NCT03751020

Brief Summary

The purpose of this study is to test the feasibility of writing interventions specifically designed for lesbian, gay, and bisexual (LGB) emerging adults (ages 18-29) that are aimed at improving the outcomes: depression, suicidality, substance abuse and HIV risk behaviors.

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
108

participants targeted

Target at P50-P75 for not_applicable depression

Timeline
Completed

Started Oct 2017

Geographic Reach
1 country

3 active sites

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Start

First participant enrolled

October 27, 2017

Completed
9 months until next milestone

First Submitted

Initial submission to the registry

July 25, 2018

Completed
4 months until next milestone

First Posted

Study publicly available on registry

November 23, 2018

Completed
1 month until next milestone

Primary Completion

Last participant's last visit for primary outcome

January 1, 2019

Completed
6 months until next milestone

Study Completion

Last participant's last visit for all outcomes

June 27, 2019

Completed
1.2 years until next milestone

Results Posted

Study results publicly available

August 28, 2020

Completed
Last Updated

August 28, 2020

Status Verified

August 1, 2020

Enrollment Period

1.2 years

First QC Date

July 25, 2018

Results QC Date

May 20, 2020

Last Update Submit

August 27, 2020

Conditions

Keywords

Expressive WritingMinority StressLesbian Gay Bisexual

Outcome Measures

Primary Outcomes (8)

  • Change in Depression.

    Depression will be measured using the Center for Epidemiological Studies -- Depression Scale (CESD). An overall depression score is computed as the sum of 20 items, with items 3, 11, 14, and 16 reversed. In cases with internally missing data (items not answered), the sums are computed after imputation of the missing values: # items on scale / # actually answered, multiplied by the sum obtained from the answered items. A range of 0-60, with higher scores indicating more depressive symptomatology during the past week.

    Baseline, Post Intervention (day 5), and 3 Months.

  • Change in Psychological Distress.

    Psychological Distress will be measured using the Brief Symptom Inventory (BSI). The BSI consists of 18 items scored 0-4. Items are averaged to yield a final score of 0-4. The higher the score, the greater the psychological distress.

    Baseline, Post Intervention (day 5), and 3 Months.

  • Change in Anxiety.

    Anxiety will be measured using the Beck Anxiety Inventory (BAI). The BAI total score is reported, which is the sum of all 21 items; with no subscales. The range of scores is 0-63, with higher scores indicating higher anxiety.

    Baseline, Post Intervention (day 5), and 3 Months.

  • Change in Suicidality - Suicidal Ideation.

    Suicidal ideation will be measured using the Suicidal Ideation Attributes Scale (SIDAS) . Total SIDAS scores are calculated as the sum of the five items, with controllability reverse scored (10=0, 9=1, …, 0=10). Total scores range from 0 to 50.

    Baseline, Post Intervention (day 5), and 3 Months.

  • Change in Alcohol Use.

    Alcohol use in participants will be assessed using the Alcohol Use Disorders Identification (AUDIT) instrument. The AUDIT consists of 10 items. Each of the questions has a set of responses to choose from, and each response has a score ranging from 0 to 4. All response scores should be added and recorded as "Total". Total scores of 8 or more are recommended as indicators of hazardous and harmful alcohol use, as well as possible alcohol dependence. (A cut-off score of 10 will provide greater specificity but at the expense of sensitivity.) The score range is 0-40. Higher scores indicate greater hazardous drinking.

    Baseline, Post Intervention, 3 Months

  • Change in Drug Use.

    The Short Inventory of Problems-Modified for Drug Use (SIP-DU) is a 15-item scale that asks respondents to rate each item on a dichotomous scale ("No" = 0, "Yes" = 1). Total score reported, which is the sum of all items; no subscales: Range 0-15, higher scores indicate greater problems with drug use.

    Baseline, Post Intervention (day 5), and 3 Months.

  • Suicidal Intent

    Suicidal intent will be assessed using a single item that asks: Within the last 3 months/past week, have you seriously considered attempting suicide? \[yes/no\] Number of participants who reported suicidal intent is reported. Originally titled "Change in Suicidality - Suicidal Thoughts".

    Baseline, Post Intervention (day 5), and 3 Months.

  • Attempted Suicide

    Suicide attempts will be assessed using a single item that asks: Within the last past 3 months/past week, have you actually attempted suicide? \[yes/no\]. Reported are the number of participants who reported that they had attempted suicide. Original title: "Change in Suicidality: Suicide Attempts".

    Baseline, Post Intervention (day 5), and 3 Months.

Secondary Outcomes (22)

  • Self Injury.

    Baseline, Post Intervention (day 5), and 3 Months.

