the needs of the SGM population. It addresses an important gap in the current landscape of mental health promotion for the SGM population. The findings from this trial will provide new knowledge on promoting help-seeking among the SGM population, paving the road for future research that focuses on addressing mental health issues faced by the SGM population.

          Trial registration

          Chictr.org.cn: ChiCTR2100053248.

          Highlights

          • •

            First study to examine the efficacy of intervention in promoting help-seeking behaviours among LGBTQ+ population.

          • •

            The first RCT can offer a comprehensive understanding of help-seeking intervention for the Chinese LGBTQ+ population.

          • •

            Well-adapted assessments and questionnaires are used in this study

          • •

            Follow-up at 1-month and 3-month post-intervention will be conducted to demonstrate the long-term effect.

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          Most cited references64

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          Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: conceptual issues and research evidence.

          Ilan Meyer (2003)
          In this article the author reviews research evidence on the prevalence of mental disorders in lesbians, gay men, and bisexuals (LGBs) and shows, using meta-analyses, that LGBs have a higher prevalence of mental disorders than heterosexuals. The author offers a conceptual framework for understanding this excess in prevalence of disorder in terms of minority stress--explaining that stigma, prejudice, and discrimination create a hostile and stressful social environment that causes mental health problems. The model describes stress processes, including the experience of prejudice events, expectations of rejection, hiding and concealing, internalized homophobia, and ameliorative coping processes. This conceptual framework is the basis for the review of research evidence, suggestions for future research directions, and exploration of public policy implications.
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            Effect of web-based depression literacy and cognitive-behavioural therapy interventions on stigmatising attitudes to depression: randomised controlled trial.

            Kathleen Griffiths, Helen Christensen, Anthony F. Jorm … (2004)
            Little is known about the efficacy of educational interventions for reducing the stigma associated with depression. To investigate the effects on stigma of two internet depression sites. A sample of 525 individuals with elevated scores on a depression assessment scale were randomly allocated to a depression information website (BluePages), a cognitive-behavioural skills training website (MoodGYM) or an attention control condition. Personal stigma (personal stigmatising attitudes to depression) and perceived stigma (perception of what most other people believe) were assessed before and after the intervention. Relative to the control, the internet sites significantly reduced personal stigma, although the effects were small. BluePages had no effect on perceived stigma and MoodGYM was associated with an increase in perceived stigma relative to the control. Changes in stigma were not mediated by changes in depression, depression literacy or cognitive-behavioural therapy literacy. The internet warrants further investigation as a means of delivering stigma reduction programmes for depression.
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              A systematic review of mental disorder, suicide, and deliberate self harm in lesbian, gay and bisexual people

              Michael King, JOANNA SEMLYEN, Sharon See Tai … (2008)
              Background Lesbian, gay and bisexual (LGB) people may be at higher risk of mental disorders than heterosexual people. Method We conducted a systematic review and meta-analysis of the prevalence of mental disorder, substance misuse, suicide, suicidal ideation and deliberate self harm in LGB people. We searched Medline, Embase, PsycInfo, Cinahl, the Cochrane Library Database, the Web of Knowledge, the Applied Social Sciences Index and Abstracts, the International Bibliography of the Social Sciences, Sociological Abstracts, the Campbell Collaboration and grey literature databases for articles published January 1966 to April 2005. We also used Google and Google Scholar and contacted authors where necessary. We searched all terms related to homosexual, lesbian and bisexual people and all terms related to mental disorders, suicide, and deliberate self harm. We included papers on population based studies which contained concurrent heterosexual comparison groups and valid definition of sexual orientation and mental health outcomes. Results Of 13706 papers identified, 476 were initially selected and 28 (25 studies) met inclusion criteria. Only one study met all our four quality criteria and seven met three of these criteria. Data was extracted on 214,344 heterosexual and 11,971 non heterosexual people. Meta-analyses revealed a two fold excess in suicide attempts in lesbian, gay and bisexual people [pooled risk ratio for lifetime risk 2.47 (CI 1.87, 3.28)]. The risk for depression and anxiety disorders (over a period of 12 months or a lifetime) on meta-analyses were at least 1.5 times higher in lesbian, gay and bisexual people (RR range 1.54–2.58) and alcohol and other substance dependence over 12 months was also 1.5 times higher (RR range 1.51–4.00). Results were similar in both sexes but meta analyses revealed that lesbian and bisexual women were particularly at risk of substance dependence (alcohol 12 months: RR 4.00, CI 2.85, 5.61; drug dependence: RR 3.50, CI 1.87, 6.53; any substance use disorder RR 3.42, CI 1.97–5.92), while lifetime prevalence of suicide attempt was especially high in gay and bisexual men (RR 4.28, CI 2.32, 7.88). Conclusion LGB people are at higher risk of mental disorder, suicidal ideation, substance misuse, and deliberate self harm than heterosexual people.
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                Author and article information

                Contributors
                Yuanyuan Wang
                Runsen Chen
                Journal
                Journal ID (nlm-ta): Internet Interv
                Journal ID (iso-abbrev): Internet Interv
                Title: Internet Interventions
                Publisher: Elsevier
                ISSN (Electronic): 2214-7829
                Publication date PMC-release: 18 March 2022
                Publication date Collection: April 2022
                Publication date (Electronic): 18 March 2022
                Volume: 28
                Electronic Location Identifier: 100524
                Affiliations
                [a ]Vanke School of Public Health, Tsinghua University, Beijing, China
                [b ]Department of Medical Psychology, The School of Health Humanities, Peking University, Beijing, China
                [c ]National Clinical Research Center for Mental Disorders, Department of Psychiatry, and China National Technology Institute on Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
                [d ]Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, China; School of Psychology, Center for Studies of Psychological Application, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, China
                [e ]Division of Psychology, Faculty of Health and Life Sciences, De Montfort University, Leicester, UK
                [f ]Black Dog Institute, University of New South Wales, Sydney, NSW, Australia
                Author notes
                [1]

                Contributed equally.

                Article
                Publisher Item ID: S2214-7829(22)00031-8 Publisher ID: 100524
                DOI: 10.1016/j.invent.2022.100524
                PMC ID: 8943403
                PubMed ID: 35342718
                SO-VID: 3a7944f0-8a51-4a95-b6c3-03de56908ae8
                Copyright © © 2022 Published by Elsevier B.V.
                License:

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                Date received : 18 January 2022
                Date revision received : 8 March 2022
                Date accepted : 11 March 2022
                Categories
                Subject: Full length Article

                Keywords: internet-based intervention,lgbtq+,psychoeducation,help-seeking,rct
                Data availability:
                Keywords: internet-based intervention, lgbtq+, psychoeducation, help-seeking, rct

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