Lesbian, gay and bisexual (LGB) youth experience high rates of peer-related bullying. They are much more likely, compared to heterosexual youth, to experience depression, suicidality, illicit drugs, and become HIV infected. Bullying drives, in part, these health disparities. Worse, anti-bullying programs have shown small to moderate effects. GB males will therefore continue to enter toxic school environments. Bullied LGB youth also have less access to coping resources. We hope to improve health and academic outcomes of LGB youth through an online program these youth can easily access. The study's aims are to: 1) develop a culturally competent, state-of-the-art game to reduce bullying among LGB youth. Diverse groups of LGB youth will provide feedback throughout game design. 2) Evaluate the game's feasibility, acceptability, usability and outcomes in a controlled study among 240 adolescent LGB males 14-18 years of age. Feasibility will be assessed by evaluating factors (e.g., log-on rates, use/duration of components, retention rates), and capacity requirements for future trials. Acceptability and usability will be measured quantitatively and qualitatively by asking about emotional dimensions of the user experience; key factors such as readability, comprehensibility, relevancy, helpfulness, credibility and aesthetics; and gaming (i.e. storyline, game-play, characters). Intervention and control groups will be compared on outcomes (i.e., depression, substance use, sexual risk) and hypothesized mediators (self- efficacy, social skills and future orientation). The application is highly innovative as it is, to our knowledge, the first 1) online program targeting young LGB males who are bullied, a format that can reach far greater numbers of LGB youth than face-to-face interventions, 2) bullying prevention program to utilize a gaming format to attract participation and build retention, 3) bullying intervention addressing social and emotional learning among LGB youth and, 4) first online intervention focusing on 14-18 year old LGB males. The game is informed by stress and coping, social and emotional learning, and social cognitive theory and a logic model that relates theory, game mechanics, hypothesized mediators, and outcomes. Three integral game components will affect outcomes. Participants will take on the role of a virtual `coach' to learn how to effectively cope with bullyng; learn social skills -associated with reduced bullying - by partnering with other players; develop a positive orientation towards the future by identifying role models and developing action plans to achieve positive future selves. This intervention will access large numbers of LGB youth, give them skills sets to avoid bullying, and use on-line technologies to ensure program fidelity; resulting in improved health and academic outcomes among LGB youth, while yielding insights to inform the design of interventions for other marginalized populations.
Young gay and bisexual (GB) males are much more likely, compared to heterosexual youth, to experience suicidality, depression, substance abuse, and high-risk sex. They are also much more likely to be bullied at school and studies (reviewed in the application) strongly suggest that bullying victimization is a driver of these health disparitis. However, very little support exists to support these youth. As such, the aims of this application are to develop a state-of-the-art, Internet intervention for 14 - 18 year old GB males and to evaluate the feasibility, acceptability, usability and outcomes of the program. This intervention will be the first: 1) online program targeting young GB males who are bullying victims, a format that has the potential to reach far greater numbers of GB youth than traditional face-to-face interventions, 2) bullying prevention program to utilize a gaming format to attract participation and build retention, 3) intervention addressing social and emotional learning with respect to bullying among GB youth and, 4) first online intervention focusing on 14-18 year old GB males - as opposed to the typical focus on GB 'youth' who are 18 years of age and older. Our focus on younger youth has the potential to affect secondary prevention of the development of downstream psychosocial health problems that result from bullying. Thus, this application could lead to great public health impact by addressing an important problem among GB youth and by giving them real life skills they can use to reduce bullying victimization and longer-term negative health outcomes.
