Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor St. W., Toronto, ON, M5S1V4, Canada.
Faculty of Social Work, University of Regina - Saskatoon Campus, Saskatoon, SK, Canada.
BMC Psychol. 2021 Jun 7;9(1):94. doi: 10.1186/s40359-021-00595-6.
This study tested the efficacy of AFFIRM, a brief affirmative cognitive-behavioural group intervention tailored to reduce psychosocial distress and improve coping among sexual and gender minority adolescents and young adults (SGMY).
SGMY (n = 138; M age = 22.44) were allocated to immediate 8-week AFFIRM intervention delivered at 12 community-based organisations or an 8-week waitlisted control. At baseline, post-intervention or post-waitlist, participants completed self-reported assessments of depression, hope, coping, and stress appraisal. Implementation outcomes of feasibility and acceptability were also assessed.
Compared to waitlist, SGMY in the intervention condition significantly reduced their depressive symptoms (b = - 5.79, p = .001) as well as increased reports of hope (agency: b = 0.84, p = .001; pathway: b = 0.79, p = .001), and coping by emotional support (b = 0.59, p < .001), instrumental support (b = 0.67, p < .001), positive framing (b = 0.59, p < .001), humour (b = 0.36, p = .014), planning (b = 0.49, p < .001) as well as reflective coping (b = 0.27, p = .009). Intervention participants were also less likely to perceive stress as a threat (b = - 0.43, p = .001), and more likely to perceive stress as challenge (b = 0.67, p < .001) and have the resources to deal with that stress (b = 0.38, p = .016) in comparison to waitlisted control participants. All outcomes had medium to large effect sizes. AFFIRM participants reported low attrition (8.5%) and high levels of engagement and acceptability (e.g. 99% agreed intervention was relevant to their lives). Over 63% of the community organizations that participated in the training hosted AFFIRM at least once during the study.
Results demonstrate efficacy for the community-based implementation of an affirmative clinical intervention designed for SGMY to address depression and foster coping with universal and minority stressors.
本研究测试了 AFFIRM 的疗效，AFFIRM 是一种简短的肯定认知行为小组干预措施，旨在减少性少数和性别少数青少年和年轻人（SGMY）的心理社会困扰并改善应对能力。
SGMY（n=138；M 年龄=22.44）被分配到 12 个社区组织中的即时 8 周 AFFIRM 干预组或 8 周候补对照组。在基线、干预后或候补后，参与者完成了自我报告的抑郁、希望、应对和压力评估。还评估了可行性和可接受性的实施结果。
与候补组相比，干预组中的 SGMY 显著降低了他们的抑郁症状（b=-5.79，p=.001），并报告了更高的希望（能动性：b=0.84，p=.001；途径：b=0.79，p=.001），以及通过情感支持（b=0.59，p<.001）、工具支持（b=0.67，p<.001）、积极框架（b=0.59，p<.001）、幽默（b=0.36，p=.014）、计划（b=0.49，p<.001）和反思应对（b=0.27，p=.009）来应对压力。与候补对照组相比，干预组参与者也不太可能将压力视为威胁（b=-0.43，p=.001），而更有可能将压力视为挑战（b=0.67，p<.001），并拥有应对压力的资源（b=0.38，p=.016）。所有结果的效应大小均为中等至较大。AFFIRM 参与者报告的辍学率较低（8.5%），参与度和可接受度较高（例如，99%的人认为干预措施与他们的生活相关）。在参与培训的社区组织中，有超过 63%的组织至少在研究期间举办过一次 AFFIRM。
结果表明，针对 SGMY 的基于社区的肯定临床干预措施的实施具有疗效，可以解决抑郁问题，并培养应对普遍和少数群体压力源的能力。
