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Supporting Parents in Affirming Their Children's Experiences of Stigma

Development and Initial Trial of Two Brief Interventions to Support Parents in Affirming Their Children's Experiences of Sexuality and Gender

Status
Recruiting
Phases
Phase 1
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT05919849
Acronym
SPACES
Enrollment
129
Registered
2023-06-26
Start date
2023-11-29
Completion date
2026-08-31
Last updated
2026-01-09

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

Conditions

Parent-Child Relations

Keywords

Parental Acceptance, Sexual and Gender Minority Youth

Brief summary

The purpose of this study is to develop and test two brief online writing interventions to improve parental acceptance of sexual and gender minority youth (SGMY) in the Southeast United States.

Detailed description

The purpose of this study is to develop and test the acceptability, feasibility, and preliminary efficacy of two brief online writing interventions to improve parental acceptance of sexual and gender minority youth (SGMY) in the Southeast United States. Parental support represents the strongest predictor of sexual and gender minority youth's (SGMY) mental health. However, many parents react to their SGMY's disclosure with rejection. Even relatively accepting parents can experience discomfort, while SGMY often report lingering unmet needs from their parents into adulthood. Few interventions exist to help parents support their SGMY child and none has been tested in a randomized trial with efficacy for decreasing parental rejection and increasing support of their SGMY. This proposal will develop and test the efficacy of two theory-based interventions that aim to address this gap. Results will identify mechanisms contributing to parental rejection and develop scalable approaches to reduce these mechanisms to shrink the substantial mental health disparities affecting SGMY. If efficacious, these interventions can be scaled up through online platforms capable of bypassing barriers to parental support of SGMY across high-stigma regions. The focus of this registration is the randomized controlled trial.

Interventions

BEHAVIORALBrief online writing intervention

Participants will be instructed to write for 20 minutes across 3 consecutive days. They will be writing based on the prompts given to them.

OTHERControl condition

Participants will be instructed to write in order to control for time and writing engagement.

Sponsors

University of Maryland
CollaboratorOTHER
Vanderbilt University
CollaboratorOTHER
Ben-Gurion University of the Negev
CollaboratorOTHER
Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)
CollaboratorNIH
Yale University
Lead SponsorOTHER

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)

Masking description

Participants will be made aware of the writing intervention they will complete.

Intervention model description

This study is a 3-arm randomized control trial (RCT) design in which an anticipated129 parents of SGMY will be randomized into one of three conditions.

Eligibility

Sex/Gender
ALL
Age
15 Years to No maximum
Healthy volunteers
No

Inclusion criteria

1. Parents are eligible if they meet the following criteria: 1. Be a parent, grandparent, or any other family member who considers themselves a guardian of an SGMY between 15-29 years old, 2. Live in the Southeast United States (Louisiana, Mississippi, Alabama, Georgia, South Carolina, North Carolina, Tennessee, Arkansas, Kentucky, Florida), 3. Identify as heterosexual and cisgender, and 4. Report non-acceptance of their SGMY. 2. SGMY are eligible if they meet the following criteria: 1. Self-identify as SGM, 2. Are 15-29 years old, 3. Live in the Southeast United States, and 4. Have a parent enrolled in the trial

Exclusion criteria

3. Any individual who meets any of the following criteria will be excluded from participation in this study: 1. Active mania, psychosis, or suicidality, and 2. Unable to provide informed consent.

Design outcomes

Primary

MeasureTime frameDescription
Change in Parents' Rejecting and Supportive Behaviors Measured By the Parent Non-Acceptance ScaleBaseline, 5 Days Post-Baseline, and 3 Months Post-BaselineThe 10-item Parent Non-Acceptance Scale is a self-reported instrument assessing positive and negative indicators of parental acceptance of their SGMY. Parents report level of agreement on a scale from 1 (Strongly Disagree) to 6 (Strongly Agree), with a higher score on negative indicators representing a higher level of non-acceptance and a higher score on positive indicators representing a lower level of non-acceptance.

