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Sexual and Gender Minority Emerging Adults Eliciting Narratives

Sexual and Gender Minority Emerging Adults Eliciting Narratives (SEEN)

Status
Completed
Phases
NA
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT05899218
Acronym
SEEN
Enrollment
20
Registered
2023-06-12
Start date
2023-07-17
Completion date
2024-04-01
Last updated
2024-11-25

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Gender Identity, Mental Health Wellness 1, Sexual Orientation

Keywords

racial/ethnic identity, intersectionality, mental health treatment seeking, intervention, narrative

Brief summary

Critical narrative interventions (CNIs) have not been examined for addressing psychological outcomes (e.g., depression, anxiety, self-esteem, empowerment, psychological well-being) within sexual and gender minority emerging adults (SGM EA) of color; therefore, this pilot study will examine the use of CNIs to impact SGM of color psychological outcomes. Prior literature has shown that CNIs have the potential to increase empowerment, self-efficacy, and social support as a prevention strategy for mental health. The research study is being conducted to see if telling your story through photographs or video can improve the mental health and well-being of emerging adults that identify as a member of a sexual and/or gender minority and a racial and/or ethnic minority. Participants will be asked to complete the following research procedures: 1. take a survey online (about 20-30 minutes), then an interview about everyday experiences as sexual/gender minority of color and your experiences in seeking out mental health services. 2. After the interview, participants will have one month to tell their story, answering two prompts Tell us a time you have felt seen and Tell us a time when you have felt unseen. You will be randomized to one of two formats of telling your story: taking photographs or making two short videos. 1. Photographs: Those that are randomized to the photograph condition will be asked to take 12 photos total telling your story and answering the prompt. 2. Videos: Those that are randomized to the video condition will be asked to create two (1-3 minute) videos telling your story and answering the prompts. 3. At the one-month time frame, participants will be asked to fill out another survey (about 20-30 minutes) and then complete an interview about the photos or videos created.

Detailed description

The research activities involve a two-arm pilot enrolling a sample of 30 participants who identify as sexual and gender minority (SGM), racial/ethnic minority/person of color (POC), and living with moderate to severe depression. After consent and completion of the baseline survey (15-20 min) and interview (45-60 min), participants will be randomized into one of two critical narrative interventions: photo-novella (n=15) or digital storytelling (n=15). All participants will be given the same two prompts for their narrative intervention asking, Share an experience of when you have felt seen as an SGM Person of Color in Philadelphia. AND share an experience of when you have felt unseen as an SGM person of color in Philadelphia. Photo-Novella: Participants in the photo-novella intervention will be asked to tell their story through 12 photographs and a caption (6 for the first prompt and 6 for the second prompt). Participants will be instructed to take a photograph answering the two prompts. Participants may use their smartphones or digital camera to capture their photographs. Participants may also edit their photographs using photo-editing software for aesthetics. Participants will also be asked to provide a short caption (no more than two sentences) explaining their photograph and provide a title for their work. Participants will be provided with a basic guide on photography and how to snap a picture. Digital Story: Participants in the digital storytelling intervention will be asked to tell their story in 3-6 minutes (two videos total, 1-3 minutes each) utilizing a video format that can include still or moving images, sound, music, and voiceover. Participants will be provided with a guide on software or applications that they can use to create their stories. Participants will be provided with a manual or basic guide to digital stories for their reference. Participants will be provided with guidance on expectations of the video, including format, length, quality, and closed captions for accessibility. At the baseline visit after the survey and interview, participants will be randomized into one of the two intervention conditions (photo-novella or digital story). Once the participant is randomized, they will be provided with the electronic manual (based on their intervention). The research team member will provide guidance on what to expect (i.e., how many photos to take and what the prompt is) and go over the manual with the participant. The participant will then be given the opportunity to ask questions. The participants will be given one month to complete their narrative and be asked to digitally submit their work to the research team during the 1-month visit. Participants will also be given the opportunity to present their work at a gallery (but not required to), which will be scheduled later (about ten months from the date of the first enrollment). The gallery and participation in the gallery are entirely voluntary and will not affect participation in the study. A week before the scheduled 1-month follow-up, a research team member will reach out to the participant to confirm the 1-month study visit via phone, e-mail, or text as indicated in the participant's preferred contact method. A research team member will reach out every two days for confirmation until received from the participant. Participants will receive a link via email a day before their one-month follow-up visit to complete a follow-up survey (15-20 mins). During the one-month follow-up, a research team member virtually on Zoom will conduct a follow-up interview (45-60 mins) asking participants about their experience of creating their critical narrative piece. At the one-month follow-up, research team members will review the final critical narratives of the participants digitally. Two days before the one-month follow-up, participants will receive a link via email to a Box folder (that is HIPAA compliant) where they can upload their photos/videos. The participants will be notified of the gallery date and invited to attend. The gallery is optional and does not impact participation in the study.

