AFFIRM Online: Utilising an Affirmative Cognitive-Behavioural Digital Intervention to Improve Mental Health, Access, and Engagement among LGBTQA+ Youth and Young Adults.

Digital mental health interventions may enable access to care for LGBTQA+ youth and young adults that face significant threats to their wellbeing. This study describes the preliminary efficacy of AFFIRM Online, an eight-session manualised affirmative cognitive behavioural group intervention delivered synchronously. Participants (M = 21.17; SD = 4.52) had a range of sexual (e.g., queer, lesbian, pansexual) and gender (e.g., non-binary, transgender, cisgender woman) identities. Compared to a waitlist control ( = 50), AFFIRM Online participants ( = 46) experienced significantly reduced depression ( = -5.30, = 0.005, = 0.60) and improved appraisal of stress as a challenge ( = 0.51, = 0.005, = 0.60) and having the resources to meet those challenges ( = 0.27, = 0.059, = 0.39) as well active coping ( = 0.36, = 0.012, = 0.54), emotional support ( = 0.38, = 0.017, = 0.51), instrumental support ( = 0.58, < 0.001, = 0.77), positive framing ( = 0.34, = 0.046, = 0.42), and planning ( = 0.41, = 0.024, = 0.49). Participants reported high acceptability. This study highlights the potential of digital interventions to impact LGBTQA+ youth mental health and explores the feasibility of digital mental health to support access and engagement of youth with a range of identities and needs (e.g., pandemic, lack of transportation, rural locations). Findings have implications for the design and delivery of digital interventions for marginalised youth and young adults.