ABSTRACT
The purpose of this study was to investigate preliminary outcomes associated with an undergraduate course titled, "Wellness and Resilience for College and Beyond” (WRC), which teaches students evidence-based skills for emotional health. Three campuses in Southwestern Pennsylvania with no previous experience delivering this course implemented the one-semester WRC during the Fall 2019 semester;24 students completed a baseline survey and at least 1 follow-up survey. Participants completed electronic surveys at baseline, post-semester, and 3-month follow-up. Paired t-tests were used to compare baseline scores to scores at post-semester and 3-month follow-up. At post-semester, students reported significant improvements in psychological inflexibility, resilience, mindfulness, emotion dysregulation, distress tolerance, life satisfaction, dysfunctional coping, and adaptive skills use. With the exceptions of life satisfaction and emotion dysregulation, significant gains were maintained at 3-month follow-up. Notably, the follow-up assessment occurred at the beginning of the COVID-19 lockdown in the U.S. (March 2020), which may have affected life satisfaction and emotion dysregulation for participants. There was a nonsignificant decline in anxiety at post-semester which became statistically significant at 3-month follow-up. These preliminary data show proof of concept that WRC can be implemented successfully on new campuses with no previous expertise in this course and can achieve meaningful improvements on several emotional health outcomes with high relevance to collegiate mental health. In addition to these data, barriers to implementation and scale-up are discussed at length with "lessons learned” that may have broad relevance to the implementation of emotional wellbeing coursework in higher education and support such efforts to address student mental health at the population level.
ABSTRACT
Background: Sexual and gender minority youth (SGMY;eg, lesbian, gay, bisexual, and transgender youth) are at greater risk than their cisgender heterosexual peers for adolescent relationship abuse (ARA;physical, sexual, or psychological abuse in a romantic relationship). However, there is a dearth of efficacious interventions for reducing ARA among SGMY. To address this intervention gap, we designed a novel web-based methodology leveraging the field of human-centered design to generate multiple ARA intervention concepts with SGMY. Objective: This paper aims to describe study procedures for a pilot study to rigorously test the feasibility, acceptability, and appropriateness of using web-based human-centered design methods with SGMY to create novel, stakeholder-driven ARA intervention concepts. Methods: We are conducting a longitudinal, web-based human-centered design study with 45-60 SGMY (aged between 14 and 18 years) recruited via social media from across the United States. Using MURAL (a collaborative, visual web-based workspace) and Zoom (a videoconferencing platform), the SGMY will participate in four group-based sessions (1.5 hours each). In session 1, the SGMY will use rose-thorn-bud to individually document their ideas about healthy and unhealthy relationship characteristics and then use affinity clustering as a group to categorize their self-reported ideas based on similarities and differences. In session 2, the SGMY will use rose-thorn-bud to individually critique a universal evidence-based intervention to reduce ARA and affinity clustering to aggregate their ideas as a group. In session 3, the SGMY will use a creative matrix to generate intervention ideas for reducing ARA among them and force-rank the intervention ideas based on their potential ease of implementation and potential impact using an importance-difficulty matrix. In session 4, the SGMY will generate and refine intervention concepts (from session 3 ideations) to reduce ARA using round robin (for rapid iteration) and concept poster (for fleshing out ideas more fully). We will use content analyses to document the intervention concepts. In a follow-up survey, the SGMY will complete validated measures about the feasibility, acceptability, and appropriateness of the web-based human-centered design methods (a priori benchmarks for success: means >3.75 on each 5-point scale). Results: This study was funded in February 2020. Data collection began in August 2020 and will be completed by April 2021. Conclusions: Through rigorous testing of the feasibility of our web-based human-centered design methodology, our study may help demonstrate the use of human-centered design methods to engage harder-to-reach stakeholders and actively involve them in the co-creation of relevant interventions. Successful completion of this project also has the potential to catalyze intervention research to address ARA inequities for SGMY. Finally, our approach may be transferable to other populations and health topics, thereby advancing prevention science and health equity. International Registered Report Identifier (IRRID): DERR1-10.2196/26554