Interventions

BEHAVIORALCritical Narrative Development

Participants are asked to answer two prompts (describe an experience where you have felt seen as an LGBTQ+ person of color and describe an experience where you have felt unseen as an LGBTQ+ person of color).

Sponsors

University of Pennsylvania
Lead SponsorOTHER

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE

Eligibility

Sex/Gender
ALL
Age
18 Years to 24 Years
Healthy volunteers
Yes

Inclusion criteria

* identify as a sexual minority * live in the United States * identify as a person of color * be aged 18-24 years * have a smartphone and or computer access * identify as living with moderate to severe depression as indicated on the PHQ-9 (score of 10 or higher) * do not report suicidal ideation in the past month.

Exclusion criteria

* Identifies as a cisgender heterosexual man or woman * Does not live in the United States * Identifies as non-Hispanic white or Caucasian * Is not between the ages of 18-24 years (inclusive) * Does not have access to a smartphone or computer * Plan to move out of the region for the next six months * Does not consent to study procedures * Meets criteria for an unmanaged psychotic disorder * meets criteria for none to mild depression on the PHQ-9 (score of 9 or less) * reports suicidal ideation in the past month

Design outcomes

Primary

MeasureTime frameDescription
Generalized Anxiety Disorder-7 (GAD-7)1 monthscores range from 0 to 21, higher scores indicate higher levels of anxiety severity.
Rosenberg Self-Esteem Scale1 monthscores range from 8 to 56, higher scores represent an individual with higher self-esteem.
The Flourishing Scale1 monthscores range from 8 to 56, higher scores represent an individual with many psychological resources and strengths.
Patient Health Questionnaire (PHQ-9)1 monthscores range from 0 to 27, higher scores indicate higher levels of depression severity.

Secondary

MeasureTime frameDescription
General Belongingness Scale (GBS): Sense of Acceptance Sub Scale1 monthscores range from 12 to 84, higher scores represent higher sense of belonging.
Intersectional Discrimination Index -Anticipated Discrimination (InDI-A)1 Monthscores range from 0 to 4, higher scores represent higher anticipated intersectional discrimination
The Queer People of Color Identity Affirmation Scale (QPIAS): Identity Based Growth Subscale1 monthtwo subscales, identity based growth with scores from 7 to 49 with higher scores representing higher growth, and identity cohesion with scores from 5 to 35 with higher scores as higher identity cohesion
Multidimensional Scale of Perceived Social Support (MSPSS)1 monthscores range from 1 to 7, higher scores represent higher perceived social support.
Internalized Stigma of Mental Illness Scale (ISMI-9)1 monthscores range from 1 to 4, higher scores represent higher internalized stigma towards mental illness.
LGBTQ+ POC Microaggressions Scale-Brief (LGBTQ+ PCMS-B): Racism in Dating Subscale1 monthscores range from 0 to 20 for each subscale, higher scores represent higher levels of racism in LGBT community, Heterosexism in Racial/ethnic community, and racism in dating/relationship.
Attitudes Toward Mental Health Treatment (ATMHT) Scale1 monthscores range from 20 to 80, higher scores represent more positive attitudes towards mental health treatment seeking.

Other

MeasureTime frameDescription
Acceptability of the Intervention Measure (AIM)1 monthscores range from 5 to 20, higher scores represent higher acceptability for the intervention.
Feasibility of the Intervention Measure (FIM)1 monthscores range from 5 to 20, higher scores represent higher feasibility for the intervention
Intervention Appropriateness of the Measure (IAM)1 monthscores range from 5 to 20, higher scores represent higher appropriateness of the intervention.

Countries

United States

Participant flow

Participants by arm

ArmCount
Photo-Novella
Participants in the photo-novella intervention will be asked to take 12 photographs and write a caption for each photo based on two prompts. Critical Narrative Development: Participants are asked to answer two prompts (describe an experience where you have felt seen as an LGBTQ+ person of color and describe an experience where you have felt unseen as an LGBTQ+ person of color).
10
Digital Storytelling
Participants in the digital storytelling intervention will be asked to create two videos (1-3 minutes each) based on two prompts. Critical Narrative Development: Participants are asked to answer two prompts (describe an experience where you have felt seen as an LGBTQ+ person of color and describe an experience where you have felt unseen as an LGBTQ+ person of color).
10
Total20

Withdrawals & dropouts

PeriodReasonFG000FG001
Overall Studydeemed ineligible out of country10
Overall StudyLost to Follow-up22