Secondary

MeasureTime frameDescription
Change in Secondary Parental Acceptance and Rejection Measured By the the Parental Acceptance/Rejection QuestionnaireBaseline, 5 Days Post-Baseline, and 3 Months Post-BaselineThe 24-item Parental Acceptance/Rejection Questionnaire describes the way parents act towards their children. Parents report how true each statement is on a scale from 1 (almost always true of me) to 4 (almost never true of me) where a higher score indicates a higher level of rejection.
Change in Secondary Parental Acceptance and Rejection Measured By the Five-Minute Speech SampleBaseline, 5 Days Post-Baseline, and 3 Months Post-BaselineThe Five-Minute Speech Sample (FMSS) is a measure of parent-child dynamics where parents talk for 5 minutes about their thoughts and feelings about their SGMY. The qualitative interview is coded and scored appropriately to measure parental behavior towards their SGMY
Change in Parent-Child Relationship Quality and Stress Assessed by the Parental Environment Questionnaire Conflict, Involvement, and Regard for Child SubscalesBaseline, 5 Days Post-Baseline, and 3 Months Post-BaselineThe Parental Environment Questionnaire Conflict (12-item), Involvement (12-item), and Regard for Child (5-item) Subscales assess perceptions of parent-child relationship quality. Parents rate how true each statement is on a scale from 1 (definitely true) to 5 (definitely false), where a high score on the conflict scale indicates greater parental conflict, a high score on the involvement scale indicates less parental involvement, and a high score on the regard for child scale indicates high regard for child.
Change in Parent-Child Relationship Quality and Stress Assessed by the McMaster Family Assessment Device General Functioning SubscaleBaseline, 5 Days Post-Baseline, and 3 Months Post-BaselineThe 12-item McMaster Family Assessment Device General Functioning Subscale further assesses perceived parent-child relationship quality and stress on a scale of strongly agree (1) to strongly disagree (4), where a higher score indicates lower general family functioning.
Change in Parent Anti-SGM Bias Assessed Using the Social Distance ScaleBaseline, 5 Days Post-Baseline, and 3 Months Post-BaselineThe Social Distance Scale assesses anti-LGBTQ (Lesbian, Gay, Bisexual, Trans, Queer) stigma by assessing parents' responses to different scenarios from 0 (definitely unwilling or completely uncomfortable) to 3 (definitely willing or completely comfortable), where a lower score indicates stronger anti-LGBTQ stigma.
Change in Parent Anti-SGM Bias Assessed Using the Lesbian, Gay, Bisexual Affiliate Stigma MeasureBaseline, 5 Days Post-Baseline, and 3 Months Post-BaselineThe Lesbian, Gay, Bisexual Affiliate Stigma Measure (LGB-ASM) measures affiliate stigma faced by heterosexual family and friends of sexual minority people. Parents rate how much they agree with each statement on a scale from 1 (strongly disagree) to 6 (strongly agree), with the option to claim not applicable. A higher score indicates stronger affiliate stigma.
Change in Parent-Child Unresolved Conflict Measured Using the Unfinished Business ScaleBaseline, 5 Days Post-Baseline, and 3 Months Post-BaselineThe 11-item Unfinished Business Scale was adapted by Principal Investigator Pachankis with strong psychometric properties to measure parents' unresolved negative thoughts and feelings towards their SGMY. Parents rate statements about their SGM child on a scale from 1 (not at all) to 5 (very much), where a higher score represents greater unresolved parent-child conflict.
Change in Parent Depression and Anxiety Using the PROMIS (Patient-Reported Outcomes Measurement Information System®) Depression, Anxiety, and Anger ScalesBaseline, 5 Days Post-Baseline, and 3 Months Post-BaselineThe 63-item PROMIS Depression, Anxiety, and Anger questionnaires measure parent-reported frequency of depression, anxiety, and anger symptoms over the past 7 days on a scale from 1 (never) to 5 (always), where higher scores indicate higher severity of symptoms.
