Feasibility of a Multi-Level School Intervention for LGBTQ Youth

Six items assessing current suicidality that were adapted from the longer, treatment-based Columbia Suicide Severity Rating Scale. The first two items ask about passive ideation and active ideation, and affirmative responses link to follow-up questions about methods, intent, plans, and attempts. The scale is scored as follows: 0 = no to passive ideation and no to active ideation 1. = yes to passive ideation (but no to active ideation) 2. = yes to active ideation (but no method, intent, plan) 3. = yes to method (but no intent or plan) 4. = yes to intent (but no plan) 5. = yes to plan Attempts can be scored on its own or added to the overall scale for a risk score of 6 if participant has a recent suicide attempt.

Time frame: Change between baseline and post-intervention/follow-up (12 weeks).

Population: All participants who completed the Proud \& Empowered intervention. Participants were from four high schools within Los Angeles County. Two schools were assigned to the intervention condition while the other two were assigned to the control condition. Participants were in 9th through 12th grade, and identified as sexual and/or gender minority.

21-item self-report assessment of anxiety symptoms. The total score is calculated by taking the sum of the 21 items. There are five responses an individual can choose from for each item, these being Not at all which is scored as a 1, Mildly, but it didn't bother me much which is scored as a 2, Moderately -- It wasn't pleasant at times which is scored as a 3, Severely -- It bothered me a lot which is scored as a 4, and Decline to answer which is scored as a 5. The total score ranges from 0-63. Higher values indicate higher self-reported anxiety: Score of 0-21 indicates low anxiety, Score of 22-35 indicates moderate anxiety, Scores of 36+ indicates potentially concerning levels of anxiety. Subscales are calculated through summation.

Time frame: Change between baseline and post-intervention/follow-up (12 weeks).

Population: All participants who completed the Proud \& Empowered intervention. Participants were from four high schools within Los Angeles County. Two schools were assigned to the intervention condition while the other two were assigned to the control condition. Participants were in 9th through 12th grade, and identified as sexual and/or gender minority.

21-item self-report assessment of depression symptoms and severity of depression. The items are rated on a 4-point scale ranging from 0-3 based on the severity of each item (e.g., 0=I do not feel sad, 1=I feel sad much of the time, 2=I am sad all the time, and 3=I am so sad or unhappy that I can't stand it). The total range of scores is from 0-63. Higher values indicate a worse outcome and indicates a greater severity of depression. Scores of 0-13 indicates minimal depression, scores of 14-19 indicates mild depression, scores of 20-28 indicates moderate depression, scores of 29-63 indicates severe depression. Subscale values are achieved through summation.

Time frame: Change between baseline and post-intervention/follow-up (12 weeks).

Population: All participants who completed the Proud \& Empowered intervention. Participants were from four high schools within Los Angeles County. Two schools were assigned to the intervention condition while the other two were assigned to the control condition. Participants were in 9th through 12th grade, and identified as sexual and/or gender minority.

16-item assessment measuring specific coping strategies people use in response to stressful events. Individuals respond to 16 items, with each item assessing components of Problem Solving, Cognitive Restructuring, Social Support, Express Emotions, Problem Avoidance, Wishful Thinking, and Social Withdrawal. Individuals can respond in 5 different ways, these being Never, Seldom, Sometimes, Often, or Almost Always. These responses are scored from 1-5 with Never being a 1 and Almost Always being a 5. The total score is a summation of item scores with a range from 16-80. Higher scores in a particular primary scale indicates that the individual implements that form of coping strategy more often.

Time frame: Change between baseline and post-intervention/follow-up (12 weeks).

Population: All participants who completed the Proud \& Empowered intervention. Participants were from four high schools within Los Angeles County. Two schools were assigned to the intervention condition while the other two were assigned to the control condition. Participants were in 9th through 12th grade, and identified as sexual and/or gender minority.

20-item self-report assessment of post-traumatic stress disorder (PTSD) symptoms which addresses all 20 DSM-5 symptoms of PTSD. A total symptom severity score can be calculated by summing the scores for each of the 20 items. Each item has five possible responses including Not at all which is scored as a 0, A little bit which is scored as a 1, Moderately which is scored as 2, Quite a bit which is scored as a 3, and Extremely which is scored as a 4. The potential range of scores is 0-80. Higher scores indicate a worse outcome where the individual has higher severity of PTSD symptoms.

Time frame: Change between baseline and post-intervention/follow-up (12 weeks).

Population: All participants who completed the Proud \& Empowered intervention. Participants were from four high schools within Los Angeles County. Two schools were assigned to the intervention condition while the other two were assigned to the control condition. Participants were in 9th through 12th grade, and identified as sexual and/or gender minority.

54-item survey across 10 domains of minority stress. Assesses experiences of minority stress among adolescents. Each statement reflects past-30-day thoughts, feelings, and situations a person may have experienced, with response options of 1 = yes and 0 = no. A total score was calculated by summing the 54 items. The total score ranged from 0-54. Higher values correspond to a worse outcome, meaning the individual in question has had more stressful experiences.

Time frame: Change between baseline and post-intervention/follow-up (12 weeks).

Population: All participants who completed the Proud \& Empowered intervention. Participants were from four high schools within Los Angeles County. Two schools were assigned to the intervention condition while the other two were assigned to the control condition. Participants were in 9th through 12th grade, and identified as sexual and/or gender minority.

Measures individual's usage of various substances in their lifetime and within the past 30 days as well as the ways in which individuals have used marijuana, tobacco, or nicotine in the past 30 days. Each substance is individually analyzed for both lifetime usage and past 30 day usage. Individuals can answer Yes or No for both lifetime usage and past 30 day usage. Each substance can range from 0 to the maximum number of survey responses. In addition, for marijuana, students can specify the way in which they used it with response options of smoking, vaping, edible or beverage form, or other. For nicotine and tobacco, students can specify the way in which they used it with the response options of smoking, vaping, or other. Yes responses indicate a worse outcome indicating that individuals have used or are currently using the substance in question.

Time frame: Change between baseline and post-intervention/follow-up (12 weeks).

Population: All participants who completed the Proud \& Empowered intervention. Participants were from four high schools within Los Angeles County. Two schools were assigned to the intervention condition while the other two were assigned to the control condition. Participants were in 9th through 12th grade, and identified as sexual and/or gender minority.