Baseline characteristics

CharacteristicPhoto-NovellaDigital StorytellingTotal
Age, Categorical
<=18 years
0 Participants0 Participants0 Participants
Age, Categorical
>=65 years
0 Participants0 Participants0 Participants
Age, Categorical
Between 18 and 65 years
10 Participants10 Participants20 Participants
Age, Continuous20.80 years
STANDARD_DEVIATION 2.1
20.60 years
STANDARD_DEVIATION 1.58
20.70 years
STANDARD_DEVIATION 1.81
Ethnicity (NIH/OMB)
Hispanic or Latino
1 Participants0 Participants1 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
9 Participants10 Participants19 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants0 Participants0 Participants
Race (NIH/OMB)
American Indian or Alaska Native
1 Participants0 Participants1 Participants
Race (NIH/OMB)
Asian
5 Participants5 Participants10 Participants
Race (NIH/OMB)
Black or African American
3 Participants3 Participants6 Participants
Race (NIH/OMB)
More than one race
1 Participants2 Participants3 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants0 Participants0 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants0 Participants0 Participants
Race (NIH/OMB)
White
0 Participants0 Participants0 Participants
Region of Enrollment
United States
10 participants10 participants20 participants
Self-Identify as LGBTQ+
LGBTQ+
10 Participants10 Participants20 Participants
Self-Identify as LGBTQ+
non-LGBTQ+
0 Participants0 Participants0 Participants
Sex/Gender, Customized
Sex assigned a birth
Female
8 Participants8 Participants16 Participants
Sex/Gender, Customized
Sex assigned a birth
Male
2 Participants2 Participants4 Participants
Sex/Gender, Customized
Sex assigned a birth
X (third gender)
0 Participants0 Participants0 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
deaths
Total, all-cause mortality
0 / 100 / 10
other
Total, other adverse events
0 / 100 / 10
serious
Total, serious adverse events
0 / 100 / 10

Outcome results

Primary

Generalized Anxiety Disorder-7 (GAD-7)

scores range from 0 to 21, higher scores indicate higher levels of anxiety severity.

Time frame: 1 month

ArmMeasureValue (MEAN)Dispersion
Photo-NovellaGeneralized Anxiety Disorder-7 (GAD-7)10.71 score on a scaleStandard Deviation 5.16
Digital StorytellingGeneralized Anxiety Disorder-7 (GAD-7)11.00 score on a scaleStandard Deviation 3.7
Primary

Patient Health Questionnaire (PHQ-9)

scores range from 0 to 27, higher scores indicate higher levels of depression severity.

Time frame: 1 month

ArmMeasureValue (MEAN)Dispersion
Photo-NovellaPatient Health Questionnaire (PHQ-9)14.29 score on a scaleStandard Deviation 4.72
Digital StorytellingPatient Health Questionnaire (PHQ-9)11.50 score on a scaleStandard Deviation 0.93
Primary

Rosenberg Self-Esteem Scale

scores range from 8 to 56, higher scores represent an individual with higher self-esteem.

Time frame: 1 month

ArmMeasureValue (MEAN)Dispersion
Photo-NovellaRosenberg Self-Esteem Scale25.43 score on a scaleStandard Deviation 4.72
Digital StorytellingRosenberg Self-Esteem Scale25.00 score on a scaleStandard Deviation 2.98
Primary

The Flourishing Scale

scores range from 8 to 56, higher scores represent an individual with many psychological resources and strengths.

Time frame: 1 month

ArmMeasureValue (MEAN)Dispersion
Photo-NovellaThe Flourishing Scale39.29 score on a scaleStandard Error 10.53
Digital StorytellingThe Flourishing Scale41.13 score on a scaleStandard Error 6.24
Secondary

Attitudes Toward Mental Health Treatment (ATMHT) Scale

scores range from 20 to 80, higher scores represent more positive attitudes towards mental health treatment seeking.

Time frame: 1 month

ArmMeasureValue (MEAN)Dispersion
Photo-NovellaAttitudes Toward Mental Health Treatment (ATMHT) Scale57.86 score on a scaleStandard Deviation 9.41
Digital StorytellingAttitudes Toward Mental Health Treatment (ATMHT) Scale45.63 score on a scaleStandard Deviation 13.26
Secondary

General Belongingness Scale (GBS): Sense of Acceptance Sub Scale

scores range from 12 to 84, higher scores represent higher sense of belonging.

