@文章{info:doi/10.2196/39094，作者="Bauermeister, Jose和Choi, Seul Ki和Bruehlman-Senecal, Emma和Golinkoff, Jesse和Taboada, Arianna和Lavra, Joshua和Ramazzini, Lionel和Dillon, Fred和Haritatos, Jana"，标题="一个身份确认的网络应用程序，帮助性和性别少数青年应对少数群体压力:试点随机对照试验”，期刊=“J Med Internet Res”，年=“2022”，月=“8”，日=“1”，卷=“24”，数=“8”，页=“e39094”，关键词=“女同性恋，男同性恋，双性恋，变性人，酷儿，和其他性少数和性别少数;+同性恋群体;青春;青春期;歧视;少数的压力;心理健康;弹性;性和性别少数群体; SGM; intersectionality", abstract="Background: Efficacious mental health interventions for sexual and gender minority youth have had limited reach, given their delivery as time-intensive, in-person sessions. Internet-based interventions may facilitate reach to sexual and gender minority youth; however, there is little research examining their efficacy. Objective: This study aims to describe the results of a pilot randomized controlled trial of imi, a web application designed to improve mental health by supporting lesbian, gay, bisexual, transgender, queer, and other sexual and gender minority identity affirmation, coping self-efficacy, and coping skill practice. Methods: Sexual and gender minority youth (N=270) aged 13 to 19 (mean 16.5, SD 1.5) years and living in the United States were recruited through Instagram advertisements. Approximately 78{\%} (210/270) of the sample identified as racial or ethnic minorities. Participants were randomized in a 1:1 fashion to the full imi intervention web application (treatment; 135/270, 50{\%}) or a resource page--only version of the imi site (control; 135/270, 50{\%}). The imi application covered four topical areas: gender identity; lesbian, gay, bisexual, transgender, queer, and other sexual and gender minority identity; stress and coping; and internalized homophobia and transphobia. Participants explored these areas by engaging with informational resources, exercises, and peer stories at a self-guided pace. Both arms were assessed via web-based surveys at baseline and 4-week follow-up for intervention satisfaction, stress appraisals (ie, challenge, threat, and resource), coping skills (ie, instrumental support, positive reframing, and planning), and mental health symptoms among other outcomes. Main intent-to-treat analyses compared the arms at week 4, controlling for baseline values on each outcome. Results: Survey retention was 90.4{\%} (244/270) at week 4. Participants in the treatment arm reported greater satisfaction with the intervention than participants in the control arm (t241=--2.98; P=.003). The treatment arm showed significantly greater improvement in challenge appraisals (ie, belief in one's coping abilities) than the control (Cohen d=0.26; P=.008). There were no differences between the arms for threat (d=0.10; P=.37) or resource (d=0.15; P=.14) appraisals. The treatment arm showed greater increases in coping skills than the control arm (instrumental support: d=0.24, P=.005; positive reframing: d=0.27, P=.02; planning: d=0.26, P=.02). Mental health symptoms improved across both the treatment and control arms; however, there were no differences between arms. Within the treatment arm, higher engagement with imi (≥5 sessions, >10 minutes, or >10 pages) predicted greater improvement in stress appraisals (all P values <.05). Conclusions: The results provide initial evidence that asynchronous psychosocial interventions delivered via a web application to sexual and gender minority youth can support their ability to cope with minority stress. Further research is needed to examine the long-term effects of the imi application. Trial Registration: ClinicalTrials.gov NCT05061966; https://clinicaltrials.gov/ct2/show/NCT05061966 ", issn="1438-8871", doi="10.2196/39094", url="//www.mybigtv.com/2022/8/e39094", url="https://doi.org/10.2196/39094", url="http://www.ncbi.nlm.nih.gov/pubmed/35916700" }