Change in Secondary Parental Acceptance and Rejection Measured By the Children's Report of Parent Behavior InventoryBaseline, 5 Days Post-Baseline, and 3 Months Post-BaselineThe Children's Report of Parent Behavior Inventory (CRPBI) is a 10-item rejection/support subscale assessing level of rejection/support. Parents report how much each statement describes the way they acted towards their SGMY ranging from 1 (not like you) to 3 (a lot like you), where Acceptance and Psychological Control scores are the totals of the individual items in the respective sub-scales, and Firm Control score is obtained by taking the sum of the Firm Control + subscale, adding 24, and by then subtracting the total of the Firm Control -- subscale.
Change in Parent Report of Child Depression and Anxiety Using the PROMIS Depression and Anxiety ScalesBaseline, 5 Days Post-Baseline, and 3 Months Post-BaselineThe 15-item proxy-report PROMIS Depression and Anxiety Scales measures parent report of their SGM child's depression and anxiety symptoms by asking frequency of the SGMY's symptoms over the past 7 days on a scale from 1 (never) to 5 (always), where higher scores indicate a greater severity of parent-reported symptoms.
Change in Parent Negative Emotion Using a Modified Positive and Negative Affect Schedule (PANAS)Baseline, 5 Days Post-Baseline, and 3 Months Post-BaselineThe 20-item Positive and Negative Affect Schedule (PANAS) inquires about parents' positive and negative affect towards their SGMY. Participants indicate how often they have felt either positive or negative indicators on a scale of 1 (very slightly or not at all) to 5 (extremely). A high score on positive affect indicators indicates a higher positive affect towards the SGMY, while a high score on negative affect indicates a higher negative affect towards the SGMY.
Change in Parent Empathy Measured By the Questionnaire of Cognitive and Affective EmpathyBaseline, 5 Days Post-Baseline, and 3 Months Post-BaselineThe 31-item Questionnaire of Cognitive and Affective Empathy (QCAE) measures parent empathy toward their SGMY. Parents rate how much a statement relates to them on a scale of 1 (strongly disagree) to 4 (strongly agree), where a high score indicates a high level of empathy toward the SGMY.
Intervention Acceptability Measured By the Client Satisfaction Questionnaire3-Month-Post-BaselineThe Client Satisfaction Questionnaire is an 8-item measurement of perceived helpfulness, likelihood of recommending, and positive experience. Participants rate statements on a scale of 1 (most negative) to 4 (most positive), with a high score representing a higher level of satisfaction.
Intervention Acceptability Measured By the Treatment Acceptability Survey3-Month-Post-BaselineThe 17-item Treatment Acceptability Survey assesses perceived helpfulness, likelihood of recommending, and positive experience of the interventions. Participants rate statements on a scale of 1(strongly disagree) to 4 (strongly agree), with a higher score representing a higher level of acceptability.
Intervention Feasibility Measured By Percentage of Intervention Sessions CompletedMeasured Throughout Intervention (Up to 2 Weeks)Intervention feasibility will be partially measured by the percentage of intervention sessions participants complete.
Intervention Feasibility Measured By Percentage of Fully Engaged SessionsMeasured Throughout Intervention (Up to 2 Weeks)Intervention feasibility will be partially measured by the percentage of fully engaged sessions, defined as the number of writing sessions that included at least 313 words.
Intervention Feasibility Measured By Number of Platform Technical/Accessibility IssuesMeasured Throughout Intervention (Up to 2 Weeks)Intervention feasibility will partially be tracked by the number of platform technical or accessibility issues noted throughout the intervention.
Change in Parent Perceived Stress Using the Perceived Stress ScaleBaseline, 5 Days Post-Baseline, and 3 Months Post-BaselineThe 10-item Perceived Stress Scale assesses parents' perceived stress by asking about frequency of thoughts and feelings during the past month on a scale from 0 (never) to 4 (very often), where a higher score indicates a higher level of perceived stress.

Countries

Israel, United States

Contacts

Primary ContactDanielle Chiaramonte, Ph.D.
danielle.chiaramonte@yale.edu646-429-9407

Outcome results

None listed

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