Time frame: 1 month

ArmMeasureValue (MEAN)Dispersion
Photo-NovellaGeneral Belongingness Scale (GBS): Sense of Acceptance Sub Scale24.57 score on a scaleStandard Deviation 6.16
Digital StorytellingGeneral Belongingness Scale (GBS): Sense of Acceptance Sub Scale23.75 score on a scaleStandard Deviation 6.25
Secondary

Internalized Stigma of Mental Illness Scale (ISMI-9)

scores range from 1 to 4, higher scores represent higher internalized stigma towards mental illness.

Time frame: 1 month

ArmMeasureValue (MEAN)Dispersion
Photo-NovellaInternalized Stigma of Mental Illness Scale (ISMI-9)2.64 score on a scaleStandard Deviation 0.23
Digital StorytellingInternalized Stigma of Mental Illness Scale (ISMI-9)2.51 score on a scaleStandard Deviation 0.16
Secondary

Intersectional Discrimination Index -Anticipated Discrimination (InDI-A)

scores range from 0 to 4, higher scores represent higher anticipated intersectional discrimination

Time frame: 1 Month

ArmMeasureValue (MEAN)Dispersion
Photo-NovellaIntersectional Discrimination Index -Anticipated Discrimination (InDI-A)2.17 score on a scaleStandard Deviation 0.73
Digital StorytellingIntersectional Discrimination Index -Anticipated Discrimination (InDI-A)2.47 score on a scaleStandard Deviation 0.79
Secondary

LGBTQ+ POC Microaggressions Scale-Brief (LGBTQ+ PCMS-B): Racism in Dating Subscale

scores range from 0 to 20 for each subscale, higher scores represent higher levels of racism in LGBT community, Heterosexism in Racial/ethnic community, and racism in dating/relationship.

Time frame: 1 month

ArmMeasureValue (MEAN)Dispersion
Photo-NovellaLGBTQ+ POC Microaggressions Scale-Brief (LGBTQ+ PCMS-B): Racism in Dating Subscale6.57 score on a scaleStandard Deviation 5.5
Digital StorytellingLGBTQ+ POC Microaggressions Scale-Brief (LGBTQ+ PCMS-B): Racism in Dating Subscale2.13 score on a scaleStandard Deviation 3.64
Secondary

Multidimensional Scale of Perceived Social Support (MSPSS)

scores range from 1 to 7, higher scores represent higher perceived social support.

Time frame: 1 month

ArmMeasureValue (MEAN)Dispersion
Photo-NovellaMultidimensional Scale of Perceived Social Support (MSPSS)5.69 score on a scaleStandard Deviation 0.96
Digital StorytellingMultidimensional Scale of Perceived Social Support (MSPSS)4.69 score on a scaleStandard Deviation 0.93
Secondary

The Queer People of Color Identity Affirmation Scale (QPIAS): Identity Based Growth Subscale

two subscales, identity based growth with scores from 7 to 49 with higher scores representing higher growth, and identity cohesion with scores from 5 to 35 with higher scores as higher identity cohesion

Time frame: 1 month

ArmMeasureValue (MEAN)Dispersion
Photo-NovellaThe Queer People of Color Identity Affirmation Scale (QPIAS): Identity Based Growth Subscale35.57 score on a scaleStandard Deviation 11.69
Digital StorytellingThe Queer People of Color Identity Affirmation Scale (QPIAS): Identity Based Growth Subscale32.88 score on a scaleStandard Deviation 5.79
Other Pre-specified

Acceptability of the Intervention Measure (AIM)

scores range from 5 to 20, higher scores represent higher acceptability for the intervention.

Time frame: 1 month

ArmMeasureValue (MEAN)Dispersion
Photo-NovellaAcceptability of the Intervention Measure (AIM)18.43 score on a scaleStandard Deviation 2.3
Digital StorytellingAcceptability of the Intervention Measure (AIM)16.25 score on a scaleStandard Deviation 3.58
Other Pre-specified

Feasibility of the Intervention Measure (FIM)

scores range from 5 to 20, higher scores represent higher feasibility for the intervention

Time frame: 1 month

ArmMeasureValue (MEAN)Dispersion
Photo-NovellaFeasibility of the Intervention Measure (FIM)16.86 score on a scaleStandard Deviation 2.79
Digital StorytellingFeasibility of the Intervention Measure (FIM)16.38 score on a scaleStandard Deviation 2.88
Other Pre-specified

Intervention Appropriateness of the Measure (IAM)

scores range from 5 to 20, higher scores represent higher appropriateness of the intervention.

Time frame: 1 month

ArmMeasureValue (MEAN)Dispersion
Photo-NovellaIntervention Appropriateness of the Measure (IAM)18.71 score on a scaleStandard Deviation 2.21
Digital StorytellingIntervention Appropriateness of the Measure (IAM)16.37 score on a scaleStandard Deviation 2.07

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026