  • Rumination

    Baseline, Post Intervention (day 5), and 3 Months.

  • Perceived Support

    Baseline, Post Intervention (day 5), and 3 Months.

  • Hopelessness

    Baseline, Post Intervention, 3 Months

  • Lesbian, Gay, Bisexual (LGB) Identity

    Baseline, Post Intervention (day 5), and 3 Months.

  • +17 more secondary outcomes

Study Arms (3)

Expressive Writing (EW)

EXPERIMENTAL

Expressive Writing (EW) prompts individuals to write about personally stressful events, potentially enabling cognitive processing of unresolved, psychological and physiological stressors.

Behavioral: Expressive Writing (EW) Intervention

Self-Affirmation (SA)

EXPERIMENTAL

Self-Affirmation (SA) interventions prompt individuals to write advice to a (hypothetical) similarly stigmatized person regarding how best to cope with stigma-related stress. By affirming one's own stigmatized identity through the process of helping another similarly stigmatized person.

Behavioral: Self-Affirmation (SA) Intervention

Control

PLACEBO COMPARATOR

Participants randomly assigned to the control condition will be asked to write about what they have done since waking up that morning for 20 minutes across 3 consecutive days.

Other: Control

Interventions

The EW intervention will utilize the procedures piloted earlier with gay and bisexual male college students in urban and rural regions of the US. In this condition, participants will be instructed to write for 20 minutes across three consecutive days in a free-form manner about the most stressful or traumatic LGB-related event that they have encountered.

Expressive Writing (EW)

The SA intervention will ask participants to read a brief description, over the course of 3 consecutive days, of a (hypothetical) LGB youth who is facing minority stress. Each day's description will contain a different LGB youth facing a different stigma-related stressor derived from Phase 1 and 2 interviews. Participants will then be asked to write a letter for 20 minutes to advise the LGB youth how best to cope with minority stress drawing on their personal experiences.

Self-Affirmation (SA)
ControlOTHER

Participants randomly assigned to the control condition will be asked to write about what they have done since waking up that morning for 20 minutes across 3 consecutive days. This control matches the time and activity of the EW and SA arms and has been implemented across dozens of EW and SA studies.

Control

Eligibility Criteria

Age18 Years - 29 Years
Sexall
Healthy VolunteersYes
Age GroupsAdult (18-64)

You may qualify if:

  • Self-identify as lesbian, gay, or bisexual
  • Live in Washington county, Tennessee (TN), or any of its 6 contiguous counties in northeastern TN
  • Have personal Internet access
  • Hair at least 2cm in length

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (3)

Yale University

New Haven, Connecticut, 06520, United States

Location

College of the Holy Cross

Worcester, Massachusetts, 01610, United States

Location

East Tennessee State University

Johnson City, Tennessee, 37614, United States

Location

Related Publications (1)

  • Pachankis JE, Williams SL, Behari K, Job S, McConocha EM, Chaudoir SR. Brief online interventions for LGBTQ young adult mental and behavioral health: A randomized controlled trial in a high-stigma, low-resource context. J Consult Clin Psychol. 2020 May;88(5):429-444. doi: 10.1037/ccp0000497.

MeSH Terms

Conditions

DepressionSuicidal IdeationSubstance-Related Disorders

Interventions

Methods

Condition Hierarchy (Ancestors)

Behavioral SymptomsBehaviorSuicideSelf-Injurious BehaviorChemically-Induced DisordersMental Disorders

Intervention Hierarchy (Ancestors)

Investigative Techniques

Results Point of Contact

Title
Dr. John Pachankis
Organization
Yale University School of Public Health (Social and Behavioral Sciences)

Study Officials

  • John Pachankis, PhD

    Yale University

    PRINCIPAL INVESTIGATOR

Publication Agreements

PI is Sponsor Employee
Yes

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
DOUBLE
Who Masked
INVESTIGATOR, OUTCOMES ASSESSOR
Purpose
PREVENTION
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

July 25, 2018

First Posted

November 23, 2018

Study Start

October 27, 2017

Primary Completion

January 1, 2019

Study Completion

June 27, 2019

Last Updated

August 28, 2020

Results First Posted

August 28, 2020

Record last verified: 2020-08

Data Sharing

IPD Sharing
Will share

De-identified individual participant data for all primary and secondary outcome measures will be made available.

Shared Documents
STUDY PROTOCOL, SAP, ICF, ANALYTIC CODE
Time Frame
Data will be available 12 months after study completion for three years.
Access Criteria
Data access requests from qualified academic investigators for non-commercial research interests will be reviewed by study investigators. Requestors will be required to sign a data access agreement.

Locations