None listed
Conditions
Brief summary
Members of the LGBTQIA+ (lesbian, gay, bisexuals, transgender, queer, intersexual, asexual, plus other gender, sexual, or romantic minority identities) are at higher risk of poor mental health. One therapeutic approach that has been shown to improve mental health for this community is Acceptance and Commitment Therapy (ACT). In addition, digital programs that promote mental health have been shown to be effective and acceptable in this community. This project aims to conduct the first randomised control trial (RCT) evaluating a digital mental health promotion program underpinned by ACT with the LGBTQIA+ community. The intervention used in this program is called YOLO (You Only Live Once), which has demonstrated efficacy in improving mental health with university students. Findings from this RCT will inform changes necessary to the YOLO program to co-design a world-first digital ACT program for LGBTQIA+ people. This trial will involve three distinct phases. Phase 1 involves the quantitative evaluation of efficacy based on self-report data on measures of mental health and ACT processes. This will determine the efficacy of the program to improve mental health. Phase 2 involves the qualitative analysis of feedback provided during YOLO modules. Phase 3 involves interviews with participants about their experiences with the YOLO program and desired changes. Both phases 2 and 3 will inform changes to the YOLO program to make it more LGBTQIA+ affirming in future projects. This research is guided by six research questions: Question 1: Will the YOLO program be associated with improved mental health for members of the LGBTQIA+ community compared to a waitlist control? Question 2: What changes will participants recommend to improve the usability of the program and make it LGBTQIA+ affirming? Question 3: Will the YOLO program improve ACT processes for members of the LGBTQIA+ community compared to a waitlist control? Question 4: Will ACT processes mediate the mental health changes that occur during the RCT? Question 5: Does completion rate influence the mental health outcomes experienced during the RCT? Question 6: Do changes in ACT processes mediate the relationship between LGBTQIA+ minority stress and mental health outcomes? In brief, we hypothesise that completing the program will improve the mental health of participants. We anticipate high usability, but a myriad of changes recommended to make the program more affirming. We further predict that ACT processes will improve throughout the trial and that these changes will influence the mental health outcomes gained. As well, we predict that completion amount of the program will influence the mental health outcomes and changes in ACT processes reported, in that those who complete all modules will report higher mental health and ACT process changes. We finally predict that the relationship between LGBTQIA+ minority stress and mental health will be influenced by ACT processes.
Interventions
This trial will involve the evaluation of the YOLO (You Only Live Once) (Viskovich & Pakenham, 2020) mental health promotion program with members of the LGBTQIA+ community through a randomized control trial (RCT). Members of the community will be recruited through a variety of active channels, including partner community organisations such as Open Doors Youth Services, online social media channels, and snowballing.
The intervention used in this study is the You Only Live Once (YOLO) program pr
This trial will involve the evaluation of the YOLO (You Only Live Once) (Viskovich & Pakenham, 2020) mental health promotion program with members of the LGBTQIA+ community through a randomized control trial (RCT). Members of the community will be recruited through a variety of active channels, including partner community organisations such as Open Doors Youth Services, online social media channels, and snowballing. The intervention used in this study is the You Only Live Once (YOLO) program previously validated with a sample of university students (Viskovich and Pakenham, 2020). The program is not designed to treat mental illness but teach skills to promote mental health. This online self-guided mental health program is underpinned by Acceptance and Commitment Therapy (ACT). It contains four modules that cover all six core ACT processes and are each approximately half an hour long, and modules are designed to be completed sequentially. Participants will be recommended that they complete one module per week over four weeks, but will be able to complete them at a pace that suits them (for example, all in one session). The modules include include: Module 1: Values and committed action Module 2: Cognitive defusion Module 3: Acceptance Module 4: Mindfulness and the observer self Intervention content includes animated presentations, videos, audio files, and written exercises. The program is completely self-guided and involves no researcher or clinician involvement. Participants will complete baseline, immediate-post, and 12-week follow up assessments. These will cover a wide range of psychological constructs such as mental health, life satisfaction, ACT processes such as acceptance, and LGBTQIA+ minority stress. Participants will also be able to provide feedback as they complete each module on what they liked and didn’t like about the program. This will be through a survey embedded within the program which will appear at the end of the module. Automated SMS and email reminders will be sent to participants during the program to encourage module and assessment completion. Tailoring programs to the LGBTQIA+ community are an important component of online mental health interventions for this group. Therefore, as the program was initially designed to promote wellbeing for university students, the content will be re-shaped to remove reference and applicability to students. Process tailoring will be conducted by choosing affirming LGBTQIA+ imagery and promoting it as a preliminary evaluation of a program specifically for this community. Content tailoring will ensure that the programs content is general in nature for safety, but the existing content will not be shaped around common LGBTQIA+ experiences (e.g., “coming out”). This to firstly determine the impact of more generic therapeutic content, and secondly to serve as a blank canvas to inform future changes to the program following this RCT. When participants sign up for the program, they will be offered the opportunity to complete interviews with members of the research team about their experiences and identified areas for future improvements to the program. Participants will also be invited to provide feedback on each module following completion to identify in-the-moment user-identified changes. The original trials of YOLO were not pre-registered. For more information about the program, please consult the reference below. Viskovich, S, Pakenham, KI. Randomized controlled trial of a web-based Acceptance and Commitment Therapy (ACT) Program to promote mental health in university students. J. Clin. Psychol. 2020; 76: 929– 951. https://doi.org/10.1002/jclp.22848
Sponsors
The University of Queensland
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Educational / counselling / training
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
16 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
1) Living in Australia 2) A member of the LGBTQIA+ community 3) English language proficiency 4) Aged 16 and above Given poorer mental health often reported in the LGBTIQA+ community, participants will be allowed to continue any other psychological support as required outside of the program. Participants will also be eligible to participate if they currently experience severe mental illness.
Exclusion criteria
None.
Outcome results
None listed